Episode 347 Colleen's VBAC After Fertility Challenges & Navigating Trauma + MTHFR & Velamentous Cord Insertion

Colleen’s first pregnancy ended in a miscarriage at 6 weeks. At 12 weeks along with her second pregnancy, Colleen and her husband found out that their daughter would be born with a genetic condition called Trisomy 18. Colleen shares her experiences with Trisomy 18 and how she found the right support to help her navigate through it all. Due to IUGR and other medical concerns, Colleen had her daughter via Cesarean with an 85-day NICU stay afterward. To her surprise, Colleen had a third pregnancy just 6 months after her daughter’s delivery which ended in a heartbreaking second-trimester miscarriage. After discussing her pregnancy and birth histories at an appointment, Colleen’s doctor referred her to be screened for a MTHFR gene mutation for which she came back positive. MTHFR (methylenetetrahydrofolate reductase) is a gene that impacts your ability to process and absorb folate. It can be responsible for complications during pregnancy and is detected through a simple blood test. Colleen and Meagan talk more about what MTHFR means, and what Colleen was able to do to have a fourth uncomplicated pregnancy and a beautiful, smooth VBAC delivery! Needed Website How to VBAC: The Ultimate Prep Course for Parents Full Transcript under Episode Details Meagan: Welcome to the show, everybody. We have our friend, Colleen, on with us today sharing her stories and navigating through this amazing journey that we call birth. Birth is such a journey, wouldn’t you agree, Colleen? Colleen: Absolutely. Meagan: One of the most unique things about it is obviously through the stories we all hear. They are all unique and individual to us and even one birth that you’ve given doesn’t mean the next birth is the same. So we’re going to be talking today about navigating through birth and we know that a lot of the times through these journeys whether it be because of a Cesarean or because of how we were treated or because of how our body responded or whatever it may be, sometimes and a lot of the times, we experience trauma. Trauma is viewed differently from everybody and processed differently. We are going to be talking about navigating through trauma. Then Colleen is actually going to share some of her fertility journey as well. I think that’s also a really important thing because we have so many mamas out there– we know. We know. We see it. They have to navigate through fertility challenges. We’re going to be talking about that along with a VBAC. Let’s get into that here in just a minute. We do have a Review of the Week then like I said, I’m going to introduce Colleen and turn the show over to her so she can share her beautiful stories. This review is from lexieemmarie . It says, “So thankful. I just wanted to say thank you for creating this podcast. I had my baby girl via emergency Cesarean at 30 weeks due to several medical complications with my baby. We spent 95 days in the NICU and while in there waiting for my sweet girl to grow, I started to research VBACs to see if it was right for me. Once I found this podcast, it sealed the deal. I absolutely can’t wait to VBAC with my next pregnancy. You all are incredible to listen to because you provide the wealth of knowledge and positivity but are also fun and entertaining to listen to. Amazing job, ladies.” Aww, that just made my heart so happy. Oh my goodness. Thank you so much, Lexi, for your review. As always, we love these reviews. They make our hearts and our minds so happy. You guys, this is what we want. We want you to have that wealth of knowledge. We want to have you feel inspired and guided and uplifted and educated along the way through all of these stories. As usual, leave a review if you haven’t yet. We would be so grateful. Meagan: Okay. We have Ms. Colleen. She lived in Michigan. Did you have your VBAC baby in Michigan? Colleen: I did, yes. Meagan: You did. Colleen: My husband and I live in a suburb of Detroit in Gross Point so that’s where I gave birth in August of 2024. Meagan: Awesome. Awesome. Okay. Wait, 2024? Just right now? Colleen: Yeah, I’m 2 weeks postpartum. Meagan: Yes, I love it! So really, really fresh. Colleen: Fresh. Meagan: I love sharing stories that are so fresh like that. It is right there in your brain. Colleen: Exactly. Meagan: Oh my gosh. Okay. She has two beautiful children now and one two-week-old baby. Your two-year-old daughter is Gianna? Colleen: Gianna, yes. Meagan: She was born via Cesarean due to chromosomal abnormality. Do you want to share what that means? Colleen: Yeah, I would love to. Gianna has a chromosomal condition called Trisomy 18 that we did find out about through the genetic screening early on in pregnancy that she was considered high risk for coming down with Trisomy 18. As the pregnancy progressed, it became pretty evident that it would be the reality. For those of you who don’t know, Trisomy 18 on its surface means that the baby will have an extra 18th chromosome in some or all of their cells. How that manifests itself is through some pretty serious medical complexities that require quite a bit of care. I will get into that a little bit more with my story but that is the quick version of Trisomy 18. She is also now 2 years old and a bubby, sometimes sassy, little girl. Meagan: Is there another name for it with an E? Colleen: Edwards Syndrome, yes. Meagan: I have another friend who has that and I seriously adore him. He is thriving and doing amazing in life. Colleen: Yes. She is a warrior. She is so strong. She is so beautiful and has brought nothing but love and joy to everyone who knows her or who don’t know her. There are so many people from