Episode 340 Denise's VBA2C + Pediatric Physical Therapy + VBAC Doula Gina Shares About the Microbiome

Dr. Denise DeRosa is a Pediatric Physical Therapist from New York City. She had two Cesareans and was confident that those would be her only birth stories. But when she unexpectedly became pregnant with her third, Denise started looking into her options. She researched VBAC, found The VBAC Link, and felt that she could have a VBA2C. Having worked in the hospital where she planned to give birth, Denise knew she would face pushback. She knew they were skeptical and she knew they would try to meddle. She worked hard with her doula to get her mind solid, her body strong, and to prepare for any situation or anything that would be thrown at her. Ultimately, she believed in herself. So with an unsupportive provider in an unsupportive hospital with an apprehensive family, Denise’s preparation paid off! She labored hard, advocated for herself, and vaginally birthed a 9-pound, 5-ounce baby. Gina, one of our VBAC-certified doulas from California, co-hosts today’s episode and shares information about how C-sections affect an infant’s gut microbiome. She also mentions things we can do to help mimic the benefits of birthing vaginally if a Cesarean is necessary. Dr. Denise DeRosa's Website How to VBAC: The Ultimate Prep Course for Parents Full Transcript under Episode Details Meagan: Hello, everybody. Welcome to the show. We have our friend, Denise, from New York City with us today. Hello, Denise. Denise: Hi. Meagan: I’m so excited for you to be sharing your stories. You are a VBA2C mama just like myself. Denise: Yes, I am. That’s right. Meagan: Yes and when we were talking about the C-section aspect of things, it reminded me a little bit of myself. Didn’t dilate, baby didn’t come down. What do we know? We know that this is a very common, common thing. In addition to Denise, we have a very special co-host today and her name is Gina Benson. Hello, Gina. Gina: Hi. Meagan: She is one of our VBAC doulas. Tell us where you’re at, Gina. Gina: I am in the Sacramento area of California based in Roseville. Meagan: Okay, all right. Then we‘re going to make sure that she has her website and everything so if you guys are in her area looking for a doula, go check her out for sure. She is going to do a Review of the Week for us today. So I’ll turn the time over to you. Gina: All right. “I’ve waited and prayed about this moment to be able to write the words, ‘I got my VBAC’ feels surreal. Two years ago, I gave birth to my daughter via Cesarean and since the OR, I’ve been dreaming of a VBAC. It felt like a primal right I was robbed of. Yesterday, I gave birth at home with gestational diabetes to a 9-pound, 2-ounce baby. I pushed him out of my vagina, pulled him out of the water, and sobbed in joy relishing in my redemption and power. This would not have been possible without The VBAC Link. I listened every day postpartum, sobbed and cheered with the Women of Strength. I cannot recommend this podcast enough to all expectant parents. Thank you, thank you, thank you.” Oh my gosh, do you guys have the chills? Because I literally have the chills. You know how when as a woman you shave your legs and you’re like, Oh, I just felt my leg hairs grow? Yep, that just happened. Oh my gosh, thank you for such an amazing review and huge congratulations. I’m so glad that you’ve been able to walk the walk with us here at The VBAC Link. This is why we’re here. We want to inspire, encourage, empower, and help you know for yourself what is best for you. We don’t judge here at The VBAC Link, but we really, really do love your reviews. So thank you so much. Okay, so that review also talked a little bit about a big baby. Denise also had a larger baby with her VBA2C baby. I feel like there are so many things that are going to come together within this review and within everything. So, Denise, I want to turn the time over to you to share your C-sections to start and then your VBAC. Denise: Perfect, thank you. Hi everybody. I’m Dr. Denise DeRosa. I’m a pediatric physical therapist. I feel like I have to lead with that because who I am is what I do. That with motherhood is all merged together and really helped me in my journey for a successful VBAC. We’ll start at the beginning with my first baby. I was pregnant. Everything was going great. Everything was wonderful. I was still working. I had an uncomplicated pregnancy. The only thing that was a little off was that the baby was measuring big. I was like, okay. Whatever. It should be fine. Those machines are way off anyway. I go to 40 weeks, 40 and 1, 40 and 2, 40 and 3. I’m 40 and 5 days and my doctor is like, “All right. I want to induce you tomorrow.” I’m like, “Okay, sounds good.” I didn’t know anything. I worked at the hospital as well so I’m just trusting that we’ve got this and we were good. I loved my doctor. Everything was going great. That night before I went in to get induced, I actually did start feeling something. I was like, What is that? It feels like cramps or something. I don’t know. At 3:00 AM, I think I’m in labor. “Hon, get up. We’ve got to get to the hospital. Let’s go. Let’s go.” We get to the hospital. It’s 3:00 AM and I’m 3 centimeters dilated. I’m like, “Oh, okay. I guess that’s good. I don’t know.” We get all the things– the epidural, the Pitocin, and I pretty much just lay in the bed, sleep, do a puzzle game on my iPad, and relax because that’s what they tell me to do. It is very easy for me to relax now. It gets to be 11:00 AM the next day. I’m like, “I feel a little bit different. Can I be checked?” I get checked. 