Episode 265 Amy's HBA2C + Cervical Exams

We have another follow-up story on the podcast this week! We love hearing from our previous guests and today, we get to follow up with our friend, Amy. Amy was on the podcast for episode 102 sharing her VBA2C story and now we get to hear her HBA2C story! Amy talks about her journey to embracing home birth with her fourth baby, how she found the right team, and how she worked through her fears. When labor began, Amy was steady and strong. She was ready and so was her team. Then everything completely stopped. Instead of giving in to discouragement, Amy trusted the process. Her team went home and she knew she needed rest. 10 hours later, labor kicked in HARD. Amy birthed her baby shortly after! Meagan and Amy discuss the pros and cons of cervical exams before and during labor. Women of Strength, you do not have to have a cervical exam if you do not want one! Additional Links The VBAC Link Episode 102: Amy’s VBA2C ICAN of Summit County The Lactation Network How to VBAC: The Ultimate Prep Course for Parents Full Transcript under Episode Details Meagan: Hello, hello you guys. We only have a couple of weeks left of 2023 and it is blowing my mind. I cannot believe how fast the year has gone and how much has happened. I hope that you have had an amazing year and are gearing up for the holidays. I definitely have had a good year and am not ready for the holidays. I’m never ready for the holidays. It is always a crazy hustle and bustle. But I am always ready for a new episode and story to share. Today we have a special episode. I feel like this is a fun one because we like follow-ups. It’s really fun to sometimes have follow-ups. We have an HBAC after two Cesarean births to share with you today. I’m going to let our guest tell you more about her births and I’ll give you a little bit of a preview, but Amy, is it 102 what you said? It’s 102. Amy: Yes. It’s 102. Meagan: So episode 102. If you want to go and hear more, she’s got four babies you guys. If you want to hear more of the other babies’ stories, definitely go check out episode 102. Review of the Week But of course, we have a Review of the Week so we want to get into that. This is by meganlindsayyy . It says, “The support that I needed.” It says, “After my C-section, I said I wouldn’t even consider getting pregnant again unless I was guaranteed a VBAC. When we were surprised by our current pregnancy, I felt like I had already lost control and a say in the outcome. I immediately went back to my same OB and hoped for the best. Something happened when I was about 20 weeks pregnant. I wasn’t able to sleep. I got up at 4:00 AM and I began researching how to have a successful VBAC. That was the morning I found Meagan and Julie on Facebook. I was listening to their podcast later that day. By the evening, I knew that I had to totally change my plans.” Ooh, that just gave me the chills right there. It says, “I was going to let my birth happen to me.” I was going to let my birth happen to me. That is so powerful right there. Women of Strength, you do not need to let birth happen to you. You can go and you can birth and you can be in control of a lot of things in your birth. It says, “Because of these women I realized that I have a voice in what happens to me. I switched my provider and hospital and am in the process of hiring a doula. I am creating a thought about our birth plan. It is because of these women that I feel confident to go for my VBAC.” Well, meganlindsayyy , I am so happy that you felt that you were able to find your voice again and find your power and take control of your birth and not let birth happen to you. This was back in 2022 and here we are at the end of 2023 so meganlindsayyy, if you are still listening, please let us know. How did things go? How did your birth go? I hope that it went really well and that you felt empowered no matter how it ended. You too, Women of Strength. If you are in a situation where you are not feeling that support and you’re not feeling the love, know that it is okay. It is okay to do what’s best for you. If that’s leaving a provider or switching things up birth location-wise, that’s okay. I know it seems daunting. It is. It is daunting. I did it myself at 24 weeks, but it is so worth it usually. Of course, if you haven’t had a chance to leave a review in the 2024 year, we would love to bring in some new reviews. Go over to Apple Podcasts or Google Play or you Android users. I don’t know. Google whatever or you can actually Google “The VBAC Link” and leave us a review there. Amy’s Stories Meagan: Okay, cutie pie. I am so excited to have you back today. So, so excited. I’m so excited to get into this story, but I also want to talk about something that we are going to talk about at the end. I know that this kind of goes into your birth about cervical exams. I want to talk about cervical exams. What do they look for? What do they do? What do they tell us? Are they necessary? And all of those things. We are going to talk more about cervical exams at the end, but I would love to turn the time over to you and your cute little baby. You guys, if you hear the cute little baby noises, we’ve got a baby on the show today. Amy: We do. We’ve got a wide-awake 6-month-old. Don’t mind the squawks. Well, thank you so much. Obviously, I’m incredibly excited to be back. I didn’t think that was ever even going to happen. If anybody has listened to my first episode, at the end of the episode, Julie was cheering on our husband. She was cheering on us both to have a fourth baby. It was a joke between you and I and it was an ongoing thing in our home. My husband would call it nagging. I just called it persistence, but here we are. Honestly, I really didn’t think I was going to have another baby so I just feel incredibly blessed, excited, and just really happy to share another story. I’m just really hoping that this story can help somebody else who maybe is feeling some fears about a VBAC or a home birth or any part of my story. I feel like there is a lot of different kind of factors that play into it, so thank you for having me. I’m super excited. But yeah. I guess I’ll get started. We know that with every VBAC story, we start with our C-sections. Like you mentioned and I mentioned if you want to hear the full two Cesarean stories and my first VBAC after two C-sections story, check out episode 102 because there are some long, detailed stories. I’m not going to go through them all, but I do think they are important just to hear how I got to where I am today because each birth and pregnancy really builds upon the last. My knowledge, my passion, and just all of the information I learned played a role in my decisions for the next one. So just a real quick birth history. Gosh, it’s been almost 10 years ago. My oldest is 9.5. I will go back to 2013. I really did plan the most natural delivery possible with a birth plan but I didn’t have a doula. I was induced at 41.5 and on Pitocin for 30 hours. Two epidurals, every drain and tube and monitor coming out of me that could possibly come out of me even though I really wanted none of it and then after two hours of pushing, the covering OB came in and said, “We should have done a C-section hours ago.” I gave up. My body just– you know, the adrenaline kind of left my body and I said, “That’s fine. Whatever.” She was 10 pounds and probably OP. I started planning my VBAC in the postpartum room. Let’s fast forward a couple of years. I switched providers and thought she was VBAC-supportive. It