Episode 327 Adriana's HBAC + What Does the Science Say About VBAC?

Adriana is a scientist and professor at New Mexico State University in Las Cruces, New Mexico. During her first pregnancy, Adriana was faced with the possibility of her baby having a severe genetic disease. She became so involved in researching the details of it that she didn’t consider the need to research her birthing options as intensely. However, after a long and difficult induction process which ultimately ended in a Cesarean, Adriana was left feeling like she failed as a scientist. She was determined to take charge of her next birth and apply her years of research skills to learning everything about VBAC. Adriana went on to have a peaceful home birth surrounded by a big support system and empowered by her research. She also gives listeners tips on how to interpret published articles on VBAC and explains terms like abstracts, confidence levels, and p-values. “I just found the data is so strong in showing that VBAC is super safe for non-high-risk individuals. Again, having a previous Cesarean does not automatically make you high risk…I had three high-risk factors if you will and still, with those factors counted in, I knew that VBAC was really safe for me just based on the data that I found.” Dr. Adriana L. Romero-Olivares' Website Needed Website How to VBAC: The Ultimate Prep Course for Parents Full Transcript under Episode Details Meagan: Women of Strength, we have another amazing VBAC story for you today. This VBAC story follows a C-section that was unplanned which let’s be honest, most of ours are, and it had a lot of interventions. We have our friend– oh my gosh. I can’t speak today. Adriana, hello. Adriana: Hi. I’m so excited to be here. Meagan: Oh my gosh. I’m so excited for you to be here. Tell me. Okay, so you’re currently in Mexico. Where were you when you had your VBAC? Adriana: I’m in New Mexico, so the U.S. Meagan: Oh, you’re in New Mexico. Adriana: Yes, exactly. In New Mexico in the U.S. and I had both my unplanned Cesarean and VBAC here in New Mexico. Meagan: Oh, you did? Very good to know. You guys, she is a scientist and a professor. She spent many years researching microbes which is really cool. Do you say fungi? Is that how you say it? Adriana: You can say it fungi, fungi, fungi. People say it in different ways and they are all correct. Meagan: It’s like fungus, right? And bacteria? Adriana: Yes. Meagan: I have so much interest in that weirdly enough because it is in our gut. I have a really weird interest in gut health right now. Anyway, and how they are impacting the global climate. Something that’s kind of cool about her science journey is it really seems like it was spun after VBAC, right? Adriana: Yeah. I mean, I’ve had an interest in sciences forever, but I guess I had no idea how much science was behind VBAC and getting into this VBAC project that I had for a while, I feel like it really ended up helping me to grow as a scientist which was really cool. Meagan: So cool. We’re going to maybe talk a little bit more about the science of VBAC here in the end so make sure to stick with us. I do have a Review of the Week before she starts sharing her story. This is from eoliver14 and it says, “Love this podcast.” It says, “I’m not one to usually listen to podcasts but ever since I came across this one, I haven’t been able to stop listening. I’m preparing for my VBA2C” so VBAC after two Cesareans “and these stories have been so amazing and helpful.” eoliver14, I hope all went well if you have had a baby since then or if you’re still preparing, I hope that this podcast is still inspiring you. And if just like eoliver14 this podcast is inspiring you and helping you and building you up, please leave us a review. We love them so much and I really truly, truly, truly believe that so do honestly all of the listeners. I think a lot of listeners love these reviews. It’s so fun. You can leave that at Apple Podcasts, Spotify, or really wherever you listen to your podcasts. Even if you Google “The VBAC Link”, you can review us there. Meagan: Let’s get going into this story. So unplanned C-section. Adriana: Yes. I want to give a very brief background of my life just to get into the mindset that I was when I had the unplanned Cesarean. My husband and I have been together for a really long time. We are going to celebrate our 20th anniversary this year. We met our first year of college and then we’ve been together ever since but we only had our first child in 2021. That is because we prioritized our careers for a really long time. We are both scientists. We are both professors so we did our Bachelor’s together then we did our Master’s and then we did our PhD’s together. Then we did long distance for a while because we were doing post-doctoral research which is a thing. Then in 2020, we both landed a job in New Mexico State University where we are right now so in August of 2020, we moved across the country from New Hampshire and from New York City to New Mexico. We sort of started our new life in a new city during the pandemic with a new and very demanding job. In April of 2021, which was just a few months after we moved to– we live in Las Cruces, New Mexico. When we moved here, the biggest surprise of our life happened which was that I was pregnant. It was a surprise pregnancy. The pregnancy was just overall uneventful in the sense that I just didn’t have any sort of discomfort or anything. I was just tired and that’s pretty much it but then when I was around 16 weeks pregnant, I got a phone call out of nowhere. I got the news and this is the way that it was told to me. They were like, “You have a 50% chance