10 centimeters, wonderful, beautiful. They turn off everything. You know when they turn off that epidural, it’s like, bam. This is intense. Meagan: Especially when you were not feeling anything before. Denise: Exactly. Meagan: It can definitely pick up and be a little bit more than maybe you were expecting. Denise: Yes. I am in a Semi-Fowler position which is the one where you’re essentially leaned back but not all the way back. You’re inclined at a 45-degree angle. My hips and knees were at 90/90. It was essentially like I was sitting on the toilet but I was leaning back. I’m sure everybody knows the position that I’m talking about. That’s the position to push. My husband is holding one leg. The nurse is holding the other leg. My doctor is telling me to push. It’s just a disaster. I have to be honest with you. It was crazy because I didn’t know how to push so he was telling me to push like I’m pooping and I’m pushing like I’m holding it in. Everything was spasming and everything was just a disaster. I remember saying, “Let me get up. Let me move my body. I’m a physical therapist. Let me move my body. I just need to move around a little bit and I’ll be good. Just let me get up.” “No, you can’t get up. You have the catheter in.” Meagan: Intuition. Your intuition was kicking in to move. Denise: Yeah, exactly. My pelvis was stuck in the position. I was just lying there. The only thing they did was flex my knees up and down. I think I got the peanut ball at one point but it’s not like it was side-lying. There was no internal/external rotation. It was just one plain movement. Anyway, I pushed for 2 hours and nothing happened. My doctor was like, “All right. Why don’t we give you a break? We’ll turn on the meds. Relax for an hour and then I’ll come back and we’ll push again for an hour.” I’m like, “Okay, sounds good. I need a break. Wonderful.” A rest. He’s like, “But you know, if nothing happens, we’re going to have to get the C-section.” I’m like, “Okay, well let me try again.” No food. No water. Only Jello and ice chips. I hadn’t eaten since the day before. I was just so out of it between the drugs and the not eating. I did sleep a little bit when I was relaxing there but I was shot. My doctor came back after an hour and he goes, “Denise, I just went across the hall and the girl across the hall, I turned off her meds and she pushed 3 times and the baby came out.” I was like– let’s just say my hand went up in the air with one specific finger up. I essentially flipped off my– it wasn’t even the doctor. It was just the situation. I was like, “Forget this. This is ridiculous.” Okay? Now that’s the kind of relationship my doctor and I have that we can joke around and all of that stuff and after, I apologized. He was like, “Don’t worry. I deliver people in handcuffs. That was not the worst thing.” Meagan: What? Denise: Yeah, you know if you are stationed at the hospital, you deliver everybody. You know? Meagan: Yeah. Denise: What do you think happened? I stayed in the bed. I pushed. Inefficient pushing. Baby never dropped. I was dilated to 10 centimeters but nothing happened. Okay, by the end of it, I was like, “Please give me a C-section. This is the worst day of my life.” She came out. They lifted her up and everybody in there was like, “Oh my god. Look at this big baby.” I was like, “What is she, 100 pounds?” I was so delirious. You know, at that point you are so delirious. Anyway, it was a girl. She was 9 pounds, 10 ounces. It was a big baby. She never dropped down. I didn’t move my body and had a healthy baby, a healthy mom. Everybody was happy and I was just like, oh gosh. This is the best and the worst day of my life. When you become a mom, it’s just the best but maybe not the best experience. Meagan: Yeah. Denise: That was my first birth. At the time, I was like, okay. It is what it is. I’ll try harder for the second one. Now that I know what my body does, I’ll VBAC. My doc was like, “That’s fine. You can VBAC for the second, no problem.” Okay, great. In between my first and my second, I actually was pregnant and I was 8 weeks. I went to the doctor. I had a heartbeat but my doctor was like, “Come back in 2 weeks. Something is not right on here.” I’m like, “Okay.” I was going down the shore, the Jersey shore with my family. All 20 or us, a big Greek family vacation and I remember I was there and my doctor was like, “Okay, I want you to come back after that because the baby is measuring a little small.” I’m like, “Okay, no problem.” I’m down there and of course, that baby didn’t make it. I wound up miscarrying while I was on vacation with my family. I called my doctor and he was there for me. He would call me every day and be checking in, “How are you doing?” I thought that was something doctors don’t really do. He’s a special guy. I could really tell. I felt like he really cared about me and cared for what was happening. In between my first and second, that happened and then I wound up getting pregnant with my second and I was like, oh I’m going to VBAC. Everything’s going to be good. I took a labor and delivery course. I read my whole textbooks because sometimes physical therapists will be part of labor. So I’m like, I’m going to read up on this a little bit more. I take the course. Fast forward to 40 weeks and I started. I woke up in the morning. It was 6:00 in the morning and I was like, Oh, I feel something. This is great but let me not call my doctor right now. Let me stay home. Let me do the movements. I’m bouncing on the physioball. Of course, I have one of those. I’m walking around, doing the stairs, doing lunges, doing different positions. I’m like, “Let me just see where this goes,” and waiting as long as I can. I’m in touch with my doctor the whole day. 7:00 comes around. My husband comes home from work. I call my doctor. He’s like, “Okay, well why don’t you just come to the hospital and I’ll check you? You’ve been in labor the whole day.” I’m like, “Okay, that sounds good.” I go to the hospital. He checks me. I’m 0 centimeters dilated. Zero. I’m like, “Come on.” He says to me, “Well, you’ve tried. You did.” He’s like, “But what do you want to do? You want to keep contracting on an old uterus scar and something bad happens?” Meagan: Oh dear. Oh dear, oh dear. Denise: I was like, “No, I don’t want to do that.” At the time, I didn’t educate myself enough on risks. I just thought it was me. I was like, I’m a physical therapist. I’ve got this. I exercise every day. I’m good. I’m going to do it. When he said that to me, I was like, “No, I don’t want something bad to happen.” Essentially, I had a repeat C-section because I wasn’t really in labor is what I tell people. Yeah, that was my second and he was fine. This baby was 9 pounds, 4 ounces. Meagan: Staying in the 9’s. Denise: Another large baby. Yeah, it was fine. I felt like at the time, I was like, I did everything I could. Obviously, now I know I could have done more but at the time, I was like, I did my best. This is just my story and I’m fine with it. It is what it is. I have been growing my business for a few years at that point. My pediatric physical therapist business here on Statton Island and I felt like that was my third baby. You know, when you are a businesswoman, your business is like your child. Meagan: Yeah. Uh-huh. 100%. This business is one of my children. Yes. Denise: Yeah, exactly. I was like, I have my boy