was a little bit of a bait and switch and some scare tactics at the end. I ended somehow in a scheduled C-section at 40 weeks and day with no TOLAC. I didn’t really realize it was insane until I met my next provider, but her C-section was straightforward. It was really nice to have a C-section without the labor and 30 hours of Pitocin, but I just didn’t feel like honestly, that was even a chance at a VBAC. She had some big baby fears because she is VBAC-supportive with other people so that was hard to learn about after the fact. My second, Delaney, which is my Delaney. I know you have a Delaney. She’s 7. My oldest is Adeline and she is 9.5. My second is Delaney and she is 7. She was my “scheduled” C-section, but I kind of look at her as a CBAC because I really, really did in my heart plan for a VBAC. She was 9 pounds and 3 ounces so also larger. Fast forward a couple more years. I switched to yet another doctor, kind of the VBAC king in the area. I did all of the research and all of the prep, the chiropractic care, and did all of the things, right? I got a doula and I did have my– which is when I was on the podcast– VBAC after two C-sections just riddled with a lot of interventions after getting to the hospital. The most significant one was him breaking my water at 4 centimeters when I got there for really no apparent reason. Baby turning OP, pushing for an hour, and then it was a forceps assist. I think while it was empowering and it was really life-changing, I think after the fact as I thought more about it, I did this big mental dump on my computer even though I assumed we would never have another baby. I did this big document of what I would do next time. It’s really interesting to look back because I did it pretty quickly after the birth. Not necessarily regrets, but how I would do things differently even down to the first trimester. Meagan: I actually think that’s really powerful. Amy: It was. It was helpful. Meagan: I really think that’s great. Amy: I’m glad I did it because I did look back at it and it was interesting to look at. Although it was a VBAC, and I will say I still feel really blessed and I do think it paved the way physically and emotionally to have another baby vaginally, I didn’t really have those healing moments that I was hoping for. That was really hard for me because the NICU team whisked him away. It was a boy and that was the first gender we didn’t know. It was really special to have two girls and then a boy. He was our smallest baby. He was 8lbs, 12 oz and I think he was 41.4 but I didn’t get to hold him after. I didn’t get to do the golden hour. I didn’t get to do immediate skin-to-skin. He did spend an hour in the NICU for observation which was hard. I was happy he was healthy but with a forceps assist and an OP baby, I could have had a lot more damage than I did and I only had a second-degree tear which I was very grateful for because it could have been a lot worse. But he was fine and we were healthy and I healed well. It was a really great postpartum period and the hormones were real and the birth high is real. That really solidified my passion for birth and what I wanted to do moving forward. I met another mom through my same OB because everybody flocked to this OB. She actually recorded a podcast episode around the same time as me, Tanya. I hope it’s okay if I share her name. We actually ended up through meetings and through our VBACs starting an ICAN chapter in our community in November of 2020 amidst the pandemic. We went through the ICAN leadership training which was really exciting. We now have an ICAN chapter that’s been going pretty strong now for about 3 years and we have just grown our passion even more and connected even more to the birth community. So yeah. Those are my three stories in a nutshell. Meagan: Tell everybody how to find that ICAN chapter in your area if they’re listening. Amy: Okay, sure. I wasn’t sure if I should share the details. ICAN of Summit County. I live in the greater Akron area. We serve the whole Summit County area. There is also a very active, large ICAN chapter in Cleveland which is one of the longest-standing ICAN chapters or the longest-standing which is really neat. That is the chapter we started going to and it really helped us. We love having our own chapter here. We’re growing but juggling a lot of babies. I had to take some pauses at times, so that’s been really exciting and has really just helped grow our passion and desire to keep doing this kind of work. Yeah. Through all of that, I still kept listening to podcasts and just devouring everything I could. I had plans to become a doula and just hadn’t been able to pull the trigger yet, but have always had this hope that one day I will be able to help other women. As the years went by, I still didn’t feel like our family was complete, but I do want to add that I know a lot of women deal with this so I want to speak to this because sometimes, I think that maybe women are not afraid or ashamed to talk about it, but I did struggle with the difference between if I really wanted another baby or child and do I really want another birth experience to do differently. I’ve heard other people talk about that. I’m glad I took quite a few years to trick my husband into having another baby, no, to get pregnant again because I wanted to make sure that I was doing it for the right reasons. But yeah. It was tugging at my soul and I think he was unofficially done. Around comes Mother’s Day 2022 and I conceived baby number four and that was the best Mother’s Day gift ever. That’s where the story starts. I think always in the back of my head, I daydreamed and dreamt of this home birth plan. I said, “That’s a dream of mine that will never happen because of my history and because we’re not having any more kids and because my body probably can’t do that. I’ve always needed an epidural. XYZ.” I had my birth team planned in my mind for years even. This is what I’m going to do if I get pregnant again, but I never thought I’d actually have to commit to that. Along comes this pregnancy and we’re super excited about it. I started my OB care with the same doctor who is extremely supportive. I knew he did co-care for home births just from talking to other women. I went along with my pregnancy. It was textbook. I tried to stay as active as I could. I wasn’t as sick this time, so I was just trying to really stay healthy and do all of the things right that I could because I know that I have big babies. I don’t know if my weight gain plays into it, but I tend to gain a lot of weight every time no matter what I’m doing. With my son, he was the smallest and I had been running the whole pregnancy, so I thought, “I’m going to try to have another smaller baby.” I continued with OB care. I didn’t do all of the VBAC things. We have the lists, right? The Spinning Babies and the red raspberry leaf tea and the dates and stuff. I had three kids and I was working. I didn’t have time to do all of the things, but I really tried to prioritize what I thought was most important. I tried to start early by interviewing as many doulas as possible and really trying to find somebody who would really be the best support for me whether I was in the hospital or at home because I still hadn’t committed even though I knew in my heart I really wanted to at least try for a home birth. I interviewed a lot of doulas. I found one who was spectacular. She wasn’t necessarily the most experienced years-wise, but I was okay with that because of some