168 Breana's VBAC with a Special Scar + Preventing Preeclampsia

Breana’s first birth was not only an emergency Cesarean at 24 weeks due to severe preeclampsia, but she was also given a classical incision and told that under no circumstances would her body be able to tolerate labor in the future. The news broke Breana’s heart as she longed deeply for a natural, unmedicated birth. Breana researched extensively and found a community of women who also had special scars. When birthing unassisted seemed like her only option, Breana found Amish midwives who were willing to attend her birth. Her VBAC was triumphant, restorative, and wonderful in every way. When our bodies are properly fueled and nourished, our birth outcomes are better and our babies are healthier. Breana is a perfect example. We’ve always been told that preeclampsia has no known cause, but what if there WAS something we could do to prevent it? Additional links Special Scars, Special Hope Silent Knife: Cesarean Prevention and Vaginal Birth after Cesarean (VBAC) My Homebirth after Preterm Classical Cesarean - Issue 47, Natural Mother Magazine The Brewer Pregnancy Diet Blue Ribbon Baby Pages The VBAC Link Blog: Birth After Premature Cesarean C-Section Incision Types: Learn More About Special Scars Full transcript Note: All transcripts are edited to correct grammar and to eliminate false starts and filler words. Julie: Welcome, welcome. It is Women of Strength Wednesday and you are listening to The VBAC Link podcast. This is Julie and Meagan is here with me today. We have a really neat story for you today. It’s been a while since we have had somebody on our podcast with a special scar, which is a scar that is different than the low, vertical incision or the bikini cut scar that most parents have when they get a Cesarean. Meagan: More horizontal, you mean? Julie: Yeah. Did I say vertical? Meagan : Yeah. Julie. Oh, well. Meagan : That’s okay. Julie: Different than the low, horizontal incision that most parents get when they have a C-section. There are lots of different types of special scars. This type that we are talking about today is a classical incision which means it’s over the top of the uterus and it goes vertical down the belly, or down the uterus rather. Sometimes it’s vertical on the belly and sometimes it’s not It just depends. But I’m really excited because Breana, our guest today, is from Pennsylvania. I’m actually just going to read her bio and what she wrote. Before I go into that and introduce her, I want to have Meagan share a Review of the week with us. Review of the Week Meagan: Okay. This is from Gaby and she is on Apple Podcasts and her subject is “Hopeful for a VBAC.” She says, “I feel so lucky to have the time and space each evening (after my littlest has gone to bed) to listen to the meaningful and beautiful birth stories on The VBAC Link. I am hopeful for a VBAC in early September after having a traumatic birth story with my first child. Whatever this new story holds, I will be able to handle it better because I educated myself with this podcast. Thank you for sharing these stories with us all.” I am assuming that was-- let’s see. That was July 4th of last year, so she has had her baby by now. Julie: Are we going to stalk people? Meagan : Yeah, I was going to say. We are either going to have to stalk her on The VBAC Link Community on our Facebook. If you are not on that, definitely tune in to that on Facebook. Just search The VBAC Link Community, answer the questions, and we will make sure to get you in there. It’s an amazing community and yeah, Gaby. If you are still listening, email us. We would love to hear how things went and yeah. I’m going to turn the time back over to you, Julie. Breana’s story Julie: All right. Here we go. Breana is really, really incredible. Her story is really awesome and I am just going to read her little bio for you because I don’t think I could say it better myself. She says, “My name is Breana and I am a wife and stay-at-home mom of two girls. In April 2018, my first daughter was delivered at just 24 weeks due to severe preeclampsia via a classical Cesarean.” I’m just going to do a little pause there for a minute. She had a preterm Cesarean and it’s a classical incision with a special scar. This is kind of a big deal. We have a blog about birth after premature Cesarean and also about special scars , but she has both of these. So she says, “I was told I would never be allowed to carry past 36 weeks and that I would need repeat Cesareans for all future babies or I would have a uterine rupture due to the classical incision I have been given. After much searching, I discovered the Brewer diet for preeclampsia and the Special Scar Organization , both of which were answers to my prayers. In August 2020, after a healthy, full-term pregnancy, I had a lovely home birth after classical Cesarean with wonderful, Amish midwives.” Okay. I want to pick apart all of these things and talk about them. But instead of doing that and taking up the whole time, I am going to turn the time over to Breana and let her share her wonderful story because this is a must-listen, I think, for everybody because it covers so many things. And then after she is done sharing her story, we are going to pick something to talk about. Breana: Okay, thank you so much. Yeah. My name is Breana. I have been married to my husband, Michael, for almost four years. I am a stay-at-home mom of two beautiful girls and we live near Pittsburgh, Pennsylvania. In November 2017, I got pregnant with my first baby. I was seeing midwives at a birth center in Pittsburgh for prenatal care and was planning to have an unmedicated birth at the center, but I had a really difficult pregnancy from the start and was dealing with severe morning sickness, like, vomiting every day several times a day. It was really hard for me to eat due to that and I think that my empty stomach was only making me sicker, but I didn’t realize it at the time. As a result, I wasn’t being well-nourished. That was