and my girl. I have three bedrooms in the house. I have a healthy boy and a girl. That’s another thing too. As a physical therapist, I see a lot of different things and all babies are miracles. That’s how I feel. All babies are amazing and I’m like, You know what? I’m good. I’m going to work on the business. I’m going to go back to work. We have healthy babies. We’re good. You know that expression? You make plans and God laughs. Right? You know? I was like, you know what? I wound up getting pregnant when I wasn’t trying to get pregnant. I had been trying for the other two and I was nursing and that’s the other thing. You can’t get pregnant, right? Meagan: A lot of people think. Denise: But you know, it’s funny. I got pregnant the month after my ya-ya passed away. Ya-ya is Greek for grandma. I was like, You know, this biotch just had to reincarnate herself and she hit me. I’m like, Why couldn’t she get my cousins? They don’t have any kids. They could have kids. I’m like, Ah man. She reincarnated herself. She cursed me. I don’t think babies are a curse. It’s just at the time that I was feeling all the feels. Meagan: You weren’t in that space. Denise: I was like, you know? I was done having kids. I was like, oh my god. I can’t get pregnant. I’ll have another major abdominal surgery. Here we go. Also, Meagan, I know you know. No one wants to watch more than one kid so it was– I was shocked. Yeah. I was shocked. Denise: I was like, you know what? I did have two miscarriages. One before my first and one between the first and second. Let’s just see what happens. I’m not going to tell anybody. Let’s just see where it goes. I’m not going to decide what to do now. I’ll just wait a little while and see what happens. You know, when you have two kids and you’re pregnant with a third, that pregnancy flies. Meagan: So fast. Denise: Very fast. I was like, oh my gosh. I’m almost in the third trimester. What am I going to do? At every appointment, my doc’s like, “Denise, when are we going to schedule your section?” I don’t like to pick baby’s birthdays. For me, I would rather they come when the baby is ready and I wanted to go into labor at least and then get the C-section. Then I was like, I got to this point where I was like, I have to make a decision here. What am I doing? Am I going to just schedule a Cesarean or am I going to actually try to do this? So I’m like, let me look things up. I found you guys. I found out that women actually have vaginal birth after two Cesareans. This does happen. I’m thinking with my own individualized plan here, I had no complications with either one. I didn’t have high blood pressure. I didn’t have anything go badly so I really felt like I was a great candidate. Then there’s there my doctor who was like, “No, you’re not a good candidate. Your baby never dropped. Your babies were big and you didn’t dilate on your own.” I’m like, “I know, but I just feel like I can do it.” So this is something that I tell my patients all the time that you need to listen to your mom intuition. There’s nothing that can steer you wrong. If you feel like something’s wrong with your baby or yourself, you need to get it checked out. It’s probably nothing and everything is going to be fine, but at the same time, the way that mom feels directly impacts baby and I just felt like, you know what? I feel like I can do this. I feel drawn to this and I’m going to go for it. Then the things that really drove me over the edge was that my cousin had a successful VBAC at the beginning of my third trimester so I was like, oh. If she can do it, I can do it. Then I also got in touch with a doula who I had been talking with professionally and we met. She said something to me that I will never forget which is, “I have total and complete trust in your body’s ability to birth.” I’m like, “No one has ever said that to me. I’ve only been told I don’t dilate and my pelvis is too small and I grow too-big babies,” not “You grow really healthy babies, really chunky ones with lots of rolls and that’s the best.” I was never told that. I’m like, you know what? If anyone can do this, it’s me. I trust in myself. I’ve got to go for it. This is my last chance because if I got another section, then it would be my tubes tied and that would be the end of the road. That would be fine with me too because I don’t really want more than three abdominal surgeries anyway. I made that decision to go forth with trying to achieve my VBAC. I have to tell you, I left all my cards on the table. There was no stone left unturned. I went in. I stopped working in September and I used all of October to prepare myself mentally, physically, emotionally, and spiritually because I would be reading even on The VBAC Link, the Facebook group all of the things people did. I didn’t do everything. Listen, you only have so much time in the day when you have two kids already. But at least I was doing things that felt right for me and my body. Meagan: I love that you pointed that out because there are so many things, right? We even suggest it here at The VBAC Link. We’re like, here’s a whole list of things you can do to improve. Gina, I’m sure as a doula you have things that you suggest to your VBAC clients and I know I do too but it one, can get a little overwhelming honestly and two, like you said, time is a thing but three, here’s a list. Pick what is appropriate for you. If every single one of those things is achievable, great. If not, pick some. Go with it. Right? Denise: Yeah. There are a thousand, bajillion things you can do. Meagan: There really are. Denise: Like I said, I picked what was right for me. I met with my doula. We did a pre-labor class specific for my body and how I would plan to move my body based on my anatomy. I know I’m a little asymmetrical from holding baby on one hip. I’m like, oh I’ve got to get that checked out. I prepared a lot and it was actually fun now that I’m looking back. I listened to you guys. I listened to other podcasts. I listened. I watched documentaries. I read books. I tried to do what felt right for me and then also educating myself on papers and even looking at my own research about different things that they tell you to watch out for when you’re trying to achieve something that I achieved. Meagan: Out of the list– sorry to interrupt you– what were maybe your top three things that you were like, these were the best things? Obviously, you hired a doula and you got some education. What are, in addition to those, the top three things you