Episode 277 Clair's VBA3C + PPROM + Close Pregnancy Duration

Happy podcast Wednesday, Women of Strength! You do NOT want to miss today’s episode. Clair shares her beautiful journey to a VBA3C. After fully dilating and pushing for hours but ultimately ending in C-sections with her first three babies, Clair finally had the vaginal birth she so badly hoped for with her fourth! Clair shows just how powerful birth can be when a woman’s intuition is combined with informed consent and an open-minded birth team. There were unfortunately some technical difficulties during this episode and part of Clair’s third birth story was not recorded. Clair graciously submitted this written account below. 24:08 “With my third baby (attempted VBA2C), I dilated quickly and smoothly, baby was descending beautifully, and I started feeling like it was time to push. I pushed for a long time - a couple of hours - and he was coming down, but slowly. We tried many different positions, moving around, etc… but it was taking a while. Looking back, I was having some back labor and it’s likely that when my water broke on its own, he dropped into a posterior position. After several more hours, we could see his head! I thought a VBAC might really happen! But baby’s heart rate started having decels and having a hard time coming back up, so we decided to transfer to the hospital for monitoring. I was pretty exhausted by that point, so I was hoping that IV fluids would help me regain strength and keep going. When we got to the hospital, however, they would only let me labor in the operating room because I was a VBAC patient, so I was very limited in mobility and my options. Baby seemed stable, but they were basically prepping for surgery from the moment I walked in the door and wouldn’t tell me baby’s stats. We eventually called it, opting for a C-section on our terms so we could have delayed cord clamping and a calm environment. Baby boy was almost 10 pounds and had very healthy APGAR scores! I was disappointed I didn’t have a VBAC, but I felt respected by my midwife the whole way through. Postpartum physical recovery was difficult, but emotionally this birth was much less traumatic because I had a supportive birth team. I also took two intentional weeks to do nothing but be with the baby and rest, which I hadn’t done with my previous two births, and that made a huge difference in my mental health and bonding with my baby!” Additional Links Needed Website How to VBAC: The Ultimate Prep Course for Parents Full Transcript under Episode Details Time Stamp Topics 01:56 Review of the Week 04:30 Clair’s first pregnancy and birth 07:50 Recovering from a C-section while moving 09:24 Getting pregnant at 3 months postpartum & dual care during COVID 14:39 Laboring at home to complete & hospital check-in 17:49 Clair’s second Cesarean 19:08 An emotional recovery 23:38 Third labor with a home birth midwife 24:08 Pause in story – read caption! 24:20 Fourth pregnancy 28:49 Moving to Utah 35:34 Midwifery care in the hospital 38:47 Active labor begins 45:04 Circumvallate placenta Meagan: Hello, hello Women of Strength. We are at the end of February here and we have a story that I swear– VBAC after multiple Cesareans is very highly requested when it comes to this community so we have a story for you guys today for VBAC after three C-sections. Not only was it a VBAC after three C-sections, but it was also a pre-term VBAC after three C-sections. I think in a lot of places around the world if someone came in pre-term and they have had three C-sections, finding that support is going to be hard. It doesn’t need to be necessarily hard, but I know that it can be so I’m excited for this story from our guest, Clair, today because it’s a story that just shows that it is possible even if you have certain things stacked against you that the medical world looks at in a negative way. 01:56 Review of the Week So we are going to be sharing that story here in just a few minutes, but of course, we have a Review of the Week and this was shared on Apple Podcasts. It’s by brittleesmith . It says, “Highly recommend for both VBAC mamas and mamas in general.” It says, “In 2019, after 30 hours of labor, I ended up birthing my son via unplanned C-section. I was devastated and knew my future birth had to be different. I immediately started digging into VBAC resources and came upon your podcast. I listened to every single episode before I even became pregnant with my second baby. The knowledge I gained from both of you as well as your many guests is truly invaluable. This resource is great for any expectant parent, not just VBAC moms and I wish I had discovered you all before my first child. “I am thrilled to announce that I got my VBAC this past February and I owe a lot of thanks to y’all. Keep it up, ladies.” Oh, I love that. I love when people say, “We found you. We learned and then we got our VBAC,” or “We found you. We learned and I didn’t get my VBAC but I had a better experience.” This is what this podcast is here for to help people have a better experience, to learn the information, to feel more empowered to make the best choice for you, and even sometimes when the experience doesn’t go exactly as we planned, to still have a better experience because we know what our options are. As usual, if you guys have not left a review, we would love them. They actually help Women of Strength find this podcast. They help people find the information and the empowerment for their births, do drop us a review. You can leave it at Apple Podcasts. You can even Google “The VBAC Link” and leave us a review there or wherever you listen to your podcasts, drop a review. 