great reviews from friends and we just really clicked. She was comfortable with the idea of home birth or hospital birth and I know not all doulas are. I think that is one important thing to take into consideration. I did start Webster’s chiropractic care pretty early because I knew the only time my body ever went into labor on its own was with my third, my VBAC. For me, that was a really huge thing. It was a really huge deal to know that my body wasn’t broken because it never went into labor with my first two. Thankfully, that wasn’t really a fear of mine anymore because I knew it could be done and I knew it could happen. The other thing that I really did was I wanted to do some mental health work around some of my fears and anxieties to try to really figure out if I was nervous about a home birth because my intuition, like you talk about, had a fear that something was going to go wrong medically or if it was just anxiety. I worked a little bit with a mental health therapist and it was just nice to talk it out. I worked through those things and what my hesitations were and why and what my fears were and why. I really do think that helped a lot. Meagan: Do you have any tips for our listeners that your therapist gave you to help recognize fear versus intuition? Do you know what I mean? We talk about this a lot on the podcast. Amy: She probably gave me tools and I have an awful memory. There were some charts she wanted me to make, so I’ll have to find those and send them to you, but it had to do with working through the root and then figuring out the why and not so much– I just had a weird fear of having a really catastrophic emergency. I don’t know if that’s just because I’m a nurse and that’s where my mind goes or if because people tell me that it’s so dangerous, so then I finally worked through that by looking at statistics and listening to all of the stories and realizing that it isn’t an irrational fear but that we needed to come up with a plan. We had all of the different plans set in place for that. But yeah. I’ll have to see. I’m sure she had some. I probably didn’t do the homework, but she probably had some exercises for me. Meagan: I think you did. Amy: Yeah, I guess in a roundabout way. It helped to talk to someone who is not your partner and not your mom and not your coworker. So yeah. We did the prenatal co-care. He was on board with the home birth plans as much as an OB can. He was really great in that sense, but I was dragging my feet to make a decision and I think this is partly my procrastination and partly my not-commiting to the idea because then I wouldn’t have to do it. I interviewed a lot of midwives and around 28 weeks, I hired a midwife and the medical professional in me decided to go with a CNM. In Ohio, laws are different everywhere, but certified nurse midwives are the nurses who have the nursing school and a master's degree in nursing. Most of those do not practice in the home birth setting in Ohio. Those are the midwives you would get in the hospital and we do not have any free-standing birth centers sadly, so we just have very few options here. But there are about four nurse-midwives now that do practice home births or come to the home. So I hired one and she was really wonderful. I kind of knew her a little bit personally through another friend. I had my first visit with her and I was feeling really excited. I had my doula hired. I had my photographer hired who was a home birth mama herself times two and I loved the idea that she also would just really understand the space and what I needed. She wasn’t just a photographer. She was like another doula through my whole pregnancy and she was wonderful too. Unfortunately, after my first visit, we waited about four weeks to see each other again, and then the day of that visit, she let me go as a patient over the phone unfortunately due to some things she read in my records. It’s frustrating because she really knew my history really well and I gave her this huge stack of records to be nice. In the op report, it talked about the uterine window which we all know is a little bogus. I understand why she was– Meagan: I had that too. Amy: Yeah. I wonder if she had never seen that, but who knows? I do feel that things worked out the way that they were supposed to but the only reason it was difficult was because I was now 31 weeks and you don’t want to have to change providers that late. I respected her and I would rather have someone who was 110% comfortable anyway. The other CNMs in the area, I will say, wanted to do continuous fetal monitoring at home. One wanted to put in a hep lock at home. They are just a little bit more conservative because of, I think, the climate in Ohio and their license which I totally understand. It worked out for the best in the end. But I raced to interview a couple more midwives and thankfully, one that I had heard of but never talked to, we clicked instantly. My husband talked to her. He told some kind of joke about a uterus and she laughed then he hired her on the spot. We fell in love with her. She is just amazing and we just instantly clicked and I knew she was my person. I continued my care with her. That was 33 weeks on and her office was an hour away. That was one of my hesitations originally with some people up north was the distance. I did some co-care with my OB and with her. Then at 37 weeks, my OB who our whole area just adores, and beyond. Women drove to him from other states. He was unfortunately let go from the hospital. I don’t know the details. I hate to say the word fired, but yeah. Terminated. It left a lot of women. It was really devastating for the birthing community up here in northeast Ohio because a lot of women go to him for breech deliveries, twin, triplet vaginal birth. You know, the renegade of the hospital who is kind of operating on his own accord. He would go to home births and a lot of women would never have even been given an option to have a vaginal delivery without him. It was really heartbreaking. Meagan: One of the most supportive people at birth was let go for whatever reason. Amy: Yeah, unfortunately. There were a lot of tears shed by a lot of people who had delivered with him and who worked with him. Anyway, I don’t want to get too caught up by that, but it was really upsetting for somebody whose hospital transfer plan was an amazing OB. I had all of these birth plans written out and now, my non-urgent hospital transfer– I didn’t really have that option. To me, I’m like, “Well, there goes my home birth because what if I need pain relief or whatnot?” I did transfer to the local hospital midwife group in the hospital about 2 miles down the road in Akron. Thankfully, I delivered my first with them and they had records. They were really wonderful when I went in at 39 weeks saying, “Hey. I had co-care for a home birth.” Even this one OB walked in and I got so nervous because it was supposed to be a midwife. She was running behind and this OB walked in. I’m like, “Oh crap.” The OB just goes, “What do you need from me? I see you are planning a home birth.” I almost cried on the spot because it was wonderful to have this fresh out-of-school OB be okay with that. I’m like, “Thank you so much for that. I really needed that today,” because I am 39 weeks. The end of the pregnancy went fine. I did all of the things, some Miles circuits. I didn’t go crazy with the dates or the tea or anything. I tried to stay active. I didn’t have as many Braxton Hicks as I had in the past, but I definitely had the