a really bad start. When morning sickness didn’t go away by the second trimester, I expressed to the midwives my symptoms, which were severe nausea, persistent, debilitating migraines, and swelling. The midwives just dismissed my symptoms as common side effects of pregnancy and they blamed my migraines on hormonal changes. They told me to take Tylenol along with caffeinated coffee for the migraine and they assured me that the nausea would probably ease up soon. But by mid-April, I had a prenatal visit which included routine testing for which I was instructed to fast. When I got to that appointment, I was feeling really hungry, tired, and weak. When the midwife took my blood pressure, she looked shocked and asked if I was feeling all right. I remember being sort of frustrated and saying, “No. I really don’t feel well, which is what I have been trying to tell you for weeks.” But they had acted like it was all normal and no big deal. I just thought, “Okay, I guess this is how pregnancy is for everyone.” It was my first pregnancy, so after taking my blood pressure a few times, it was still super high and was what they considered to be within the hypertensive crisis zone. It was 180/110. After a quick urine dip test, they concluded that I needed to go immediately to the hospital for some additional tests and monitoring. That’s how it was put to me, so I really didn’t understand the fullness of the situation or realize how it serious it was. I imagined that I would just go in for a quick ultrasound, or blood test, or something and be home by that evening. But obviously, that wasn’t the case. When I arrived at the hospital, they told me they were surprised I hadn’t already had a stroke and said I needed to go to the ICU immediately. Meagan: Whoa, scary. Breana: Yeah. They told me I had to be prepared for an emergency C-section at any moment and that I would not be leaving that hospital pregnant. So it was extremely scary to have all of that thrown at me out of the blue. They told me that I had severe preeclampsia for which there was no known cause or cure and that the only possible way to save mine and the baby’s life was to deliver as soon as possible. They said there was this fine balance between giving my baby as much time to develop as possible and also not holding off so long that my body would begin to shut down from the preeclampsia. I was admitted to the hospital on a Tuesday and my daughter was born on the Friday afternoon. We spent four days in the hospital leading up to the C-section. By Friday afternoon, we were told that delivery could no longer be held off and that my daughter’s best chance was for me to have a C-section immediately. I expressed to them my wish to give birth vaginally, but I was told that she may not survive a vaginal birth. So it was a recommendation that we proceed with a C-section. They explained to me that given the extreme prematurity of my pregnancy, they would probably have to do a classical C-section so as not to risk cutting the major uterine arteries on my under-developed lower segment. They said that would mean a vertical incision on the upper portion of my uterus, which came with more risk and will make it impossible for me to ever deliver vaginally for future pregnancies. Obviously, the idea was pretty horrifying to me not only because surgery was my worst fear, but also because I had really wanted an unmedicated, natural birth and I was crushed at the prospect of never, ever getting to experience that. I was super hesitant after hearing that and my mind was reeling. Then, they told me that if I didn’t consent to the C-section right then and there, they would have to do one anyway, but in that case, there would be no time to give me an epidural, so I would be put under general, which I was terrified of, and also that they would definitely have to give me a classical, but that if I consented now, we would have more time to take it slow and maybe do the low transverse after all. Looking back, there was definitely a lot of pressure and I wasn’t really in my right mind because of all the drugs they had me on. It was honestly a struggle even to keep my eyes open. I asked that my husband and I be left alone so that we can think about what to do. I was a young 20-year-old, first-time mom and was trusting that the experts knew best. Obviously, I mean, I would have cut off my limbs if they told me it was necessary to save my baby’s life, so I was willing to do anything they said. Our daughter, Aurora, was born at 24 weeks weighing just 1 pound, 8 ounces, and measuring 12 inches from head to heel. We only got to see her for a brief moment before she was whisked off to the NICU, so there was no immediate skin-to-skin whatsoever. I couldn’t see her for probably the first 12 hours and they didn’t let me hold her for over two weeks. Even after that, it was often a fight with the NICU. So I often felt really alone trying to be an advocate during that time. She had a lot to overcome in the NICU and we ultimately spent 104 days there. She was born in April and we didn’t get to take her home until August. When we finally did leave, a respiratory therapist who had been there at the beginning told me he hadn’t thought she was going to live more than a few days. But she is two now and has absolutely no health problems at all which is really remarkable for a baby born so premature. Meagan : That’s awesome. Yeah. Breana: She’s so smart, and beautiful, and healthy and we are so, so proud of her and just so thankful to God for getting us through such a challenging time. I was also able to exclusively breastfeed her which I had been told wouldn’t be possible with a micro-preemie and I was actually laughed at when I let the NICU know I was staying full-time so that I could be with her and breastfeed her. So I just want to encourage other NICU moms to fight for and advocate for their babies in the NICU. I want to mention that during the four days leading up to the C-section, I was confined to a bed with IVs and constant