04:30 Clair’s first pregnancy and birth Meagan: Okay, cute Clair. It’s been so fun. I just was scanning over your stuff and I was just excited because of all of the people you had at your birth, I know personally because you are also here in Utah. I’m so excited to hear your whole story and your journey. I just want to tell you congrats in advance because it is so amazing. So amazing. Clair: Thank you so much. Yeah. We didn’t expect to be in Utah, but it turned out to be a really great place to birth so we are really grateful to be here. My story actually starts on the East Coast thousands of miles away and I was due with my first in May 2019. I didn’t really know much about birth in general. I’m the oldest child and kind of a rule follower. I was like, “Well, if I just do everything the way I’m supposed to, then birth will just happen.” Yeah. I had a really supportive OB. He has several children of his own. His wife was a friend of mine. He was a really great doctor. But at around 32 weeks, I was flying at the last possible second I was allowed to fly and running through an airport. I kind of felt the baby kind of settled in a weird spot after that. I started having prodromal labor at 39 weeks or something. That went on for about two weeks. What I didn’t realize was that these were all signs that maybe he was posterior and not in a great position. My OB, even though he was really wonderful, wasn’t trained to determine where the baby is, just that the baby is head down. Meagan: Right. Clair: So at 41+1, early in the morning, I was over a week past my due date. I was losing my mucus plug. “Hey hon, we’re going to have a baby today.” I was so excited. We ended up laboring all day at home. We went to the hospital. I had really, really bad back labor so I ended up with a lot of IV fluids. I had a couple more interventions. They broke my water eventually and basically, what ended up happening was that 41+2, so 9 days after my due date, I had dilated to complete, but the baby wasn’t dropping at all. He wasn’t engaged. He was still really, really high and after a while, his heart rate wasn’t tolerating labor well anymore and they recommended a C-section. Meagan: Did they have you push? Clair: I didn’t push. Yeah. They said he was still too high. They didn’t recommend that. Meagan: Interesting. Isn’t that how we get babies down? Clair: Yeah. I’m not really sure. Meagan: Yeah. Yeah. Clair: It definitely was a situation he was not used to or prepared for. He was kind of surprised and honestly very sad that I didn’t have the birth experience that I wanted. He came to visit the next day and just spent a few minutes with us. His wife came to visit who I was friends with. It was really hard and pretty traumatic, but it also could have been much worse. His bedside manner, I was really well taken care of. 07:50 Recovering from a C-section while moving So that was really hard. It was a challenging physical recovery because I had 48 hours of labor and most of it was without an epidural. It was really intense. The hardest part of that birth was that the first time I saw my son, I saw a picture of him that the nurses showed me because they took him away to be measured right away. So that was really hard. He was 9 pounds, just that plus not being in a great position and being with a provider that didn’t have a lot of options of what to do if baby is not descending properly. That was a difficult adjustment to motherhood especially because that baby was born in Louisiana. We were moving back to Virginia where we have a lot of family and friends. We were planning on moving two weeks after the baby was born, but because he came late, we actually left the hospital and started driving north. I would not recommend this. Don’t do it. Meagan: That’s a lot. That’s a lot. Clair: It’s a really bad idea. Meagan: Oh my gosh. Clair: His first night out of the hospital was in a hotel in Birmingham, Alabama. Yeah, don’t do it. So yeah, that was just hard because we were moving and I’m trying to physically recover. So it was pretty wild. 09:24 Getting pregnant at 3 months postpartum & dual care during COVID Clair: That was my first. My second– we surprise got pregnant three months after that baby was born. Meagan: Okay. Clair: He was a cycle zero pregnancy. I had no idea. I just felt off and was like, “Maybe I should take a test,” and I was so shocked that I was pregnant. Meagan: Oh my gosh, yeah. Clair: Like I said, we were in a new state. I found a birth center that would do my prenatal care because I knew midwives knew more about positioning and how to track it and maybe had some recommendations about things they could do to encourage baby to be in a better position because my pregnancy had been great. But because it was right around 12 months between deliveries, they wanted me to have co-care and deliver at a hospital. I kind of just took their word for it like, “Oh, well if that’s what they are recommending, then the risk really must be that much higher.” So then in the middle of all of this, COVID happened and hospitals– I was due in May 2020. Hospitals were kind of changing their– Meagan: Everything. Clair: Yeah, but by the week it felt like. Meagan: By the day. They were changing by the day. It was insane. Clair: Yeah. It was crazy. So it was March. I was due in two months and I had just reached out to the birth center basically begging them to let me deliver out-of-hospital because I was like, “I don’t want to deal with the hospital system right now. I know that they are truly supportive,” but they said that they weren’t comfortable with that. So my plan was to labor at home with the midwife from the birth center, laboring home with me then to transfer to the hospital while I was in labor. She was