Episode 250 Charlotte's VBAC with Gestational Diabetes + Is it Possible?

You don’t hear VBAC stories with gestational diabetes very often, but we want to change that! Charlotte joins Meagan on the podcast today sharing her experience with gestational diabetes and a surprise preterm delivery at 32 weeks. Though she had some pretty significant curveballs thrown at her, Charlotte’s commitment to controlling what she could along with an amazingly supportive team allowed her to have an empowering birth experience. Charlotte knew she wanted a VBAC for an easier recovery. What she didn’t know was truly how much of a blessing in disguise it became during the intense weeks she spent as a NICU mama. Additional Links Real Food for Gestational Diabetes by Lily Nichols Real Food for Pregnancy by Lily Nichols Needed Website How to VBAC: The Ultimate Prep Course for Parents Full Transcript under Episode Details Meagan: Hello, hello. You are listening to The VBAC Link and I am excited to be sharing a story with you today that we have gotten a lot of requests about. It’s something that we don’t see very often and my question is why? I don’t really know why we don’t see these stories popping up. Even in the community, I’ve had to search through our VBAC Link Community on Facebook to find these stories. There are three I think. So I’m excited to talk about this story today because I know that it’s very much requested. We’re going to be talking about gestational diabetes. Gestational diabetes again, is something that we don’t see but it’s actually pretty common. Crazy enough, we’re seeing a rise in fact. Last year, in 2022, there was an article published talking about the actual rise that we’re seeing. They said, “The new analysis of 3.25 million birth records follow a string of studies that suggest gestational diabetes has become increasingly prevalent over the last three decades,” which is kind of crazy. Every year anywhere from 2-10% of women will be diagnosed with gestational diabetes. We know that the Cesarean rate here in the U.S. is just above 32%. If you think about the 32% and 2-10%, you’ve got to think that people who are going for a VBAC are having gestational diabetes. My question is, are we not seeing VBAC with gestational diabetes because providers aren’t allowing us? That’s my question. Charlotte, today, welcome to the show. She is going to be sharing her story about gestational diabetes and her VBAC. Right, Charlotte? Charlotte: That’s right. I’m super excited. Meagan: Yes. Yes. I’m so excited. I’m so glad that we connected. Charlotte lives in South Carolina in Greensville specifically. They have two baby boys– not baby, baby but they are young. She has a very baby and then a younger baby. She works in healthcare administration for a very large healthcare system and has truly become a birth nerd outside of work. This is something that birth just does to a lot of us. It captivates us. Right, Charlotte? Charlotte: Totally. Meagan: Do you feel that your birth is what brought you into your obsession with birth and VBAC in general? Charlotte: It’s life-changing. Once you’ve been through it, it was such a seismic shift for me and it opens your eyes to what women are going through. Then you hear people’s stories and everyone has something that has stuck with them. People who are years and years older remember exactly how their birth story was. I’m very Type A, so I just turned to research. I love it. Meagan: Yeah. Yeah. That’s why I became a doula, through my own birth experiences and I know that’s why a lot of other doulas become doulas or midwives or why OBs become OBs. It’s really awesome and we are really excited to have your episode on the show. So thank you for being here today. Review of the Week I have a Review of the Week as usual so I’m going to get into that and then we will share Charlotte’s birth stories. Today the review is from Blanely and it says, “There For Me When I Needed Support.” It says, “I got pregnant right at the start of the pandemic in 2020. It was a very lonely time isolated with my toddlers. I couldn’t even hug my mom or get her support in the beginning. I had to switch providers due to insurance changes and I was scared. The VBAC Link became my companion at this time. Julie and Meagan, my friends, I would listen with one earbud while caring for my boys. It was educational and encouraging just when I needed it. I learned tons about birth and how to advocate for my VBAC. “In January 2021, I had my successful VBAC. It was a wonderfully redemptive process. Even though they aren’t being produced right now, it is still the first thing that I recommend to any of my friends who are expecting. VBAC or first baby, I just love it and I hope it comes back soon.” Well, this was back in the pandemic and we did take a break and we are back. So thank you, Blanely . I hope you are still with us and I hope you just heard your wonderful review. We really do appreciate these reviews so much so if you haven’t had a chance, I always ask. Stop and go check out on Apple Podcasts, Google, or wherever you’re listening, and leave us a review. We absolutely love them. Charlotte’s Stories Meagan: Okay, Charlotte. Oh my gosh. I am serious– you’re going to be the first episode, I believe. I don’t recall any other episodes of gestational diabetes. Charlotte: I think that’s right because I looked when I was diagnosed. I found a birth story that was a VBAC not on a VBAC podcast about gestational diabetes. It was one that I could listen to. Meagan: Yes. Yeah, and we’ve got some that had diabetes previously before pregnancy, but none with gestational