did that really, really impacted the situation? Denise: The top three things were that I got my mind solid. I literally was like, Denise, you can do this. There was no– I had an intention. I think I listened to that– Henci Goer. Meagan: Henci Goer? Uh-huh, so good. Denise: I listened to that podcast maybe the week before and she said something like, “Have an intention, but not a goal because when you don’t get it and it’s a goal, then you feel all the feels. You feel like you failed.” I had an intention but I also had a feeling of, I’m going to do this. I’m not going to try. I’m just going to do. I’m an athlete as well so if you’re an athlete or you’re someone who pushes yourself physically, you can labor naturally like I did. I’m telling you, you can. You know like when you’re on the treadmill and you’re running and you just keep going and going? It’s the same thing in labor. If you mentally train yourself with the physical, you’re going to be successful. My top three tips would be get your mind solid and really find your why. Why do I want this VBAC? How is it going to feel? What is it going to be like? Imagine it. Then two, get your body right and then three, prepare for any situation that they’re going to throw at you because they are going to throw things at you to make you sway the other way. They’re going to tell you that you can’t do it. They’re going to tell you, as I get into my story, when you get to the hospital, they’re going to throw things at you. I’m not even mad at the doctors in the hospital and the nurses because honestly, I really feel like doctors are really great people. They’re not bad people at all. They are good people and the nurses are part of birth. This is the most sacred part of healthcare in my head– also palliative care and hospice care is important too but birth is really so important. Unfortunately though, there are policies in place and there are rules and regulations. I think everybody is just doing their best with that but my top tips would be mind solid, body solid, and prepare for anything they are going to say and throw at you because it’s going to come. Meagan: Yeah, it’s probably going to come. I love that. In our VBAC course, we focus so much on the mental prep too. I think a lot of times, we are more focused on that physical prep and what we can do with our body, but I think the mental part connects so deeply to the physical part that we cannot skip it. Denise: No, you cannot. Meagan: I skipped it with my second and look at what happened, I had a repeat section. Denise: So yeah, that’s that. I guess I’ll get into my third birth now yeah? Meagan: Yeah. Denise: Okay. Another healthy pregnancy, uncomplicated, everything was fine. I get to my third trimester and that’s when I decided to go for the VBAC. I’m doing all the things like I said and I get to 40 weeks. I get to 40+1, 40+2. I go to the doctor and I’m like, “I’m not going to get checked today. I’m just going to talk to him.” He comes in the room, arms folded, you know? He’s like, “What’s going on? You don’t want to schedule?” I’m like, “Doc, I want you to know that I have so much respect for what you do.” I essentially did a fear release which you talk about in the course as well. It’s so important and holding things back and preventing it from labor. I essentially did a fear release with my doctor where I told him that I loved him and I respected him and I didn’t think I know more than him because I definitely don’t. I don’t know how to cut through and do all of the surgeries and everything. I’m a conservative health profession, okay? We don’t do any surgeries. No blood, no thanks. I just said that to him. “I don’t think I know more than you. I just feel like I can’t schedule it and I feel like there are things that I can do.” We talked about successful VBACs after two Cesareans at the hospital and it was essentially, “You have to get there when you’re pretty much ready to push. They’re going to try and give you a section and they’re going to try and give the epidural and they’re going to try and do the things and they’re going to try and meddle. You come to the hospital in pain, you’re going to get pain medicine because it’s part of hospital regulations and all of that stuff.” I was like, “Okay.” He gave me my answer. It was too late to switch at that point. I thought about switching to a midwife and having my baby at home, but that was just something I really knew my husband would never go for. He was already scared that something bad was going to happen to me and the baby because that’s what he was told at the appointments. We did essentially fear release on the 7th and on the 8th of November, I woke up with the same cramping I had with my second. I was like, oh, this is something. I think the fear release must have worked. Awesome. All right. Let’s just see how this goes today because I have to keep my mind right. I have to go about my day. That’s what everybody in every single VBAC Link story said they did. I walked my daughter to school. I take my son for a walk around the block. I did the curb walking. I did the Miles Circuit. I ate my dates and my tea. It was a normal day. I just ignored it and the contractions would get closer together and they would get farther apart and then change in intensity so I thought this was prodromal labor. I think I said that right. Meagan: Prodromal. Denise: Prodromal. Okay, sorry. I’m like, okay. This is what this is. I’m just going to rest and that evening, I put the kids to sleep and I was like, let me try to rest because I don’t know what tomorrow is going to bring if I’m going to be fine or if I’m actually going to do this. So I go to sleep. I wake up 2 hours later at 12:00 and between 12:00 and 4:00 AM, I was laboring by myself. I didn’t want to wake up my husband because I didn’t want to go to the hospital too soon. I didn’t want to wake up my kids obviously because no one wants to be around them when you’re in labor, right? Or maybe you do. I don’t know. I went in the bath. I’m trying to manage my contractions. I’m in the shower for an hour. I’m in the bath for an hour. I’m trying to sit. I’m trying to stand. Everything was worse sitting. 