supposed to be– that midwife was supposed to come with me as kind of like a doula almost in the hospital just as support. Meagan: Yeah. Yeah, a monitrice or whatever they call them. Clair: Yeah, yeah, exactly. So then I had to find a doctor to do co-care with. I had a new friend in the area who had a C-section with her first and she had a not-great experience with this one doctor in the area, but that was the one that the midwives usually worked with so I kind of took her experience as, “Maybe not. I don’t want to work with him.” I found someone else who was really VBAC-supportive historically, but then he had me do an ultrasound to determine scar thickness. This was all in the third trimester. Pregnancy was going really well, but in the third trimester, I had to start doing my appointments with him. Baby was actually breech pretty late on, so I started doing chiropractic care during that pregnancy and she flipped on her own. It was great. I was so grateful. So then at that ultrasound, we determined that yes, she is head down. He was concerned about my scar thickness, although then I did a lot of research and was like, “I’m just not sure that this is actually evidence-based.” Meagan: Yeah. Clair: And then also, they were telling me that she was going to be 12 pounds. I carried a big baby a year before, literally to the day almost and I was like, “This feels just like my first. She’s got to be around 9. I don’t think she is that much bigger than he was.” Meagan: Was the ultrasound saying 12? Clair: Yeah, yeah, yeah, yeah. Meagan: Okay, okay, okay. Clair: Yeah. The ultrasounds measured it and I mean, spoiler alert– it turned out to be way off. She was 9 pounds, 3 ounces. Meagan: Most of the time it can be. Clair: Yeah. Yeah, especially with bigger babies later in pregnancy. I was in a fine headspace with that. I was like, “I know that this can be off. I’m not worried about it,” but they were really nervous and anyway, basically backed me into scheduling a C-section, but I pushed it as far down the due date path as I could because I had gone over with my first and I still really wanted a chance to labor. So chiropractic care this whole time was really helping. I had bad hip pain with my first and I didn’t have any with her after that. They wanted to do another scan at 41 weeks later or another ultrasound at 41 weeks just to check on baby, but I got them to do a non-stress test instead because I was like, “What are we going to look at?” She was healthy at 40 weeks. I was really glad that I had advocated for myself there because that was good. I did have one funky day of pre-labor at 40 weeks where I really thought I was going into labor. It was early labor then it stopped. I was checked after that and I was at 4 centimeters. I was walking around for a week and a half it turned out to be at 4 centimeters dilated so it was kind of interesting to know that that could happen. Meagan: Yes. Clair: The midwives I was with said they see that with VBACs a lot too that the body just takes things slower sometimes which was interesting to hear their experience of that. 14:39 Laboring at home to complete & hospital check-in But yeah, I went into labor at 41+3– or 41+2 I guess– which was when my son was born a year before. I was in early labor all day. My water broke as I was nursing my one-year-old for bed. Meagan: Oh my gosh. Clair: It was kind of crazy and exciting. I was like, “You’re going to meet your sister.” I put him down for sleep. The midwife came over. I labored from a 6 to a 10 in three hours. By 9:00 PM, I was fully dilated. She was dropping. At that point, looking back, I wish I had just stayed home because she was almost born at that point, but I didn’t because I still had the midwife’s voice in the back of my head, “Oh, it’s only been a year. You’re at a higher risk for rupture.” I just was worried and at that point in labor is not the time to be making decisions like that. Meagan: You’re very vulnerable. Clair: Yeah. We ended up transferring. I get to the hospital. They stick a thing up my nose to check if I have COVID. Meagan: Oh jeez, yeah. Clair: So you’re in labor already really uncomfortable and they’re like, “We’re going to swab your nose.” You’re like, “Thanks.” They wouldn’t let the midwife in which we kind of knew, but she came with us just to see if they would let her in, but they were only allowing one support person so my husband came with me. I ended up getting an on-call doctor who wasn’t the doctor that I had been seeing. It actually turned out to be the first doctor that I was trying to avoid in the first place. Meagan: Oh, really? Clair: Yeah, so that I was not happy about. He literally takes one look at my chart and says, “A VBAC? This baby is going to be 12 pounds? Don’t even bother trying.” I was like, “Um, okay.” Meagan: You’re like, “But I’m 10 centimeters.” Clair: Right. Everything is fine. I’m healthy. She’s healthy. Heart rates are all good. We’re doing it. It’s not a question of can I because it’s happening. But he started– I mean, I won’t tell you the things he was telling me about what happens if I should have had a C-section and I don’t and the whole dead baby thing. The nurses were trying to keep him out of the room for me. It was so bad. It turns out later that he did talk to the midwives the next day and was like, “Why did you send her in at all? Why did you tell her she could VBAC?” Basically, he confided in them, “You don’t know what it’s like to be sued.” I guess he had something in his past where he had been sued for something that had happened, so he was just really scared but he was taking that out on me. Meagan: Which is not okay. Understandable, but not okay. Clair: Right, yeah. It took