diabetes. So congratulations on being our first. I hope you are not the last. If you are listening out there also, and you had gestational diabetes and you had a VBAC, we do want to share your story. We want to help people just like Charlotte when she was out there looking for these stories and only found one, we really want to add some stories because it’s really not something that we are seeing or hearing. I’d like to turn the time over to you. We know that every VBAC has to start with a C-section, so if you want to talk about your firstborn’s birth, we would love that. Charlotte: Absolutely. Well, thank you for having me. I, once again, was telling you that this podcast really started my journey. There was the C-section and then some conversations with providers that fueled the fire. Then after that, The VBAC Link was one of the first things that I turned to. It’s super surreal being here today. I’m married to my husband, Hunter, and in 2020, my father had– before the pandemic started– two back-to-back major surgeries which put things into perspective. Then the pandemic hit and a lot of things got canceled. It’s the same story for a lot of people. We were like, “Okay.” We had been putting it off. We’d been together for 11 years at that point and we were like, “Let’s just go for it.” We got pregnant very quickly in the first month. We were super excited. It was an uncomplicated pregnancy other than just the general stuff from the pandemic. It’s tough to be pregnant and not have the support or feeling like you can go and be out with your friends or see your family without potentially killing them or being scared of that. Meagan: I know. There was all of this fear. And even then, for a lot of my doula clients here in Utah, they were being told that if they went out and they got COVID, they were threatened. They were like, “You won’t have your baby. You won’t have your husband. You could kill your baby.” They were saying these very, very scary things. Charlotte: Yeah, so that wasn’t great. In hindsight, with that pregnancy, I had a lot more time to myself worrying. Overall, it went very well. Right around the time that they were making sure with no questions that you had a birth support partner and all of that you were starting to see– even though he was delivered in January 2021 which was almost the worst of it. We were at a normal OB practice. As I mentioned, I worked in healthcare administration and academic medicine. I work remotely now, but back then, prior to the pandemic, I was going to the hospital. I was very comfortable with physicians. My mother was a physician. So yeah, I had no issue with that. I really had no reason to question medical care. Meagan: Right. Charlotte: There was also a new birthing center, a new birth wing of our hospital. They had always delivered babies but they had delivered at the other hospital in town for whatever reason. I was one of– within the last year, it had opened 11 months ago. They were still– I mean, it was amazing. Meagan: Getting on their feet. Charlotte: They were. I think there were just some growing pains but they had everything you could think of in this new center. So anyway, I was 30 weeks pregnant so I did deliver a little early with this guy. My son, Auggie. Augustus is his full name. Meagan: I love that. Charlotte: Yeah, I had a trickle come out in the middle of the night around 38 weeks and I was like, “What is that?” It could be pee. It could be whatever. Nothing started. We went back to bed, no big deal. I finished up some things with work the next day. We just said, “You know, why don’t we just get this checked out?” We went to labor and delivery. They tested it and it was negative for amniotic fluid so we were like, “Okay, great.” We went back. We got home around 9:00 PM that night. I went to bed early. I just was tired from being in triage. It always takes longer than you expect and then woke up at 1:00 AM to pee as everybody does in the last trimester of pregnancy. There was more of a gush at that point. That’s when I knew for sure that the startings of my labor started with water breaking. Now I know, that can be the start of a ton of positioning issues which is what happened with me. Yeah, so then I really quickly went into labor. I had actually done a birth class virtually with a doula. I didn’t have a doula, but I felt like, “Okay, I’m going to try to go as long as I can without an epidural.” That was always my thing. “I’ll go as long as I can, but I’ll still probably have one.” I always had this disclaimer. I started laboring. It felt very primal and very natural. It was dark. I was on all fours, but it felt intense from the beginning. I say this now to my husband, “I never feel like I’ve had early labor with either of these labors. It just goes straight to intense for me personally.” So I was feeling really like, oh my gosh, grunting and moaning and doing all of the things. We did that for about 4-5 hours. Then I started to feel nervous. I wanted to go ahead to the hospital. We made our way there. When I got there, they checked me. They checked the amniotic fluid. It was the amniotic fluid. I believe it had been the time before as well. They checked me and I was 4 centimeters so I was super excited. I felt like, “Oh, this is moving super quickly and I’m going to have this baby today.” I was on the birth ball. I was prepared, or so I thought. I got to my room and felt, “This is super intense. I am nervous that this is going to move super fast that I won’t be able to get an epidural, so I’d better go ahead and get anesthesiology to come. There were a bunch of people coming in