heavy pressure in the pelvis. I could hardly walk and everything. I felt really low this time and a lot of back pain and hip pressure and hip pain this time. I tried not to focus on the when. When is labor going to start? You can get really obsessive with that, especially when you are known to go over too. I tried to stay really present and be there for the kids and enjoy those last days. I did begin to lose my mucus plug at my midwife’s office which was really funny at 39 weeks. I’m like, “What is this?” She was like, “It’s your mucus plug.” I was giving a urine sample. I’m like, “Oh my gosh.” Things were starting to brew a little earlier which was really exciting. I started having some mild contractions and then I think I was– so let’s see. I was due on February 2nd. The actual early labor contractions that were noticeable started on a Monday. I was 40 and 4. My parents were over for dinner and they were consistent enough. I was just getting irritable so I went up to my room. I excused myself from dinner. I’m like, “I’m going to go lay down.” That was my first day off work. That was a Monday. My last day of work was the previous Thursday. I had gotten a manicure. I’m like, “This is going to be a pampering day,” which was maybe helpful I think. I think a day of rest really did help my body switch into gear. I know that everyone says to rest and that it will happen when it’s time and it did. So yeah. Contractions kind of started kicking up that night. Something of note with my first VBAC, so my third birth was that my contractions immediately went to 1-2 minutes apart and that’s why I went to the hospital so early. I was like, “Don’t call everybody in too soon. You know that this is how your body is in early labor.” I took a shower and I rested. I was just out in the sunroom which was my happy spot in our new house. I think I was watching The Bachelor which was ridiculous but I was like, “Okay. If I can still watch TV, it’s still early labor.” It went on. I texted my team a little bit, but just said, “Hey, I think things are brewing. I had some bloody show around 8:00 PM, but I’m going to just keep doing what I’m doing and resting.” So I think it was around 11:00 PM that I could no longer watch TV or want to so I was like, “Okay. I’m going to keep everybody updated, but no reason to call in the troops yet. I’m going to let my husband sleep.” I think I did text everyone around midnight. Contractions were 2-3 minutes apart. They were definitely getting more painful. I was still breathing through them, but just getting nervous because my midwife was an hour away. I think my husband woke up around 1:00 AM and urged everybody to come over. Everybody got there around 2:00 AM. This was 2:00 AM on Tuesday morning, so February 7th. It was the day she was born. My doula got there first. She kind of just stayed by my side. She did hip squeezes and rubbed my back. She was just super wonderful and supportive. Everyone, as they came into the house, just let me be. What I love about home birth is that they don’t disrupt you. They hold the space for you. They are quiet and respectful of your environment and just check on you when they need to. They take your vitals every so often, listen to the baby’s heartbeat, and really, they just hung out in my living room until I needed them again. I just labored up in my bedroom for most of the night. I took a lot of showers. It was a lot of leaning over the bed and hip rolls on the ball. Nobody ever checked me, so talking about cervical exams. I never really thought about it and they never asked. It would have been interesting to know where I was through all of this, but yeah. I never got checked once during the whole birth. That was, I think, really cool in the end. Everybody filed in around 2:00 AM and stayed through most of the night. Then around 9:00 AM, I went downstairs to see my older kids. They stayed home from school because they were up throughout the night too coming in and out of the room. I really did want them there for the birth. They were really interested and I thought it would be really special. But when I went down to see them, everything stalled and fizzled out completely. I guess I just didn’t think of this as an option. I was really in it, I felt. I was having painful contractions that were coming regularly. I was really having to work through them. Everything died down. I had some food. I said goodbye to them. My husband took them to my mother-in-law’s for the day. We just thought I was going to rest. I went on a walk with my doula. We did some curb walking. I felt huge pressure to get things moving faster because my team had been there since 2:00 AM. I was doing the thing. We were here. I thought this was the real deal and then it fizzles. I finally had this talk with my midwife. I think I was naked or maybe in a robe after getting out my one of my million showers which I loved the shower. She was like, “Let’s just regroup. Let’s just have a chat. I think you need to–let’s just reset. I think we need to get out of your space. Things are happening. You’re doing the work. I don’t doubt that, but I think you just need to rest.” I’m a people pleaser and I wanted them to go home and get some rest. The whole team stayed there for 12 hours. They have babies of their own and they were amazing. She said, “I think this will be good for you.” I had a big cry. That release, I felt so guilty that they had all been there. I felt like maybe this was a false alarm and I just had everybody come over for no reason, but in the end, it was good for us. We had a rest. We napped on and off and ate some food. He’s smearing blueberries all over my shirt. We ate some food, took some showers, and just hunkered down just my husband and I. I think it was really good for us to just have some time. I was napping on and off and my husband decided to take some clothes to the kids at my mother-in-law’s house which is about 20 minutes away. Around 7:00, my mom and dad came over. He planned this behind my back without bothering me. I was like, “Okay, whatever.” My mom had talked about being a deliveries in the past, but it just never felt like the right time. It never really felt right to have someone else in the room. I said, “Whatever. She can sit with me. That’s great.” She was just sitting in the corner quietly of the room and I was resting and then all of a sudden, 7:00 hits. My husband is still gone and I am just like, all of a sudden, contractions come back out of the blue super strong and powerful. My husband Facetimes me with the kids a little after 7:00 and then all of a sudden, I had this giant contraction. I threw my phone out of the bed and yelled, “I can’t talk.” I felt really bad. I just managed to text, “Come home now. Not doing well,” or something like that. I just didn’t even know this could happen where you could labor, have this break, and then it could just shoot you right into active labor, transition. He comes home as fast as he can. My mom is in the room. God love her. She’s a nurse by trade of 50 years. Never in OB and she was just like, “Okay. Do you want help? Do you not want help?” Finally, I’m like, “Rub my back or something.” I couldn’t really talk at this point. It really went from 0 to 100. She was doing hip squeezes as best as she could. We’re getting myself in and out of the tub a couple of times, having to keep putting new hot water in it. God love my mom with her bucket of water and we’re doing it. It was just me and her here. I think I texted the group, “Can’t do