of your child having a fragile X chromosome which is a genetic disease.” I was like, “What? What is it? What’s that?” I had never heard about it and I was like, “50% chances? That’s pretty high.” I remember I was in my office and Jovani, my husband, was there when we got that phone call. We were just very confused then when we started to look into it, it’s actually a pretty terrible genetic disease to have so all of a sudden, our whole life shifted. We were very concerned. Since the very beginning of my first pregnancy, there were a lot of interventions just because I was of advanced maternal age. I was 36 at the time and after 35 you are of advanced maternal age. It doesn’t matter if everything looks good but if you are older than 35, that’s it. They were like, “Oh, we recommend this testing and this other testing and this other one” and so on. One of those testings was genetic testing which I think we wanted to do either way just to be prepared in case of anything. So then we started to look into, “What is this genetic disease?” Once again, it was pretty bad. So then yeah, it was 50% chances. That’s pretty terrible. That’s where I brought in my scientist skills. I was like, “Wait a minute.” So then I got in touch with a genetic counselor. I don’t think this is just the way it is for everyone, but the particular genetic counselor that I spoke with wasn’t really helpful even though I told them, “I’m a scientist and I have a pretty strong molecular biology background. I understand DNA and genes very well.” I was looking for very specific information and they were just not really helpful. So then both Jovani and I spent so much time digging into the scientific literature and trying to find information about this disease. That’s how we came about some newer testing that really looks deep into the DNA sequence that they find in your baby and then they’re able to tell very precisely what your chances are of your child having this disease or not based on the genetic sequence. Then we just spent a lot of time looking into that, finding that information, then advocating for my baby to get this genetic testing done because it was not something that my insurance wanted to cover. Long story short, after a few couple months looking into that and making calls and so on, we found a way for that testing to be done. Then when we got the results back, 50% chances were wrong. The information I got was wrong. Meagan: That’s some pretty wrong information to get. Adriana: Yes. It got me thinking how many people are probably given this information with the statistics totally wrong? So then the 50% chances when I looked into it went down to 5% chances and then when we did the additional testing, it went down to 0.1% chances. Essentially, null almost. Meagan: Oh my gosh. Adriana: Yes. Yeah. You know, even though we were very grateful for that, it sort of set this tone in my pregnancy where I was so stressed the whole time. I just didn’t put any time in researching how I have to prepare to give birth. I was just in survival mode if that makes any sense just grateful that I didn’t have to worry about the genetic disease. I think at around week 35, they were like, “Because of advanced maternal age, we recommend an induction at week 39.” I was like, “Okay. They’re recommending this. Let’s just go ahead and do this.” I’m a very tall person and Jovani is tall as well so we make big babies kind of. I knew the date of conception of my baby and I knew that based on that date of conception, I was going to be 40 weeks on December 31st. Then somewhere around 30 weeks, they were like, “No. Because of what your baby is measuring, your due date is actually December 22nd so then that means we–” Meagan: 10 days earlier. Adriana: Exactly. They were like, “That means we would like to induce you on December 15th.” Once again, I was like, “Fine. Yeah, sure.” So then on December 15th, we went into an induction. It is a very long story, but long story short, the induction lasted three days and nothing happened. I was given Cervadil and Cytotec and nothing happened. I didn’t dilate. Nothing. Meagan: Your body was really not ready. Adriana: It was really not ready. I was really desperate. I was like, “What’s going on? Why are things not happening?” No one was giving me any information even though I was asking, “What’s going on?” They were like, “Just relax.” I ended up asking a nurse because the doctor came in and was like, “Well, we tried Cytotec and Cervadil and it’s not working so the next thing to do is Pitocin.” He was like, “Is that what you want?” I was like, “I don’t know. Let me think about it.” I asked a nurse, “What do you think about me getting Pitocin?” The nurse was like, “No. No. They are setting you up for failure. You haven’t dilated at all. No. Just say no.” So then I just was desperate for any advice. I ended up saying no and I was discharged. They were like, “We’re going to discharge you but you have to come back.” It was a Saturday when I was discharged and they were like, “You have to come back on Tuesday for a second induction. But a lot of times after a failed induction, people go home and they come back in labor a few days later.” I wasn’t. On Tuesday, I went back. This was December 21st I think or something. So I went back for a second induction and then when I went in, I was already soft on my cervix. I felt things were advancing really well and I was excited. Then it was almost a three-day induction once again. So they started giving me the same thing. They gave me Cytotec first and they waited for a few hours then I had the Foley bulb inserted. It’s like a blur because there were just so many