and out. I’m sure it slowed things down at that point, but I had a medical student and an attending come in and ask if I wanted to be part of a cervical check study. I work in academic medicine so yeah, of course. Definitely. Let’s sign up because that matters for students. You learn all of these things after the fact. You don’t want to say no to things like that. Meagan: It’s kind of awkward because you’re like, “I know you need to learn and I want to help you.” Charlotte: Yeah, but it’s like, “No. I don’t need more checks. I don’t need more people interrupting me.” Meagan: Especially with your water broken. Charlotte: Now I know. Right. Right. So anyway, there were things like that and they come in. I’m feeling very intense still and I’m 7 centimeters. Meagan: Wow! Charlotte: I’m feeling amazing. I’m going to keep moving this along. This is great. I’m texting all of my family and friends, “Hey, this is easy. I’m getting my epidural and in a couple of hours, this is done.” So they gave me my epidural. It worked great and I just chilled. I knew about the peanut ball and I did do the peanut ball, but I think I just laid around. I had my catheter. I was drinking all of the fluids and the popsicles, and just the normal things. You’re hooked up to everything at that point. We were just chilling and then time passed and it was the whole day. They checked me again, “You know, okay. You’re taking some time but it’s still normal.” I actually had a midwife that was the person on call, or the 24-hour provider, so I did have a midwife caring for me. They just kept saying, “This is normal for a first birth.” I was like, “Okay.” More time passed. They decided, “Okay. Let’s get some Pitocin to keep this going.” So I started Pitocin. I’m sure you’re hearing the same old story, the cascade of interventions. Meagan: You know, it does. It does happen like that. Not always, but it does where it’s like, “All right. We’ve been going. We’ve been going. We do need to get this labor going.” Pitocin is the next option, right? Charlotte: Yep. And so yeah, then it started with that. I knew, “Okay, let’s do the peanut ball. Let’s move around.” I didn’t know. I thought a peanut ball was enough. It wasn’t with the right positions and had I known all of the positioning issues I came to find out my son had, if I had a doula and if I had the right tools at my disposal, I would have held off on the epidural. There are so many things I would have done and that’s tough for me. That’s something I struggled with. What if I could have done better if I had known? Meagan: But you can’t blame yourself. You can’t blame yourself. Charlotte: No, you can’t. So anyway, time passes. All in all, the labor was 27 hours. I don’t know exactly the duration of time, but at one point we got multiple checks. “Okay, you’ve gotten a little farther. Great. Let’s do internal monitoring. Let’s do this. Let’s see. Okay, the baby is not coming down as much as we would like. He’s OP, asynclitic.” I come to find out that I think he had a nuchal hand because he came out like this and his hand was super bruised up. Meagan: Oh yeah, so when your water broke, he just [inaudible]. Charlotte: Yep. And asynclitic, your head is tilted to the side. He had all of those things. He was not coming down. An OB manually tried to push him up and switch him and was sweating and working hard for 30 minutes on that so you can imagine my body going through it. My epidural kept breaking through so I’d go from zero to 100 Pitocin, 9-centimeter contractions, and just pain. Meagan: And messing with things. Charlotte: Mhmm. Tons of meds. They’d try to get it all back and I’d be fine again. But it’s like, in hindsight, we did throne position. They let me push on all fours. They let me push. I did end up getting to 9 centimeters or so when we started pushing. They let me push for 4 hours. So in hindsight, there is a lot that they let me do with an epidural, just things I think would be part of a positive story. All in all, 27 hours passed. I’m exhausted. Nothing is wrong with me. Nothing is wrong with the baby, but the midwife comes in and says, “Look. I think we need to call it. I don’t think he’s coming down. He’s super high still.” Right or wrong, I don’t know if more time would have helped, but he was starting to get a swollen part on his head and they just said, “I think it’s time. You can definitely have a vaginal birth one day.” She said that to me and I was like, “Okay. I’m done too.” I definitely was tearful. You always have those angels in your story. I had an angel nurse that came and said, “Oh, honey. I’ve had 3 C-sections and it’s great.” At the time, it’s what I needed just the right person at the right time to comfort you. Meagan: And being able to relate. I think being able to relate and be like, “Okay, you did it. You’re here.” Charlotte: Exactly. I was whisked away into the C-section. Usually, the husband doesn’t follow you right away. They do all of the things and then they come in. Well, my husband never comes in. Meagan: Oh. Charlotte: My husband had not eaten and had not slept. He ended up getting lightheaded and almost passing out in which case he was being cared for by the midwife that was caring for me in the PACU. Meagan: Oh no. Charlotte: He never came in. They got his phone which was a godsend and I had this amazing CRNA that took the most amazing pictures of the C-section that ended up being a big part of my healing process, being able to see everything. Meagan: Yes. Yes. Yeah. It’s weird because sometimes you don’t even think or know if you want to see that, but it is so healing, or at least it was