Cesarean Awareness Month #1 Meagan & Julie + The Hospital System

We are bringing you extra episodes all month long in honor of Cesarean Awareness Month! Meagan and Julie kick off the conversation with a passionate discussion about the realities of birthing in a hospital setting. Doulas are birth workers who uniquely experience births in all settings. Meagan and Julie share what they have seen and how it has formed the strong opinions they have now. Additional LinksJulie’s WebsiteHow to VBAC: The Ultimate Prep Course for ParentsThe VBAC Link Facebook CommunityFull Transcript under Episode DetailsJulie: Welcome, welcome. You are listening to The VBAC Link podcast. This is your cohost for the day, Julie Francom. I’ve missed you guys so much. It’s so fun to be back here but I am also here with Meagan Heaton, the cofounder with me of The VBAC Link. We are so excited to be on a really special episode with you today. We were actually having lunch together the other day and talking about life, birth, and everything. We just decided that it would be better if we recorded the conversation so that’s what we’re going to do today. We’re going to record our conversations about birth, VBAC, and everything in between. Review of the WeekBefore we get into it though, Meagan has a review for us. Meagan: Yay, yes I do. It’s always so fun to have you on Julie. I am excited to have our conversation that we were having the other day only recording it because it is definitely a great conversation to be had and to be heard. If you guys didn’t know, April is Cesarean Awareness Month. This month, we’re going to be kicking off with some extra episodes in addition to our stories. Here is number one for you. As Julie said, I do have a review of the week. This is from mathletic and it says, “Empowering and Addicting.” It says, “This may be my second time leaving a review, but it is because I am preparing for my second VBAC and felt that it was necessary. I first found this podcast as I prepped for my VBAC in 2019. I religiously listened to a new episode on the way to and from work daily and am always excited for Wednesday morning’s new episode.” Julie, that is crazy to me that people have been listening since 2019. Julie: Forever. Meagan: It is 2023. It says, “This podcast has given me so much education and strength that I took going into my TOLAC and achieving my successful VBAC in May 2019. I am now preparing for my VBAC as I am 36 weeks pregnant and due in early June.” This was in 2022 by the way so last year.“Although I have now had a VBAC, I knew starting my mornings off with this podcast again with this pregnancy would be something that would help me get into the right headspace. I sometimes feel like Meagan and Julie are now my new friends.”We are. We are friends with all of you. Julie: We are your friends. Meagan: Yes. “As we commute to work together–” We’ve been commuting to work with her, Julie. Julie: Yeah. Meagan: “I am very bummed to learn that there was a break, but I am so pumped when I found out that they were returning this May.” So yeah, seriously, this was a long time ago, you guys. We returned in 2022. “Thank you for all that you are doing in helping us mamas feel educated and strong as we go into our next births. I recommend this podcast to all my friends even the first-time mom friends as it’s been such a great wealth of knowledge going into any birth.” I could not agree more. This podcast is going to teach you so much and not only how to have a VBAC but how to avoid a Cesarean in the first place. As we know, Julie and I were talking about this, Cesareans are through the roof. It is above 32% here in 2023. It is sad. It’s scary and it’s concerning. It is concerning. Why are we having so many Cesareans? We are going to take one moment and then we are going to get going into this wonderful new episode. Cesarean Awareness MonthMeagan: Okay, Julie. Hi. I miss you. I love you. I just saw you last week. Julie: It was so great to have lunch with you and just jibber-jabbering away about life, the birth work, getting old, and my salty attitude about birth. We’re going to talk about it.Meagan: Your salty attitude. You guys, she has become a little salty and sassy. Julie: I am. I’ve always been that way, but I feel like I was pretty good at toning it down and being diplomatic, especially doing The VBAC Link and things like that. I definitely have opinions as we all do. I was just making sure that we were including everybody and that everybody has a safe space here. We certainly want to do that on this episode as well, but I will hit 100 births this year. Meagan, you are probably at 600. Meagan: No. Julie: But either as a doula or a birth photographer and you know what? One thing that I wish people could understand a little bit more or take more seriously is that doulas and birth photographers probably have the most unique perspective on childbirth because we see births in the