near and far who love her. It’s great. Meagan: Yes. Awesome and then we’ve got Sonny who was born via VBAC just two weeks ago you guys. She says, “As a mama of a medically complex child, she is passionate about awareness and education for those within her daughter’s condition. She also enjoys running, reading, cooking, and volunteering.” Colleen: Yes, that’s a little bit about me. Meagan: I love it. Welcome to the show and thank you so much for being here with us. I would love to turn the time over to you to start sharing Gianna’s story. Colleen: Amazing. Thank you so much for having me on. The VBAC Link was a staple on so many of my walks when I was getting ready to give birth. I just found it to be so uplifting and empowering and I’m so glad that I found you as a resource. A little bit of background before getting to my VBAC– it really does begin in about 2022. It starts out with some of those fertility issues that you had mentioned at the start of the podcast. My husband and I decided to start trying after about two years of marriage and we got pregnant pretty quickly. That ended early in a miscarriage at about 6 weeks. But we said, “Okay, let’s try again.” We had processed and accepted that miscarriages do happen so we quickly said, “Let’s give it another go.” But we had those reservations and that in the back of our mind of moving forward cautiously. We did get pregnant quickly again. Throughout the first trimester, we just kept it tight-lipped. We just told immediate family and then decided we wanted to do the genetic testing of course to find out the gender. We didn’t really give too much thought to what else you learn from that bloodwork. As my pregnancy progressed throughout the first trimester, I was feeling confident then at about 12 weeks, we received a call from my midwife. She told us that it was a girl and that she came back high-risk with Trisomy 18. We weren’t expecting that. It was scary and a shock and the more we learned and the more we read in those early days was devastating to us. We were just coming off the heels of a miscarriage so then to have this thrown at us was just a real curveball. In order to move forward and navigate that, my husband and I were always planning on keeping the pregnancy so it just meant, what does that mean going forward? After talking with more specialists and maternal-fetal medicine at the health system that I was at at the time, it became very apparent that they weren’t really willing to help. We needed to find another health system. We are so fortunate because we were living out of state for quite some time then moved home before we started to try. We were living in Chicago and then moved back to Michigan. University of Michigan, so CS Mott Children’s Hospital is for sure the best in the state and one of the best in the country for caring for kids with my daughter’s condition. We switched all of my prenatal care there and they provided us with hope and were willing to monitor me and have a very wonderful NICU. They were willing to provide interventions and things after she was born. But as it related to my pregnancy, it completely deterred any sort of plans and any sort of “normalcy” that one might have. It was shrouded in sadness and anxiety and fear and unknown. Each ultrasound and each week was closer and closer to meeting her but also closer and closer to what does this mean for her? What does this mean for our family? I completely abandoned any apps or what size fruit she was going to be at a certain week because she had intrauterine growth restriction. That rulebook and those guidelines went out the window. I was really afraid to connect with her when I was pregnant. A lot of the time I would say, “Okay, be in tune with her. Read to her and rock her and listen to music with her,” and I would just end up in the nursery that we decorated in tears because I just had so much fear and sadness around what was to come. With that being said, because my plans had been derailed, I really threw myself into learning about her condition and learning about what would come afterward. That gave me hope as a very Type A person. I needed to be doing something to prepare and connected with other families from around the country to give me and my husband hope and learn about what life with children with Trisomy 18 looks like and what they are capable of really was our main driver throughout pregnancy. With that said, I did not prepare for birth at all. I didn’t learn about how it could possibly go. I really just, like I said, focused on what care for her would look like. Just as a very small example of what that even looked like was when I came to write my birth plan, I probably wrote a couple of things like, “Oh, open to epidural. Do you have a birthing ball?” I honestly had a line in there that said, “If she is born not breathing, resuscitate her.” That is where my head was throughout pregnancy and it just came to however she was going to arrive, that was second to her being here and us starting to care for her. Meagan: Yeah. Colleen: That said, my care team, obviously I was being seen by the MFM department at CS Mott. They were very supportive. I never felt like they weren’t looking out for both me and her. I think they wanted me to deliver vaginally and with the understanding that if it came to a Cesarean that would be what it was. My husband and I made it very clear that we wanted to be treated however they would handle a typical pregnancy. Meagan: Anybody else, yeah. Colleen: Yes. Yes. If it meant a C-section, that’s what it was going to be kind of thing. She was showing that she wasn’t tolerating labor. We got to the end of pregnancy and we were discussing what birth would look like. We