for me. Charlotte: Mhmm. It helps you piece things together. Once again, parts of that were a really positive thing. I had a clear drape. I didn’t ask for that. They did the clear drape. They did skin-to-skin to some extent, or delayed cord clamping– not as much as you would want, but they did all of that. But I was so out of it by that point. I was shaking. I was passing out constantly, so I was holding my baby, but I thought he was suffocating on me, so I was just like, “Just take him to his dad.” It was uncomplicated and exactly what we thought. It was all positioning issues. No big deal, really. They take me to PACU and wheel me in. The Type A person in me goes, “Okay, forget recovering from that. Now I need to take back control of my experience. Hunter, get me a cold brew coffee.” I just shake my head like, “Why didn’t you just sleep when you could have? I drank a cold brew in PACU and put that kid to my boob and they were like, “Wow, you know how to do that already?” I just was like, “Yep. I want to be the mom now. I want to get back to normal.” Well, that was the beginning of a very traumatic couple of days when I didn’t sleep at all in the hospital. I got very engorged. He had latch issues. I was told to start pumping. I got an enormous oversupply, like 90 ounces in one day. Meagan: Oh my gosh. Charlotte: A couple of weeks in, yeah. It changed our experience. Obviously, he ended up getting a milk protein intolerance. It layered on. I don’t blame the C-section on that, but I do blame my mindset a little bit– and probably got some bad advice from lactation. They didn’t know I was going to have an oversupply and go crazy like that. But yeah, I had trauma from that too. I’m like, “Okay, I’m recovering from a C-section and I’m pumping around the clock and all of that isn’t coinciding with me caring for my baby.” My husband learned to do everything in the hospital. Meagan: Or caring for yourself. Charlotte: Yep. It was all focused on my recovery. Anytime he needed to eat, it coincided with me needing to pump. It was heartbreaking, really. The second I allowed myself to stop, we started bonding luckily. After that, our relationship truly began. But yeah, it was a traumatic experience. You don’t expect that you’re going to have this life-changing thing and then have to have you recovering from a C-section too. Meagan: Right. Charlotte: That’s kind of that story. I definitely feel good over time with therapy. I’ll give a plug to EMDR therapy. It’s a type of eye movement therapy. I had one session of that and it helped me get down to a rational level why I was so upset by that experience and just starting to talk about it with people and watch everything helped over time. Looking at those pictures, it no longer became such an emotional thing as time went on. But I still felt sad when I saw people having what I wanted– a good breastfeeding experience and a typical birth. But more and more, I did have a typical birth. In my close friend group, maybe four or five of us have had a C-section. Several were breech, but it started to be like, it wasn’t that I was feeling alone. It was that I started to question, “What’s going on? Why is this happening?” Meagan: Right. Yeah. That’s how it was in my tight friend group. There are four of us from high school. Three out of the four of us have had multiple C-sections. Charlotte: Yeah. Yeah. And more and more so, I’m rooting for people to get a vaginal birth. I’m like, “Get a vaginal birth, please. Have a routine situation.” Meagan: I know. Charlotte: You don’t see it very often, at least not in my close group. That’s what really made me question things. Fast forward to January 2022 and I’m not quite thinking of having a baby yet, but I had a routine OB appointment. I asked about VBAC. I said I wanted to probably stop taking my birth control and that maybe sometime this year, we would start trying. They said, “Yeah, we’re a VBAC-friendly practice.” I told her maybe a one-minute spiel on what happened to me. She said, “Just based on what you’ve told me, I would say you have a 20% success rate.” Meagan: Oh. Charlotte: I guess she can calculate it in her head without even doing the calculator. I guess they’re super friendly like that. They do so many. Come to find out, they have a super high episiotomy rate and a lot of other things, and they’re not friendly really at all. Meagan: You’re like, “You are ‘friendly’.” Charlotte: Yeah. So I felt completely gutted by that. I hadn’t even really committed that I wanted a VBAC, but feeling that I was told that just was so upsetting. It made me start listening to The VBAC Link. Through a couple of episodes, I heard about requesting your operative notes so I did that which was amazing. On that note, it said a bunch of things that I didn’t know. I didn’t know asynclitic. I didn’t know some of the terms which made me able to speak to it in a more educated way. Then yeah. I messaged the doctor. She was like, “No, absolutely. Nothing was wrong. You could totally do it.” She still gave me a success rate of 54% but she was like, “That’s just a conversation topic. You can absolutely do it.” I was like, “Okay, great.” She told me I was 10 centimeters, so they saw. I got there. I can do this again. I started interviewing doulas even before I was pregnant. I just started to hear positive things like, “If you can get through an OP, asynclitic baby, water breaking, 27-hour labor, you’ve got this. With a well-positioned baby, it would not be like what you experienced.” Hearing these things, I started to get hyped up like, “I can do this.” Meagan: Excited, yeah. You felt the