this much longer,” to the birth team but not much information got relayed to the team. No one’s fault, it was just a lack of communication between me, my mom, and my husband who was the communicator. Things are getting pretty hard. I’m very vocal and my contractions are back-to-back. My back is just killing me. I think at this point, my husband is home. At 7:40 at night, he’s home. He’s moving cars to the neighbor’s driveway. I’m in the water at this point and there was a pop in the water. I knew from past episodes of other birth stories that that’s when your water breaks in the water, Amy. I didn’t want to believe that was happening because my water has never broken on its own. It was broken for me. This never gets relayed to anybody. My mom was like, “I knew you were probably in transition, but I just didn’t tell anyone.” I’m like, “Okay,” after the fact. Then I was vomiting too. That never got relayed to the team. They’re asking my husband, “Are here contractions different? Has she tried an Epsom salt bath? Where are they located?” I’m looking back at the texts and he’s like, “She’s not answering. They’re different. She wants to be checked now.” I feel like I was yelling but I was probably whispering. At that point, I was like, I need to be checked now because if I’m not very close, I can’t do this anymore. A lot of things, I think I verbalized but they were probably in my head. I was like, “I need an epidural. This isn’t going to happen soon. Get me to the hospital.” I was just– Meagan: Well, that’s what happens in the end. We have this sense of, “I can’t. I don’t want to. I’m done,” but that’s the end. Amy: Yep. Yep. I’m not going to sugarcoat it. It was pure misery and it felt like my bones were breaking but I was trying. I was relaxing my body as much as I could because I knew I needed to. I was in the tub for most of that portion. So I was definitely in transition and nobody knew. I think my husband called my doula and just recently, she said, “I heard you in the background and I grabbed my keys and ran,” because I think I was doing the low, birthy moaning but no one else. I just never thought to call my midwives because in those moments, I couldn’t have even thought straight. I wasn’t thinking to text or call anyone because I was just trying to survive in that primal birth state. She was like, “I sped so fast.” God love my doula. She walks in the door first. I think it was 8:45 at this point, so 7:00 PM was when everything kicked up fast. She walks in and she was really just doing all of the comfort measures she could. I was in the water. I think all the other birth team started heading over. My midwife had an hour drive and she got stuck behind a train. The midwife assistant, who was hired because she lived more in my area which is great, happened to be nearby at a basketball game for her son so she headed over to “check” me. It’s important to note that when they were there the first time, they had all of their equipment, but they packed it all back up and took it home. So when she comes upstairs to check me, she has a flashlight and a doppler, maybe a pair of gloves in her pocket. I never get checked so that’s the end of that. That story ends, but she heads in and our photographer gets there at 9:45. One of the heartbreaking parts of my VBAC was that my photographer left the hospital during my epidural and never came back. I was very heartbroken that I didn’t have photos. God love my photographer. She made it just in the nick of time. She shows up and she also had an hour drive and a baby of her own at home. She gets there at 9:45 and at this point, I think I’m just up to the bathroom a lot. I couldn’t stop going to the bathroom. TMI, but pooping. I just remember the midwife was dragging me off the toilet. She is very direct and I didn’t know her that well. She is a midwife in training also thankfully, so she is very close to the end of her midwifery training thank God, but she was like, “We need to go. Come on, honey. It’s okay if you keep pooping. Come on. Get off the toilet now.” I was bearing down. I didn’t know it, but I was definitely having fetal ejection reflex at that point. I think I was still in denial that it was the baby. I was doing these grunts and moans. I just think I was still like, “Oh, I’m probably 6 centimeters.” I didn’t want to let myself down. I still had so many fears of, “Am I going to end up in the hospital for pain relief? Am I going to get to 10 centimeters? Is the baby going to be OP again?” and all of these things. I get back in the tub and it’s all very blurry and fuzzy at this point. But piecing together from what people told me in texts, I know she said to reach down and see what you feel. I said, “It burns.” I was like, “Oh my gosh, it burns.” She was like, “Well, what do you feel?” I was like, “I don’t know what that is. It’s fleshy.” In that moment, I thought it was a butt. I thought, “Oh my gosh. This baby is coming out breech. My midwife isn’t here yet and I’m at home.” I think it was the head. I don’t know. I really didn’t know what I was feeling. I was kind of afraid to touch it. Meagan: Probably cap it or– Amy: I was like, “What is this?” I guess we knew it was close. She’s trying to look with a flashlight. I really did think I wanted a waterbirth, but I guess I wasn’t in a position that the midwife assistant liked because I kept liking kneeling where I was giving no room for the baby to come out. She kept going, “You have to lean forward or sit back. You can’t kneel like that because the baby can’t come out if you’re sitting on your leg.” You know, whatever. We decided to get out of the tub which was very hard to get up over that edge of the tub. For anyone who has seen my birth video because I had posted it to the group, they helped me out of the tub. It was very difficult and very miserable. I made my way to the side of the bed. At that point, I think my body is pushing and I don’t even realize it. I don’t remember if there was pain. It’s all kind of a blur. It was just all very intense. I know that from photos, I was squatting next to my bed with my arms around my husband’s neck. He’s holding up all of my weight. They said that I was pulling him over. He is 6’1”, 250. I’m 5’5”. I was a maniac, pulling on him with all of my strength. I birthed her head next to the bed and I honestly don’t remember feeling it. I do not remember any crazy pain or anything. I think I was just so in birthland. Her head comes out and I just remember my body shuts down. No urge to push. No contractions. I’ve heard other people say this, I think, on your podcast so it felt very validating to hear this. Everybody was like, “You’ve got to keep pushing.” I really didn’t want coached pushing. From the hospital, you get yelled at to push, push, push. But she was like, “You’ve got to push. The head’s out.” I just remember it being very– not scary, but just very urgent and very matter-of-fact. “We need you to push.” Meagan: “You’ve got to do this.” Amy: Yeah. “You’ve got to do this.” By my husband, there’s a small spot next to the bed. You always birth in small spots. My husband is behind me. My doula is next to me. My mom is somewhere in there. The photographer is across the room. I just instinctively rolled onto the bed. You have to remember, there are no chucks pads down. We are not having a baby on a bed right now. We aren’t planning for it, so I had a mattress protector down, thank God, but no chucks pads. I rolled onto my side. My leg was up in the air, and at that point, it gets a little