interventions. People were coming in and out of the room the whole time. I was still sort of having a hangover of the last induction because for three days I was so tired. I was so hurt. They couldn’t find my vein so then I had multiple bruises in my arm. It was just so many things. I felt kind of a hangover if that makes any sense. Meagan: Yeah. Adriana: I started dilating with the Foley bulb. It came out so at the beginning, things seemed to be going well. Meagan: Better. Adriana: Yeah, better. I was like, “Okay.” I think when I– I don’t even know how much I dilated, but at some point, the OB/GYN came in and she was like, “You know, I recommend to you that we rupture your waters just so that things start going.” I was like, “Yeah, sure. Things seem to be going well so let’s do it.” They ruptured the waters and then that was pretty much it. I don’t feel like things started happening or anything. I was getting cervical checks very, very, very often. I think that sort of messed up my head to some level. They hurt me. They are not the most comfortable things to go through. Meagan: Especially early on in labor. Adriana: Exactly. Meagan: Right when your Foley just came out, you probably had a posterior cervix, pretty closed still. Adriana: Exactly, yeah. There was some bleeding going on. It was really terrible. So then a few hours after my membranes were ruptured, I think maybe the doctor could see that I was not relaxed for obvious reasons and she suggested getting an epidural. She was like, “Oh, I suggest you get an epidural because I think that would help you relax. That can speed up things.” I was like, “Okay.” So then I ended up getting an epidural and then I got one and it only worked on half of my body so then I had to get another one later on. After many, many, many hours, things were not happening. I did end up getting contractions after the Pitocin and the contractions, I could feel on half of my body and then eventually, I just couldn’t feel them. I could just feel the pressure. That went on for hours. I mean, I think I got the Pitocin. It started at 8:00 PM maybe or 5:00 PM and then they were increasing the dosage and then around 6:00 AM I think they had gotten to the highest dose that you can get and I was not. They checked me and I was at 5.5 or 6. Then the doctor was like, “Okay, we’re going to stop the Pitocin and let your body do things.” My body didn’t do anything. The contractions completely stopped once the Pitocin was removed and we waited for an hour or two and this time, my waters had been ruptured for over 24 hours so she was like, “You know, there’s nothing else we can do. We’ve tried everything. Nothing is happening. I recommend having a C-section.” I mean, I think when I really felt I had no other option, I was like, This is what needs to happen and what I have to do, so sure. Let’s go ahead and do it. Fortunately, it wasn’t an emergency C-section or anything. We still waited for 4 or 5 hours just sitting there waiting for I guess the team to get their act together. They took me to the OR and my baby was born around noon. Everything went fine. I had no complications. My baby had no complications so it was pretty nice but the recovery was so tough. It was just that something inside me didn’t feel right. I was like, “What just happened? What just happened? Why did I end up having a C-section?” I would just think about it over and over and over at night when I was nursing and when I was alone with my thoughts and so on. I was like, “What happened?” Those sorts of things and why when I asked questions why no one answered the questions. They were just treating me as if I was an uneducated person. They just didn’t want to engage and I think that’s wrong in general to everyone just the way that you are dismissed when you ask questions is pretty terrible. They are on a schedule and they have no time or interest in my opinion or in engaging. Then I started to think about it a little bit more and then in my mind, I was like, Well, I guess if I have another child, I can always do things differently. That was the mindset I was in for a few months. Then when I went to my 6-month follow-up appointment to check me and make sure everything was okay. I asked the doctor, “So, if I have another child, I would like to have this child vaginally so I would want to know why did I end up having a C-section? What happened? I know it was failure to progress according to your notes but what does that mean?” She looked at my chart for 10 seconds and she told me, “You cannot deliver vaginally because your pelvis is too small.” I was like, “What?” I was like, “No. No. That cannot be.” I know that your body doesn’t. You can have your pelvis one way and it doesn’t really mean anything based on your body but I have a pear-shaped body so I was like, “I don’t think my pelvis is too small.” So then I asked her, “How do you know that my pelvis is really small?” She was like, “Because you failed to progress.” She did not want to engage. She did not want to. I just left that room and I was livid. I was so angry that she did not want to engage. She did not want to have a conversation. I didn’t even know if I was going to have another child at that point but I was like, If I ever get pregnant again, I’m just not going to come here. I just kept thinking about it over and over and over. I was like, I just need to reach out to someone who can help me understand this a little bit better. I reached out to a local doula and asked for information about VBAC in general. I didn’t know it was called VBAC at the time. I was like, This happened to me. If this were to happen to me again, can I deliver vaginally? She