all agreed that an induction at 37 weeks was going to be the plan for a couple of different reasons. From our perspective, we wanted to just start caring for her knowing that she was going to have complexities. We were in the best place possible to start that process. There is some research that would show that the longer that babies with Trisomy 18 are in utero, you could run into a stillbirth situation. Now again, it’s a little bit more on the anecdotal side because many, many kids with Trisomy 18 are born vaginally at 40-41 weeks and it’s how you want to play it. Meagan: You have to weigh it out for what’s best for everybody. Was IUGR becoming a problem at all or was she still small but staying within her own growth chart? Colleen: Toward the end there, we were seeing some stagnated growth so yeah, they were very much of the mindset, “Let’s just get here here,” kind of thing. She was born at 3 pounds, 12 ounces. She was just a peanut. Meagan: Little tiny, yeah. Colleen: I was induced at 37 weeks without having much knowledge of what the induction process was going to look like for me and I went in at a centimeter. They started with a cervix softener so that they could then insert the Foley balloon. I was in bed a lot. I utilized the tank of nitrous oxide. I labored that way for a while just to mitigate that pain. I was walking around a little bit but honestly, the Foley balloon for me in the whole induction process was probably the worst part. I was in quite a bit of pain after that. Meagan: Were you dilated at all before when they tried to insert that or was it a closed, posterior cervix? I’m assuming at 37 weeks, it’s not doing much. Colleen: I was a centimeter when I came in and I was maybe a 2 when they inserted it I believe. Yeah. It was very apparent that my body was probably not ready for that process. Meagan: Yeah. Colleen: Yeah. That also became apparent once the Foley balloon came out but then pretty much I got to 5 centimeters and just parked it there for quite a bit. The pain was pretty intense so I received an epidural after laboring I would say probably 14-16 hours or something like that. The attending OB wanted to take additional steps by breaking my water and my husband and I were talking. We said, “If they break my water and then I don’t progress, then what situation are we in?” We also knew beforehand that my daughter did have a confirmed heart defect. We wanted a more gentle approach to induction especially when it came to Pitocin. We really wanted to take it slow and monitor her to make sure she was tolerating it and things like that. We opted for Pitocin before breaking my water and took it slow. I would say probably another 6-8 hours went by. We were taking it very slow. I wasn’t progressing and then we started to see some sporadic, not super consistent but enough to keep make us aware of her, decels that she was having. Again, the attending OB really wanted to continue on. She wanted to break my water. She wanted to optimize my chances for a vaginal birth, but again, I think my husband and I were so zeroed in on having her here safely that even the attending OB after observing some of the decels into the night was like, “Okay, I think–” Meagan: That was enough. Colleen: Exactly. She arrived via C-section on October 28, 2022 at 3:18 in the morning which we find incredibly special because 318 is a universal number around Trisomy 18. We just feel that she was meant to be here just as she is. That was enough for us to say, “Okay. We did what we think we needed to do to get her here safely.” Meagan: And happy birthday to her today. She will be 3? Colleen: She’s actually turning 2. She’s turning 2. Yep, yes. So that was my obviously first birth experience and it was– I can’t even say different than what I expected because again, I really went into that not having much of a reference or much preparation at all. I say, “Okay. That was my experience. It was a C-section.” We weren’t thinking at the time. We always knew we wanted future children but with the timeline, we had an 85-day NICU stay with her. There were other things that we were focusing on. Meagan: You and the reviewer. You NICU mamas are amazing. Colleen: Perfect review for today. After 85 days, we came home in January of 2023. We were getting settled into home life and then fast forward to about 6 months postpartum. We had just been home for a couple of months and much to my husband and I’s surprise, we were pregnant again. From the first miscarriage to my daughter, we had that hope and that mentality of, “We have no reason to think that anything is going to go wrong so let’s just operate from the stance that everything is going to be okay.” We took a similar approach this time around. We said, “Okay. We’re going to roll with the punches. Gianna’s going to get a sibling a little bit sooner than we initially had thought. Let’s just play it like everything is going to be okay.” We had met with a geneticist and knew our risk for having another child with Trisomy 18. We were just slightly above the general population when it comes to the statistics there. We weren’t super concerned. It was a very, very low risk. We decided to do the genetic testing anyway. I didn’t consider myself to be high risk so I moved my care to a little bit closer to home. The University of Michigan is a little over an hour for us. I had a great experience but wanted to move just a little bit closer to home to a practice that is very utilized on this side of town by many women. I did the genetic testing and everything was good. We were having a boy and then the very next day, I woke up to a very large gush of blood. I went to the emergency room. This was on a Saturday. They did an