Episode 390 Johanna's HBAC + PROM + Supportive Provider + Postpartum Planning

Johanna is a girl mama joining us today from Canada. She had an unplanned C-section with her first, an HBAC with her second, and was pregnant with her third at the time of recording! Johanna reflects on her experiences with both supportive and unsupportive care during her pregnancies. Meagan and Johanna dive into your options surrounding PROM, the significance of intuition in decision-making, the impact of provider choices on birth outcomes, and the nuances of VBAC postpartum recovery. The VBAC Link Blog: Home Birth VBAC Everything You Need for Your HBAC Supportive Providers 10 Signs to Switch Your Provider What to Do When Your Water Breaks Labor Guide Coterie Diapers - Use code VBAC20 for 20% off How to VBAC: The Ultimate Prep Course for Parents Full Transcript under Episode Details Meagan: Hello, Women of Strength. We have our friend Johanna with us from Canada today, and she's going to be sharing her HBAC story. So for those who may be , new to the VBAC world, or just all of the acronyms that the VBAC world has, HBAC is pronounced home birth after Cesarean. So if you are one of those who really wants to look into all of your options for birthing locations, which I encourage everyone to do, definitely listen up here. We're going to be talking about a lot of really great things including picking a provider and PROM knowing that you maybe had a provider that wasn't ideal the first time and more about HBAC. So we are going to be diving into a lot of really, really great, juicy topics. But in place our review today, Johanna and I are actually going to talk a little bit more about picking the right provider. So, Johanna, welcome to the show. Johanna: Thank you. Meagan: I am so excited for you to be with us today and so grateful that you are here to talk about this topic. Because like I was saying before we pressed record, I see daily in our community, every single day, and not even just our community, in other VBAC communities or this is weird, but people's statuses, like my friends and family's statuses on Facebook, where you type like, "Hey, I'm looking for this," or "I'm feeling very frustrated," or "I need prayers." People will seriously say, "I don't know what to do, you guys. Has anybody ever heard of VBAC?" on their own status? But especially in the VBAC groups, I see people and I just want to yell, "Hey, you over there. You're with the wrong provider" or, "Hey, you should move." That's a really hard thing because especially when I type that it can be like, oh my gosh, who is this broad telling me that I'm with the wrong provider and that I chose wrong? I'm not trying to say that. I'm not trying to say you chose wrong. Like, how dare you choose wrong? It's just like, hey, what you're telling us in this community is screaming, you're the wrong provider. So, Johanna, you , mentioned before we press record that you realized after your first birth that you were with the wrong provider. What made you realize that you were with the wrong provider? And were there signs during pregnancy that you recognized and maybe pushed away? Or was it really not something that you recognized until after? Because I know really, it can go both ways. Johanna: Yeah, I think that there were signs during the pregnancy. I mean, one of them, and I just didn't listen to my gut because you don't know what you don't know. I put too much blind faith that it was all gonna work out. But I never felt comfortable with her. I didn't have a good connection with her. I was asking a lot of questions about what I can be doing because my first birth, I really wanted to be a home birth. She basically just didn't give me very much information about what I can be doing. She sent me to your generic birth course through the hospital. Yeah. I didn't really feel like she was really invested in the outcome of my birth. I was just like another one of her patients. So I didn't feel great about that. And then when push came to shove with my birth and things weren't going great, she threw her hands up in the air and just took a step back and didn't really advocate for me or try and help me through things. So I was left with a pretty unpleasant taste in my mouth. Meagan: Yeah, I mean, exactly what you said just a minute ago. You didn't feel that she was invested in the outcome of your birth. And then it proved. It proved to be true when she just threw her arms up. So you had that experience, and you're not alone. There are so many of us out there. Me too, me included and a lot of people on The VBAC Link team included. We have all been in a similar situation where our providers, threw our hands up, weren't invested in our birth and our experience and had to go out there and seek that support that we deserved. So if there's anything we talk about on The VBAC Link, and I'm sure you've heard it, is find the right provider. I mean, seriously, you guys, I say it daily, every single day. If I'm not typing it, if I'm not voice memo-ing it, if I'm not saying it in my mind, it's find the right provider. Johanna, what would you give for tips for our listeners to find that right provider? And how did you find that right provider? Johanna: So I found my midwife that I used for my second birth and I'm actually using again for my third birth because I am 31 weeks pregnant today. Meagan: Oh my gosh. Oh my gosh. Yay. Johanna: I found her actually because when I got pregnant for the second time, the first thing I did was get a doula. Meagan: Uh-huh. Johanna: I asked her for recommendations on a VBAC friendly midwife. She had recommended this midwife. So immediately I was like, yes, I would like to meet her. When I met her, instantly, I felt so much more at ease. So I would say going with your gut. If something doesn't feel right, even if it's the tiniest thing, just look for a new provider. Just find someone where it feels