empowerment back. You were feeling empowered. That is what is so important because on that first visit, any empowerment that you had was wiped like an erase board. It’s like, “Oh, you’re 20%.” Okay, great. So that’s so good to hear that you were being built back up. Charlotte: Absolutely. So yeah. So then months passed and then in July-August we decided to start trying again. Luckily, again, we were pregnant again and came to find out we were having another boy, another son. We were very excited and that’s when my preparation started. I did all of the things. I joined a midwife practice. It was a midwife practice that delivered at the most acute hospital. They were actually affiliated with the big health system here. So that gave me comfort that I would be able to birth in a suite that had a pool but it would be in a hospital right down the hall from an OR if I needed it. That was great. I hired a doula that had VBACs, that was the VBAC whisperer in town. I went to Webster-trained chiropractic and did prenatal yoga. I did everything I could think to do. I tried not to go overboard with eating and then yeah. I even went to a pelvic floor specialist to practice pushing. I did everything I could think of. That was how I could control it. My control thing with me– I just wanted to feel like I did everything in my control to get this. If it doesn’t happen, I think I could come to peace with that. That’s what I felt would be the case. So anyways, fast forward. Routine pregnancy up until 28-29 weeks when you get the gestational diabetes screen. Did it, failed it. I was bummed by that, but also heard, “Oh, so many people fail it.” So then I did the 3-hour test. I think I failed three of the four that you needed in the time. You needed two to pass. So yeah. I failed it. I was surprised how gutted I was. I was devastated by that because I kept waiting for the other shoe to drop the whole pregnancy because I hadn’t had any barriers. You know all of the barriers that people have where you have to advocate for yourself. I hadn’t experienced that even having a VBAC consult with their OB group that helped them out. I supposedly went to the doctor who is all pro-C-section. He was even surprisingly very supportive. So what’s going on? Meagan: What’s going to give? Charlotte: Yeah. The midwife said, “Nope. You can still see us. You can still come to us even if you have to go on insulin, but you really need to try and stay diet-controlled.” That was what I heard. “Diet control is what will help you stay a normal-risk patient.” That’s easier said than done I’ve come to realize. It’s challenging too because time passes. You have to get an appointment with the dietician. You have to get your supplies through insurance so it takes a while to get in the routine of taking your blood sugar multiple times a day and then maybe weeks pass before you can figure out what’s causing you to have spikes. So it’s a whole new thing. I’m trying to focus on VBAC, prenatal yoga, and all of the things that help you be super zen, but now I have multiple appointments and tracking logs. It was very stressful for me. There are certain things– your fat and blood sugar, for example. There is very little you can do to control that. It’s very challenging to get that control because it’s all about your placenta and how it is metabolizing quicker. It’s not what you ate in pregnancy. There are a lot of misconceptions about it. The best thing that I can share is Lily Nichols has Real Food for Pregnancy and then Real Food for Gestational Diabetes and maybe you can link to those, Meagan. Those two books were super helpful for me because of what I can find out– they probably work for some people, but the dietician stuff you get just from the hospital in one visit, and the handout is really high carb. Considering it’s the carbohydrates and the sugars that are causing issues, it doesn’t work. The plan just on paper doesn’t work for everybody to control their gestational diabetes. That was too high for me. When I followed that plan, I wasn’t in control of my diet. Lily Nichols, you can take bits from each, but I found that that book, and that’s what my midwife suggested, was lower carb and all about real foods. It had stuff about supplements and all of that. I found that super helpful to staying diet-controlled. In hindsight, even though I probably had it the whole time, I ended up only doing diet control for two weeks before I gave birth. So lucky for me in some ways, it was one of the silver linings. I didn’t do the diet for very long but I did get all of the information I needed. Eventually, they were telling me, “If you became insulin-dependent or needed insulin or were out of control,” I think it was 90% of your readings needed to be in control. You could have a one-off here and there. If they weren’t then you needed to start seeing a maternal-fetal medicine doctor who could consult on your diabetes and insulin. You could still deliver with the midwives, but my perspective was if you’re on insulin, you have to start having NSTs weekly. You have to start having– I can’t remember what it is called– BP or some other weekly testing for the baby. I can’t remember. It’s some acronym just to check their heart rate and all of that. I can’t remember what it’s called but there are two types of weekly testing you would have to have if you were on insulin. I don’t think you have to have growth scans, but I think they would probably start to offer them to see how baby was doing. That’s where I feel like maybe people start to get discouraged by their providers when their growth scan is large or when they