hospital, out of the hospital, at birth centers, with hospital OB/GYNS, hospital midwives, out of hospital midwives, and unassisted births. We have seen a few of those. We have such a unique perspective and we see how things unfold in each environment with each intervention and with each provider. I wish that somebody would hone into that and try and work to collect those experiences and perspectives because if you ever want to hear about the state of childbirth in the United States and probably even in the world because a lot of countries are not too different from ours, talk to a freaking birth worker that does hospital and home births because that is where you’re going to find these priceless gems and perspectives that you’re really going to learn from. Yeah. I just wish that people could see that. Meagan: It’s hard because we have clients hire us as their doula or their birth photographer and we talked about this at lunch the other day how we come in and one of the mean things as a birth worker that we are going to do is talk about what birthing experience that person wants. It is important to us as birth workers and as your friends to help you get the best experience that you can get and help you get a lot of those things that you desire. Am I wrong there? That is one of the biggest things. Julie: No, I think that’s right. Meagan: That’s one of the biggest things of what being a doula is. It’s one of the most important things is helping these clients and helping our parents get these births that they want. We come in and we ask things like, “What would you like for your birth? How do you envision your birth? What kind of things do you desire to happen or not happen in your birth?” It’s more often than not a very similar answer. It’s usually things like, “I would like to labor at home as long as possible. I would like to go unmedicated. If not, as long as possible before getting an epidural. I would like to have a vaginal birth and avoid unnecessary interventions.” Julie: Don’t want to be induced. Meagan: “Don’t want to be induced. I want to go into spontaneous labor,” is just what I was going to say so they don’t want to be induced. “I want to avoid a Cesarean.”Julie: “I want my water to break on its own.” Meagan: Yep. “I want to avoid a Cesarean. I want to push as my body and myself direct.” Julie: “I don’t want to push on my back.” Meagan; “I don’t want to push on my back.” Things like this. If you’re listening to this episode, I’m assuming you’re shaking your head, “Yep. That’s what I want too. That’s what I want too.” It’s not a bad thing that we want these things. It’s not a bad thing. Julie: It’s a good thing. It’s natural. It’s instinctual. It’s primal. Meagan: Yes. These things are things that we want for a reason. What I hear when I hear these things is, “I want to birth the way my body is going to birth and was made to birth.” Right? Julie: Yep. Meagan: But as birth workers as Julie was talking about, we have this interesting perspective because we’ve seen things. I’m not going to sit and say that I’ve seen all of the scenarios and all the things in birth. I’m not. Again, no I have not been to 600 births but I have been to a lot. I’m still learning as I go but there are so many situations where I can see things unfolding. So we have this client and these people that are wanting this type of birth and then what Julie? 37, 38, 39 weeks. Julie: “Oh, we’d better do an ultrasound to see if your baby’s measuring big or check your fluids My gosh, I hear you complaining so much about being pregnant. Let’s just induce at 39 weeks. You can pick your baby’s birthday. You can do this.” Or all of a sudden, maybe your blood pressure is maybe a little bit high so maybe you have preeclampsia so you have to test that. What does that do? It stresses you out so it makes your blood pressure high even more. Everyone starts to get a little anxious because the due date is approaching. Mom, dad, and parents are getting anxious. Providers are like, “Okay, well we don’t want you to go past this date” Especially with VBAC. Oh my gosh, it’s not safe to go after 40 weeks because that increases your chance of uterine rupture. Not true, by the way. Meagan: Or we’ve got a big baby. Julie: “Or we’ve got a big baby and your last baby was 8.5 pounds so we want to make sure.” All of these are non-evidence-based reasons because people treat 40 weeks like an expiration date rather than an average. That’s when, in a hospital system, things start to happen that decrease your chances of all of those beautiful, perfect, wonderful things that you want in your birth. Meagan: Yes. Julie: Sorry, go ahead. Meagan: No, you’re fine. You’re fine. I was just going to say that this is what we see happen so often. We meet with our clients at 24-34 weeks pregnant and these are their desires. This is what their hearts and their souls are saying. Based on a lot of the time, what they have learned too. They know