right. Meagan: Yeah. I can relate to that so much because that's how I was feeling. I was searching, I was searching, I was searching. I mean, it was insane. I interviewed a lot of providers, but that's what I was searching for is that immediate like, oh, I'm in the right place. You are my person. And it took me a long time. And that sucks. It sucks that it took so long. I know that in some areas they're really rural and it's almost impossible to find that feeling. But I agree. So just as a reminder for those looking, before we get into the story, I wanted to make sure that you know to ask open-ended questions. Do not say, "Do you support VBAC? Yes or no?" Do not say, "Do you support me to go to 40 weeks? Yes or no?" Let's ask open ended questions. "How do you feel if I approach my due date and I haven't had a baby yet? How do you feel about VBAC? What is your experience with VBAC? How do you support your VBAC clients to make sure patients get the birth that they want? How do you advocate for them?" Asking these big open ended questions and then like Johanna said, diving deep. What is your heart and your gut feeling and saying? If at any point you are questioning, which I think is when people come out on social media, that is when I think they comment and they're writing, "Hey, I'm, feeling defeated. Hey, this is what my provider said." It's because they're doubting. They're questioning. That's their intuition. If that even comes into play at all, it's time to switch. It is time to switch. And first-time parents, if you are out there listening, this applies to you too, right? We have to avoid these unnecessary Cesareans which are happening all over the world. We have to follow our intuition. So that's another thing we talk about until we're blue in the face-- intuition. So follow that intuition. Ask open ended questions. Really dive in deep because your provider really can make an impact. And really, really quickly, we're going to just barely skim the surface on PROM. PROM is premature rupture of membranes. Johanna and I have both experienced it. She's two for two. I'm three for three. Maybe you won't be three for three girl. I don't know. I'm hoping you're not. Johanna: Fingers crossed. Meagan: I'm hoping you won't. But if you are, we know that it's okay. Vaginal birth still happen. But talking about providers, if you have PROM, which means your water breaks before labor begins, and just to let you know, it can take hours, even days for your body to turn over into labor after your water breaks. But if you have PROM and you don't have a supportive provider, that is right there the beginning of a fight. It shouldn't have to be a fight, but that can impact things because they want to get things going. Some providers won't even induce labor or touch you or 12 hours later they're like, "Nope, you haven't had a baby. You have to have a C-section." So yeah. So really quick Johanna, do you have any tips for our listeners who might have had PROM or may have PROM? Johanna: Yeah, it's difficult because especially when I experienced it, I mean, I experienced it for both births and the second time I really felt anxious because I was like, oh no, I'm on a ticking time-clock again. Meagan: Yeah, yeah. Because that's how you were treated. Johanna: Yes. I was lucky that I have a super supportive provider. And she was like, "Baby's fine, you're fine, everything's fine. We're just going to wait it out." Yeah, I mean crucial to have the right provider that is going to give you that grace and give you that time and that space, but just know the facts. Just arm yourself with information that as long as the fluid is clear, as long as you have no signs of infection-- at least here they make you come in for non-stress tests like every, I don't know if it's 12 hours or 24 hours when your water has broken. As long as everything's looking okay, you can wait, I think, up to 72 hours. Meagan: I've actually even had a client wait five days. Johanna: Holy smokes. Meagan: Five days. Close monitoring you guys, really close monitoring. But it was nothing that said a baby needed to be born. So five days is maybe abnormal. This was a home birth transfer to hospital. Even with five days rupture of membranes, the hospital did not "make" her, as I'm putting quotes up, have a Cesarean or do anything different because she advocated for herself. But it really can. 72 hours. It really can happen. So okay, we are going to stop talking about this, you guys. We're going to have links in the show notes to dive deeper into questions for your provider. What about premature rupture of membranes and things like that. So we're going to have those in the show notes if you want to dive more into that. You can dive in. But we're going to take one quick break for the intro, and then turn the time over to Johanna. Okay girl, thank you so much for chatting with me about that. I really do think it's so important. Johanna: I think knowledge about everything is your best friend when you're planning for any birth, but especially a VBAC. Meagan: Right. I know. It does suck that VBAC has to be so much more intense in our prep and our research and all these things because we're just moms going in to have vaginal births. That's all we are. But, but unfortunately that's not how it's viewed. That's just not how it's viewed in most areas of the world. So yeah, all right. Let's talk about that first birth. Johanna: Okay. So I got pregnant with my first daughter Mila in the summer of 2020. So heavy, COVID times. So that was scary enough. Because of COVID and the shift in culture towards socialization and going into hospitals and stuff like that, me and my husband decided to look into home birth which was not really on my radar before, but the more that I looked into it, I was like, oh, this is super beautiful, and I love the idea of birthing my baby at home in the piece and quiet of our own space. Meagan: Yeah. And a lot safer than a lot of people think. Johanna: Yeah. Yeah, for sure. The more I looked into it, the more I was like, okay. This is a totally viable option for us. I had a pretty uneventful pregnancy. I was very lucky. I had very minimal symptoms. Everything went well. I didn't have anything scary happened during the pregnancy. I will say that I didn't take the best care of myself. I am usually a pretty active person and I totally just didn't do much exercise or working out. I think in the back of my mind, I was scared that something bad was going to happen if I overdid it. It was just a lot of first-time mom anxieties. Meagan: Totally get it. Johanna: Yep. I didn't eat the best. I didn't take the best care of myself. I didn't do a whole lot to prep for the birth other than your typical childbirthing classes, bringing baby home through the hospital, generic courses that I think a lot of first-time moms, that's what they do, right? I read a couple of books. I read the What to Expect books, and I think I read Ina May's Guide to Childbirth. Meagan: Great book. Johanna: Yep. But I had no idea what to expect. When it came to labor and birth, I really was going in blind. I will say, I just put my faith in that my provider was going to hold my hand through it. That was a mistake. So yeah, I mean, it was a pretty uneventful pregnancy. There wasn't a whole lot to say other than it was COVID and everything was scary and didn't really know what was going on. When I was 41-ish weeks, my water ended up breaking. It was the middle of the night, and I didn't really know what happened. It was just like a little squirt and went back to bed. And in the morning, it was like when you move a position and a little bit comes out and you move a position and a little bit. It was one of those. And then I lost my mucus plug. So I was like, oh, I better call my midwife. So I gave her a call, and she totally brushed me off. She was like, "No, I think it's probably just discharge. I wouldn't worry about it." So that was another red flag was her just totally brushing off my feelings and what I believed was going on. So I hung up the phone and I was like, well, I don't really know what to do now. I'm fairly certain that my water's broken. So I waited a couple of hours, and it continued to trickle out. I eventually called her again and she was like, "Okay, okay, you can come in. You can come in and I'll check, but I'm pretty sure it's just discharge." So I went in and sure enough, she was like, "Oh, your water did break and it's amniotic fluids. Look at that." Meagan: Interesting. Johanna: Yeah, I could have told you that. So I was like, "Well, what do we do now?" And she was like, "Well, we can wait up to 72 hours as long as everything's healthy. That's fine, so we'll keep monitoring things." She sent me home and told me to just relax. She said, "If labor doesn't pick up today, go to bed and in the morning, do a castor oil induction." I did that. When I woke up the next morning and nothing had happened, I did do the castor oil induction. I will say that I will never do that again because it was horrible. Sorry for the TMI, but it just gave me severe diarrhea, and then nothing happened, and I was super uncomfortable. So that wasn't fun. That wasn't fun. That didn't work. I went in for a non-stress test that afternoon. She decided to check me, and I had made zero progress. I was not dilated at all. I had zero effacement or anything like that, so no progress. I felt super discouraged. My water has been broken for however long at this point-- 36 hours, I think, probably. I've made no progress. The castor oil induction and failed. I had barely slept the night before, so I was tired and I was just stressed. I was like, when is this going to happen? Meagan: But at this point you weren't really thriving with contractions. Nothing was too intense to be telling you that there should be progress, right? Johanna: Literally not a single contraction or anything. Nothing was happening. Meagan: True PROM, and so your defeating feeling is super normal because in our minds we were told our water breaks, we should be having a baby. But if we have PROM, don't expect to be dilated. Right? Johanna: Yes. Meagan: I did too. I expected to be way dilated and I wasn't. Johanna: So I felt super defeated. And like I said, I wasn't sleeping. I barely got any sleep the night before because I was just anxious for birth to get going. I ended up crying in her office about how stressed I was to end up in a C-section because my sister had a long, pretty terrible labor that ended in a C-section. It was just not a great experience for her. I don't exactly remember what my midwife said, but I did not feel reassured leaving that appointment. But we did end up deciding that if I didn't go into labor that night, I was going to be induced the next morning because I was just not sleeping well. I was not able to rest and relax because I was just anxious. So I was like, okay. I guess my home birth plan is out the window, but at least there's a plan. I ended up going home. We had dinner, and I started getting contractions just after dinner which was exciting. Meagan: Yeah. Johanna: But then they petered off after, like, I don't know, an hour or two. So we went to bed, had the hospital bags packed and everything ready to go for an induction the next morning. Labor started around 2:00 AM. It started on its own around 2:00 AM. Meagan: How many total hours is this until labor comes? Johanna: I think it was about 48 hours after my water broke that I had the rupture of membranes that my labor actually started. I will say, it was pretty intense right off the hob. I hear a lot of women say that their early labor is like, "Oh, I took my other kids for a walk. I baked a cake. I did this. I did that to distract myself." My labors are not like that. My labors are intense right out the gate. I tried to eat something