invited me to a VBAC course and the course was super awesome. They shared a ton of statistics on inductions and VBACs and so on. She also suggested doing a birth story processing which was pretty awesome too. So then 18 months later, I got pregnant with my second child and I knew exactly what I wanted which was not what I had before. I knew that I wanted a VBAC ideally and that I wanted as few interventions as possible. I wanted a provider who would engage with me and I wanted a provider who would follow evidence-based facts and of course, a provider who was VBAC-supportive. I looked for all of those things around my town. We have two hospitals. It’s not a huge city and I asked around. Basically, the information that I got was that they were VBAC tolerant but because I was of advanced maternal age, probably none of them would be comfortable having me as a patient. So then I ended up finding a midwife practice and that was what I ended up choosing because they were all that I wanted. They were amazing and I did end up having the most wonderful experience throughout my pregnancy with them. Throughout my pregnancy, I did a lot of research on my options. I educated myself on physiological birth and I also took classes on a home birth. I did a bunch of other things. I did a fear-release hypnosis. I did the birth story processing which was I think one of the most helpful things that I could do throughout my pregnancy. I didn’t really think that I had trauma related to my past pregnancy or fear of any sort, but then through the birth story processing, I ended up finding out that I did have some birth trauma and I had a lot of fear for this new pregnancy associated to my experience with my last pregnancy. Then I did the Daily Essentials of Spinning Babies every day. I didn’t skip any day just in case position was an issue last time. I ended up getting my documents from my last pregnancy like my records– Meagan: Your op reports. Adriana: Yeah. I ended up getting them actually one week before my VBAC. It was always something that I knew I needed to go get this done but then I kept forgetting. Then before my VBAC, I was like, I need to get this report and I need to read it so I can get some closure. I ended up finding out some really interesting things. This is a parenthesis. They said that my uterus was boggy when they were doing the C-section and they said that they had to take out the uterus and massage it because it was boggy. I was like, What is that? I looked into that a little bit more and I ended up finding out that my uterus was so tired from the Pitocin and the contractions that it was not working. That gave me some closure if that makes sense. I was like, It’s not because my body wasn’t working. It was just overtired. I had listened to the VBAC Link podcasts every day also. I did daily walks and you were my companion throughout those walks and just listening to all of the different stories gave me an idea that birth can go in many different directions and it helped me understand that you really have very little control over your birth experience. You can prepare all you want but then at some point, you have to let go because you can’t really control the situation. As a scientist, that is very frustrating because we are always in control of our experiments. But in a way, we can never control the outcome of the experiment so in a way, I was like, Okay, this is one more experiment. Yes. I did have spotting on week 18 of my pregnancy and I was diagnosed with marginal placenta previa and possible accreta so for a few weeks I was like, Well, maybe this is just not meant to be and that is okay. But then it ended up resolving by week 28 so I was cleared for VBAC. Throughout the pregnancy, I kept my plans secret from almost everyone including my parents and my in-laws. I told Jovani, “You are forbidden to talk about this with anyone.” As you start getting closer to your due date, people start asking questions which to me is like, why do they want to know such specific information like where are you giving birth? I never ask that but some people really want to get all the details. I just told him, “Just lie and tell them that it’s going to be at a hospital. Just say whatever you want. I don’t care. I just don’t want people asking questions and just getting reactions over my birthing plans and decisions.” Exactly. I don’t want to give explanations to anyone. I don’t have the energy to educate anyone at the moment. I know that I am making the right decision for me and that’s pretty much it. So that was really difficult keeping that information from some friends but as my due date got closer of course, we shared the information with my parents and just our families in general and our in-laws. I did share my plans with a few very, very close friends of mine. Most of them were supportive. Some of them– I guess I had to deal with some anxiety on their side. My doula helped me a lot with that because I was getting almost angry that they were anxious. My doula was like, “You have to remember that they love you and they love your baby. They are scared for you and your baby so try to understand them.” It gave me that perspective like, yeah. If I didn’t know, if I wasn’t educated enough on facts, I would probably be anxious too. Especially around week 35, their anxiety passed on to me and I started to have a lot of doubts about my decision. I was like, Is this the right decision? Is this really what I want? By then, I was so soaked on data and stats because I just put so much time into researching all of that, that it was how I calmed myself down. It was like, You know the data. You know the stats. You know