4:00 AM comes and I’m like, I think these are getting closer together. I download the contraction timer on my phone. I’m like, let me actually time these. They were 5 minutes apart. I’m like, okay. Let me text my doula. I text her but you know when you are past 40 weeks and everybody is texting you, “How are you doing? Did you go into labor yet?” All of the questions. I turned my phone on the Do Not Disturb thing a day before because I couldn’t take anymore of these questions. I already had my own anxiety and stress about this. I turned my phone on Do Not Disturb. I called and texted her and then she texted and called me back and I wasn’t getting any messages because I turned my phone on Do Not Disturb. I was like, oh goodness. 6:00 AM rolls around. I finally get in touch with her. I text my mom, “Can you please come here?” My doula gets there and at this point, I’m trying to just focus on my breath like we’ve practiced. I’m like, okay. Breathe in. Breathe out. I was trying to do whatever I can to manage this pain. I didn’t want to go to the hospital at all at that point but I didn’t want to go too early. When my doula got there, it was a complete 180. Oh my gosh. She came. She did the pain pressure points. She massaged. She got the essential oils. She did the rebozo think. I put on my Folklore and Evermore soundtracks for my Swifties in here and I was just jamming. It was like I was on the treadmill running like I used to do back when I was young and had better knees. It was great. I could have stayed there forever. I probably did it for an hour because I remember I listened to both albums and I was just fine. I was kneeling on the physio ball and everythings was good. I thought, man. I should have tried for a home birth. Oh well. I’m not going for a fourth so no home birth for me. My doula was like, “All right, Denise. Do you want to try to bring baby down and try some different positions?” I’m like, “Yes, let’s do it,” because I knew that would be one of the things. I go to my stairs with one leg up and one leg down. I go to down on the floor into a half-kneeling position and I’m like, “Okay, let’s do this contraction. Breathe in. The contraction comes.” My water breaks. I’m like, “Oh my gosh.” Water is just dripping down my leg. That never happened before. My water just broke. Wow, this is amazing. I’m like, “Okay, let’s go get changed.” My doula was like, “Okay, this is time to go to the hospital.” I’m like, “Oh my god. This is great. I’m getting on way.” I go upstairs and change. She’s like, “Okay, we’ve got to move,” and my mom is like, “Come on, Denise. We’ve got to go to the hospital now. Come on!” My mom was very anxious and I said to her, “Mom, I know it’s your birthday and I’m trying to be nice to you but please don’t push me. If I’m not ready to go to the hospital, I’m not going to go.” I love my mom. She’s my best friend and she really just cares for me. Meagan: Yeah, and a lot of the time, they’re like, if you’re in this much labor, you go to the hospital. That’s how they were raised too. Denise: Right, exactly and that’s fine. It’s just that I knew I didn’t want to go and also, I think the day before I listened to your podcast with Julie about going to the hospital and how everything shifts from when you’re at home and you’re so calm, cool, and collected and everything is good but when you get to the hospital, it’s like, bam. Interventions, stress, people talking at you. Meagan: Touching, talking, questions, lights, new voices, new space, new smells. You have to re-acclimate. Denise: Meddling. Right. That was fresh in my brain too. I’m like, “I’m going to go when I’m ready.” Anyway, we’re ready. We’re ready to go. Let’s go. I get in my husband’s car. My mom is in the back seat. My doula drove herself because she was going to leave from the hospital when it was done. I live in New York City. There’s traffic everywhere. It’s Thursday at 10:00 AM and there really shouldn’t be traffic then but of course, there was. I couldn’t sit, right, because everything was getting worse. I’m leaning on my husband’s truck with my arms in the middle and my butt at the window. God help whoever was next to us in the car like, “What is happening over there?” Meanwhile, my mom is in the backseat crying in between. I lost control of my breath so I was literally screaming during contractions. It was like I was at a concert except it wasn’t fun. I said to my mom while she’s in the back, “Mom, I’m okay. The baby is getting ready to come out. It’s going to be fine. I’m going to be fine. The baby’s fine. I’m fine. See? I can talk in between contractions just when it comes, it’s very strong.” She was like, “I know. It’s okay. It’s all right.” My poor mom on her birthday. She thought I was going to have the baby in the car. That’s what she thought. Meagan: I’m sure she did. Denise: Yeah, she was like, “Oh my god. There’s a police cop over there. Flag him down. Flag him down.” She opened the window but then we already passed. It was quite a scene actually now that I think about it. Anyway, we get to the hospital and of course, there’s construction at the hospital so it takes me 10 minutes to walk up to L&D.” Now this is the hospital that I used to work at so I’m like, oh god. Please don’t let anybody see me like this, not my old co-workers or my boss. Please let me get to L&D. Please, please. All right, I make it up. It took me 10 minutes but I make it up. It was 10:45 AM. I get there and the nurse was like, “Come on, hon. Let’s get in the room.” I have a contraction, I’m like, “Please wait.” She’s pushing me, “Come on, come on.” I’m like, “Please don’t push me. I’m in the active stages of labor.” Who do I think I am? I think I know stuff. Meagan: You do know stuff. You do know stuff. Denise: Thank you. I get into the room and girls, I’m not joking. There are 12-15 people in that room with me. They’re all talking at me, talking at me, “Do you want the epidural? Do you want the C-section? We need to give you an IV. We need your insurance card.” Where am I going? You’re going to get my insurance card. Relax everybody. Chill. Because you can’t get a bracelet on me? Everybody knows who I am. The doctor has probably been talking about me for days. It’s fine. You’re going to get the insurance card. Meanwhile, I’m in such late stages of labor at that point. I’m contracting every 30-45-1 minute. I forget. I was like, “Please. I prepared for this.” I knew they were going to come at me like this. Not me, specifically. It’s not a personal thing. It’s just what I was. Meagan: It’s just what they do. It’s just what they do. You’re a label. Denise: And I’m not offended. I didn’t take it personally. I was ready though. I knew they were going to come at me and I had a plan which was, don’t say no and don’t shut down. I also heard along my journey, “Don’t say no. Don’t