intense because the midwife assistant was by herself and they do like to have two people there. The resuscitation equipment is not in the house. There is nothing to help me or baby if anything goes wrong. There was some intensity in the moment and she did tell my mom to put a timer on the clock and that after 60 seconds, we were going to call EMS. When I heard that, when I heard her say– So 60 seconds does go by and thank God, my mom is a nurse but nobody knows she’s a nurse. The funny part is that nobody knows that she was an RN of 50 years and on the other side of the house, my dad, I didn’t know he was there. He is a physician by trade, retired. Nobody knows any of that so it was funny after the fact. Funny, but not funny. Comical, after the fact. She’s like, “Put 60 seconds on the clock.” I think it is a conservative amount. I know the head can be out for longer, but I think coloring and other things factor in. So as soon as I heard my midwife very calmly– and everything was very calm I have to say. It was the most beautifully handled situation. I never felt scared. I didn’t feel traumatized after, but she very calmly said, “Please call 9-1-1,” to my mom which has to be hard for a grandma who was supportive of home birth– I know my mom and dad were supportive and I know my dad especially was concerned from his background. I know they had a lot of questions and they trusted me and my research. I live really close to two huge, big hospitals, but that had to be really scary. When she did it, she did great. She went downstairs to open the doors for EMS and she missed the baby being born because when I heard, “Call 9-1-1,” I gave the most roaring push my doula called it. I scream pushed and my midwife did go in and released her arm. Meagan: She had shoulder dystocia, right? Amy: She did have shoulder dystocia, yeah. I guess technically it was a dystocia if I don’t know. I felt like I needed to know and I’ve done a lot of research of was it really? Could I have changed positions or was it rushed? In the end, I think we’ll call it dystocia because she went in and she helped, but she popped right out with a little bit of assistance. By the time my mom got upstairs from opening up the door, baby was born. It’s all such a blur. I think she needed a little stimulation. Her coloring wasn’t perfect coming out, but I don’t think there were any concerns. Her APGARs were fine. We just stimulated her a little bit. She started crying. Everybody had this huge sigh of relief because we didn’t have the equipment. My midwife still wasn’t there yet. She did a beautiful job and I’m just forever grateful for her skill set and the fact that she knew how to handle it. I love that my story can show people that situations can arise. I don’t want to say emergencies, but tough situations can arise where these skills are needed and these midwives are wonderfully trained. EMS walks in and they see this baby that is crying and pinked up. We’re all laughing and happy and riding the birth high. They’re just like, “Okay, you’re good here?” We’re like, “Yep, we’re good.” They’re like, “Congratulations.” They left. They did not. They said, “We would rather deal with a gunshot wound than deliver a baby.” They had a cord clamp. They were like, “Do you need a cord clamp?” We’re like, “No, thanks though.” That was all they brought with them. It was cute. There was apparently a line of men down my steps, nine EMS, two squads, three guys– Meagan: They didn’t need anything. Amy: No. I’m glad they responded. It’s not that I wanted that to be a part of my story necessarily but it was what needed to happen and she felt that she took the steps she needed to feel comfortable delivering on her own. It all ended up wonderfully. Things can go wrong with shoulder dystocia, so I was very blessed that she came out as well as she did. I didn’t have a tear. I had maybe a first-degree tear which was great. She was 9.5 pounds so not my smallest either, my second biggest. We found out she was a girl and yeah. The rest is just the beautiful postpartum bliss. My midwife shows up, I don’t know. She was born at 10:10 PM. The midwife shows up at 10:25 totally bummed because you don’t want to miss it. I loved her and we had such a great bond. I’m so glad she was there with me a lot of the day. She was just, there was just so much joy in the room. They did all of the postpartum stuff you do at a home birth. They weighed her and measured her. We latched. My placenta– I’ll go back. My placenta, I love that they don’t rush it in home birth. I stood up. They were like, “Maybe gravity will help.” I had cramps. I wanted to get up and take a shower. We just crack up because I walked a few steps across the room and my midwife, God love her, had this chucks pad under me because I’m sure I was bleeding and dripping. I gave this little cough push and midway walking through my room, the placenta just plops out like rapid speed. It drops the chucks pad down to the ground. It lands on it. We all start cracking up. We might have named it my plopcenta. Meagan: Plopcenta. Amy: To this day, my daughter still calls it that. But it was hilarious. It was kind of fun. So that happened. I took my shower. She was here. I still couldn’t believe it went down that way and that my mom was there for the birth even though she never was really planning on it. Yeah. I’m sure there are so many details in there I missed, but I’ve been talked forever. Literally, it was just going from thinking you have this scarlet letter of big babies and C-sections and OP babies to– I don’t know. It was really fast. From 7:00 PM to 10:00, it all happened really fast. Meagan: Yeah. Amy: With hardly a push, maybe two coached pushes at the end there with a little bit of help from a midwife, but yeah. It’s wild how each delivery is different. I’m just really grateful that I had the team I had and trusted myself and body and the process and yeah. We’re just really grateful. In the end, it was beautiful. Meagan: I am so happy for you. So happy. And look how beautiful. I know everybody right now can’t see her, but she’s so beautiful and so darling. With having EMS and stuff like that involved, that a lot of the time can have trauma involved with that too or maybe for future kids, maybe some people will say, “Oh, well this had to happen last time,” and maybe question you doing home birth. Do you have any tips for anyone? Like you said, “It’s not necessarily what I would have loved to have happen, but it happened and it was fine.” Amy: I think I had to debrief a lot because I’m the type that wants to know why. So kind of what happened with my first VBAC, I felt really victorious, then as I started nitpicking the birth and all of the interventions, I kind of had a huge dip in my mood and got really upset about it. I have to work through it and go through all of the details. With this, I remember saying it out loud. I really didn’t feel like it was traumatic. I really had to think about the why and why they were called. I felt like it was– Meagan: Extra precaution, yeah. Amy: I said to my midwife after the fact– she’s been catching babies for 10 years. I said, “Would you have called at 60 seconds?” I just don’t know if she can answer that without having been there because I think you do have to look at baby’s coloring. I think they can tell by the cardinal movements as they are coming out. I don’t think she was turning as she was supposed to. She wasn’t turtling in, but she wasn’t doing the cardinal movements that she was supposed to. I don’t