ultrasound and said, “Baby is looking good.” I was again, about 12 weeks at this point. They said, “Sometimes just bleeding in the first trimester happens.” I took that at face value. I came home Now mind you, with my daughter’s condition, she has a lot of medical equipment and lower muscle tone so it’s a lot of carrying her around and at that point, she was still pretty small but again, I’m pregnant and I’m hauling her medical equipment plus her some days. I’m a stay-at-home mom so I’m trying to navigate all of that. I’m going about my daily life not really thinking much of it just saying, “Okay, that’s what it is. The first trimester bleeding.” I went back to the OB that week and they also confirmed, “Oh yeah, it could just be bleeding.” I said, “Okay.” Then about 2 weeks later I’d say, again on a Saturday, it happened again. The bleeding had tapered off then it happened again. I went back to the emergency room to make sure everything was okay and it was a different emergency department. The nurse practitioner came back in after the ultrasound and said, “You have a really large subchorionic hematoma.” Meagan: I was going to ask if that’s what it was. Colleen: Yes. We had done research obviously between the two ultrasounds and people said, “If you do, it likely will heal on its own.” Meagan: It takes time, but if you do activity and things like that. Colleen: Yes. I would say probably about 2.5-3 weeks went by with me not knowing I had it. I hemorrhaged again. This time, I really tried taking it easy leveraging my husband, my mom, and my mother-in-law to really help care for my daughter so I would be able to rest and recover. When I had gone to the OB that Monday just because I had been in the emergency room over the weekend, they painted it like there was not much you can do. If you can take it easy, great. If not, I actually went in that Monday and I had brought up the subchorionic hematoma and the provider that I met with said, “Oh, yeah. You have it but actually, I want to talk to you about something else.” It was a potential marginal cord insertion or a velamentous cord. Meagan: Okay. Colleen: She said, “I actually want you to be more aware of this than the subchorionic hematoma.” Again, it was pushed to the side. At that point, in partnership with some other pretty inappropriate and I would say frankly bad bedside manner from the practice, I was looking to move again. They were very insensitive around my daughter’s condition. They made me to be othered because of her. I just didn’t appreciate that. I was like, “This is a different birth.” I didn’t appreciate that treatment. They asked very inappropriate questions about her and her life expectancy and things that were very triggering for a) someone who was fresh out of birth and a very traumatic pregnancy. I just felt that was very inappropriate to ask those things especially when we are also not talking about my daughter. We are talking about this pregnancy at hand that was having some issues. I was looking to switching providers. I have my best friend in the area. I loved her. She was pregnant at the time as well. She loved her OB so I was looking to switch. I couldn’t get in for a couple of weeks so I just said, “Okay.” At the next month’s appointment, I would switch practices away from where I currently was. In the meantime, I would say about a week and a half later, I was bleeding again. It was on a Monday so I got in that day and I personally had a little bit of peace around it because I just said, “Okay, this has happened before. Baby has always been okay, but let’s get in.” So I got in that Monday and I was given an ultrasound and the ultrasound tech put the wand over my belly and then very quickly went out of the room. My heart sank. I just knew what that meant. She came back and I asked, “Was there a heartbeat?” She just shook her head no. I was by myself because my husband was home with my daughter and it was just completely unexpected and devastating. It crushed us because we again had just come off of something so difficult and had so much hope and for that to be the result was quite crushing. I had reached out to the OB that I had planned to switch to and I just explained the situation. She said, “I’d like to still see you.” I went in about 2 weeks after my miscarriage and just laid everything out for her. She shook her head after me telling her about my first miscarriage and then my daughter and this most recent miscarriage. She took it all in and she goes, “I think there is something going on. I don’t think these are just flukes so I want to run some tests.” She ordered some pretty extensive bloodwork mostly in the autoimmune space but she also ran for MTHFR. After many vials of blood and a few weeks of waiting, I came back negative for anything autoimmune but I did in fact come back for MTHFR and she is a provider who believes that it does make a difference. She said at the time that she provided us with this glimmer of hope. She said, “If I know that a patient has that, I start them ideally on a pretty ‘easier’ regiment or something to get them started to see if that makes any difference in their pregnancies. If not, we can build with Lovenox injections and things like that.” Basically she said, “I want you on additional folic acid.” I took methylfolate and a baby aspirin. But she posed it to my husband and I. “Do you just want to go the Lovenox route? Once you go on Lovenox, I won’t be able to walk you back on additional pregnancies. If you have a successful pregnancy–”. Again, knowing this wasn’t going to be the answer and that we could potentially have another loss or more issues with pregnancies but we wanted to start on that first step before jumping forward. She