the evidence-based information so they are like, “Based on that, I don’t want to do these things.” But then 37, 38, 39, 40 weeks come and we have these new introductions and new seeds being planted.For some reason, those things leave. They leave our minds. Julie: Well, you’re tired. You’re very pregnant. You’re easily influenced and yes you want to be done. Yes, it sounds nice to be done sooner. Oh no, you don’t want to have a complication or preeclampsia, or a big baby. That sounds scary. Shoulder dystocia sounds really complicated. In some instances, it is for sure, but when you start planting those little seeds, then they grow into self-doubt. It’s easy to confuse our worries and our fears with intuition. Meagan: They’re lost. Yes. Yes. That is the hardest part. We are getting these seeds planted and then they’re being watered. The seeds are growing and the roots are pushing out what our intuition was saying from the beginning. Then we make choices and decisions. We are human beings that have the opportunity to make these choices and decisions, but sometimes we are backed into these corners because our seeds are being poured on. We are being flooded with overwhelming, scary feelings. As a birth worker, it can be frustrating. I’m going to be super honest. Julie must be spitting the salt at me. I don’t know what she’s doing here. It’s so infuriating to see and heartbreaking to see someone we know and loves go into this space that we know is not where they wanted to go and then see the cascade happen when it didn’t need to. The other day, everyone at Zupas was probably like, “Whoa. These two broads are crazy.” We are very animated. Julie: We weren’t very quiet. Meagan: We’re not quiet people first of all and we are animated. I feel like in the past, Julie has been a little bit toned down with her bluntness. She’ll be blunt but I’m over the top and she’s like, “Oh my gosh, Meagan stop.”Julie: Now I’m just like, “Heck yeah, girl.” Meagan: So us together, we’re at Zupas saying these things. One of my questions is, and I wish I had the power, knowledge, and time to produce this huge study because I really want to know what happens if we do nothing. What happens? What happens? Julie started adding to that. Do you want to talk about what you added to that?Julie: Yeah. Meagan: Do you remember? Julie: Yes. Okay, sorry. My mind is going on 17 different paths right now like it usually does. I think if you really, really, really want to get a good perspective about birth, really sit down and talk to a doula. One that you haven’t hired because I know when my clients hire me, they hire me for my knowledge and my experiences and to support them. I’m not going to say my full, unbiased opinion to a client because I don’t want them to feel like I’m not supportive of them. I am supportive of them. Meagan: Or jading them. We don’t want to jade. Julie: I don’t want them to get doubts about their birth plan going into it because everybody else is planting doubts so I don’t want doubts to come from the doula. But really, sit down and talk to a birth worker because I’ll tell you what. I see way smoother births at home. I see way less need for induction at home. I see more love and support in the birth space at home or a birth center. I see more mother-led pushing, way more mother-led pushing at home. I never ever see anyone birth on their back at home ever. I see more partner involvement. I see kids involved. I see whoever you want at your birth involvement. I see mothers who are satisfied with their birth experiences at home. I see babies healthier and more skin-to-skin time and happier families and happier outcomes at home hands down. Yes. Are there a few here and there where it is hard and they need more help or there is a hospital transfer every now and then? Sure, but I guarantee that you are more likely to have problems and your baby is more likely to have problems in a hospital because it is set up to control things and it’s not set up to trust the mother-baby unit, to trust the parent-baby unit, the birthing person, whatever pronouns you choose to use, insert them here. It’s not set up like that. It’s not your provider’s fault. It’s not your nurse’s fault. It’s not anybody’s fault. It’s the system and the way that it’s integrated and taught to these health providers that birth has to look xyz and has to be done by xyz. The baby should be this size. The mother’s xyz has to look like this. It is all set up to facilitate a system that does not trust the parent-baby unit. It does not trust it. At home, it is very well-trusted. It just is. It just is. I don’t want to sugarcoat it. This is maybe where my saltiness comes in but you are way more likely to have that birth experience at home. Yes, it can be done safely. Yes, there are still providers at home that will keep an eye on you and transfer you as soon as you might need any medical assistance because it does save lives. It