start to have NSTs obviously. There’s much more surveillance and then they encourage you to get induced. If you are on insulin, it’s a lesser time that they allow you to go. They make you go anywhere from– I’d have to look it up but it’s like 37 if it’s really out of control to 39 if it’s insulin-controlled. Diet-controlled, you’re treated like any other birth. That’s where, I think, maybe you’re seeing not as many VBACs. You have a lot of barriers that come in. Meagan: Yeah, because they’re not in control or they’ve been transferred to MFMs and they’re like, “At this point, it’s just better to get this baby out earlier and control blood sugar and have a repeat Cesarean.” Charlotte: Yeah, and I might have made that decision myself. You just start to get medicalized again and it’s discouraging. You worry, “What’s happening to the baby? Is it okay? The NST is not looking good.” I just think it takes that from you. It’s needed sometimes, I’m sure. In some ways, it was a blessing in disguise. I would have had a C-section if my son could have stayed in for two more months. It was a blessing in disguise in some ways that it happened when it did. So anyways, I guess I’ll continue unless you have other things you want me to talk about. Meagan: No, I just pulled up the book and sent it to myself, so we’re going to make sure that we have it in the show notes. Charlotte: Yeah, great. Meagan: Because I think that’s really important to have. Charlotte: Yeah, yeah. Just more tools at your disposal. Lily Nichols is a dietician and she even says, “Some of the stuff that they are still teaching is archaic. We’ve found that there are better ways to do these things.” She helped develop the gestational diabetes stuff for the ADA so she has major credentials. Yeah. I think she is legit. Anyway, two weeks pass. 32 + 2 and I feel huge. I’m not, but I feel pressure low. I told my mom, “I can’t do this for much longer,” the night before which is weird. I had also bought some Easter stuffies with names on them for my son and I bought one for my other son which was foreboding. He was here by Easter and wouldn’t have been otherwise. Meagan: Yeah. That is interesting. Charlotte: I don’t know if my body knew or if I knew in the back of my head that he was going to come early. I started to feel pressure and just weird but nothing like I would have noticed. I just started to feel like, “Oh, gosh.” I had a pedicure for later that day. That weekend, I was going to have my baby sprinkle. I didn’t have an in-person shower with my son and didn’t end up having one with my second son. But I had all of these things planned. I had a pedicure, of course, and all of that stuff coming up. I don’t think that’s what put me into labor, but it was kind of funny. I’m like, “If I ever have another kid, I probably wouldn’t get a pedicure.” Meagan: Yeah. You’re like, “It’s a little coincidental for me.” Charlotte: Yeah, so I was just like, “I need my back massager,” because I was already feeling something in my back. I was like, “Oh my god, it feels so good.” I get home. My husband and my son are home and we have just learned about rebozo. I was taking a Hypnobirthing class. That was the other thing was my hypnosis class. So he was doing rebozo shifting for me and it felt so good. I was like, “Okay, great.” I was practicing my hypnosis and I was just like, “This is Braxton Hicks I think, but man. These are crazy.” I never remember someone saying that Braxton Hicks hurt. It’s waves. It’s definitely a wave each time. I lay down and I told my husband, “I’m just going to rest for a second and I’m going to get in the bath.” Well, when I get to the restroom, there’s blood. That freaked me out, obviously. I still don’t think I’m in labor, but I’m like, “Something might be wrong.” Meagan: Especially at 32 weeks, right? You’re like, “Uhh.” Charlotte: So I go get in the car. I told my husband, “I just need to go to triage.” It’s 30 minutes away. I always knew we were going to have a little bit of a drive to get to the hospital. I drive myself to the hospital in labor now that I’ve come to find out. I was doing my hypnosis techniques. I was just like, “Let me just get there as fast as I can.” Luckily, I got there fast. I think I got there in 25 minutes. I got there super fast. My mom had me a month early and drove herself to the hospital. That was always her claim to fame. I had to do it too. Meagan: You’re like, “I’m going to do it too.” Charlotte: Yeah. I had to do it too. My parents live in town, so they came over to watch my son so my husband wasn’t far behind me. I get to triage and they put me on the monitor. Baby was fine. It doesn’t look like I’m having contractions which is good news. They’re like, “Okay. Let’s get the midwives in. I’ll check you if that’s okay.” She’s like, “Oh, yeah. These are not really typical waves.” Then she checks me and I see her face go white. She’s like, “You’re 5 centimeters, so I’m going to need to call the doctor because we can no longer help because you’re preterm,” which was a bummer. I’m like, “Okay, great.” Then she says, “Ope, there’s a contraction.” For whatever reason, it wasn’t showing contractions, I think that happens sometimes in preterm births apparently because they are so far up or small or something. Meagan: Yeah, I was going to say that they are used to tracking them lower and it’s not. The uterus is smaller. Charlotte: So anyways, the doctor comes in. He’s a resident. All of these things could have been bad, but it’s so funny. I ended up having the most amazing providers. It was just interesting to me. All of the things I was worried about– I don’t