monitoring. I was denied all food and drink during that time. I was absolutely starving and so thirsty but was told that it was too dangerous for me to eat in case we needed to suddenly rush in and do a C-section, in which case my stomach would need to be empty. Of course, it was really frustrating to try and go along with that reasoning when the days kept ticking by and a C-section just wasn’t happening, and all the while I was starving and just feeling weaker and weaker. I was also given magnesium sulfate through my IVs to prevent convulsions and diuretics to flush fluid out of my lungs. Julie: Oh my gosh, that is the worst. Meagan: Yucky. Julie : So awful. Breana: Yeah. I’ve since learned that diuretics are contraindicated during pregnancy due to their ability to deplete blood volume expansion and preeclampsia, which, of course, was the entire reason I was there in the first place. But essentially, they gave me a drug that accelerated the problem and it was within just hours of receiving the diuretic that they told me the C-section could no longer be put off and it was the only way to save my baby’s life. Julie: That makes so much sense. I had preeclampsia with my first and I had the magnesium sulfate drip during labor and my preeclampsia got way worse the first week after he was born than it had been my entire pregnancy. I was swollen up like the Michelin Man, or whatever you call it. All the way up from my feet to my legs were swollen up like a balloon and listen to that. I am just reading about the Brewer’s diet and I am super intrigued. So we are going to talk about that when you are done, but I am not going to keep interrupting I am going to let you go on with your story right now. Breana: Thank you. I am trying to pack it all in and not be a chatterbox the whole time, but thank you for giving me the time. Yeah, so that was terrible and again, I was a first-time mom and I was just like, “Okay, I am at the hospital. They are supposed to help me. They obviously know more than I do, so I’m just going to trust them.” When I’m asked if I think my C-section was unnecessary, I hesitate to answer because the C-section itself may have been necessary at that point, but only because of the improper care I received leading up to it. I was admitted into the hospital for preeclampsia symptoms, given high doses of magnesium sulfate, of which a side effect is breathing difficulties. Then, I was given a diuretic for problems rel to breathing difficulties and I was then given a C-section for severe preeclampsia symptoms, which the diuretic is known to exasperate. So this is a quote, I am going to read it real quick, from the documentary “The Business of Being Born”, which I think is a really great thing. Everyone should watch. It sums up how I feel about my experience. It says, “Step-by-step, one intervention leads to a series of interventions and then that result is the mother finally ends up with a Cesarean and everybody says, ‘Thank God we were able to do all the interventions to save your baby.’ But the fact of the matter is, if they hadn’t started the cascade of interventions in the first place, none of that would have been necessary.” So obviously, I was extremely sick when I arrived at the hospital and something needed to be done for me, but based on the studying I’ve since done regarding the decades of research on preeclampsia, I believe that ensuring I received proper nutrition should have been the first order of business that day instead of what did happen, which, unfortunately, was the opposite. My C-section recovery was pretty brutal. I had never experienced pain like that and I haven’t since. The hours immediately after the surgery consisted of me going into shock and having persistent vomiting and dry heaving that I couldn’t get under control which was pretty excruciating since I had just been freshly stitched up. It took a while, probably weeks, for me to be able to stand and walk without wincing in pain. It was not an easy recovery. When I was counseled in the ICU after the C-section, I was told that I had indeed been given and a classical incision after all which meant I would now need repeat C-section’s at 36 weeks for all future deliveries and that under no circumstances will I ever be able to labor because the risk of uterine rupture was just too great for me. I was told this by doctors who claimed to be very VBAC supportive. They told me that I was not a candidate because I had a classical scar. The way they talked made me feel like I had been given this crazy, outdated procedure and was now forever damaged, so that was really hard to work through. But it also got me thinking about how if this procedure was, in fact, so outdated, then what about the women who had a VBAC in the early 1900s? I thought they had to have existed and wouldn’t that mean that someone somewhere must have done it? Another thing they told me upon discharge was that it was likely that I would get preeclampsia again and there was nothing that could be done since there was no known cause or cure other than delivery. So now, I was pretty terrified of getting pregnant again, but at that time, I just had to focus on my daughter who was in critical condition in the NICU. When we got home from the NICU, I looked everywhere and I couldn’t find any stories of anyone who had had a VBAC with a classical scar, so that was pretty discouraging. Everyone has the low transverse scar and everything I came across just said what I had been told before which was that classical scars could never, ever VBAC. Basically, it seemed to be a unanimous consensus that VBACs can and do happen, however, I was just that one exception. Eventually, I think after searching the keyword “classical VBAC”, I came across the book online called Silent Knife . I hadn’t even read it yet and I didn’t know what it had to say about classical scars, but I thought, “What the heck? I will see if I can find this author on Facebook.” I did find her and she ended up being a practicing midwife in