for breakfast. A few hours after that, I woke my husband up. We tried to eat breakfast. I got in the bathtub to try and relieve some of the discomfort. I hung out in there for a while. We had rented a birth tub. My husband got that set up. I called my midwife. She came probably around 11:00 AM, so at that point, I'd probably been laboring for like, I don't know, eight or nine hours. I was not coping well. It was very intense and I was not coping well with the pain. She checked me, and I was a 3. I was like, dang it. In my mind, what I know now is that it's not a linear thing and that it's not going to take another 18 hours to go from a 3 to 9. But in my mind then I was like, oh no, I can't do this for however many more hours because I'm already not coping well and I'm only at a 3. So I told her I was totally deflated and I told her, "I want to go to the hospital and get an epidural." She was like, "Okay, if that's what you want to do, that's fine." So I think between the time that she checked me and I was at a 3 and the time that I got the epidural, it was about two hours. That car ride to the hospital, wow, was not fun. But yes. So, in that two hours that it took between her checking me and me getting the epidural, she checked me again right as soon as it kicked in and I was at a 9. Meagan: Whoa. Johanna: Yeah. Meagan: 0 to 100. Johanna: Yeah, when I say that car ride, it was ripping through me. Meagan: Yeah, you were in transition at that point. Johanna: Yeah. When we were in the hospital waiting for the anesthesiologist to come in and do the epidural, my midwife and husband are joking around trying to make me laugh. I'm like, "This is not where are at right now." I was not having it because, obviously, I was in transition, and it just was not where I was at. So yeah, she was like, "Okay, well you're at a 9 now, that's great. So rest for an hour and then we'll probably be pushing." The epidural was heavy. I felt nothing from my ribs down. So an hour went by and she's like, "Hey, you're complete. Start pushing." I felt nothing. I'm trying to push, and she's telling me that I'm doing a pretty good job considering I have an epidural, but baby was still high. And then all of a sudden, I think I'd pushed a couple of times and all of a sudden, all of these doctors and nurses and bunch of people just start run into the room and they're all speaking French because it's a French speaking hospital. Meagan: Oh my gosh. Johanna: So I have no idea what's going on. Nobody is telling me anything. They're all speaking a different language. And I was just like, "Can somebody please tell me in English what's going on?" They told me that she was having late decal every time that I was pushing. Meagan: Okay. Johanna: So between pushes she was fine, but every time I'd push, her heart rate would go down and then have trouble recovering. At no point did anybody recommend maybe trying a position change or anything like that. Like maybe her cord was being pinched in that position. If only I knew now or knew then what I know now. Meagan: Yeah, like hydration, movement, doing something, pushing in a different position. Johanna: Yeah, yeah no. So like I said, my midwife threw her hands up and stepped back and let the OB take over and didn't say anything to me after that. The OB basically let me push three times and then was like, "Nope, this is going to take too long. We need to have a C-section," and she called a C-section. Meagan: Wow. Do you remember how low your baby's heart rate was getting? Johanna: No, I have no idea. Meagan: Okay, interesting. I mean late deceleration are less ideal, right? We don't want them to happen late. We want that to be the recovery period. But yeah, there could have been some things done. Johanna: Yeah, and looking back, it's frustrating to know that maybe if one little thing had been changed, the outcome could have been totally different. Yeah, but you can't blame yourself for that either. It's hard to look back and be like, the what if's. But yes, you did whatever you did in the moment with the information you were given. Johanna: Exactly. So I went in for the C-section. It went fine. There were no complications, but being strapped down to a table in a really cold room and having the shakes and not feeling that, not being the person to get to hold your baby. I mean, everyone listening to this podcast pretty much knows what thats like and how it was demoralizing and traumatizing for sure. But it went fine. She was born healthy. I didn't have any complications. But yeah, the emotional trauma was real and not just for me, but for my husband too. We got discharged about 24 hours after the C-section and going home and seeing the birth tub still set up in our living room was a very emotional experience. We both ended up breaking down crying. Meagan: Yeah. Johanna: So I had to do a lot of emotional recovery from that birth as well as physical recovery because the physical recovery from C-section was also extremely rough. I remember every time I would have to get up out of bed, it felt like I was being ripped in half. It's rough, but I knew right from the moment she was born that I would be VBACing my next baby because we had always planned on having a few kids. Meagan: I want to point out to everyone, too, the importance of postpartum support and postpartum help and planning. We never know the outcomes of birth. I didn't know the outcomes. I didn't realize that it was going to take me 15 minutes to walk 10 stairs up to my bedroom. I didn't realize it was going to take me 15 minutes to walk down the stairs. I couldn't be holding anything. I didn't realize how exhausting it was going to be to get out of bed to go to the restroom let alone taking care of a newborn baby and also thriving as an individual. So it's really important to really try not to ignore the postpartum period. I think it's easy to do because we're so focused on the