a long time for me to get over this and forgive him for some of the things that he said. Anyway, so my body starts having a stress response. Labor starts slowing. My cervix starts swelling a little bit. Basically, my body is like, “We don’t feel safe here. We’re not having this baby here.” 17:49 Clair’s second Cesarean I did push for two hours, but contractions weren’t really working the same way. He started talking about, “Well, if it’s an emergency, we have to put you under general,” and all of this stuff so I did end up getting an epidural. I basically got backed into a corner and eventually, we said, “Let’s just call it and have the C-section because we can do it on our terms and maybe get a couple of the things we still want.” We really wanted delayed cord clamping. I really wanted to be able to see her right away which I didn’t get to do with my son. So we felt like if we just called it, we would be able to do some of those things because it wasn’t an emergent situation. So really, for no medical reason, I had my second C-section. She was 9 pounds, 3 ounces and the doctor actually said to my husband after that, “Oh, by the way, your wife has a fine pelvis. There is no reason she can’t birth vaginally. She can totally do this again in the future.” Meagan: Oh gosh. Clair: My husband was like, “I don’t want to talk to you right now about that.” Meagan: Yeah, like get out of my face. Clair: Yeah, after you just did what you did and backed us into surgery, and he just wanted to be able to control the situation. Meagan: Yeah. 19:08 An emotional recovery Clair: So emotionally, it was really hard to recover from that. I had a really hard time just working through some of the things that he had said and the images he put in my mind, but it was physically a lot easier. Meagan: Yeah. Clair: We did move again after that baby, but we only moved within the state so that was easier. We move a lot and we’ve moved with every baby at some point which is kind of crazy. 21:22 Clair’s third pregnancy So that’s my second baby. And then about, I don’t know, 15 months later, we got pregnant with our third. We were pretty excited. We had a really early, early miscarriage between those two and it was still really hard and painful but it was like the day after we found out we were pregnant so that was a surprise and that made us think, “Well, are we ready for another baby?” I kind of just started like, “Yeah, actually I think we are,” even though at the time, I felt totally overwhelmed. So that’s kind of beautiful because if we wouldn’t have had that baby, we wouldn’t have our third right now. We were in the same state. The VBAC laws in the state are pretty lenient so I end up having the opportunity to find a home birth midwife because I just at this point really did not want to go back to the hospital after everything. There really weren’t any hospital practices that I knew of and I kind of looked around a lot that were VBAC-after-two-C-sections supportive. So I look around. I found a home birth midwife. I had a beautiful pregnancy. Kind of in the back of our head the whole time, we were thinking, “If we just stayed home with our daughter, things would have happened naturally. It just would have been fine.” The whole pregnancy, I was a little bit nervous, but I had some really, really awesome supportive friends– the same friend who had a C-section and had a VBAC since then. She was so in my corner and another good friend of ours were just cheering me on the whole time. My midwife was really, really supportive. I did have some fears and worries, but I was just like, “We’re just going to walk it out. I have no reason to believe I can’t birth this baby vaginally.” I was continuing chiropractic care. The friend who had a VBAC had since become a doula. I planned on having her there. 23:38 Third labor with a home birth midwife Clair: I went into labor six days after my due date after this pretty beautiful, smooth pregnancy in the early morning and then again, I was dilated to 10 by 9:00 in the morning. It was five hours later after my– Meagan: You labor beautifully. Clair: Right. At this point, I was like, “I know my body can do this,” but I just had never made it all the way. I was starting to feel pushy. I pushed for hours and hours and hours which turned out to be really hard. The midwife, when I started pushing was like, “We’re going to have a baby so soon,” and then– 24:08 Pause in story – read caption! 24:20 Fourth pregnancy Clair: My son was nine months old when we got pregnant with our fourth. Like I said, we had moved to this mountain town in Colorado. We were far away from a lot of things, so it was really hard for me to find a provider in general let alone one who was going to be supportive of a VBAC after three C-sections. I was really open to if I needed to have a fourth C-section, I was open to that. I just wanted to do what was going to be best so I was looking at all of my options. All of our family was back east though and we were looking at support after the baby was born so we were thinking we might go back to Virginia and have the baby there. I ended up doing remote care with my midwife from my previous birth, my last birth, for all of my prenatals. Everything was looking great. The bloodwork looked great. I was taking my blood pressure and checking with her occasionally. I was doing that with her while also looking for a provider and trying to discern what we were going to do for the birth. I should also mention that during this time, I started going to pelvic floor physical therapy. It had been recommended to me a few times, but I never pursued it before. My chiropractors in Colorado had a really strong recommendation for someone