the chances of things going wrong. Of course, there are chances of things going wrong, but the chances are so low that it’s almost impossible for this to happen. If something were to happen, okay. You were one of those improbable chances, but it was a chance that I was willing to take based on the statistics. Once again, that really helped me deal with the anxiety and if I would have had energy at the time, I would have been more than happy to share all the data and stats with friends and family. This is also how my husband ended up being convinced that I wanted a VBAC and that I wanted a home birth as well. I remember this one day, I think there was some sort of miscommunication between him and I at the beginning. At first, he wasn’t super happy that I was going with a midwifery practice but then I was like, “They are trained professionals. It’s not like Call the Midwife where she shows up with a tissue.” I was like, “No. These people come with equipment. That’s how it is.” So that calmed him down but I think he thought I was going to give birth at the hospital so then one day I was watching, I don’t know if you hear of this terrible thing that could happen with an uncertified midwife where the baby was footling breech and it was a really terrible story. I was watching something on YouTube and it came up and Jovani was like, “I don’t understand these crazy people who want to give birth at home.” I was like, “Hello, I’m planning to give birth at home.” He was like, “What?” So I told him, “Yes, Jovani. I am planning to give birth at home. This has been the plan the whole time.” He was like, “No, I thought it was going to be at the hospital.” I was like, “No. It’s going to be at home.” He was really, really, really nervous for a while so once again, I shared statistics and data with him. The midwives also were like, “Bring him in. Have him bring all the questions that he wants and we will answer them. We are here to help.” All of a sudden after a couple weeks after having that conversation, I shared a lot of resources with him. I told him, “Do you want to come with me to the midwife’s appointment so you can ask any questions you want?” He was like, “No, it’s okay.” I was like, “Oh, so you’re cool with me having a home birth?” He was like, “Yeah, if that’s what you want. I respect that. I respect your choices. I trust you as an individual and the choices that you make so that’s totally fine.” Giving him resources so that he could see the data I feel like really, really helped him. Then with some of my family members like my brother, for example, he was like, “Why do you want to do this? Why don’t you just, why? Why do you want to do this that isn’t the norm?” I explained to him my rationale and he was like, “Okay.” I had some other conversations. I have a family member and she is a physician and she was also like, “Why would you want to do this? Cesareans are so easy especially if they are scheduled. You just go in. You don’t suffer and then you just come out with a baby.” I was like, “Have you had a Cesarean?” Of course, she hasn’t. I was like, “It’s not really that easy. The recovery is really, really, really tough and there can be some very serious complications. If it’s needed then that’s wonderful,” but I know that I did not need one for my first pregnancy and I know that I did not need one right now. So then at 39 weeks, I started to feel very anxious because nothing was happening and I was very worried that I was not going to go into labor on my own because I never went into labor last time even though I know I was early. But I was still worried that, What if I never go into labor on my own? I’m going to start getting very nervous if I go past 40 weeks. Then at 39+5, I had prodromal labor at night so I felt excited to experience real contractions I guess for the first time. I was also very worried that I was not going to be able to go unmedicated because the prodromal labor was quite intense and I got thinking about all of these people who have shared their stories that they had prodromal labor for weeks. I was like, Oh my gosh. That’s horrible. I reached out to my doula and I was like, “Okay, I had prodromal labor last night. I’m very worried about not being able to handle the unmedicated birth that I want to do.” She suggested we do a welcome baby hypnosis session and to focus on relaxation so I guess once again, as a scientist, I never thought that I would be into hypnosis. It just ended up being this wonderful resource that helped me a lot during my pregnancy and during labor. On my due date exactly, so I woke up and noticed that I had lost what looked like pieces of my mucus plug and then within a few hours, I started having some mild contractions around 1:00 PM and then the contractions continued to get more intense throughout the afternoon and the evening. At midnight, my contractions were super intense but they were not consistent. I couldn’t get any sleep because of the intensity of the contractions but I did try to rest as much as possible. Around 4:00 PM, my doula checked in and she was like, “What’s going on?” I was like, “I’ve been having these contractions on and off.” I felt the contractions where you feel period cramps and they were more in my abdomen. They were so intense in that area but just according to what people said, they were like, “We could feel them in my whole belly.” I was like, “These are just weird. I don’t know. Are they real contractions or not?” Just because they were not consistent, I would get them every 3 minutes, every 5 minutes, every 7 minutes. Sometimes they would last a minute but sometimes less and sometimes more so I was just