said, “Pick up those supplements when you feel like you are ready.” We needed time. We needed months of healing and of focusing on my daughter’s care to just really level-set for our family. But in December of last year, we felt strongly that we wanted Gianna to have a sibling so we decided to try again. I got pregnant and began those supplements. From that perspective, my pregnancy was very difficult. Now, it also gave me that time both prior to getting pregnant and then throughout my pregnancy to really– I really wanted to level-set my approach and my outlook on pregnancy. I had felt like I had been always in this cycle of seeking out information or researching based on issues and I think my and as well as my husband, the trauma aspect always played into it of, okay. Here’s a symptom. It could be something very normal or it could be these very unique, rare things that we got used to feeling comfortable in that space. Meagan: Yeah. Colleen: I sort of recognized that as something that I needed to work through. I needed to work through some things that were either emotions I pushed aside. I pushed aside the thoughts and feelings around especially that second miscarriage because I said, “Okay, I have a daughter with medical complexities.” I needed to jump back in and I think that distraction helped me push those thoughts away but then I will say they came back. They reared their head and I said, “Okay. It’s time for me to deal with them.” So going back to talk therapy has been really helpful for me for working through some of those emotions as well as unprocessed things with my daughter’s pregnancy and birth and care and things like that, the realities around her life and how it’s impacted myself, my family, and things like that. I went back to talk therapy and then also got pregnant. I thought that was the perfect time to really sort of level-set my outlook on pregnancy. We forewent the genetic testing around. We just said, “What will be will be.” For now, the fourth time, we are choosing to believe that all will be well. We will have these feelings. My first trimester almost felt like the closer I got to the end of my first trimester, the more anxiety I had because I had that second-trimester miscarriage that I just had the opinion that it could happen at any time and why wouldn’t it just happen to me again? There were some friends who didn’t know that I was pregnant until my anatomy scan just because I felt like I needed to hold it close to my chest. Meagan: Just keeping your space safe. Colleen: Exactly. Exactly. And protecting my own emotions. So the first trimester for my son did have some of those thoughts and feelings. The OB who I had switched my care to was very accommodating. She had a little portable ultrasound machine in her office if I felt like I needed that reassurance that she would provide the ultrasound for me. She asked me how often I wanted to come see her. She was just very understanding and accommodating based on my previous circumstances. It also allowed me the space, especially as I moved through pregnancy, to really think about birth and think about how that process could be healing as well. In my second trimester, I remember going on a walk because I needed to clear my head and just feeling so overwhelmed by not knowing where to start and then I was being hard on myself because I was like, I should have done this with my daughter. I should know these things already. This is my second birth. I was being very self-critical as if I didn’t have other things to focus on with her. That’s when I came across The VBAC Link. I actually came across it because my husband and I had taken some on-demand birthing classes through Mommy Labor Nurse and we very much so said that we needed a refresher and probably to take some more diligent notes this time around. It was a resource that she has promoted so I checked it out and I just immediately felt like it was going to be so helpful as it was throughout pregnancy just listening to the podcast episodes, referencing the blog, getting your emails, and just really feeling like I had a resource that was going to support me. I can’t express how grateful I am for that because– and I’m about to get emotional– of how along pregnancy and that journey has felt. I’ve constantly felt like I’ve been up against walls that it’s been exhausting to have to overcome and to break down. Meagan: Yeah. It’s a terrible feeling to feel so alone in this really big moment in your life and not feel like you know the direction all the time and then also making decisions and then having the world pretty much question why you are making that decision. It’s so heavy and that’s why I love this community so much because they make you feel connected to people that are not even within reach. They are hundreds and thousands of miles away. Colleen: Absolutely. Absolutely. Just to have that support because it very quickly became my goal to VBAC because I flipped the script after finding The VBAC Link. I said, “There is nothing pointing to my body not being able to do this. I’m going to go for it.” I’m a competitive person and sometimes I’m competitive with myself and I said, “This is going to be a competition and I’m going to do this.” I will say getting into the true VBAC part of it, my OB was very supportive. She said, “I think you are the perfect candidate to VBAC.” She did want to see what my body did closer to which made me a little bit nervous. She was like, “I’m not for induction but I would do augmentation.” I was like, “Okay. Let’s see.” Again, it was a motivator to me to do all of the things that I could do to edge myself along kind of thing. The biggest thing I leveraged was walking. I walked a ton