has. We’ve seen it. We know it, but most of the time, you are— yeah. I’m just going to pause that here for a second and go into where you were trying to lead me here, Meagan. Meagan: You’re just fine. Julie: Sorry. I just have so many opinions clearly. Meagan: It’s passion, Julie. It’s passion. You are passionate because you are seeing things. I am too. I’m seeing things that are unnecessary. They are unnecessary. We will circle back to where I was going, but we will start where you were at. There are so many unnecessary things that are happening in the system that is so frustrating as a birth worker to see because we also have seen the other side. We have seen. Yes, Julie and I personally have experienced the other side. She was at home. I was at a birth center. We have seen it and experience it. The passion that is coming to you through this episode is because we believe. We know as we’ve experienced it ourselves as people who have given birth in a system that is “off” the straight and narrow path as a lot of people will say. When people were hearing that I was going to VBAC after two Cesareans out of the hospital because I kept it quiet from most people. But you know what happened when it happened online. People were attacking me, “How dare you?”Julie: People are going to throw salt at us now for this episode. Message me on Instagram @juliefrancombirth. I will engage with you. Meagan: But no. This is passion coming from you. This is your passion in saying, “I have seen other things. I’ve seen other opportunities.” Julie: I’ve seen the other side. Meagan: We know. We know, women of strength. We know that it is not always suitable, comfortable, or appropriate for you to birth outside of the hospital. We know that. We do. We definitely just have seen things outside of the hospital that are incredible. Julie: Way better. They’re way better. They are. Hold on. Let me interject here for just a second. People might say, “Oh, well you’ve only been to a hundred births. Providers do a hundred births a week in a hospital.” Not a hundred births a week. That would be a lot. But significantly more. I am not going to argue that at all. I’ve only been a doula for 8 years, 100 births. That’s 10-12 a year besides having babies in between then as well. Last year, I did almost 30 which was super great. But here’s the thing. When you’re in a hospital, you’re only seeing hospital births. You are only seeing hospital births. You are only seeing, I don’t even know statistics for this, maybe 90-95% of people have an epidural in a hospital? I don’t know. Maybe 70%? I don’t know. I should probably rescind that number. But a lot. And if you don’t have an epidural, guess what you have? You’re hooked up to an IV. You have continuous fetal monitoring. You are in the very system that we’re trying to break away from right now. That is what you see. You don’t see hands-off birth. You don’t see the normal, physiological process that happens when you do nothing. Yes, at home you have intermittent monitoring every 30 minutes. You do the lab work and stuff like that. The routine tests and everything like that is done at home prenatally and during the birth, but what happens? You don’t get to witness that if you work in a hospital in the labor and delivery unit. You don’t get to see that. Meagan: Just a quick search by the way, it’s 65-80% of people receive epidurals and stuff. Julie: Huh, there you go. Meagan: But yeah. They don’t. Their opinions is tainted a little bit. This is why I kind of wish that I had the power to do this study. If there is one and you are listening and you are aware of this study, please let us know. But the study of what happens if we do nothing? We know the ARRIVE trial. We know that if we induce people at 39 weeks, we sort of know what happens. Julie; Do we induce them at 39 or do we induce them at 40 and 5? Meagan: This is the thing. Really, this hasn’t really been done for a long time. We know that ACOG says 42 weeks is the cutoff. We’ve got an increased risk of things like stillbirth and things like that. But okay, so at 42 weeks, we assess. But what happens if, at 38, 39, 40, and 41, we do nothing? What happens if we don’t strip our membranes? What happens if we don’t even perform a cervical exam until 42 weeks? Julie: What happens if we don’t talk about induction? We don’t even talk about it. Meagan: Yes. Don’t talk about induction. So what happens if we do nothing? What does our Cesarean rate do then? I’m really curious. Do we go down? Do we go up? Do we start having more issues? I don’t know. Julie: What does maternal and fetal mortality look like? Because right now, it is a disaster. Meagan: Yes. It just makes me wonder. Cesarean Awareness Month is something that is near and dear to our hearts. We want to bring awareness to it. Cesarean is 32.1% right now. Julie: Yeah. It went up. 2020 and 2021 preliminary data, the Cesarean rates went up. Surprise, because of