super, super, super confused and my doula told me, “You’re probably having prodromal labor again.” I was like, “Oh my gosh. No. This cannot be. It cannot be because I’m not going to be able to withstand this for much longer.” It had been 15 hours or so at that point. So I was tired and I hadn’t slept at all. This was around 4:00 AM so then my doula once again suggested I reach out to the midwives and ask them if I could have a cervical check. She was like, “That’s going to give you an idea of if this is actual labor or if this is prodromal labor. I was like, “Okay.” So then I texted my midwife. I didn’t want to call them because I didn’t want to bother them at 4:00 AM so I texted them and I was like, “Can I go to your office?” even though I don’t know why I suggested that because it would have been horrible to get in my car and drive to their office. I was like, “Can I go to your office in the morning so that I can get a cervical check?” They replied and they were like, “Yeah, sure. You can come to our office. We will see you there at 8:00 AM.” At this point, it was 4:30 AM and I think it was at 7:00. I was like, “I just don’t think I can do this for one more hour.” I texted them again and I was like, “Can I go to your office now? The pain is pretty intense. Can I go now?” Then one of them replied and she was like, “Actually, we can go to your house. We can go to your home and we can check you there. Are you okay with that?” I was like, “Yes, yes.” They ended up coming at 8:00 AM and they checked me. She was like, “You’re 6 centimeters dilated.” I was like, “Oh my gosh. Thank you.” I was so excited. I was like, “Oh my gosh. Yes. I knew this could not be prodromal labor for so long.” She was like, “You’re 6 centimeters dilated.” I was also leaking some amniotic fluid so she was like, “Things are about to get more intense now.” She offered some pain medication. I don’t remember what it was but she was like, “This is the pain medication that I can give you. Yes. It’s going to reduce the pain but it’s also probably going to slow down things. Are you okay with that?” I was like, “No. Don’t give me anything. I just want to get this over with.” I knew understanding– I feel like the first part of labor was very confusing. I was like, “Are these contractions? Are these not? Am I dilating? Am I not?” But understanding physiological birth, I knew very well that after 6 centimeters, things are about to get really intense but they are also going to be faster ideally. I guess I sort of trusted that. I was like, “Things are about to get more intense. I know that for sure and ideally, they’re going to get faster so I think I can keep doing this for a few more hours so no pain medication, thank you.” She was like, “Okay. I’m going to check in again with you at 11:00 AM.” It was 8:00 AM at this point. She was like, “If anything happens, just let me know.” She left and I think as soon as she left, things got really intense. I lost my mucus plug and then I had bloody show and I continued to labor peacefully at home. I was just in my room quietly. My mom and my dad were here because they live out of town and I asked them to please come to support me and to help with my son, my toddler. They were here but they were in the living room so it was only Jovani and I in the room. I sort of continued to ride the wave. That was my main coping mechanism. I was like, “Okay. A contraction is about to happen and then I would just count and Jovani helped me with back pressure.” Sort of the next few hours are a blur again. I think I was just so focused on coping with the pain, I was just counting over and over and over. I used a comb for a little bit but just was counting and riding the wave is what helped me the most. At some point, my doula and her student showed up. I think Jovani texted them. I don’t know. Meagan: 4-1-1, come! Adriana: Yes. They came in and they helped me. They did some massage and helped with back pressure as well. That made a huge difference. I got into the shower at some point. Huge relief to get some hot water on my belly. That really helped. Also, at some point, I had two midwives and one student midwife. At some point, they showed up as well. They started setting up the birth pool and then at some point, I noticed my contractions were not as back-to-back as they were a few minutes before. Once again, understanding physiological birth, I was like, “I’m getting close. I know my contractions are not back to back anymore so I know I’m getting close to being done.” My midwife– I had asked some questions to her before and I was like, “How do you know? I don’t want constant cervical checks so how do I know that I’m about to be done?” I remember she told me, “We know. We are trained to listen to the birthing person and we can tell when they are getting close.” So I guess they could tell and around that time, she was like, “Okay, I think it’s time for you to jump into the pool.” I think this was around 11:30 or something. I was on my knees and my arms were on my bed. That was the position that I felt most comfortable laboring in so when I stood up, I felt something coming out. I was like, “Oh my gosh. Something is coming out.” I went into the pool and within a few minutes, I started to feel very strong contractions in my whole abdomen finally. Up to this point, the contractions were only on my lower belly. My body started to push and after two pushes, the head of my baby came out and on the third push, all of him came out. I don’t know how long that took. It short of felt like forever to me but they told me it was pretty quick so I don’t know, maybe 15 minutes. I have no idea. It’s really funny how you lose