and I just found a routine in the business of life that worked for me that I could rely on each and every day and say, “Okay, these are the three things that I’m going to do throughout the rest of pregnancy to a) give myself peace mentally and physically, but also just to say life is busy, but this is what I’m going to do to move myself forward.” It was a lot of walking. It was a prenatal that I just really adored and I just committed to a pretty nutritious diet to make sure that I was nourishing my body in all the ways that I could. Around 36 weeks, I received a cervical check and was starting to dilate and efface. I was about 2 centimeters. Meagan: Wow. Colleen: Yes, with about 70% effacement at that time. My OB said, “Things are looking good. You are on the right track here.” I just kept doing what I was doing. I did opt for a membrane sweep at 38 weeks and I will say having never labored before, between that 36 and 38-week mark, I was having a ton of prodromal labor which was very frustrating because I never knew what was real. We went to labor and delivery once. I got turned away and sent home. I thought it was the real deal. Yes. Prodromal labor is a tease. But after the membrane sweep, it became very apparent that I was actually in labor. That afternoon, my husband and I and my daughter lay on the couch. I was having closer and stronger contractions and we joke that it was absolutely the real deal because all the times leading up with prodromal labor, everything was squared away. My meals were prepped. Everything was squared away with my daughter. My in-laws and my parents were ready to go and jump in. The day that I started to be in labor, our basement flooded with our sewage backed up. Meagan: Oh no. Colleen: I’m actively in labor and my husband comes up and says, “This is absolutely the real deal because this wouldn’t have happened if you weren’t.” I’m in labor and my father-in-law are bleaching the floor and scrubbing. It was a whole thing and I was like, This isn’t funny right now but it will be funny one day. And it’s funny. I was able to labor at home for a few hours. I got to the hospital. I had the membrane sweep at noon that day. I got to the hospital around 9:30 PM and was at a 5. I was feeling pretty good about that. I was feeling those contractions of needing to pause. I wasn’t really able to talk through but still at that point now knowing what later labor felt like that it was just the beginning of things. I had a wonderful labor and delivery nurse who was super supportive. I never felt being there like I had to convince anybody. They knew that my plan was a VBAC. The attending OB was cool with it. My OB lived just a few minutes away from the hospital and said that she would be there within a moment’s notice when I did deliver so I would have her for the moment of. I got to a 5. They did put me on the monitors and had me hooked up so my movement was pretty limited which kind of limited what I was able to do. I wanted to walk a little bit more. I was only able to sit on the birthing ball in a certain area of the room. That was a little bit tricky. The shower was really nice and I did appreciate laboring in the shower but it was the attending OB who had checked me when I first got there and determined I was a 5. A few hours later, the labor and delivery nurse checked me and said, “Oh, I think you are a 7.” My goal was to get to active labor before I decided if I wanted an epidural but ideally, I wanted to go unmedicated. So when they said I was a 7, I was like, “Oh, okay. All right. That’s the motivation I needed to keep pushing on. I can do this.” My contractions were becoming more frequent but they weren’t getting stronger. It almost felt like at a moment’s notice when they had to put the IV in or if the pain was too intense that I would start to space out again which I found to be interesting. But when a few hours went by, the pain was intensifying. They wanted to check me again and it was the OB this time who had checked me earlier and she said, “Oh, you’re a 6.” My husband and I said, “Well, they said I was a 7 when they checked me last time.” She said, “Yeah, but I’ve got the frame of reference and you’re more of a 6.” That messed with my head. Meagan: I’m sure. Colleen: My breathing was no longer effective. The pain was getting to me. The next step they wanted to take was breaking my water. I just didn’t feel like I was in the headspace to continue on without the epidural. Meagan: You were mentally derailed. That can happen. Colleen: Yeah. When it came to my birth plan this time around, I was a little bit more descriptive because I had done more research. I wanted to go the unmedicated route if I absolutely could. If not, at least active labor. I really didn’t want any augmentations or interventions when it came to breaking my water or Pitocin. I really wanted to be able to do it on my own but I will say and I think this is one of my bigger takeaways from this birth is that even when things don’t go according to plan, you really have to trust your gut. I will say in those moments, my gut was telling me I think what needed to happen to service the overall goal which was my VBAC. I said, “Okay. I think in order for my body to relax, I want the epidural.” I get the epidural. My body did just that. I was able to relax. My contractions were getting closer together again. They did break my water and now we were into the morning hours here. I get a call from my OB and she said, “Hey, I’m aware of your situation. I see that your contractions are getting closer together but they are still not at that strength that we are really wanting to see.” She said that, “If you are okay with it, they want to start me on very