know had there been two sets of hands if they would have been called that soon. Maybe we would have gotten baby out before, but I’m actually just really grateful they called and I have to reframe it that way. Maybe working with a therapist if you felt like some of the things that happened weren’t necessarily healing or what you wanted. Yes, you love blowing raspberries. I just thought of it as, “Hey.” Some of my medical friends that I work with or colleagues who thought home birth was so dangerous, look how proactive they were. There are some midwives who think they can do it but they don’t help at the right time or they don’t transfer quickly enough. My midwife always said, “I will never second-guess your intuition. If you say that you need to go to the hospital, I’m going to follow your guidance. We’re never going to risk anything and we’re never going to cut things close.” That’s why I felt so comfortable with this team. I had an emergency transfer plan and I had a non-urgent transfer plan. Everything was spelled out very nicely. I knew they weren’t going to push the limit. Meagan: Yes. Amy: I just had to tell myself that she didn’t have resuscitation equipment. She needed extra hands. When I went through the postpartum follow-ups, they were so wonderful. They come at one day. They come at three days. A lot of that was very therapeutic for me to talk about the why. I didn’t even realize at that time that she was born that it was one of the reasons. She really didn’t have anything with her. A lot of it was in her trunk because we weren’t planning to have the baby that quickly. I think I had this long, drawn-out early labor phase and that’s just how my body was in the past. In my first two other labor, I went from 4-10 with an epidural in an hour. I think my body does this pause until I relax and then I go real quick. That’s just how it has been with the other two. So yeah. I think if you have some parts that might– and it’s okay for parts to be traumatic. It can still be a beautiful birth if there are parts that don’t go perfectly as planned. I think that’s one of the things I had to work through a lot, but it was just still very healing. I just had to look at the why. That’s how I got through that part. I didn’t love sharing that part at first because I didn’t want people to say, “I told you so,” from some of my more medically-minded friends and colleagues. I think shoulder dystocia is scary, but I think after hearing some other birth stories, I feel like, some doctors aren’t even as skilled at handling dystocias as the midwives are or they jump to way more intense interventions because they can and midwives have to have the skills. Meagan: I just love that you did. I love that you did share that because it’s not your traditional– it’s what people fear when they have home birth of having to transfer and EMS. That’s what I noticed is that I love that you were like, “I had to break it down to the why and not let that make it be traumatizing.” She really had nothing, so she was only being the smartest midwife she could be in case this little baby needed help. She knew that this other midwife wasn’t close and couldn’t make it to her in time, so she got the help. I love that you pointed that out because really, most emergencies can be handled within an appropriate time. I know that there are always nuances, but I love that you are like, they got there and were like, “Are you good? Okay, bye.” Amy: I know. I mean, yeah. I always had a little fear of hemorrhaging even though I never had. I had a little fear of, I don’t know, other major things like a dystocia or malposition where I’m not going to be able to push baby out because in my past, I had it and I think it’s important to know that having an assisted delivery for my third, for my first VBAC, really cut my confidence down. Meagan: I’m sure. Amy: It really made me not believe in my body and I kept going, “Well, I really didn’t push the baby out myself last time,” because he really did jump to interventions really quickly for whatever reason. He pushed the time clock. So I kept going to my midwife like, “But I don’t really have the ‘proven pelvis’ because I really didn’t push that baby out myself. They helped him out.” I don’t know where I was going with that, but I think– Meagan: Well, it placed some doubt. Amy: Yeah, it did place doubt. Meagan: It placed some doubt and that’s hard and then you went and totally– the proven pelvis thing, it’s like, no. You did. You’re amazing. Amy: We did it. Yeah. She came out really, really without too much effort. You could see the midwife assistant helped her arm out, but really, we got her out. Meagan: You did it. Amy: I want to say too that for anybody who is nervous about midwifery and their skills, it was her 7th or 8th catch ever by herself and her first dystocia. I asked her just last night, “Were you internally freaking out? Because you were very calm and confident.” She was like, “No, but you know. It was definitely my first dystocia.” I’m like, “Well, I’m almost glad you did it on your own because I hoped it built your confidence as a midwife.” Meagan: Exactly. Amy: If she had that situation. Again, I don’t want the whole story to be focused on that one moment and that one instance and be labeled with this shoulder dystocia, but I do think that it’s important for poeple who have a history of large babies to know that it doesn’t have to keep you from having a low-intervention birth or an out-of-hospital birth. You just have to trust yourself and do what you’re most comfortable with. It came down to me. This is where I felt safest and I knew that if I went to the hospital, in the past, one intervention always led to just another intervention that led to a more difficult delivery than it had to be and I just knew that walking into the hospital, I was just not going to have the opportunity to probably have no interventions unless I showed up crowning. I felt safest at home. I hired a team I felt safest with. If I could give any advice, it would be to just think about that and where you’re going to feel most comfortable and in control, safest, and hire a team that you feel 100% comfortable with. Meagan: Yes. Thank you for sharing. Thank you. Thank you. I do love all of it. I love every single detail. I love that you shared the ups and the downs. I noticed you were alone for a minute and then that’s what your body needed and then you kicked right back into gear. That is just amazing. I want to talk a little bit before we get going on cervical exams. Okay. So let’s talk about cervical exams. In the hospital, they are way more likely to perform them. Then out of the hospital, they don’t. I don’t want to make it sound like we are saying that out of the hospital is better than in the hospital at all. That’s just the way the system kind of goes in the hospitals. We have standard cervical exams. So cervical exams before labor, let’s talk a little bit about that. Are they necessary? That’s a big question. Do we have to start having cervical exams before we’re even in labor? Because we have so many providers and even out-of-hospital providers that will say, “Oh, let’s just check your cervix and see where it’s at,” or they’ll say, “Well, we’re getting to that 39-week mark. We’d better check your cervix and see if you’re going to be capable of having a VBAC.” The question is are they necessary? No. They are not necessary. It does not tell us anything. It really doesn’t. All it does is help your curiosity and tell someone where you are