COVID. Meagan: As a birth worker, what do we know that happened during that time? What did we see? I’ll tell you what I saw. Induction, induction, induction. Julie: People’s support system’s being taken away. They wouldn’t even allow partners there. Guess what else happened? Everybody put masks on. Who feels secure? Some people had to push their baby out wearing a mask. Birth, being a very instinctual and intuitive process, anything that creates that feeling of unsafety or difference or fear will interrupt that process. It will make it less efficient. So when you were taking away people’s partners from the birth room, when you’re making everyone wear a mask in the birth space, when you had a positive COVID test, or if you did not want to do a COVID test, people would come in wearing hazmat suits. Meagan: Even the fear of testing positive and then the threat of everybody being taken away including the baby. Julie: Yeah. All of these things interrupt that process and then yes, people with COVID. I can’t even imagine what it was like in the healthcare system. I cannot even imagine what it was like to be a healthcare worker during COVID and having to deal with all of that also. But then needing to also predict and schedule births to control the number of patients coming in and out of a hospital created this “need” for induction and for causing things to be a little more predictable for everybody. I can understand that to a degree but also, but it introduces the need for other interventions to get the baby here including a Cesarean. Meagan: Right. We’re seeing this stuff happen and it is just so hard because if you’ve been with us for a really long time, you know. You know what we’re for. We’re here to educate on birth after Cesarean. We’re here to educate you on your options for birth. That doesn’t mean you have to have a VBAC either. Right before this call, Julie and I had another call. We were talking about not necessarily advocating for a Cesarean, but we’re also not saying you’re bad for having a Cesarean, right? We’re not pro-Cesarean people. We’re not advocating for unnecessary Cesareans, but at the same time, we’re not shaming anyone or wanting to make you feel bad for choosing that route.Julie: Yeah, absolutely. I think it’s important to say that. Our intention is not to shame anybody but also there’s a certain point where you’ve got to stop sugarcoating everything. I tell this to my clients too. I’m not going to bounce around the issues with you. I’m going to tell you things. I’m never going to lie to you. I’m never going to say xyz. I’m not going to tell you, “You’re wrong for choosing this,” or whatever because I don’t think anyone is wrong for choosing this but I feel like it’s so easy to get coerced into doing something we normally wouldn’t have done. I feel like it’s so easy to feel safer in a hospital because that’s how we were raised. I feel like some of these things are ingrained so deeply in us that it’s hard to break away from them, but I also am not going to pretend that people’s choices are conducive to their birth preferences. There are just some things that don’t go together. Natural birth in a hospital does not go together very well. It just doesn’t. Not natural, but unmedicated, hands-off birth does not happen well in a hospital. It’s a lot harder and it’s much more of a fight to get that in a hospital versus out of a hospital. Meagan: Yeah. Well and I think too it’s important to talk about creating that space and that environment. If it’s in the hospital, okay. But let’s talk about how to set that up, how to set that space up. We just recently posted about creating a more homey, comfortable environment. We’ll make sure to drop all of it if you guys are interested in checking out these awesome things like getting into your own birthing gown. Going to a hospital, taking off your clothing, and Julie you just talked about this and in a second I want you to bring up what you were talking about with me, but naturally, showing up to a new location with new, strange faces. It’s maybe a little cold. It’s maybe a little foreign. It’s maybe a little staged-looking. Everything is folded up on the bed. Then take off your clothing. What does that do to our body and to our mind? It puts us in an uncomfortable feeling.Julie: A little bit of a fight or flight mode. Meagan: We talked about putting on this thing that is open in the back so our butts are showing. So getting into your own gown, into your own soft, cozy, comfortable gown can bring you some comfort even though you are still changing once you’re getting there or maybe you go there in that. Maybe you prepare and you get in that before and you go. Or maybe you don’t like IVs and the bottom of an IV looks yucky. There are IV covers to take it away and make it feel less hospitalized because you are in a hospital. But Julie, talk about what you were saying earlier. I was like, “Huh. I’ve actually never thought