birth. Especially with VBAC, I think we're so hyper, hyper focused on that VBAC, that outcome, and that experience which I do not shame anyone for being. I just want to plug it in. Don't forget about your postpartum because whether it's physical or emotional. You came back to this space of seeing a plan that didn't unfold the way you wanted it to. That can be very emotional, very traumatic even in some ways. So yeah, having some resources for postpartum as well. I just want to plug that in. Johanna: Yeah, that's a really good point. I did no prep for postpartum for my first birth. Meagan: Me either. Johanna: It wasn't even something that like dawned on me to think about. When I was in postpartum, I was like, wow, this is really intense. Like the sleep deprivation, the recovery, the breastfeeding, everything. It;s super intense. So for sure, don't neglect postpartum plans and getting the support that you need. Meagan: Yeah. Johanna: So anyway, I think from a couple weeks postpartum with Mila, I ended up finding your podcast and absolutely just binging it and trying to intake any knowledge I could get about VBAC natural childbirth-- just anything I could get my hands on, I was consuming because I knew that I was going to VBAC. I knew that I wanted to have a birth that was as intervention-free as possible for my second. So I ended up getting pregnant with my second daughter Bailey in the summer of 2022. The very first thing I did was I hired a doula. I already knew what doula I wanted before we even got pregnant because we had interviewed a few, and the doula that I found was actually a VBAC mom herself. And she just had a beautiful calming energy about her. I was like yep, that's who I want. So with that test, the lines turned pink, and I was already getting her on board. I ended up hiring the midwife that she recommended as well. I was intent on doing everything that I could this second pregnancy to set myself up for a successful VBAC that I could possibly do because I knew that if I did everything that I could possibly do and it still ended up in a C-section, then I don't have to have any lingering questions of well, what if I had done this? So it was like, I was going to do everything I could to set myself up for success. I was super diligent with eating well, exercising, and chiropractic care. I did all of the Spinning Babies' exercises, walking, and yoga. I did a HypnoBirthing course which I really, really liked, and I'm doing again for this pregnancy. I put up my birth affirmations. I did all the things You name it, I did it. My husband was super, super amazing and supportive and he was there with me every step of the way through every appointment and did all the coursework with me and everything like that. I'm very lucky to have a super supportive husband. I had another pretty uneventful easy going pregnancy. Other than a little bit more morning sickness and some SPD, it was pretty easy. I will say there's one thing that they make you do here, and I don't know if you guys have to do it in the US but if you're planning for a VBAC you have to see an OB around 36-37 weeks. Do you guys have to do that as well? Meagan: Yeah, so not if you're out-of-hospital. You don't have to do it. Some midwives still out-of- hospital will be like, "Hey, I want you to consult with a partnering physician," as in, "Hey, this is someone we would transfer to.: I went a consult with them, but with the midwives in hospital they require them to do a VBAC consult, and it's pretty much a visit where the OB is like, "Hey, this is what you're doing. Here is your risk. Do you comply?" Yeah. Johanna: Yes. So I ended up having to do that, and I knew it was going to be a negative experience. I knew it was just going to be fear-mongering and throwing scary statistics out. So I already had my guard up for that. And then it was also at the hospital where I had my C-section, so even just walking into that environment was very triggering. Meagan: Yeah. So I went to that and I was right. She told me, "As soon as you go into labor, you need to go to the hospital and you should have continual monitoring and and epidural just in case," and all of these things where I'm just like, no, that so goes against everything that I believe will lead to like a healthy, happy birth. I definitely didn't tell her about my plans. I actually was hoping this would end up in a home birth. I didn't actually mention this. My plan-- I didn't want to commit to a home birth. I was a little bit anxious because of my first birth ending up transferring to hospital, that I would end up having to do that again and then have that crushing disappointment that it didn't work out again. So my plan with my midwife was that I was going to labor at home as long as possible, and we were going to play it by ear. As long as everything was going well, then I would potentially have her at home. But I just didn't want to have that pressure that I needed to stay home because this was going to be a home birth. Do you know what I mean? Meagan: No, I totally do. I mean, when I was planning my, it wasn't a HBAC, it was a birth center birth. It's like a downplayed HBAC. I mean, I was in a different home. Right. I totally do. I know exactly what you mean. Johanna: Yeah. Meagan: Yeah, yeah. Johanna: So yeah, I definitely did not tell the OB that my plan was to have a home birth because I just did not even did not want to get into that. So I nodded my head and was like, "Yes, sure. Okay, great." Meagan: Yep. Johanna: At one point, also during my midwifery care for the second pregnancy, my midwife was like, "It's standard for you. The hospital wants you to sign a release form with a backup C-section date." Meagan: What? Johanna: And I was just like, "Yeah, I will also not be doing that." And she was like, "That is totally fine. Just sign that you won't do that." Meagan: I do not consent. Yeah, I do not consent in doing