low doses of Pitocin.” She said, “I think you will need a whiff of it in order to get to where you need to be.” My husband and I looked at each other and I think because of our experience with Pitocin previously and not wanting to stall out or anything go wrong, we really struggled with that piece but I think ultimately, we said, “Okay, we’re already here. If this is what my OB thinks this is what I need–” and again, I personally felt okay with moving forward in those directions, “then, let’s give it a try.” She was absolutely right. They started at a 1 and bumped it up 45 minutes later. I was feeling some pressure and I wanted to switch positions. I had the nurse come in to help me. She lifted up the blanket to move me and she said, “Oh, his head is right here.” He had been crowing for we don’t know how long. Meagan: Oh my gosh. Colleen: My husband looks down and he goes, “Yeah, his head is poking up.” My OB gets there. It was super relaxed. She just walked in. She had her sunglasses on. She was just like, “Okay, let’s do this.” She was getting set up. He had a bunch of dark hair and she was giving him a faux-hawk while she waits for things to get set up. For the moments that led up to that with anxiety around the interventions, the moment of his birth was very relaxed, very calm– Meagan: Lighthearted. Colleen: It had this great energy around it. I pushed for about 15 minutes and he was born. Meagan: Oh my gosh. That is amazing. What a way to end such a lead-up to get to this moment in your life. Colleen: Yes. His birth, the moment of his birth and the half-hour leading up was so joyous and healing like I had always hoped it would be and exactly what I think my heart needed. Just not necessarily VBAC-related, but I think I also struggled with all of the needs of my daughter and having now split time, I think going from one to two for some mamas can conjure up those feelings and that guilt around what your firstborn is not getting especially with all of her extra needs and things. I was really feeling that guilt. Now he’s here and he is exactly what my family needed. He is just this puzzle piece that was missing. We didn’t know it. We didn’t know it until he was here and now we feel that way on so many levels. Meagan: Isn’t that crazy sometimes? This is one of the coolest things I think about being a doula is that we see these couples and they think that their life is so amazing and it is. Don’t get me wrong. It is amazing. They think that they love each other more than they ever could love each other. I can see the love in their eyes. I can see the support as the labor goes and then this human being enters their family and like you said, it’s just this puzzle piece that fit that you didn’t know you were missing. It’s this extra joy and this deeper love that they didn’t even know existed and it’s one of the coolest things to see families transform. Yeah. It’s absolutely amazing. Even from no kids to one kid and from one kid to four kids, it doesn’t matter. Like you said, it’s the puzzle piece that they didn’t know they were missing. Colleen: Absolutely. I just can’t wait to watch my daughter learn from him and him learn from her. That relationship– I even had the thought where I was like, “I’m the most important thing to my daughter,” then I’m like, “Okay, but she’s going to have a sibling and that is such a gift in and of itself that I just am happy to be able to provide that,” but to your point, it is. It’s a love unlike any other love. You will always obviously hold your partnership with your partner. It’s so important and so instrumental to providing that love for your children as well but that love that you get from birthing a child is unparalleled. Meagan: Oh my gosh. It’s so amazing. It is so amazing. I feel so grateful as a doula and as someone who is done having kids– my youngest is 8 years old now but I get to keep living through all of these couples. It’s just so amazing. Oh, well congratulations. Colleen: Yes. It’s so beautiful. Again, it didn’t go on the micro-level according to plan, but on the macro-level and in my big-picture goal of having a VBAC, it was all I could ask for. Rolling with the punches and I will say again, going back to the beginning of the podcast and sharing that I’m a very Type A person, I think had my past not happened, any of these little interventions that were needed throughout this birth could have also derailed me or discouraged me and I just think all of these experiences I had up until this point taught me that rolling with the punches and just understanding that things might not always go according to plan but healthy me, healthy baby– Meagan: And a good experience. Colleen: Exactly. Meagan: Rolling with the punches while trusting your intuition because some of those punches might look like punches but it’s actually what you need. Colleen: 100%. Trusting your gut, advocating for yourself, also important to keep in mind. Meagan: Super important. Well, before we go, I wanted to quickly give some more depth into some of the things that you had brought up along the way. We talked about your daughter’s condition and then there was something that you said that is a really big tip that I give to my clients when it comes to breaking the waters versus starting Pitocin. It’s okay if you don’t agree with me, everybody out there. A lot of people would rather break water over starting Pitocin because it’s the “more natural way to get things going”. But I’m such a person of, let’s try a whiff of Pitocin that we can turn off, but if we are artificially meaning we are breaking the bag of waters by ourselves against mother nature’s choice, we can’t patch that back up and we don’t know what’s going on so we