that they really liked, so I started going to pelvic floor PT. She found all of this chronic tension that I didn’t realize I had. Actually, my hip pain had come back this pregnancy and releasing my pelvic floor actually took care of my hip pain. It was all referred pelvic floor pain which was so wild, but I felt relief within a couple of visits. She knew really good exercises to be doing during my pregnancy. It also made me more in tune with the rest of my body. I realized where else I was carrying tension and was better in check with my moods, so that was a huge game changer I think. I want to make sure that I mention that because I think that really, really impacted this pregnancy and birth. So we did an anatomy scan at 20 weeks and everything was looking good. It was a baby boy, but we found out he was measuring big which is normal for my babies at this point. Kind of around the same time, I guess, my husband got this really amazing job opportunity in Utah which meant we would have to move again. I was due in October with this baby and we would be moving during the summer. This time, we would move before the baby was born then hopefully have a couple of months to settle in. Because of that, I switched gears and started looking for providers in Utah so that I could have a pretty seamless transition. I found a really awesome midwife. I told her my whole story and when we were in Utah just interviewing and checking it out during the winter, she heard all of my stories and said, “I don’t see why you can’t birth vaginally. I think you are an excellent candidate for VBAC. I would gladly take you on.” Meagan: She is one of the most amazing midwives in Utah, too. Clair: Yeah. She has a ton of experience, too. I love how she has that much experience, so I really felt like she has seen it all. She has seen a lot and if she says I have a really good chance, but also, I totally trusted her to step in if we needed to step in and try different things during delivery. That’s the one thing I felt like could have gone differently with my third baby was maybe we could have intervened a little earlier and maybe that would have gone differently. She also promised my husband that she would be straight with him because he kind of had an experience of people trying to shield him from the truth or whatever in the past just to kind of protect him in the birth process. He just wants honesty, so she was like, “I’m going to be really honest with you the whole time. I’m going to tell you exactly what I think.” It was just a really good fit for our family. 28:49 Moving to Utah Clair: I went back and started packing up the house and everything, but I knew that I had a really solid provider waiting for me in Utah. We moved at the beginning of August. I was maybe 30 weeks or so, 29 weeks, 31 weeks, or something like that when we moved. I thought I had two months or so to kind of get settled and unpack the house and everything, then at about 35 weeks, I started having some pre-labor stuff and a few contractions, but I thought they were just really strong Braxton Hicks at night. I lost a bit of my mucus plug and that was consistent for about a week, but because with my second, I had a whole day of labor and then nothing for two weeks, I thought, “Oh, I’ve still got two weeks. Baby will be here right at 37, but that’s fine. I think I still have a couple weeks left.” I checked with my midwife and she was like, “Are you concerned about going into early labor?” I was like, “I don’t think so.” She goes, “Great. Don’t worry about it.” To my surprise on a Sunday night at 5:00 PM coming back from the grocery store to pack lunch for my husband for his first official day of work the next day, my water breaks. I come home and I’m like, “I think my water broke.” He goes, “Uh, okay. This is really unexpected,” because with all of our other babies, I went past my due date and we had been in our house less than a month. I called my friend who is a doula now. I was just kind of out of it. I didn’t really know what to do. She walked me through. “Okay, call your midwife. See what’s going on.” I called her and she was like, “We can check to make sure that your water broke, but if you are pretty sure, you’ve had several children so if you are pretty sure it’s your water, you should just go to the hospital.” She told me exactly which hospital to go to which I was really grateful for because I had no idea where to go and I really trusted her recommendation. Meagan: You were closer to a different hospital, honestly. You could have gone to this other hospital. Clair: Yes. Yeah, exactly. I was so glad that I called her. I walked in and they were like, “Oh, your midwife called ahead for you. Great. Come here. Let’s check you out.” I was at a 5, so I was 5 centimeters dilated already which was crazy. They did an ultrasound just to double-check his position. He was head down which they were happy with. This OB comes in who was on call. She sits down and just says, “Well, frankly, I don’t think a VBAC after three C-sections is too risky, but it’s just risk. I don’t see any health problems right now. You’re fine.” They hooked me up to a monitor. Baby was fine. “So we’re not going to force you to do anything that you don’t want to do. You’re going to make the call.” We were really surprised because when we knew we were going back in a hospital setting, especially after our last two experiences, my husband and I were like, “Whatever happens happens.” He even said, which was so great, “Let me deal with them. You deal with the baby.” Meagan: Mmm, yeah. Clair: “You don’t need to go in fighting. I’ll go in fighting and you deal with the baby.” But then we didn’t even have to fight. They