know if VBAC is becoming more of a thing now or because they work so closely with the midwife practice and they see it happen and they see it happen well with success— the midwife group in town has an 80% success rate. Meagan: That’s awesome. Charlotte: Anyways, yeah. So they come in and they’re just like, “We’re so sorry. You’re 5 centimeters. You’re having this baby. We can try and just slow it down. There’s not really anything we can do but you can just lay there and let’s just hope you stay in labor for 24 hours.” Meagan: Did they try to stop your contractions or anything like that? Charlotte: No, I think I was right over the cusp of when they would do magnesium. I don’t know exactly why they do or don’t, but they said they do it with younger than that or I think cerebral palsy or something like that. Meagan: They didn’t try to do any steroid injections for lungs? Charlotte: They did do steroid injections, but– it went too quickly for it to matter. I go in. We’ll just see what happens. I didn’t know what to do. I was like, “Should I be doing labor things or should I just be sitting here?” The nurses were like, “Don’t go to the bathroom. We don’t want you to start going on dilation station.” I was like, “I need to go though.” So I was feeling conflicted. We called my doula. She was in a four-day induction supporting another person, so she was not able to come and she said, “Well, do you want me to send a back-up doula?” I said, “Yeah. Bring them on. Whatever.” That doula ended up being amazing. She gets in. She gets right in. I’m starting to feel really uncomfortable. They checked me again. I’m 7 centimeters. This is moving so much faster than my last birth. This all started around 4:00 PM with not really anything except for the waves. By the time I got there at 7:00, it was starting to feel more intense and I had the baby by midnight, so 12:30. It was fast for me. I wouldn’t say precipitous or whatever. Meagan: But still, 27 hours, right? Charlotte: Mhmm. She gets in there. The doctor says, “No, you can do whatever you want.” Oh, let me back up for a second. When they said, “The baby is coming this early,” I said, “Do we need to do a C-section? Whatever. If we need to get the baby out, let’s just get the baby out.” They said, “No. If you want a VBAC, that’s totally fine,” and that it would be beneficial for the baby at this point. Having a vaginal birth at this gestation is better for the baby’s lungs than doing a C-section. Of course, they’ll do a C-section, but there are some benefits to pushing out. I was so excited by that and then they were like, “You want to go unmedicated, right? Do you?” I said, “Yeah, I do. Can I move around?” He said, “Yeah. There is no stopping this baby at this point. Just do what you need to do.” So I was able to get on the birth ball. I wasn’t in a birth room with a pool, but I was able to do my thing and move around at least. This time, I had really committed that I was going to do unmedicated because of the hypnosis and all of the things that I had done. So yeah, I labored very quickly. I had a very intense transition pretty much the whole time I was there. There was a lot of blood coming out which was scary. I was out of it, but I was like, “Is this okay?” There was blood dripping everywhere and they were like, “Yeah, you’re probably having a placental abruption.” Meagan: Did they say anything about your placenta? Charlotte: Yeah. They said, “This is probably a placental abruption, but if you’re having it and the baby is fine, it’s fine. If the baby is not fine, you’d go to a C-section.” Meagan: Then it’s not fine, yeah. Charlotte: That was interesting. I had never heard of placental abruption. That was probably why I was going into preterm labor because the placenta was starting to separate. So yeah. I just kept moving around and doing my thing. All fours were most comfortable for me and then I was 10 centimeters and the doctor came back in. The NICU staff came in and they never freaked me out about how preterm he was. That was the comforting thing. They said, “32-weekers do amazing. They do well.” Luckily, we were at a hospital that takes care of 22 weekers. We were at the best hospital for this so that was super comforting through the whole experience. I think I would have had a lot more fear had they not said those things to me. So yeah. They broke my water and they were like, “This might take a second for him to come down. We’ve got the squat bar up.” I did two practice pushes. I was feeling so much pressure. It’s like pushes that were semi-productive. And then all of a sudden, I just felt this fire in me to just push him out in one push. I pushed so hard and apparently, I screamed. I don’t remember screaming, but I screamed so loud and he shot out. Meagan: Oh my goodness. Charlotte: We got all of this on pictures too, so yeah. He came out. I don’t know if he was screaming, but he came out. Leo is my second son. He was 5 pounds, 2 ounces so he was a big boy. Meagan: Okay, yeah. That’s a good size. Charlotte: I don’t know if it was gestational diabetes or whatever, but he was a good size. They did bring him over to me briefly. All of these things, I understand. Meagan: Right, right. Charlotte: They let me hold him for 10 seconds because they needed to go get him some oxygen of course. Meagan: They needed to make sure that his little lungs needed some extra care. Charlotte: Yes. He was whisked away to the NICU where once again, there’s trauma and things. Of course, I wish that my baby could stay with me but in the moment, it was rational. He needed to go to the NICU so in the moment, I felt back