don’t know if baby’s in a weird position. We don’t know if baby is too high. We don’t know what’s going on so sometimes I think just starting that 1-4 mL drip of Pit and then you can always turn it off and it’s gone. I was going to say that’s weirdly one of my suggestions that over all of my years of doing this, I would weirdly suggest that sometimes over breaking your water. That really depends on where we are at too. If we are 9 centimeters and baby is +2 station, we’re really engaged, I dont know. It might change. But if we are at the point where you were at, I actually would suggest that. I wanted to really quickly talk about VCI and marginal. So velamentous cord insertion. You mentioned that the OB was like, “Yes, subchorionic and we’re here but then we’ve also got this.” With VCI, that is where the cord is inserted abnormally into the placenta. It can cause things like IUGR which we talked about earlier so intrauterine growth restriction. I don’t know if they gave you any stats on this but it’s a 1% chance of that happening with a singleton baby, a 6% chance with twins and then if they do share the same placenta, it can go up. I want to say it’s upward of 15%, so much higher. But a lot of the time, even VCI babies carry to term and everything is okay. I do want to throw it out there that a lot of providers do suggest a Cesarean with VCI. I don’t know if you’ve ever heard of that. People can have vaginal births but a lot of providers will suggest Cesareans. If you have VCI or are being told that you have VCI, just know that might be a conversation and you want to discuss that with your provider earlier on. She also mentioned a marginal cord insertion which is where that attaches to the side I believe so also an abnormal insertion. I don’t know. Did your provider tell you anything about that? Colleen: Not the statistics around it but they also said that I was 6 months postpartum, post-C-section when I did get pregnant again so their recommendation I think regardless was going to be a repeat C-section. Meagan: Yeah, so it can happen. Then last but not least, I just want to throw out anything that you have about MTHFR to the listeners who may have gone or are going through experiences like you. MTHFR really depends on a provider. Some people still roll their eyes at it but it’s definitely a thing. Do you have any suggestions toward anybody who may have it or maybe finding out that process? Colleen: Yeah. Meagan: Or going through the process? Colleen: For sure. Just through my own research, again, my OB was like, “Just additional folic acid.” Meagan: I love that you mentioned that by the way. Colleen: So I obviously am no expert or dietician or nutritionist but when you do have MTHFR, you can either have homozygous or heterozygous mutations. There are also two different variations. There’s the A variant and the C variant. I think there is research around the severity or the impact of each of the variants on fertility and things like that but sort of the biggest takeaway when it comes to MTHFR is that it can make you more prone to clotting issues as well as malabsorption or the inability to use folic acid effectively. That is why a lot of research will indicate that you should be on the purest form of folate which is methylfolate because it’s so easy for your body to absorb when you do have the MTHFR mutation and then when it comes to having additional methylfolate, essentially I found a prenatal that had methylfolate and was just chock-full of a bunch of good stuff. I was also taking additional micrograms of methyl folate on the side just as a pure supplement. Personally, I found that to be helpful and again, that is something that I baked into that consistent routine of mine making sure I was on a really optimal prenatal as well as taking the methylfolate every day. In addition to the baby aspirin, that was to mitigate some clotting issues. The other thing I will plug is a resource and a follow on Instagram if you don’t already follow is Lily Nichols. Meagan: Yes. We love her. She has been on the podcast. We have her books. Colleen: Yes, exactly. In addition to when you know you have MTHFR, just really ensuring that you are getting proper nutrition and that is top of the line in pregnancy when you are trying every day of your life basically. I definitely broke and cheated with my little guilty pleasures here and there of course. But I really largely throughout pregnancy tried to stick to a really vitamin and nutrient-dense diet. Meagan: Yes. I don’t know what prenatal you took and I don’t judge you for any other prenatal of course. We love Needed but you said the optimal amount. That’s what we are finding. So many of these prenatals don’t have the optimal amount and they don’t have the purest forms. We love Needed and truly 100% suggest it. But yeah, exactly what you said. It’s so important. It’s so important. Colleen: Exactly. That would be my advice to anyone who wonders. I would also advocate and press to be tested if you are having issues. I just think it would be so beneficial just to have that piece of information in your toolbox so that if you do want to ask either on your own or you do want to press your provider to take it seriously, then I would definitely recommend just saying, “Hey, can I get the bloodwork to find out?” Then you can go from there. Meagan: Yeah. Yeah. Bloodwork. You can start there and know. Colleen: Exactly. Meagan: Oh my gosh. Thank you so much for this amazing information along the way, your beautiful stories, and thank you for taking the time to share with us. Colleen: Thank you so, so much for having me. It was such a pleasure. Meagan: Absolutely. 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