this. Johanna: Yeah, yeah. I was like, I don't need that to clock above my head. Meagan: No. Johanna: So again, my due date arrived and passed. I ended up getting a couple membrane sweeps to try and move things along, but they were unsuccessful. And wow, they are very, very painful. Meagan: So can I super quick touch on that? Johanna: Yes. Meagan: Membrane sweeps-- that's a really big question we see as well. And when you talk about them being painful, that's actually a sign that the cervix wasn't ready. Like it wasn't forward. It wasn't open. If a membrane sweep is painful, it's a real big sign-- it's not a guarantee, but it's a real big sign that your cervix isn't ready. So quick rule of thumb, if you are dilated 2+ centimeters, 3 or more is more ideal. Your cervix is really forward, meaning they don't have to reach back and in, and you are effaced at least 75-80%, that's a little bit more ideal and less painful. But if they are going back, a lot of the times is because they have to reach back and in. And so that is, that is that. And then it can cause pain, prodromal labor, things like that and, and frustration because you're wanting it to work and it's not working. Johanna: Yes. So yeah, they didn't work for me, but my midwife did tell me that I was actually 3 centimeters and she could stretch me to 3. Meagan: Great. So you were at least dilated. Johanna: Yes. So despite the fact that it was super painful and didn't work, I was still feeling very encouraged to know that my body was doing something good. Meagan: Yes Johanna: Because you'll remember my first birth, I was completely closed and nothing was happening after my water broke. So I was feeling pretty good about that. At about 40 weeks and 4 days, my water broke again before labor started. It was another one of those slow trickles, and it was the middle of the afternoon, so I called my midwife, and she was like, "Okay, come meet me." She asked if the fluid was clear and I said, "Yes." And she said, "Okay, come meet me at the office later, and we'll do the non-stress test and check you out and make sure everything's dandy." So I went and everything was fine. We were just waiting again for labor to start. I felt okay because I had been through this before, and I knew my body would go into labor, but at the back of my mind I was a little bit stressing out because I was like, okay, I'm on a clock again. I went home. Nothing happened. I woke up the next day and tried to get things going with the breast pump. That got contractions going, but they never stuck around. I ended up confiding with my doula about how stressed I was feeling that I was on a clock and feeling like why can't my body just go into labor? She was extremely reassuring. She came over, and we just talked for a bit, and I felt a lot better after that. That was in the evening, the day after my water broke, and I was supposed to go in for a non-stress test. So I went and met my midwife for a non-stress test that night. It was 36-ish hours after my water had broke. Still, everything was looking good. Baby was good. She was happy. I was fine. There was no need to rush into an induction or anything like that. But she could tell I was stressed. My midwife could tell that I was a bit stressed and she was like, "It's fine. We've got lots of time. You don't need distress.: And she's like, "But I can give you these tinctures or whatever if you want to try them." It was like the blue or black. Meagan: Cohosh. Johanna: Cohosh, yes. I was like "Sure, I'll do anything at this point. I'll try anything. I don't care. So they almost look like tiny, tiny little white beads. I don't know if they're always in the same form. Meagan: Yeah, sometimes they're in drops like tincture drops or almost like you said, a pill-like bead type. Johanna: So she was like, "Okay, let's give you one now." She wanted me to take four doses an hour apart. Meagan: Did you put them under your tongue? Johanna: Yeah. So she got me to take one when I arrived for the non-stress test and then when the non-stress test was over, it had been about an hour, so she gave me a second dose, and then she sent me home with two more. So we went home, and then I took one an hour after the previous dose and it was probably 10:30 at night at that point. Contractions started going after I took the third dose and I was like okay, they're probably going to peter out again because that's what they've been doing all day. I'm tired and I want to go to bed and I don't feel like staying up another hour to take the fourth dose. So me and my husband both took a gravel because my midwife told me to take a gravel and go to sleep. Meagan: What's a gravel? Johanna: A gravel is like an anti-nausea medication, but it makes you sleepy. Meagan: I did not know that. I've never heard of that. I don't think I've never heard it. Johanna: Yeah. Interesting. Meagan: Cool. I love learning. A gravel. Johanna: Gravel. Meagan: Yeah. Okay. Johanna: So yeah, she told me to take one and go to sleep because it makes you drowsy. So I think we had fallen asleep for maybe an hour and a half and I was woken up again with very intense contractions. And this time I was like okay, this is it for real. And like I said, with both my labors, contractions were intense straight out of the gate. So I woke my husband up. Taking the gravel was a mistake because we were both super drowsy. I woke him up and I was like, "I think you need to call the doula because this is definitely happening." And so he called her over and I labored in bed. I did my HypnoBirthing tracks. I did a lot of breathing through the contractions and the HypnoBirthing was super, super helpful, I will say that. We hung out for a while and just did that. My husband tried his best to stay awake despite how tired he was. Eventually, I think I waited maybe a bit longer than I probably should have to call my midwife because I was so determined to stay at home as