were disarmed right away. Meagan: Which is amazing because especially with preterm– Clair: Exactly. I expected a frenzy and it wasn’t. It was peaceful. We just basically said, “We’re not going to do that. We’re not going to just do an automatic C-section. We’re going to labor.” They looked at my ultrasound, saw that he was measuring big, and said, “We actually would have changed your dates in our practice with this ultrasound so we think you are closer to 38 weeks.” I was pretty confident in my dates because I had been using a monitor to check ovulation and everything. I still felt pretty confident that he was 35 weeks, so I really didn’t want to induce or make labor happen any sooner than it started because I knew that his lungs could benefit from another couple of days in utero. We talked that through a little bit and the next day, there was a new on-call OB. The nurses were great. They listened to our whole story and they were like, “We are willing and ready and prepared to support you.” So the next day, we get a new on-call OB and she just says the same thing, “I don’t think this is a very good idea, but I’m not going to force you to do anything.” She listens to our reasoning both why we don’t want to induce and also about a VBAC and she goes and she calls the midwife who had been supposed to deliver or catch the baby. She says to the midwife, “I actually don’t think this is a very good idea. Why did you send you here? It is really, really risky.” The midwife says, “It’s not as risky as you think it is. Actually, go do the research a little bit. There are not great numbers out there, but what we have isn’t what you are saying it is.” So that doctor actually called a maternal-fetal medicine doctor at a different hospital that she knew and asked, “Hey, what do you think about a VBAC after three C-sections? Would you recommend it for a mom?” He basically gave her the statistics of the risk of complications with a fourth C-section versus the risk of uterine rupture with a VBAC and he said, “The numbers aren’t great, but as far as we can’t be 100% confident. We don’t have–” Meagan: Enough evidence. Clair: “--a lot of evidence, but I would absolutely support her. It’s actually less risky for her to do this vaginally if she can.” This doctor comes back and tells us that. We were shocked. She said, “I actually think a VBAC is the best thing for you and your baby. I’m going to transfer you over to our hospital midwives–” which was wild and so not what we expected. She was like, “Because I think that’s more like the model of care you wanted.” We were just floored because we never– yeah. We never expected that from a doctor. We had never been respected in that way. That alone was just so healing. 35:34 Midwifery care in the hospital Clair: This midwife comes in and I chat with her a little bit. She made sure I got some food. I hadn’t really eaten much since I got there. Meagan: I bet. Clair: It was great. They just really attended to me as a person. I still was not in labor. They weren’t checking me because my membranes were ruptured and she just talked me through that. “There’s really not that much of an increased risk of infection if you are waiting longer as long as you are not doing checks. If you don’t have an infection already, you’re probably not going to get one essentially.” We did lots and lots of things in that 24-hour period. We prayed. We asked for so many prayers from our friends. We called the midwife and chatted with her a bunch. My husband– I joke that he was my daddy doula during that time because we learned a bunch of things during our other pregnancies. We were doing a Miles circuit. We were doing Spinning Babies and abdominal lifts and everything we could think of. I was pumping. They got me a hospital pump to use. I was showering and trying to relax. We even discussed leaving the hospital and going home. We talked that through with them, but I felt pretty confident that once I went into labor, it was going to be pretty strong labor and I was confident he was pre-term. I wanted to stay. My kids were able to come visit which was huge. That was so helpful. I did a lot of fear release conversation with the hospital midwife was a big deal. I was just really worried. My oldest was only four and I was really worried about, can I do this? Can I be a mother to these four babies? It’s so much more manageable when you are pregnant. The baby is inside, so I think that was actually really helpful. I think that was kind of keeping me from labor in a sense. We just kind of did that for the next day. I was sleeping, but I was continually being monitored so my sleeping was really fitful. At 2:00 PM the next day, my nurses from their first shift are back. They were like, “Oh no, you’re still here and you’re not in labor and there’s no baby. What can we do?” I just said, “I’m so tired. I just have not been sleeping well. Every time I roll over, this monitor messes up the baby’s heart rate with mine so people come flying in the room and I just can’t really rest right now.” She talked with the hospital midwife who was on call that day and she really wanted to get things going. She was a little bit more nervous about the length of time my waters had been broken and was stronger with recommending inducing or something. She said, “Yeah. Let’s just get her off the monitors. We have two days of great readings from this baby. Let’s get her off the monitors. Let’s turn down the lights. Let’s get her in a new room, fresh environment, turn the lights down, and let her take a nap.” My husband even left. He went to go get a snack or something outside of the hospital just to totally give me my space. 