have negative energy.” You’re not able to control other people’s feelings, but you are able to control yourself. When they came at me like that, I was like, “Please just give me a second. Can you wait a minute? Please let me get through this contraction. I just want a second. Not right now.” I had all of the things listed of what I was going to say when they came at me. Came is a bad word. When they said things, I just knew how they were going to say things. Meagan: When they were approaching you, you knew your response wasn’t going to be no. It’s, “I prefer. Not right now. In just one moment,” and stuff like that versus, “No, no. Get away.” Denise: Right, exactly. Exactly. I could have been like that but I wanted to bring my baby into the world in the most positive way that I could and that’s just how I approached it. I’m like, “Just check me. Just check me before you do all of these interventions.” They checked me and I was 9 centimeters. I’m like, “What’s that? I dilated by myself.” My doula was like, “That’s amazing.” My OB was like, “Yeah, but the baby is really high.” I didn’t even hear him say that. She told me he said that after. I think I was blocking out a lot of negative things on purpose. That was one of the things I prepared for. He’s like, “Oh, but the baby is really high.” I’m like, “Okay, just give me a second.” The anesthesiologist was like, “Let’s give you the epidural just for insurance.” I’m like, “Not right now, just give me a second.” They’re like, “The baby’s heart rate is dropping.” I knew they were going to say that too. I said, “Okay, well what’s it dropping to and what’s it coming back to?” When they said it something that was essentially normal, I said, “It’s a 9-pound baby in there. Of course its heart rate is dropping. It’s being contracted by a strong uterus to get it out. Give it second.” I don’t remember saying this but my doula said that I said this which is, “I’m okay. My baby is okay. I know no one in this room thinks that I can do it, but I can. Okay?” I was like, “That’s what I verbalized.” I don’t really remember saying that but I was outside of my body I guess. She was like, “I got the chills when you said that because everybody was so anxious in that room and only you held it together.” I was like, “Well, yeah. I knew what was going to happen.” I worked in the hospital for 7 years. I get it. There is litigation. There are policies in place and people are scared for their jobs. I get it. It’s fine. So anyway, that went on for about a half hour and then the nurse who pushed me in the hallway that I wasn’t so nice to was like, “All right, Denise. Can we try a position?” I was like, “Yes, please. Let’s do it. Let’s try to switch positions please.” She gets the peanut ball and I got onto my side into internal rotation where you put your knees together and you have your feet on the physio ball. That opens the outlet of the pelvis to get the baby to drop down. I already know all of these things but no one had offered it and I wasn’t thinking straight to even bring it up. I flipped into the position and the anesthesiologist was like, “Can I give you the epidural while you are on your side?” I’m like, “No.” Meagan: Oh my gosh, he’s still pushing this epidural. Get out of my room, sir or ma’am. Denise: I know. I didn’t push anybody out because I didn’t have time for that. I was focused on what I had to focus on and what I came here to do. So I go on my side. One contraction and I’m like, “Um, I think I have to poop.” I was saying it but I had that feeling that baby dropped but I really thought that it was number two. They flipped me on my back and they were like, “All right, hold your knees up to your chest.” I’m like, “I don’t like this position.” Remember, this is the position that they put me in with my first to push baby and it didn’t work? I had PTSD from it. I was like, “I don’t like this position.” They were like, “Just try it. Just try it.” I hear my doula say to me, “Denise, J breathe.” I’m like, “Oh my god. That’s the cue. That’s the cue that I need to push. The breath that I need to push this baby out. That’s the cue we talked about. Oh my god. It’s almost over. It’s almost here.” Then I hear the whole room shift and my OB says, “All right, well if she wants to have a vaginal birth, let’s do it.” I hear my husband say– my husband was very nervous about this whole situation and he wasn’t really talking. He was there but he wasn’t really saying anything. I hear him say– everyone was saying, “Push, push.” But I hear him specifically say, “Push, push. Breathe in. Breathe out. Push the right way.” This 9-pound, 5-ounce baby shot right out of me. The doctors didnt even catch him. He landed on the table. I didn’t know that but I heard that later. That was it. I said, “Baby, baby.” They let me hold my baby right away. We did skin-to-skin. My husband got to cut the cord. I got to call out the gender and you feel the room anxiety shift. The anesthesiologist leaves of course. Meagan: He’s done. Denise: The whole energy of the room just shifts into, “Oh, okay. She did it. All right.” Meagan: It’s actually possible. Maybe we shouldn’t doubt her. Denise: Yeah. I don’t mean that in a negative way, but there is so much anxiety and nervousness about birth whether if you don’t educate yourself enough like I did or didn’t do with my second and even in the L&D, room, things can go wrong. He could have gotten stuck. I don’t know. So many things could have happened. When the air in the room changed, everything was great. Everybody laughed. The doc stitched me up. I got to nurse the baby right away and the nurse said something to me. She was like, “Wow. You are such a strong woman.” I was like, “Oh yeah, I’m a Woman of Strength now. I can say that.” She was like, “Wow, you are a really strong woman. I’m surprised the doctor let you have a TOLAC.” I said, “Oh, no honey. This was not his choice. This was my choice.” My choice was not the same choice I recommend for everybody. I put in a lot of work for this obviously as I’ve said and it’s not really for everybody and that’s okay. It’s okay to have the birth that you feel the safest and the most comfortable with because this is your start into motherhood. But if anyone feels inspired today, I’m glad that I was able to help with that. Obviously, I joke around and my OB, I still love him. He came into my room the next day and said, “Ah, here’s the champion.” Yeah. You know and he said, “Listen, you were the right person to do it. You put in the