on that day in that moment. That is not going to necessarily change anything to predict the future. It’s not going to predict the future. If you are 1 centimeter dilated and 40% effaced or something like that at your 39-week visit, that does not mean that your body is not going to do it and you’re not going to be able to have a VBAC. What does it help? Nothing, really. Maybe your curiosity. What does it hurt? Well, they can be uncomfortable. It can cause some prodromal labor if they are in there and they are too aggressive and it is stimulating things. It can hurt us emotionally because if we are getting this number and we are being told things at 39, 40, or 38 weeks even. We’ve had some people. That’s really, really hard to hear because then you start doubting yourself. It hurts us emotionally and places doubt. Are you needing a cervical exam before labor? No. Women of Strength, no. If you do not feel like you want one, you do not have to have one. Say no. Say, “Maybe next time.” And maybe next time you want one. Maybe next time, you are still like, “Maybe next time.” So that’s before labor. Now let’s talk about cervical exams in labor. You know, there are actually no real deep studies demonstrating that there are actually clinical benefits in routine exams before labor, but then in labor, they are doing it all of the time too and there’s not a ton of solid evidence that even tells us that it’s going to tell us anything but, again, what it is in that very moment. What can cervical exams in labor tell us? Well, it can tell us what we are in that very moment. It can give us an idea. It can appease our curiosity. It can tell a provider a station, a station of the baby whether how high or how low a baby is. It can help– and this is help, not tell exactly– a provider see where a baby is position-wise. But even then, you really have to be dilated enough. Your baby has to be low enough. Sometimes, the water, they can’t even tell through the bag of water if there is a bag of water and things like that. So yeas. It can help with the position, but it’s not going to always be sure exactly. Okay, so let’s see what else it can help with. Induction– if we are going in for an induction, it can help us know a base and a starting point and what method of induction may be appropriate at that time. Okay, so if there’s a medical reason or a desired reason for an induction, you may want to get a cervical exam to see what you’re going to do because they may want to place a Foley or you may be dilated enough and they may just start Pitocin. Or sometimes, from the mom’s standpoint, a cervical exam can sometimes be unofficial– again, it goes back to curiosity, but on their debate on an epidural. Maybe they are like, “I’m really, really tired, but if I’m past a 6, then I’ll keep going. If I’m a 3, I need a break.” Again, it’s a mental thing. But when would we maybe not? This is another thing. We have a lot of providers standardly every two hours, every two hours, putting their fingers in vaginas. Every two hours. Amy: No, thank you. Meagan: We are introducing things that we don’t need to be introducing like bacteria and the risk of infection. So when would you want to say, “Heck to the no?” When do we want to say, “Hell no”? I’m just going to say it. When do we want to say it? Well, we just kind of mentioned it. Maybe if your water has been broken for a long time or just broken at all. Maybe we don’t want to introduce that. Maybe we’ve been told in a previous exam that we’ve had a bulging bag because we can have an accidental rupture of membranes with a cervical exam. Not too much has changed. In your story, if you were to have gotten an exam further before they left, they would have been like, “Okay, well not much has changed, but let’s still check your cervix anyway.” But instead, they were like, “Not much has changed right now. It’s kind of slowed down. Why don’t we just take a break? We’ll leave. You hang.” Versus, “Well, let’s do a cervical exam.” If not much has changed, probably not much has changed. They don’t feel good, so if you’ve had a previous cervical exam that didn’t feel very good and not much has changed and it’s only been two hours, it’s probably still not going to feel super good. This is another thing. If one nurse came in two hours ago and now we have another nurse coming in, we probably don’t want to do that because guess what, you guys? They are subjective. Is that the right word? I don’t even know if that’s the right word. They’re not always accurate. My hand and your hand are different sizes. My fingers are different lengths and everything and everyone’s perspective is a little different. You may get a, “Oh, you’re at 5 centimeters,” and then you may get a, “Oh, you’re 3 centimeters.” Or, “Oh, you’re baby’s at 0 station,” or “Oh, you’re baby’s at +2 station.” It’s never a full-on guarantee. A big question is, “Can I say no to a cervical exam in labor?” Again, the answer is yes. You can say no. Never feel like you have to have a cervical exam. That doesn’t mean– maybe it’s changing from you don’t want one now and then maybe you want one later, but you do not have to have a cervical exam and there’s really not a ton that it really tells us what we’re going to be in three hours. It’s just not. It’s just not. So anyway, I’m going to get off my rant about cervical exams, but I don’t love them. I also didn’t have many. I did have some at my birth, but I didn’t have many. You know, I’ve been to births just like yours where we’ve never known how dilated. We fixate on this dilation number so hard and we don’t need to. So, Women of Strength, your cervix does not need to be checked. It does not need to tell anybody any information. If you want the information, get it but just know that even when you get that information, that doesn’t necessarily mean that you’re going to be 5, 6, 7, 10 centimeters in the next hour or three hours. Look at Amy. She went from 4 to 10 or whatever. We don’t even know in this situation with this last birth, really. She went from chill labor to intense active labor to a baby out. We have no idea where she was and that’s okay. But do you want to know what I can tell you? She’s got a beautiful baby in her arms right now. Amy: I do think that you have to know yourself. I know people love to know the information, but I think I would have been really discouraged had I known maybe I was 4-5 when my team left after the first 12 hours, and then I think it would have been a huge mental block. Then your body can shut down. Who knows if labor would have started back up or kept going? Part of me goes, “Man, I’d love to know where I was just so I could piece it together and tell the story with the centimeters and just maybe help someone else,” but I’m also like, “I dilated to a 10 and we knew it was time to push because my body pushed.” I think the surrendering was what I needed personally and I think that route was the best for me. For some people, that would stress them out to not know, but I think for us it was helpful. Meagan: Yeah. Amy: I do love that there are options and I do think you need to advocate for that in the hospital because you do get pressured a lot to get checked. I will say that. Meagan: Yes, you do. Amy: For sure. We know that. Meagan: All right. We will let you guys go. I will get off my cervical exam rant and we will catch you next week. Amy: Thank you for having Juniper and I. We are so, so happy to share our story so thank you so much. 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