Boston, actually, the midwife who coined the term “VBAC”. I ended up sending a message to her asking if she had ever known anyone to have a VBAC with a classical scar. She got back to me and told me that yes, many women with my kind of scar go on to have a lovely, normal, natural birth and I had to reread her message a couple of times. I was in shock. I actually cried because it was the first time I ever heard a “yes” from a birth worker like that. I was like, “Did she understand my question? Is this really what she is saying to me?” She was so wonderful and was willing to speak with me over the phone. She connected me to a couple of underground or non-traditional midwives over the country who were maybe closer to me or maybe willing to travel to me when I did decide to get pregnant again. This was around the time I also found the Special Scars Special Hope organization which was extremely helpful to me. I no longer felt like this freak who was the only person since 1950 to have been given this scar. I now could connect with thousands of other women all over the world who were like me and had all been told the same thing, that we couldn’t VBAC, yet many of them had gone on to have their VBACs, so I was just so thrilled and so encouraged to get to talk with him and hear their stories. Of course, it was around that time I also stumbled upon The VBAC Link, which was just another amazing resource for me and I was so encouraged by these other women’s stories. I couldn’t believe how much I was able to relate to them. I listened to it every day as I made dinner or folded laundry, so being on the other side of it like this is just really so surreal. I especially enjoyed the special scars episodes and was so grateful to your guys for including special scars and not leaving us out due to the negative stigma that surrounds it. I want to take a brief moment to hopefully sum up what I was referring to earlier when I spoke of the decades of research on preeclampsia. One of the things I came across when searching for answers about preeclampsia was the Brewer diet. I don’t like to refer to it as a diet because really, it’s just a nutritional outline to ensure your body is well-supported for pregnancy. The creator of the diet, Dr. Tom Brewer, was an obstetrician who, in the late 1960s and early 70s, formulated a nutritional guideline based on his findings as well as decades of research from other doctors. Of some 7000 pregnant women whose care Dr. Brewer oversaw, only 0.5% ever presented with mild symptoms of preeclampsia. He eradicated preeclampsia in populations where it had previously been upwards of 40%, which is really remarkable. I strongly encourage everyone to look into the diet. Once you understand the science behind the physiology of pregnancy, it becomes obvious why the Brewer diet has been so successful. I’ve run into a few people who have insisted that preeclampsia can’t be prevented or reversed with diet since it hasn’t been accepted by mainstream medicine. This is largely due to the fact that Dr. Brewer found it unethical to conduct a placebo study. He was also a champion for racial equality which, sadly, I believe played a part in his work being snubbed and overlooked, particularly because of the social climate of his day. I’ve always been puzzled by those who claim that diet has nothing to do with preeclampsia. Why would anyone argue the fact that a healthy diet promotes health? Why would you be so eager to dismiss the theory when the alternative is basically just accepting defeat? What I mean by that is that currently mainstream medicine has no answers and says there is no cure for preeclampsia, yet it is among the most common complications of pregnancy, affecting thousands of mothers annually. The unfortunate truth is, no one makes money from a healthy person which I, unfortunately, personally believe is one of the driving factors why the Brewer diet is ignored. But nevertheless, I encourage everyone to, at the very least, look into it and see what it’s about. Dr. Brewer wrote several books and there is a free website and Facebook group called Dr. Brewer Pregnancy Nutrition that was incredibly helpful to me. Without the Brewer diet and the support I received from the ladies in that group, my VBAC would not have been possible. So it was really important to me to just take a minute to talk about that. After I had studied so much and been blessed with all the support and information surrounding preeclampsia and VBACs, I began to get to the source of my fears regarding another pregnancy. I realized I was letting this fear dictate my life since my husband and I knew we wanted a family and we believe children are a blessing and a reward from God. So after a lot of prayer, my husband and I felt convicted to just entrust our family planning to God. At that point, I felt like I at least had a rough game plan as to how a second pregnancy would look going forward. I happened to get pregnant again in November 2019, so my due date was within days of when my first son had been. It was incredibly healing for me to be able to continue to carry that pregnancy full-term and pass those year marks from two years before. I planned to follow the Brewer diet, which I did, and I fully believe it is the reason I was able to have a successful, full-term second pregnancy completely free of preeclampsia. I did have some brutal morning sickness again, but this time, I knew how to manage it much better by eating small, healthy snacks and not really allowing my stomach to get empty. I think that helped me a lot. I initially thought I would have an unassisted birth because no hospital was willing to let me VBAC on a classical scar and I honestly felt pretty let down by those I had put my trust in the first time, so I didn’t really want to give birth in a hospital anyway. I did have contacts with midwives in other states that I mentioned before, but honestly, I knew I wanted to labor alone and undisturbed for the most part, so it felt silly for me to hire a midwife from a