38:47 Active labor begins Around 3:30, I finally get tucked in for a nap and fall asleep immediately. I was so tired. Meagan: I’m sure. Clair: It was just a lot of mental stress and I wake up an hour later at 4:30 to a rip roaring, super strong contraction. I couldn’t even believe it. I was like, “Oh my gosh. Napping worked.” It was just what I needed. It was like my body just needed to be left alone. Meagan: And even probably you mentally needed to just get out of the moment and just be. Clair: Yes. Yeah. No, definitely. I start timing them and within five contractions, they were all lasting over a minute. They were all about a minute and a half to three minutes apart. I call my husband. I’m like, “You’ve got to come back to the hospital right now.” They were really strong too, like super, super strong. Meagan: And keeping in mind you were 5 centimeters so you could be tipping into that transition active labor from no labor. Clair: Right? Meagan: No labor to active labor. Clair: Yeah, just thrown right into it. Yeah, it was wild. I felt like I was kind of behind from the beginning like I couldn’t get on top of it for that reason. It was really intense. I called the nurse in the room because I needed to go to the bathroom and I wanted to stand up, but I was like, “I don’t know what’s going ot happen when I stand up, so I’m going to call her in.” She came. She observed me in between some contractions and was like, “I think the midwife should come.” I was like, “No, it just started. Don’t worry. Don’t bother her.” She was like, “No, really. We should get the midwife in here.” The midwife comes in and checks me. I’m only at a 6 so I was a little bit discouraged because it had been a half hour-45 minutes of these strong contractions at that point, but 90% effaced. Baby was dropping. Everyone in the room was like, “This is really good news.” I was like, “Yeah, there is still a lot of work to do.” I just refused to accept that. So I’m kind of wandering around the room just laboring standing up in different positions and supported by a nurse sometimes, then I end up kneeling on the ground and laboring over a couch just leaning on it. The contractions really picked up. There really was not much of a break between them at all so I felt like I couldn’t release the contraction. Everything you hear is like, “Release the contraction. Let all of the tension out of your body,” and I couldn’t do any of that. So I’m telling my husband, “I need an epidural. I’m not going to be able to do this for a long period of time. I’m not getting any kind of a break. I can’t relax.” Meagan: You were already so tired. Clair: Yeah. I need an epidural. I’m not going to be able to do this naturally even though that’s what I planned. He was like, “No, you’re fine.” I was so mad at him, but he would look at the midwife, I guess I found out later and she was like, “No, this is happening.” She was really encouraging him, so he was like, “Nope, you don’t need it. We’re going to be there really soon.” Meagan: Good daddy doula, I guess, there. He knows what you want and will help you get it. Clair: Exactly. Exactly. I’m not saying he was just ignoring me– Meagan: Right, but he was like, “Ah, she’s got this.” Clair: Yeah, exactly. I guess the midwife had observed some kind of a change in me because at 7:00 PM– this is 2.5 hours after these contractions start– she checks me again and she asked to check me. I was at 10. I was feeling pushy, but not in the same way I had before with other labors, so I was surprised. All of the nurses in the room were like, “This is great news!” In my head, I’m like, “I’ve been there before. I’ve been there three times before. It is not over yet.” I was still very much in the mindset of, “No, we’ve got work to do.” I end up trying a couple of different positions to push. I end up pushing on the hospital bed kind of supported by pillows on all fours. They put the back of the bed up and I pushed there for about a half hour or so, maybe 20 minutes in. They were like, “Oh my gosh. We can see the head. This is so great.” Because of my third baby, I was just like, “That’s news, but it’s doesn’t mean it’s over.” Meagan: Not what I need quite yet. Clair: I’ve been here before. So I end up, yeah. I was just kind of like, “I’ve been here before.That’s not news to me, I guess.” But then I really felt a ring of fire and I was like, “Oh my gosh. This is actually happening. This is a new thing. This is a new sensation. This is a new place that I haven’t been before.” So I end up, yeah. He ends up being born. I pushed with all my might. The midwife had to tell me, “Chill out. Slow down a little bit. You don’t want to tear.” But yeah. It was just so beautiful. I was able to birth him vaginally and then they were like, “You have to roll over so you can hold him.” They were telling me what to do because I was in such disbelief when I was born. I got to hold him skin-to-skin for the first time of any of my babies which was such a gift. My husband cut the cord after it stopped pulsing and it was so peaceful. A couple of the nurses were crying because they had been there and were really invested in our story. The midwife was like, “You reminded me why I’m in this field. This is such a beautiful, redemptive story. I’m so happy for you.” I did have a small, little first-degree tear but it really wasn’t bad. He ended up being 7 pounds, 7 ounces so I’m pretty confident that he was late pre-term because that is still small for my babies. Meagan: Yeah, because they are normally 9. Clair: So he was definitely earlier. 