long as possible. I didn't want her to come and be like oh, you're a 3, right? Meagan: See? Your mind. Even in labor we trigger back. We process things as they're happening from how they happened before, and it's really hard to let go. But your mind was doing it too, right? You're like no, I can't do this because I can't be that. Johanna: Yes. So what we waited, I think it was, I don't know. I have no concept of time. But we waited a couple hours or a few hours and my doula was like, "I think we should call the midwife." I was like, "Okay, can you call her?" So we called her and shortly after we called her, I was having contractions so intense that I was having an out-of-body experience. Like very, very intense. I was getting the shakes and hot and cold lashes. In my mind I was like, I'm going through transition. For sure, for sure. I'm going through transition. My midwife was not there yet and she would not arrive for probably like another hour. Meagan: You progress quickly from history. Johanna: Yes. So, by the time she arrived, she ran upstairs to my room. She checked me and she's like, "Okay, you're at an 8, so if you want to do a hospital transfer, if you want to go, we've got to go now." And I was like, "No, that ship has sailed. We're doing this here. As long as Bailey's healthy and I'm healthy, I'd like to stay here." So she was like, "Okay, we're doing this here." And she called over the other midwife because she wasn't actually sure that it was going to be a home birth, so she didn't have the other midwife with her, so she had to call the secondary midwife to show up. It was all very hectic. This time around, I plan on calling them much more ahead of time so that it's not so hectic when they arrived because lights got turned on, equipment was shuffled around and set up and definitely took away from the vibe a little bit. But yeah. So shortly after she arrived, I was complete and I had that very stereotypical moment where you feel like you got a poo. Meagan: And sometimes you just hold back because you're like, oh crap, wait. Do I need go poo first or should I have? Wait, what should I do? I don't know. I want to have the baby, but I don't want to poop. Johanna: Exactly. So I was like, "Oh my gosh, I feel like I have to poo." My midwife's like, "It's okay. This is normal. You're good." She was just encouraging me to just do what I felt like I needed to do. I ended up pushing for probably an hour, give or take, in a sumo squat position with my midwife on one side and my doula on the other side and then my husband would switch out for the midwife supporting me on either side. And yeah, I only had to push for maybe an hour, give or take. Her head got a little bit squeezed at one point when she was coming out, so when she came out, she was in a bit of shock. Because of where I was in my room, and the equipment was on the other side, my midwife had to make the decision to clamp and cut her cord and take her over to their equipment to give her a little bit of help which was very scary. She didn't end up needing oxygen, but they thought that she might. So she ended up being okay, but it was definitely a scary couple of minutes where I didn't know what was going on. But yeah, she ended up being okay. The only thing I was a little bit disappointed in was the second time around, not being the one who gets to be the one to hold my baby and bring her to my chest and missing out on that experience again. Meagan: Yeah. Johanna: But obviously I was amazed that I had done it. I had gotten my home birth, I had gotten my VBAC. I was in shock. Meagan: I can so relate. Sometimes you're so focused on pushing that baby coming out, and then it happens and you're like, am I dreaming that this happen? And you're looking around and you're like blinking and you're like, no, I'm awake. I just did this. I just did this. And you're so excited. Johanna: I was still in La La Land because I had labored so hard for eight hours and yeah, you're out of it and just in disbelief. Meagan: Yeah. Yeah. Johanna: Like, did this really just happen? Meagan: But it did. It just happened. Johanna: Yeah. So that was a really good feeling. Recovery was like night and day. I could immediately just go and have a nice shower and walk back to my bed and crawl into my bed. It was comfortable and I wasn't in pain. I had mobility, and I could lift my baby up. It was a good feeling. Although I will say that without the epidural, the fundal massage was a really unpleasant experience. Meagan: Yes. So for everyone that doesn't maybe know, fundal massage is something that they do after labor and delivery, they essentially put their hand, sometimes fist. Now it's not like they punch you, but think about a fist. Look at the bottom of your fist. They put the bottom of their fist along your uterus, the top of your uterus. They push down and massage. They push down and they massage. And sometimes they do it three or so times. You take a deep breath, they do it. You take a deep breath, they do it. And why they're doing that is because they're checking to one, make sure your uterus is clamping back down to its normal size right after birth and the placenta is out. It starts doing its job and going boop boop, boop, right back down to its normal size. But sometimes it can get a little boggy or bleeding can occur. So yeah, you want to make sure that. Now, really quick tip. If for some reason your uterus is still staying boggy and not clamping down as much, something you can try to do if you are able is urinate. Go to the restroom. That's a really big thing to help the uterus clamp back down. And even if you have an epidural, sometimes you have to get a straight cath. And if you can't go to the bathroom, sometimes you can get a straight cath to release. But yeah, that is not as friendly when you're unmedicated. But take deep breaths. If you can, get that baby on your chest or hold someone's hand-- your