few states away and go through the whole process of having her stay with us just to make her wait in the other room while I labored. So ultimately, I decided to contact the Amish. I have gone to Amish country for festivals and stuff since I was a kid and I thought, “Okay. The Amish must be having home births. So, who is helping them?” I had this crazy idea to ask my friend if she could give me the address for one of the Amish guys that worked on her house. I thought, “What do I really have to lose by writing a letter to his wife and asking her who her midwife is?” So that’s what I did. This Amish family, they were just so kind and went out of their way to connect me with the Amish midwife who had been a midwife for 40 some years and attended hundreds of birth a year, upwards of 100 births a year. So she had a lot of experience. She was a gem and I was so fortunate. That midwife works with a non-Amish doula who is also a midwife learning and working with the Amish community. The Amish family told me that yes, the midwives were willing to assist a Yankee woman. That’s what they call us non-Amish and they gave me the doula’s phone number. I gave her a call and I remember hearing it ringing and thinking, “This is so dumb. She’s going to hang up on me when I tell her I have a classical scar. Why am I even bothering?” But to my surprise, she didn’t hang up on me. She actually asked, “When would be good for us to meet in person?” She also let me know that there was an Amish woman in their community who had had three home births after an inverted T incision and would be willing to meet with me as well after some encouragement and support. That was the first time I actually met another person in real life, not online, who had a special scar. That meant a lot to me. It was really just crazy how it worked out. It felt really meant to be. I felt so secure and comforted with them whenever I met them. Meagan : I love that. Breana: They were so respectful of my wishes throughout the whole pregnancy as well as the birth. They were hands-off when I wanted them to be and hands-on when I needed them to be. I didn’t want any ultrasounds or testing at all and they were okay with that. I took my own blood pressure and weight, and our prenatal visits were super laid-back just in my living room. It was amazing. I really couldn’t have asked for anything better. So when I was 38 weeks and 2 days, I went into labor at about noon on a Saturday. You know what they say about a full moon and it actually was a full moon that weekend. My birth was one of four or five that my midwives attended that weekend. Anyway, I didn’t recognize that it was real labor at first. I just thought Braxton Hicks or something, but I didn’t take it too seriously until the time when I was literally on my bed moaning and I acknowledged, “Okay, maybe this is real.” About that time, I went to the bathroom and realized I was losing my mucus plug. I let my doula know what was going on and it was the middle of the night at that point. I told her I wanted to labor undisturbed anyway, so they didn’t have to bother coming just yet. My contractions were mainly felt in my lower back and wrapped around, so what I really had, for the most part, was back labor. At this time, I was having contractions three to four minutes apart. I was just laying on my bed trying to relax my body as much as possible and even sleep in between contractions when I could. At that point, everything I had learned from HypnoBirthing became really valuable and helpful to me. My husband pressed the heating pad into my lower back each time I had a contraction and that counterpressure was really what got me through. I also alternated from the bed to the shower and would run the hot water on my back. So that was how I spent most of the night and my contractions were three to four minutes apart most of the time. Eventually, I could tell I was entering transition because I was getting chills and shaky legs and it was getting so much harder for me to work through my contractions. So I told my doula that I would like for them to come at that point. I think it was about 5:00 a.m. by the time they ran to my house and there were three of them. I had the older, Amish midwife who I had first mentioned, the non-Amish doula and midwife, and the Amish woman who had had three homebirths on her inverted T scar because she had offered to come to my birth and I was really happy to take her up on it. Her additional support and encouragement just meant so much to me and I knew that she really got it. She knew what it was like because she herself had done it and she is also my sister in Christ. They all are. So the whole thing was just such a blessing. When they arrived, they offered to check my cervix to see how far dilated I was which I didn’t want. I was also nervous that I would get discouraged if it was a lower number, I would have a hard time, so I told her I wanted her to check, but not to tell me the number. She checked and told me she really didn’t think I was going to be disappointed, so would I like her to tell me? And I said, “Yes.” She told me I was 9 centimeters and that my cervix was paper-thin. She told me that she could feel the baby’s head under the bag of waters and she offered to break my waters if that’s what I wanted because the pressure of the waters had made me feel a little more pushy than I was. I just really didn’t want any interventions at all though, so I opted to labor somewhere and let my body do its own thing. I sent them downstairs and it was just my husband and me again since our two-year-old had been sleeping this whole time. My midwives did my dishes and made breakfast. It’s funny because that’s what I love about home births, just how laid-back and normal it is. So eventually after laboring in bed somewhere, I was laying on my side, my husband was doing the counterpressure with a heating pad and I was working through a contraction, and I heard a loud pop and a splash because my waters had broken. I did swell up