45:04 Circumvallate placenta I had a circumvallate placenta which is where part of the placenta turns in on itself when it is developing so there is a smaller area where the placenta can adhere to the uterus. Sometimes that can be related to IUGR and a couple of other things, but it’s really hard to find via ultrasound. I kind of researched it later and sometimes, it’s cause for big concern but there’s really not much to do about it. There’s just not a whole lot to be done. I’m glad I didn’t know that because I feel like would have been a source of worry but unnecessary worry because there’s nothing I really would have done differently in my pregnancy. Meagan: I wonder if that was your body being like, “Okay, it’s time. I’m done doing my job. Now get the baby out.” Clair: Yeah, it can also be associated with pre-term or early labor. Meagan: Okay. Clair: Yeah because I was trying to find a reason. This was so strange. My midwife wasn’t worried about it at all. She was just like, “Oh, interesting. Look at your placenta. This is so cool.” Meagan: In all of the years of encapsulating them, I’ve never seen one like that. Clair: Yeah, it’s kind of rare but also, yeah. They’re not sure why it happens. I don’t know why it happened. Some people say babies that gestate at elevation are sometimes smaller too like at high, high elevation and they come earlier so I’m wondering if maybe that can be connected. I don’t know if there are more placenta abnormalities in that way at elevation. I don’t know. But yeah, he had great APGARs. He latched super well. It was so cool. The first OB that I had called me the next morning in the hospital room just saying, “Congratulations. We’re go excited for you.” My second OB, the one who basically said, “I think this is the right thing for you to try,” came to the room because she was on call again and she congratulated me and just said, “Thanks for letting us be a part of this. This was so impactful to everybody in our practice.” Meagan: Yeah. Clair: I don’t think they would have taken me on as a client upfront. Meagan: Probably not. Clair: For them to see this, and then I talked to the head midwife of that hospital OB/midwife practice and she was just saying that this is their hope that more women who really can labor without intervention or are given the chance to labor without intervention is kind of their goal. She was so happy that so many of the people in her practice got to be a witness to that because they really got to see what happens especially down to napping and leaving me alone is what helped me go into labor. Meagan: Yes. There was a lot of learning happening on all of their behalf, from the OB side, on the nurse side, on the midwife’s side, there was a lot of learning. What I love so much is when places see births like this after– I mean, I’m not saying the midwives or anything. I think the OBs were originally like, “I don’t think this is a good idea,” but then seeing it happen, it’s like, “Okay. Let’s take a step back,” because so many hospitals around the world just shut people out. “No.” They might not, like you said, have supported you walking in. “I’ve had three C-sections. I really want to have a VBAC.” She probably would have said the same. Maybe she wouldn’t have, though. Maybe she would have said, “I don’t know if it’s a really good idea, but we can support you and let you go.” But would it have been the same situtation? I don’t know. They are one of my favorite hospitals in that direction up north, so I love hearing, I love hearing all of this. And then to the point where the OB is like, “Hey, I recognize you are in my care, but I know you came from this care. Why don’t we put you back in that model of care because we offer that here?” Just these fine details that these providers paid attention to was a huge deal. Clair: Absolutely. Absolutely. It’s funny because I had a feeling that whole pregnancy that I was going to have a hospital VBAC. Meagan: Really? Clair: It was in the back of my head. “I think I’m going to end up in the hospital, but I also feel like I’m going to have a VBAC. I don’t know,” but it was this weird thought because I definitely was not going to pursue providers in the hospital, so yeah. The fact that that happened, I was like, “Wow. This is just so crazy for those reasons.” Meagan: So awesome. Clair: Yeah. I just really feel like not being afraid to voice what we wanted was such a big part of this because if we hadn’t spoken up, even though they were very, very willing to listen and were receptive, we didn’t know that so we went in saying, “This is what we want and this is why we want it.” I think that having a conversation where you think the doors might be closed is good to have. Now, it’s also good to be aware of when a provider is not actually going to be supportive of you, but in our case, we really didn’t have any choice. We were where we were and just to, I think, the more calm conversation that is had and the more providers can experience births like this, the more it will become normalized which is really the goal here. Meagan: Absolutely. Well, huge congrats on your beautiful birth and I’m so happy for you. I just love hearing how it all unfolded even though in the beginning and at the end, it wasn’t exactly– well maybe I guess it was something that you envisioned, but what on paper you were putting out that you envisioned this birth center birth with this awesome midwife, but I just love how it unfolded so much. Clair: Yeah. It was so healing for my husband. It was so healing for me. Yeah.” Meagan: Good. Good. Well, thank you again for being here with us. Clair: 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 . Congratulations on starting your journey of learning and discovery with The VBAC Link. Support this podcast at — https://redcircle.com/the-vbac-link/donations Advertising Inquiries: https://redcircle.com/brands