to myself. I was a little stunned, but I was like, “Oh my god. I feel my body. I feel no drugs, no fluid.” I mean, I think I did have a little bit of fluid, but it was just so different than my last experience where I was so drugged up. Meagan: Yeah. Charlotte: I got to see my placenta which they sent off for pathology and they found nothing. There’s no answer. It was just challenging like, “Why did this happen to me?” But it just happens sometimes. I did have COVID two months before. The gestational diabetes even– no symptoms from it, but I just wonder. I had it in February. I was diagnosed with gestation diabetes in early March and I had him in late March. It just feels like as time goes on, they’re finding placental issues. They didn’t see anything obvious. So yeah. He came. He’s healthy. We spent 39 days in the NICU which was a challenge. It really was. I don’t wish that experience on anybody. You’re postpartum and pumping and going home without your baby, being there for my son but having to be at the NICU all day every day. It was a huge challenge for us, but he had a very routine time in the NICU. He just needed time to grow. He came back to us not this past Sunday, but the Sunday before and we were just so happy. He’s eating well. He’s 8 pounds. He’s amazing. Meagan: Wow, good! Charlotte: So yeah. Now we’re on our healing journey of now it’s postpartum, the typical postpartum things. But I just can’t be thankful enough that I didn’t have to deal with all of these challenges with a C-section recovery on top of that. I mean, I felt physically back to myself very quickly. I had a very small two-stitch tear up, not down but I felt fine. I’m just grateful for that and I’m grateful for all of those providers who let me do my thing and trusted me and my boy to work together to get him out safely so yeah. That’s the story. Meagan: Yes. Your team sounds really, really awesome. Charlotte: Yeah. Meagan: Like really awesome. We hope that those types of teams are cloned all over the world, but we know that it doesn’t always happen that way, so if you’re listening and you’ve got gestational diabetes and you don’t have as supportive of a provider, know that you can always keep looking, but too, know that you can do exactly what Charlotte did. You can control what you can control. Control what you can control. You read the book. Learn how to control your diabetes. Learn all about that and then try and just take baby steps along the way even when random things are thrown at you like early term or preterm labor. That could have been where you are like, “Here’s the boot. Instead of a shoe, here’s a boot. It’s being dropped. Now I’m going into preterm labor.” But you didn’t let it. You just put those boots on and kept walking. Right? Charlotte: Mhmm, yep. Meagan: That’s so awesome. So, so awesome. Did you have any symptoms of gestational diabetes before you got tested? Charlotte: I don’t think so. No. I tried to think back on if I did. I think I caught it so early. I got the testing done. That’s another thing too. I would recommend trying to get your screening done as early as possible because the earlier you catch it, the earlier you can control it with diet. It becomes harder to control as time goes on, but you can stop that baby potentially. You can maybe diet-control enough that the baby doesn’t get too big. There’s a lot of really supportive Facebook groups. Gestational diabetes, nutrition, and all of these things because it’s hard to find information out there and it’s helpful to hear those stories of, “Hey, my baby came out and was small or was 8 pounds,” just not these huge babies that you hear of. I’m sure a lot of people aren’t diagnosed or are borderline and maybe have similar things. Meagan: Yeah, there are undiagnosed where we are like, “Whoa.” I had a client whose baby was 11 pounds. Charlotte: Yeah. Yeah. I mean, I think one way I started to feel was that this may be a blessing in disguise. Had I not just been on the borderline, maybe I would have had an 11-pound baby, and whoa, to be honest. Leo would have been big if he had gone to term. But the earlier you find out, you can diet control. You maybe can control your weight gain and have a healthier pregnancy overall. Meagan: And have fewer issues after. Charlotte: Because I felt amazing. Just the fact that I had such a high-protein diet and things in that time period, I feel like that made me even better equipped to have a vaginal birth. So yeah. I think there are positives if you can get past that initial challenge of it that, “Okay, this is just going to keep me on track to have a healthy pregnancy,” you can do it. You really can do it. I think as long as you just say, “Look. They’re going to do screenings. They’re going to offer things.” It may end up in an induction but I think it’s still worth pursuing if it’s something that you want to do. Meagan: Yeah. That is one of the things. It may end up in an induction and that is still possible. They may be telling you that your baby is big. That doesn’t mean that vaginal birth is not possible. Right? Big babies come out of pelvises all the time. Inductions and VBAC– Yes, it’s not as ideal as spontaneous labor but still very possible. Know that if you are listening, you’re not alone out there even if you might feel alone because there are not a ton of stories out there. That makes me sad so we are going to change that here on the podcast. It’s starting right here with Charlotte. Awesome, well thank you so much for sharing your story today. Charlotte: Absolutely. Thanks for having me. 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