of that.”Julie: I saw this on Instagram a few days ago. I’d seen it circulating around before. I wish I knew what account it was so I could tell you to go look at it, but I don’t remember. Maybe I saved it. I’ll have to look it up while I’m talking. But it basically said, “What would happen if we conceived babies in the same manner that we deliver them?” In order to get pregnant, okay. We need to preface this with sometimes how people need interventions to get pregnant and sometimes you have to have IVF or other things in order to have a baby. But for most people, what if in order to conceive a baby, instead of being in the comfort of your own home with your partner, or I guess wherever you decide to conceive in a car or a forest or wherever, a movie theater. Anyways, whatever your choice, not my business. What if instead of that, you first went to a hospital, changed into their gown, got your blood pressure taken, got hooked up to an IV just in case you need to have some kind of medication–Meagan: Have monitors placed on your belly. Julie: Have monitors placed on your belly, have nurses come in and out and tell you that you can’t get started until the doctor comes in– Meagan: Asking you lots of questions. Julie: Asking you about your insurance, your cycle, when your last period was, and all of these things. I don’t think you’re going to make a baby in that situation. You bring your partner and be like, “Okay, partner. Go get changed now.” Your partner gets changed and everybody’s watching you. Everybody’s watching you. Meagan: You’re on the monitor outside. Julie: I mean, when babies are born, everyone’s watching. Freaking hands are in the vagina and freaking everything. What happens if we conceived babies that way? How would that work? How would that work? Let’s flip this around. Let’s flip this around. What happens if we birth our babies in the same manner that we conceived them?We get in our house, movie theater, car, forest, whatever. We go into our home. We turn the lights down. We run a hot bath. We snuggle with our partners. You probably don’t want to have your kids or mother-in-law in your space, but what happens if we created that same environment to increase the flow of our natural hormones, to safeguard and protect that process and make it as intimate as it was when we conceived our babies? Meagan: Yeah. It’s a big question. Julie: It’s way better and I can say that it’s way better because I’ve had my own, but also, I’ve seen over a hundred almost births and I see the contrast. I see the contrast and it’s a beautiful situation when it’s allowed to unfold naturally. Every once in a while, I’ll get a nice unicorn birth that has a nice, unmedicated, parent-led birth in a hospital but it’s very rare. Meagan: I want to talk about that because, with Cesarean Awareness Month, that’s what we do during Cesarean Awareness Month. We talk about things. We do see preventable Cesareans and preventable interventions. Talking about advocating for birth after Cesrean and advocating for yourself, here we are. We go into this space, into the hospital, and we are vulnerable. What do we do? We feel vulnerable because I didn’t go to school for 4+ years. I didn’t study this. I went to the forest and conceived a baby. Julie: Or a movie theater. Meagan: I went in. I have this. I’ve learned. I’ve learned, but now I’m in this space and I’m vulnerable. It’s bright. Like Julie said, it’s this less-ideal space to give birth. We would never conceive there, so why would we give birth there? But if you’re in this space, what do you do? What can you do to create a better space? A better environment? We just had a mama. She wasn’t a VBAC but her video went viral. Julie: Katelyn!Meagan: Yep, Katelyn. Maybe actually she might not have been– actually, her episode hasn’t even aired yet but you guys definitely need to check out the video on our social media because it is so incredible. Chills all the way from head to toe. It went viral because she advocated for herself. She had nurses. Bless their heart, we love nurses. By the way, if you’re a nurse, we love nurses. I don’t want to say we hate nurses. But she had nurses following their protocol–Julie: Trying to get her on the bed. Getting baby’s blood pressure. Meagan: Trying to get blood pressure. Trying to monitor baby. They tried to get her on the bed and tried to give her a cervical exam, because how would it be if she was 4 centimeters and her midwife was called to come? These things are being told to her. She is pushing out a baby as she’s being questioned for all of this stuff. She’s literally pushing a baby out of her vagina and standing up in this hospital room. That scenario and that story is few and far between because it is hard. It is so hard. You guys, I was a mom in a birthing room the other day at the veterinarian. I had my puppy. We’re sitting there and this doctor is like, “We have to do this. We have to do this. We have to