sense of time. Meagan: Mhmm, yeah. Adriana: During that time. There were so many people in the room at that point. It was the two midwives, the student midwife, the doula, the student doula, my mom, and Jovani but it was pretty interesting because the ambiance was so quiet. Everyone was really quiet the whole time. It was really, really peaceful and then when baby came out, everybody was clapping and so on. My dad was outside the room and he was like, “It was so quiet. I was getting worried then all of a sudden, I could hear excitement and clapping.” I was able to catch him and we did immediate skin-to-skin. I couldn’t believe it. I was like, “Oh my gosh.” I couldn’t believe it. I got a shot of Pitocin and then birthed the placenta within a few minutes. My midwives tucked me into my bed. My baby was still attached to the placenta. My doula brought me a donut. Jovani got me coffee. My mom brought me a sandwich. Meagan: Oh my gosh. I love it. Adriana: Yes. It was one of the best meals I’ve had in my life. I was so happy and so excited. I had a very small tear so I didn’t need any stitches or anything and the recovery was so easy. It was nothing compared to recovering from a Cesarean in my experience after a long induction. Then it was really nice too because in the next days and weeks, my midwives visited me in my home. The checkups and everything were at home so that was pretty wonderful. I guess throughout this whole process once again, understanding, it was really interesting to me how– I don’t want to call it a project but I guess it was a project and like an experiment, like the things we do in the lab. You look for background information. You prepare everything. You inform yourself with data and what other people have found. You look at statistics so it was really interesting to me how this VBAC journey helped me grow as a scientist. That was one of the nice outcomes. Something I forgot to say is that after my Cesarean and when I did the birth story processing– because you give a bunch of information to the person who is doing the processing for you and one of the things that I couldn’t point out was why I was so bothered with the experience. If everything had gone well, what was it that was bothering me? She was the one who brought it up because one of the things I kept bringing up was, “I do research for a living. This is what I do. This is what I do every day. I research. I look at data. I look at stats. I read the literature. This is what I do. Why didn’t I do any research for my first pregnancy? Why didn’t I prepare myself? Why didn’t I second-guess what the medical doctors were suggesting me to do? If I’m always second-guessing what everyone says, especially in science, you are always like, where is the evidence? Can I see the data? Why didn’t I do that?” It was really interesting that she brought this up. She was like, “It seems like you feel like you failed as a scientist with your first birth experience. It seems like you feel like you failed as a scientist.” I was like, “Yes. That is exactly how I feel. Yeah. I feel like I failed as a scientist. Why didn’t I put any work in researching one of the most important events of my life? Why didn’t I do that?” I think a way to cope with that in my second pregnancy was doing the opposite and really doing all of the research, looking at all of the data and all of the stats. At some point, I was like, I’ve done all of the work so whatever the outcome is, it’s not on me. Meagan: It’s out of your hands. It’s out of your hands. Adriana: Exactly. It’s out of my hands. So that was something that really helped me throughout my pregnancy and throughout labor. I’m happy that I had the outcome I wanted but I think at some point, especially in the last weeks of pregnancy, I was like, Whatever the outcome is, I’ve made peace with it because I’ve done all I can to prepare and that’s it. Meagan: Yeah, that’s such a great message to share because in the end, just like you said, I actually love how you said it. I prepare. I gather. I do the experiment and not that birth is an experiment, but in the science lab, and then the outcome is really unknown. Adriana: Yeah. Meagan: It’s really unknown. Sometimes you can control it by adding whatever into it and sometimes you can’t. It’s like labor. Sometimes we go to the hospital and we can control it with Pitocin or an epidural or whatever and sometimes we still have these outcomes. Such a great message. Just in the end, it’s so hard for the not-average scientist, the average person, not the scientist, to really decode all of the literature out there. Do you have any tips for the listeners on how they can go about taking the preparation like what you did? Obviously, we have blogs and our VBAC course and all of the things to try and help break these things down into English because sometimes they are very hard to understand. Adriana: Don’t get me started. Meagan: Yeah, but what suggestions would you give to any of the listeners? Adriana: Yeah, I have a few. The scientific literature– I feel so annoyed having to write the findings of my experiments in that type of language, but I guess that is sort of how things are done. One of the things that I recommend people doing is not one that a lot of people think of, but you can reach out to the authors of the papers. I get so excited when someone reaches out to me and they are like, “I saw this paper. Can you explain to me what it means?” Most scientists are just going to be so excited to have people reach out to them and tell them, “Can you help me understand this?” Most of them are going to be so excited about that. That’s one thing you can do if you feel