right after that just because of the rush of hormones, but after that, I felt so much better. I was just really glad that I had waited for it to happen on its own because that’s the way that I wanted. At that point, I was feeling like I could push and I ultimately pushed for a good two hours. I pushed on the bed and the shower, leaning on my husband, leaning on my doula, and the yoga ball, and the toilet, and everything. Eventually, I was just so exhausted that I crawled back into bed and I was kind of on my side, kind of on my back and one of them suggested I try using a towel to play tug-of-war to help direct my pushes. I was just so tired from being up all night and pushing for so long. I had been laboring for 21 hours at that point, so the tug-of-war trick really worked for me. It was probably within minutes that she was born. We named her Athena and she weighed 9 pounds, 4 ounces, and was 21 inches long. Her size was such a lovely surprise, especially considering that she was born at 38+3. My midwife said, “Just imagine how much more she might have weighed had she come out any later.” But ultimately, it was just a really amazing experience. She was born on a Sunday morning and we just checked the time on my husband‘s watch. It was just so laid-back and exactly how I hoped it would be, but probably better than I hoped it would be. After it happened, I just laid there thinking, “I can’t believe this actually happened. I can’t believe I really did it.” You know, after you have been told you can’t do something how many times, that moment was just-- I felt amazing. I was able to pull her up to my chest for skin-to-skin immediately. I was able to breastfeed right away and they left us alone. We put off the weighing and the measuring and everything for a little while because I just really wanted that golden hour to be undisturbed and I wanted to do delayed cord clamping. My older daughter was able to come to meet her right away because she happened to wake up right after she was born which was perfect timing. I didn’t have any tears, which I was pretty grateful for with an over 9-pound baby. I was pretty sore from all of that pushing, but honestly, my postpartum was a breeze, and just a couple of days later, I was walking her down the street to show her off to my neighbors, so I felt pretty good. It was just an amazing experience. I am so grateful for the support I had and the opportunity to have such a restorative experience. I told myself that if I ever got to have a VBAC, I was going to make a big deal about it so no one else would have such a hard time finding answers like I did. So I just really appreciate this opportunity to share more than you know and I thank you guys for all you do. It really does make a difference. It definitely, definitely did with all those episodes. I’m almost done, but I did write down some key takeaways that I wanted to sum up for the listeners if that’s okay. The first one is, your body was carefully designed by a creator who loves you. He didn’t forget anything or leave anything out. Bodies heal and a scar on your uterus does not mean you are any less capable than the next woman in doing what your body was designed to do. Along those lines, something that I think maybe subconsciously made an impact on me was that when I was a teenager, I got to witness one of my younger brothers be born in the car on the way to the birth center. I think that that experience showed me how when left alone, birth really is, for the most part, simple and straightforward. I think what I took from one of your older episodes was the idea that if I were to do nothing and not schedule a repeat C-section like they were telling me I had to do, then my body would instinctively know what to do and would give birth vaginally. Obviously, uterine rupture does happen it should be taken seriously, but so should the risk of multiple Cesareans. That should always be an individual choice, not one for your doctors to make for you. The other thing that I had was to know what you want and fight for it. Find a provider who will meet your needs and respect your authority and choices even if it means thinking outside the box, like writing a letter to the Amish. You don’t need anyone’s permission to use your own vagina. I also wrote an article that’s in Issue 47 of Natural Mother magazine if anyone is interested in reading some things I may not have covered on this episode. But that was all the bullet points I had written down to share, so thank you for letting me ramble on that entire time. The Brewer Diet Julie: No, we love it. You have lots of good information in that episode. I feel like we almost don’t have to do any educational piece, but I want to talk about something that we don’t talk about a lot on our podcast. But before I get into that, I want to let you know that we have a blog about VBAC after premature Cesarean and about special scars that you can find by going to our website thevbaclink.com/blog and just in the search bar, typing those terms in, and it will pull the blogs right up. It will give you all the information you want to know. But I want to talk about diet during pregnancy. We have one podcast about pregnancy nutrition. We have a blog about pregnancy nutrition. Normally Meagan is the nutrition/exercise guru of the bunch, but I am going to kind of take over this time on that topic because I was reading some really interesting things about the Brewer diet while Breana was sharing her story with us. So I wanted to go through and just talk about a few fun little statistics that I found and we will cite these in the show notes. The first one is from the website drbrewerpregnancydiet.com . There is a tab called “Preeclampsia” on the left-hand side. Click on that tab and it talks all about the Brewer diet in relation to preeclampsia. There’s a lot of content taken from books on the subject, and studies, and things like that. A lot of the information is outdated, but nutritional needs are still pretty consistent, I