do this.” You guys, I’m a doula. I know how to advocate. Do you want to know what happened? This is a real thing. This really happened. Julie: You have a puppy?Meagan: He’s like a puppy. He’s five but he’s like a puppy. My pup. So we’re there and he’s telling me all of these things we have to do. Not only is he telling me what we are having to do, but he’s also doing things to my dog in front of me, then telling the nurse what he’s doing and charging me for these things that I did not ask for. I did not consent to them. I left and I literally paused and thought, “Holy blippity bleep, blah blah blah, bleep.” That is what happens in the birth room way too often. Julie: Yep. Meagan: Women of strength, we do not want this to happen to you. Julie has spit her salt all over and it’s all over me too. We’re feeling it. Julie: Oh, I’m not done. Meagan: We’re feeling it. We’re feeling it. Don’t let these things happen to you. It’s okay to stand up for yourself. It is okay to say, “No, thank you.” It is okay to say, “I hear you. I respect you. I feel differently. I don’t want to do that.” Or maybe at a later date. Or maybe at a later time. Julie: Or just cancel your prenatal appointments. I’m not advocating for that, but I’ve had clients be like, “You know what? I know when I go for my 37-week visit that they’re going to push for this and this so I canceled. I’m not concerned. Everything’s healthy.” Meagan: Yeah, you just don’t have to do anything. I think one of the biggest things and one of the biggest places we can start at avoiding these unnecessary Cesareans– Julie: Is by staying home!Meagan: It’s by staying home and advocating. You guys, y’all can tell where Julie is. She’s feeling it here at home birth. Julie: I just see it. Go ahead. You go then I’ll go. Meagan: I’m just saying that it’s okay to stay strong. It’s okay to stand strong and try your hardest not to let your vulnerability because it’s there. You’re so vulnerable in the end. You’re tired. You’re miserable. You’re vulnerable. We just want this baby in our arms. We just want this VBAC more than anything. Don’t let people break your vulnerability, sneak in there, and take advantage of you because there is no need. Obviously, if there is a medical, true medical reason, we understand that. Right? They happen. Like Julie said earlier, we’re grateful. We’re grateful.Julie: There’s no shame in that. You should have mercy on yourself if you got railroaded either by the system or by an unexpected emergency. Have mercy on yourself. Give yourself grace because it happens. It’s not okay that it happens if the system is the cause of that, but it doesn’t make you a bad mom. It doesn’t make you a bad human. It doesn’t make you a bad anything. It’s just what happens sometimes. Meagan: Most Cesareans are unplanned because we had no idea what was happening, but a lot of the time these Cesareans are happening because they are sneaking in, these little sneakers. I don’t even know what. I was going to call them weasels. They are weaseling their way in and tapping into our vulnerabilities. I was not the vulnerable one with my second C-section. My husband was and my provider saw it. He snatched it and turned him against me. What did I do? I walked down for a second, unnecessary Cesarean. We don’t want these things to happen to you. We want to bring awareness and maybe you’re like, “Wow. These chicks are coming in strong.” But you guys, we are passionate. We love you. Julie: We want you to have the birth you want. That’s why. Nothing hurts me more than loving someone, knowing what they want, and seeing them get railroaded in a hospital setting. We see it a lot. Meagan: That’s what we see most of these times. Julie: A lot. Especially more as a birth photographer. As a doula, I was more involved in the prenatal prep. Sometimes I show up to births as a birth photographer and I’ve never met the people. They fill out my questionnaire. They hired me. I come in and I’m like, “Hey, I’m Julie. You’re in labor. It’s nice to meet you.” Those are the hardest ones. I’m never going to watch someone suffer. If you’re suffering, I’m going to put my camera down and I’m going to help you. But for first-time parents that didn’t feel the need to do any type of childbirth education or learn anything about the process, you just sit there and watch them get railroaded by the hospital setting. You’re watching trauma unfold and you’re just like, “How is this happening?” But you know how it’s happening because you’ve been watching it for years. I’m talking about myself in the third person or second, or whatever person. But here’s the thing. It breaks our hearts. We see it all the time. We see it in The VBAC Link Community all of the time. So many times, people are like, “My water broke so I went into the hospital. I’m only 0 centimeters dilated. They started Pitocin. It’s at a 10 and I don’t know what to do. I’m not dilating and contractions aren’t