like reaching out to someone. Maybe sometimes they are not going to reply, but I would say most scientists– Meagan: Worth a shot. Adriana: Exactly. It’s definitely worth a shot and most scientists are going to be so excited that you are reaching out to them. The other thing is that most papers come with a short summary at the beginning. It’s usually called “summary” or “abstract” and in that summary, they summarize the findings in a way that is way easier to understand than if you look at the results in the discussion because sometimes also the plots are impossible to understand, the statistics are very difficult to understand if you are not trained in statistics, so reading the abstract and the summary, especially toward the end, there is usually one to three sentences with the main outcome of the experiment. They are not going to give you statistics or anything, but they are going to tell you what they have found. You will see that most scientists are really conservative on what they conclude from their study. Even if their data and stats are really strong, they are usually very conservative on the way that they conclude and then sometimes that conclusion gets lost somewhere when the information is given to you by your OB/GYN for example so I would really encourage folks to look at those last few sentences to really understand, Okay. My OB/GYN brought up this scientific article. Let me go and see what is actually written there and what they are actually saying. By reading those one to three sentences, you’re going to get a better understanding of what the scientist actually found. Meagan: Overall, with VBAC, what was the overall finding? Obviously, I kind of know a lot of the overall findings, but what was the overall finding that you found in your own research when it comes to VBAC and the safety of it? Adriana: Yeah. I just found the data is so strong in showing that VBAC is super safe for non-high-risk individuals. Again, having a previous Cesarean does not automatically make you high-risk and I guess if you think about it, I was “high-risk” because I had a previous Cesarean. I am of advanced maternal age and I also have a higher than average BMI so I had three high-risk factors if you will and still, with those factors counted in, I knew that VBAC was really safe for me just based on the data that I found. Then if you add in too the reduction of interventions, that makes the chances of VBAC really high. Meagan: VBAC high, rupture risk is lower. Adriana: Exactly. If you keep adding things, I found especially when researching for home birth, the data is really messy out there. It’s not desegregated and by this, I mean that when they show you the statistics for home birth, they show you the statistics of everything together like people who had unplanned home births for example. The outcomes of those can be very different than that of a planned home birth and they also add people who end up having spontaneous abortions at home and that’s included as a home birth. That is ridiculous so we really need desegregated data so sometimes when you go into the scientific literature, you can get the desegregated data in the scientific paper. Once again, I know that is not in an available format for people who don’t have the training but again, you can reach out to the authors of the paper and to the scientists for them to explain to you what is the actual finding or read the abstract so that you can see. Most of those papers are like, “We need more research on planned home births.” Meagan: Right. Oh, such great information. I know we have so little time but I have one more random question because in a lot of these articles, they say, “Confidence level blah-blah-blah.” Can you describe what that means as someone who is reading that? What does that mean when an author says that? Adriana: When an author says that, they are taking percentages as their confidence level. When they say 95% confidence, it’s that they mean that out of say 100 individuals, the chances of this occurring is less than 5% when there is a 95% confidence interval. Once again, it could mean depending on the type of data that out of 100 people, 95 people we know for sure backed up by statistics that 95% out of 100 individuals are going to have this outcome. That’s basically it. They are just giving you a percentage so that it is a little bit easier to understand and we also use this same thing with P-values. P-values are something that you see all the time in scientific literature. It is the exact same thing. We consider P-values smaller than 0.05 as significant so essentially, this means that there is a less than 5% chance that whatever you are studying is happening out of chance. Essentially, it’s telling you there are 95% chances that what you are seeing is actually happening and it’s not something that is happening out of chance if that makes sense. Meagan: That totally makes sense. Adriana: Yeah. Meagan: Oh my gosh. We could probably talk about this for a long time, but I will not keep you any longer. I appreciate you so much. Congratulations on your birth. Thank you so much for sharing with us and have a wonderful day. Adriana: Thank you for inviting me. Closing Would you like to be a guest on the podcast? Tell us about your experience at thevbaclink.com/share. For more information on all things VBAC including online and in-person VBAC classes, The VBAC Link blog, and Meagan’s bio, head over to thevbaclink.com . Congratulations on starting your journey of learning and discovery with The VBAC Link. Support this podcast at — https://redcircle.com/the-vbac-link/donations Advertising Inquiries: https://redcircle.com/brands