work and you knew what to do.” Yeah. Meagan: You put in the work and knew what to do. Denise: Yeah, so that’s my story. It’s a doozy. Meagan: Oh my gosh, I love it. Gina: It’s perfect. Meagan: Yeah, right? I mean, Gina, tell me about your area. Do you have a lot of unsupportive hospitals and providers in this way where they come in and you would expect a scenario like Denise’s? Gina: Probably not quite. They actually have gotten a lot better. Meagan: That’s good. Gina: They are pretty supportive even after two C-sections. We do have supportive providers for that and hospitals for that. It’s not unheard of. It’s not like, oh. You can’t do this. Meagan: Right. Right. Gina: Yeah. Meagan: That is the case in so many places. Gina: Yes. Meagan: Like in Denise’s situation. Denise: Yes, New York City and New Jersey as well. In New Jersey, if you have two Cesareans, you cannot be with a midwife. It’s not allowed. Meagan: Yeah. Even here in Utah, which is a supportive VBA2C state, but some of those hospitals also do that. They are like, “Oh no, if you’re a VBAC in general, you can’t be with a midwife.” It’s a little frustrating. We have a lot of work to do but Denise, I bet you probably didn’t change your provider’s perspective completely on VBAC. I bet the next VBAC after two Cesarean mama that came in, he likely may have said, “No. Not going to happen.” But you never know. He might have been like, “Okay. We can try it.” It takes us to show the world that it’s possible, that it can be safe, that it’s reasonable, our bodies are amazing, and so many of the things you could have had with the heart rate or the baby wasn’t coming down or a bigger baby or whatever. All of these things could have stalled you up and you were like, “No. I can do this.” You put the power in your pocket and took the lead. Denise: Yeah. Yeah. And you know, I also read this along the way too. I had three births. My doctor has been to 20,000 births. Does he remember my birth? Probably because it was so dramatic. Meagan: Monumental for him, yeah. Denise: I’m his special patient as he calls me. But it’s not the top of his list. He’s on to the next thing and that’s okay. This is his job. This is what he does. Like I said, he’s not a bad person. He just wants to control the situation so he can make it the most safe in his opinion. But for me, I felt like by the end of it, my grandmother didn’t curse me. She blessed me with an opportunity. My son is of course named after her and a lot of other amazing people like my dad and I just feel like you have to make your own story your own and you have to be comfortable with what you feel comfortable doing. I was more comfortable staying with a provider and a hospital I knew wasn’t going to be like, “Oh yeah, Denise, you can do it,” but I knew in myself that if I believed in myself and I did the work and put in the work, I could do it. And it worked out for me. I wish I had that for three births but at least I had it for one and I get to come on here and share it with everybody that they can have the same experience I did. Meagan: That’s really how I feel. Yeah, I didn’t have the experience that I wanted for birth number one and birth number two but it brought me here today and that’s okay. That’s okay. So you have said that you have even more detail of your story on your website. Can you tell everybody, and we’ll have it in the show notes, but can you tell everybody if they want to read more details on your story where they can find that? Denise: Absolutely. My business is milestonesinmotionptw.com and on there I have blogs about lots of different things but I decided to write my birth story which took me the entire fourth trimester because I had three kids by then. I wasn’t sleeping. You know all the things. But yeah, it’s a completely unedited version with a few more details. If anyone ever wants to reach out to me, I do have resources and I’m working on some virtual stuff with the business so if you have any issues post-birth with the baby with tummy time and crawling and stuff, I have some resources up there for you guys if anyone wants to check it out. And just reading the story– reading and listening to stories like on this podcast really made the difference for me too so thank you for doing it. Meagan: Oh my gosh. Thank you and like I said before, we’ll have her link in the show notes so you can go and check it out. I love that you were pointing out tummy time and all of those things that you can help with. Then cute Gina actually is going to be talking about the gut biome and the effects of it and what birth can do and all of these things. Gina, I’d love to turn the time over to you to add this extra topic. Gina: Thank you. One of the reasons that we want to try to avoid unnecessary Cesarean births is because of the type of impact that that type of delivery can have on a newborn’s long-term health. Some of the outcomes that we know can be associated with C-section births are increased risk of diabetes, obesity, and asthma. There is some research that indicates that those increased risks are because of the way the newborn’s gut microbiome develops after a C-section versus after a vaginal birth. The microbiome is basically an ecosystem of bacteria and there are microorganisms that live in a digestive tract. For a C-section birth where the amniotic sac hasn’t even been broken before you get to surgery, the baby basically has no exposure to any of the flora that are in the vagina which they would get in contact with if they were coming through the vaginal canal. That’s part of what helps to populate that healthy gut biome. It gets the healthy gut bacteria in there for the newborn. The other part we know that helps build that healthy biome is actually the contact the newborn has with the perineum. If you think about where the perineum is in relation to your anus which is the exit of your digestive tract, that’s where those bacteria are going to be. The baby also gets that exposure so it’s a combination of all of it. In a C-section birth, sometimes they get none of it or only part of it. That’s what seems to be a trigger for some of those outcomes that we see long-term for people if they have had a C-section birth. With all that said, is there anything we can do about it? Actually, yes. There is. There are a few things. One of the things that I do with my doula clients is I discuss the choices that they have for their birth and we use that to draft birth plans. I make sure we cover options for spontaneous