doula, your partner, your midwife, anybody's hand and just take really deep breaths and know that it's okay. It's okay. It doesn't last too long. But yeah. Johanna: So going back to our chat about postpartum. Meagan: Yeah. Johanna: So the recovery of vaginal versus C-section night and day for sure. But I will say that my postpartum with Bailey was way harder than with my first. It had nothing to do with the birth. I think she was asynclitic in my uterus. And so when she came out, she had a pretty bad case of torticollis and a tongue tie which made breastfeeding very difficult. I got mastitis twice in the first four weeks, like a really bad case twice in the first four weeks. I ended up with a bad case of food poisoning at three weeks postpartum. Meagan: Oh no. Johanna: And I had some prolapse symptoms as well. I will say that there were a lot of things happening in the first month, month and a half of my postpartum that I didn't expect and were very intense and difficult. I mean, just for breastfeeding, I was in so much pain that there were many times that I wanted to just give up and be like, nope, never mind. Forget this. So having good lactation support was really crucial. Meagan: Oh yes. And get lactation support before you have your baby. It sounds weird. It sounds really strange to connect with someone about breastfeeding before your baby is born. But oh my gosh, you guys, it's so impactful. I mean, we've talked about it before with The Lactation Network and other IBCLC supports. It's so important. I had similar. So my baby was born be a Cesarean. So in a Cesarean, a baby can also develop torticollis too with the way they are and the way they come out. But my baby had torticollis and she had a tongue tie. So very, very difficult. Challenging for sure and frustrating. It can impact things like mastitis and yeah, I love that you pointed that out. My was recovery all around better, but that doesn't mean my experience was all sunshine and butterflies. I really want to just highlight that one more time, you guys. Vaginal birth doesn't mean your postpartum journey is going to be the easiest. Mine wasn't. My VBAC after two Cesarean birth was not the easiest. It just wasn't. So again, get those resources beforehand. Right? Johanna: Yeah. And I will say, I don't know what I would have done if I wasn't with midwifery care and having them on call for the six-week postpartum because I swear, I called them every second day about something that was going on. Meagan: Well, and that's more unique to home birth too because even with the hospital birth midwives, it's not the same. They usually say, "Oh, I'll see you in six weeks," and you can call. You can call any OB or midwife. You can call any provider, but there's a different level of care and follow-up in that postpartum stage and it's very impactful. It's very, very impactful. Johanna: Oh for sure. Yeah. Meagan: Yeah. Oh my gosh. I love everything and I love all these tips. There are so many tips and nuggets along the way. Is there anything else that you would like to drop here for the listeners in regards to home birth or preparing or postpartum or any words of encouragement that you may have? Johanna: I mean, I think that, like I mentioned at the start, just arming yourself with as much knowledge as you can is going to be your best bet to get the outcome that you want and just feel empowered throughout your pregnancy and your birth. So just arming yourself with as much knowledge as you can get your hands on and yeah, getting a good provider, trusting yourself, believing in your body, and setting yourself up for postpartum too because that's an important thing when you're so focused on getting your VBAC is letting the postpartum stuff fall to the wayside. Meagan: Yeah. Meagan: Taking care of yourself afterwards too is important. Meagan: Yes. Taking care of yourself. We don't. We don't take care of ourselves enough, you guys. Really pamper yourself. If that means you have your postpartum doula. If that means you hire a house cleaner to come in every other week. If that means you hire or have family come in to help, just whatever. Light house cleaning or holding baby or playing with toddler. Johanna, she's going to have two, you guys. She's almost on her third, and it's another baby girl. Johanna: Oh, yes. Yes. That's three for three. Meagan: So three baby girls. I mean, you've got your hands full in your postpartum experience. Right. So really do it. I don't want to stereotype women, but sometimes we get into this space of, we can do it and we don't need to spend money on ourselves and things like that, but this stage of life is so important to invest in yourself. Really, truly invest in yourself because you deserve it. And your sleep and your experience and your mental health, it all matters so much. So yes, you might hire a cleaner and you might be spending that money, but guess what? That's okay. Do it. Johanna: And when you're taken care of, then you're a better mom to your kids. Meagan: Yes, yes. My husband always says, "When mom is happy, everyone else is happy." But really, really, you deserve it. Women of Strength, you deserve to be pampered and loved and supported. So Johanna, thank you so much again for such a powerful episode. I'm so grateful for you. And please keep us posted on this baby number three. By the time this episode comes out, you will have had this little baby girl. Johanna: Yes. I'm due January 4th, so I will definitely be sending you a message when she makes her entrance. Meagan: Please do. Please do. Okay well, thank you so much. Johanna: Thank you. Closing Would you like to be a guest on the podcast? Tell us about your experience at thevbaclink.com/share. For more information on all things VBAC including online and in-person VBAC classes, The VBAC Link blog, and Meagan’s bio, head over to thevbaclink.com . 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