think, across-the-board. There’s also a lot of up-to-date information in there as well. But I wanted to point out a couple of things. So first of all, we know that the medical system is more likely to recommend prescription medications and medical treatments to prevent and treat things than they are to recommend food to treat things. But on this website, drbrewerpregnancydiet.com , on the left-hand side, click “Preeclampsia”. It’s really, really interesting because like I was saying before, the medical system will recommend prescription drugs. They will recommend early delivery. They will recommend all sorts of medicalized things to take care of whatever it is that we are dealing with, but the medical system is not designed in a way to set up proper nutrition to help heal your body with food and to help you learn how to eat better and do better so that your pregnancy can avoid these things in the first place. It’s just not the same that way. It would kind of hurt itself by preventing the things that it is being paid to treat. Not that I’m against the medical system because I am very grateful for when it is needed, but I think there needs to be a really good balance between treating your body naturally and then using the medical system we need to. It’s really funny because the medical system, or scientists, or doctors generally claim that we don’t know what causes preeclampsia. We think it might have something to do with when the placenta is developing, but we can’t really pinpoint a cause. But Dr. Tom Brewer, the obstetrician, has pretty good logic about what causes preeclampsia. I’m just going to read a quote here from him on that website I was just telling you about. He says, “Low blood volume, which is the inevitable result of dehydration and the use of diuretics contributes directly to eclampsia, premature birth, and low birth weight. And now, there is a whole group of hypertension drugs that have come out in the last 10 to 15 years. These drugs just ravage women. They cause direct damage to all of the cells in the mother’s body, particularly to the liver, a little to the kidneys, and then to the placenta and fetus.” It’s really interesting because like you were saying earlier, diuretics, excessive doses of magnesium and things like that prevent the body from being efficient in the blood flow and it inhibits the blood from getting to the fetus, to the placenta, and to the uterus, which all are really critical for helping baby grow, right? It’s really interesting in here because he says-- I’m just reading on his website and then, let’s see. Where did it go? “The cause of preeclampsia was discovered in the 1950s and 1960s,” and I read that I was like, “Wait a minute. Doctors don’t know what causes preeclampsia, right?” But, listen to this. “Preeclampsia is caused by abnormal blood volume, which is caused by malnutrition or food deficiency.” Now listen, it might seem strange to you. Like with me, I’m like, “I was definitely not starving myself when I was pregnant with my first baby,” because I had preeclampsia with my first and I was definitely eating lots of food, but I was working really hard and I would eat a salad for lunch thinking I was being healthy, right? But when you deprive your body of the critical nutrients that it needs, it doesn’t matter what you are eating, but if you’re not eating foods that are rich and nutrient-dense, then you are malnourished. And when you’re not drinking enough water, your blood volume can’t increase in the way that it needs to in order to effectively and healthily support you, a healthy placenta, and a healthy baby. So it’s really interesting because it talks about how this particular diet that he recommends following really helps the blood volume expansion. I mean, there is a whole bunch of sciencey stuff in here that I could go on, but basically eating a high protein diet with lots of salt helps the body create the blood volume that it needs to sustain the pregnancy which essentially prevents preeclampsia and other blood-related issues. I definitely need to learn more about it and I encourage you to read more about it too, but it shows some really interesting statistics here, where normally we think like, “Oh, salt is bad. Salt is bad. Salt is bad.” But in pregnancy, salt is necessary for us to remain hydrated and again, for our circulatory system, and for our overall well-being. They compare studies of people that were on a high salt diet versus a low salt diet and the outcomes are way better on the high salt diet. Instances of preeclampsia were 37 per 1000 in the high salt diet versus a low salt diet had 97 in 1000 cases. So, three times more likely to get preeclampsia according to this study when you eat a low salt diet. Isn’t that interesting? It also goes on to compare perinatal deaths, C-sections, and placenta abruption which are all significantly higher in the low salt diet group. But the Brewer’s diet is not just about drinking lots of water, and eating protein, and increasing your salt intake, but there are some really cool things that they recommend eating including eggs, milk, meat, and fish every day. Dark, green, leafy vegetables, lots of vitamin C sources, nice, healthy grains, servings of healthy fats and oils, and vitamin A are all things that he recommends in the Brewer’s diet. Now, Dr. Brewer‘s website is called the Blue Ribbon Baby Pages , but that website has been archived now so it’s not an active website, but you can still find it if you search “Blue Ribbon Baby Pages”. That website is directly authored by him. There are lots of spreadsheets and checklists and things like that if you want to follow that diet because what that diet does is, it helps your body increase the blood volume that it needs to sustain a healthy pregnancy. Now my mind is spinning in all of these different ways because there were things I did in my second pregnancy to avoid getting preeclampsia and a lot of it-- I didn’t follow the Brewer diet as described here, but a lot of it was following these recommendations. Plenty