vaginal births as well as induction and also C-sections because reality is that some babies are going to be born via C-section and I don’t want anybody unprepared for it or not knowing what their options are to make it a better birth experience than just a sterile, surgical procedure. We have documented preferences for each of those outcomes. There are a few things that I make sure we include in a family-centered C-section birth plan that help support that healthy newborn microbiome. I learned about that somewhat from The VBAC Link doula training and I also attended a conference earlier this year called Micro Birth that was basically two days worth of people talking about newborn microbiome and how breastfeeding helps with it and everything. It was fascinating. The first option that I make sure we include in the C-section birth plan is to delay the use of the prophylactic antibiotics. That’s what they give you ahead of time to try and prevent an infection from coming on during surgery. That’s not a bad idea, but when we do it right away before the baby is born and before the cord has been cut, they can also get some of those antibiotics and that will interfere with their ability to build that bacteria in their gut. One of the ways that we can easily manage that is just delay it. Make sure they don’t give us antibiotics until after the baby is out and cord has been clamped so we know that they have gotten all of their blood and they aren’t getting anything else from the surgery or anything else from the IV. In most non-emergency C-sections, that should be an absolutely reasonable request because there’s just a matter of timing. You’re not trying to tell them, “Don’t give it to me,” it’s just a matter of when and all they do is just push it through your IV. It’s also possible for some emergency ones depending on how much time they have. That’s one of the really important ones that helps all of the other suggestions. Meagan: Fascinating. Gina: Yeah, the other one that we include in the birth plan is vaginal seeding. I know that’s part of the VBAC Link course. Vaginal seeding is using gauze or a swab in the vagina to collect the fluids that are there prior to surgery and then you use that and you wipe it on the newborn’s face. You make sure you get it in around their mouth and nose the same way they would be exposed to it if they came through the vagina during birth. That helps to transfer that to the baby. You can also make it even more effective if you make sure you include the perineum so maybe after you do the vagina one, make sure you include the perineum swab as well so you get all of it at one time and transfer it to the baby. There are a couple of times where some things that you don’t want to use this for if the birthing parents has Group B strep or genital herpes, especially if they have an active outbreak, some of those conditions we know pose a risk to newborns and this wouldn’t be a good idea. You don’t want to try to introduce that just to get the flora there. It can be difficult to get the hospital to participate in this directly. I believe that ACOG has said it’s still under research so unless you are being supervised, you shouldn’t be doing this, but if you include it in your birth plan and you actually want to do it yourself, you can get the gauze. You can get the swabs. You can do it and either you or your partner can do it for the newborn. They can’t stop you from doing it yourself but they may not want to particpate. Meagan: Yeah, they usually don’t. We have clients who have ordered the gauze and everything online and then in Denise’s situation where she was like, “I want to labor at home as long as possible,” and all of this stuff, they did it right before. They washed hands really, really well, got gloves even and did it, put it in a bag, and put it in their hospital bag because in case it does go a Cesarean route or whatever, they had it and then they don’t even have to deal with the staff. Gina: Exactly. There are always those types of things where you can take it upon yourself and do it yourself. Yeah. Like you mentioned, doing it at home would be a great idea because you want to make sure that you’ve done it and the swab and everything is out before they start prepping you for surgery because they will use the sterile cleansing options and that will destroy some of it. Always make sure you do it beforehand if you can. Then the last thing that I talk about which isn’t necessarily part of the birth plan, but it’s a really effective way to help restore and build the healthy microbiome for the baby is probiotics. You can start them yourself prenatally and have a prenatal probiotic that you take. You can continue using it while you are lactating because it will transfer to the baby as well. There is one I know Needed offers. Meagan: There’s a pre and probiotic. I really love it. I take it myself. Gina: Yeah. That one’s on my list of options that I give to people. I have a few different ones I’ve looked into that have the right mix of bacteria that they’re looking for so that’s a great one to use. The other one is that you can actually have probiotics for a newborn. That’s proven to be pretty effective if you have a C-section baby. That’s one of the most well-researched ways of helping rebuild that microbiome for them especially if you are using it in combination with breastfeeding because human milk has the perfect sugars to feed those bacteria that we are looking for so it’s a really great combination. There are a lot of different infant probiotic options out there and not all of them have the right mix of bacteria or the right type of bacteria that we know research shows comes through a vaginal birth and is also associated with good long-term health outcomes. There’s one that they have studied the most to be effective. It’s in Australia and it’s called Imploran. You can buy it online and I’ll provide the links as well but I also have a couple of others that have similar makeups that you can use. That’s what I have to say about that but it’s a very fascinating topic. I love to see even some of the negative outcomes with C-sections be improved by things we have learned along the way. Meagan: I love that. Thank you so, so, so much for sharing that with us. Denise, thank you for sharing your stories and your VBAC and your journey and all of your tips are so incredible. I’m so grateful for you. Denise: Thank you. Thanks for having us. Gina: Yes, 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