of water, making sure I am staying hydrated, not limiting my salt intake, and eat lots of protein, especially eggs. I ate eggs like crazy when I was pregnant with my second. It is just really, really interesting. I know that-- trust me. I was just sitting here eating a pint of Ben & Jerry’s ice cream when we were recording our last episode, so I am definitely not the epitome of health. And so, it can feel overwhelming. I know especially when you’re pregnant you’re like, “Oh my gosh. Do I really have to make all these diet changes? Am I going to ruin my baby if I don’t follow this very strict diet? Or how much water do I need to drink or how much protein do I need to eat?” It is so easy to get overwhelmed, right? Because I know that I do and I am not even pregnant right now. But this is the thing. The Brewer diet is a nice, healthy diet. It goes right along with the guidelines that are recommended to just maintain health overall. It follows what ACOG’s recommendations are for a healthy pregnancy. It just expands on that a little bit more and there is some really solid evidence to support following this diet drastically improves birth outcomes. But you don’t have to go making all these big changes. You don’t have to go from eating a pint of Ben & Jerry’s a day-- no, I don’t eat a pint a day. Eating Ben & Jerry’s ice cream and to a complete 180 never eating anything with sugar in it ever again. Just making small changes in your diet, incorporating more nutrient-rich foods like healthy meat, healthy fats, lots of green, leafy vegetables, and vitamin A, and vitamin C supplements are going to do better. So focus on adding things into your diet more than you focus on taking things out would be my advice from a not-so-healthy mom to maybe other not-so-healthy moms right now. Meagan, what would you add? Are you completely embarrassed by my nutritional advice? Meagan: No, no. I think it is so important. This is not in conjunction with preeclampsia. It is in conjunction with how we as women in the world sometimes, our minds just go because being skinny, and not gaining too much weight, and bouncing back, and being back in our jeans and-- you know what I mean? There’s so much pressure in a lot of things. So when it comes to VBAC, I have personally had clients be like, “Well, my baby was so big last time and I was overweight, so I had better not eat.” I had a client specifically, one client that literally starved herself her entire pregnancy because she said, “I can’t have a big baby because if I have a big baby, I won’t have a VBAC, and then they won’t let me, and if they think my baby is big, then I won’t, and if I gain too much weight, then they will just tell me I am fat, and then I can’t have my VBAC,” and I am just like-- Julie: Did she have high blood pressure or preeclampsia or gestational diabetes? Meagan: So the crazy thing, she actually did have a repeat Cesarean. Her body tapped out because it wasn’t fueled. And so, it’s just in general. We need to fuel our bodies. But in life, because there’s so much pressure to be skinny and all of these things, right? And not gain too much weight, we cut, like you were saying, we cut out our nutrients that are insanely needed. And so, if we are cutting it out before we even get pregnant, because a lot of people are like, “Oh, I want to lose this weight before I get pregnant,” and then they get pregnant, and then they were cutting out these things and not adding those necessary things like the Brewer diet talks about, it is important to understand how it can truly impact you, your baby, your outcome, etc. We don’t know the exact cause of preeclampsia, but there are things that we were going over and were shared in this story. There are things that we can do to help that have been proven to help. And so, why not do these things and pay attention to these things? I just think it is so important in general. Pregnancy, not pregnant, preeclampsia, diabetes, anything. Fuel your body because your body gives you so much and we are asking so much of our bodies every day to perform. If we cut what it needs, it is not fair to ask that. Does that make sense? Is that silly to say? Julie: Yeah. I just think like-- I have anxiety. Everybody knows that by now. I have a very anxious mind. I just think of when my mind gets anxious, it is because there are things going on that are influencing it, right? I liken that to not feeding your body. It’s like those outside things influencing my anxious mind. Not fueling your body does not allow your body to perform well. It doesn’t allow it to function effectively, just like your mind. With my mind, with my anxiety, when my anxiety is high, the whole world is falling apart. It doesn’t even matter if nothing is a big deal, but everything feels like a big deal. And so, when you are depriving your body of those nutrients, even the smallest thing your body is working hard to do will feel like a big deal to it. It can exhaust it and it can make it harder for it to do normal things when it's most important thing to do is growing your baby. Meagan: Yeah. I love everything that Breana was talking about. It doesn’t matter who you are. Check it out. Just check it out. It doesn’t do you any harm to check it out. Julie: Yeah, you can just Google “The Brewer Diet.” It is Brewer. I know we say Brewer’s because I like it to be possessive, but it is by Tom Brewer. Meagan : It’s because, in my head, I think Brewer’s Yeast, so I say Brewer’s. It is Brewer. Julie: Brewer. B-R-E-W-E-R. Take a look at that. It looks like a really good, healthy diet. So, good thing to do. Take care of your body. Keep nourishing those babies and improve your chances of lots of different birth outcomes. Closing Would you like to be a guest on the podcast? Head over to thevbaclink.com/share and submit your story. For all things VBAC, including online and in-person VBAC classes, The VBAC Link blog, and Julie and Meagan’s bios, head over to thevbaclink.com . 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