coming. Help me.” This could have been stopped if you knew that it’s okay for your water to break without labor starting and to wait at home for 12-24 hours for labor to start on its own and rest, hydrate, and watch for fever or chills or anything like that then go to the hospital. It’s a simple thing to learn but people don’t think that because they trust their system. They’re going to the hospital and getting railroaded. So many times we see that. All of a sudden, you’re water has been broken for however many arbitrary hours your hospital decides is important, and then you get a C-section because all of these things happened. If you would have just known that it’s okay to stay home, and there is evidence of staying home. We’re not just making this up. There is evidence to support this and just takes a little bit of time to learn. But anyways, that’s why I’m sounding really salty today is because I see people get railroaded by the system all of the time. All of the time and it breaks my heart. It breaks my heart. I can leave birth and not be super affected by it anymore usually, but these birth experiences are yours. They’re going to affect you for the rest of your life. We don’t only know that. We don’t want you to be railroaded by the system. We want you to know and follow your heart and follow your intuition. If your intuition is telling you, “Unmedicated birth, not pushing on your back, not getting induced, not wanting cervical checks,” then you probably want to birth at home because as soon as you walk out of the door when you are in labor to go to the hospital, your chances of having that birth go down a lot.Meagan: Yeah. I mean, studies show that people are much more likely to have interventions in labor and birth as soon as they are admitted in labor, especially in early labor. If we rush to the hospital, but in your mind, you’re like, “I don’t want to do this. I don’t want to do that. I don’t want to be induced. I don’t want interventions,” but the second we start contractions, if we run and go in, our chances of interventions are sky high and the chances of Cesarean are high because we’re pushing these things that are leading to Cesareans. Don’t shame yourself and offer yourself grace if you’ve experienced an unexpected, undesired Cesarean. You are not alone. You are not alone. But know that you have options. Sometimes I want to say to open your mind a little bit. Whether you come back to that openness or not, you come back to that original idea or birthing location, open your mind a little bit and learn the stats. See the stats. Hear the stories. Hear what it can be like.I don’t want to take away from anyone who has birthed in the hospital and had a beautiful experience because they can happen and they do happen. They do. But yes. There are a lot of other things that can happen in the home or outside of the hospital that may not lead to interventions and things like that because we’re at home and we’re doing those things. We’re doing more of nothing. We’re not doing a lot of anything. We’re doing nothing. We’re watching. We’re trusting. We’re having faith. It’s so important to understand that your body is capable of doing this. I’ve had some consults lately that broke my heart because people have literally told them they can’t. They won’t. They shouldn’t. Those three words. They can’t have a vaginal birth. They will never have a vaginal birth. I was told that. Right here, I was told that I would not get a baby out of my pelvis. Hello, okay. They shouldn’t and they can’t. Don’t believe that. If you are listening to this podcast, whether you be a first-time mom, a second-time mom, a VBAC, a CBAC, a HBAC, breech. Julie: A breech BAC. Meagan: Whatever your history is, whatever you’re coming from, know that you are capable. You are capable of making these choices. You are capable of doing this. It is totally possible. Totally possible. Yes, we might sound salty today. We might sound aggressive. Julie: We’re passionate. We’re seeing women get hurt by the system. Meagan: It’s really hard, but sometimes, we have to have these hard, raw conversations. Julie: Direct. Meagan: Direct conversations to say, don’t let the system get you. Don’t let it get you. Don’t let it bite you in the butt. It doesn’t have to be like that. It doesn’t have to be like that. I hate that it even has a label as “the system”. You guys, this is a system. It’s unfortunate that it has come to this. It is unfortunate. I wish that we could all just go back to the farm. Let’s have the farm everywhere. Ina May’s farm. Let’s bring back the farm and just give birth like that. Don’t you think, Julie? Wouldn’t that be lovely?Julie: That would be beautiful. I think it’s a double-edged sword because up until the 1940s, 1950s, maybe a little bit earlier than that, probably the 1920s or 30s, most people gave birth at home. You only went to the hospital if there was an emergency or if you were at higher risk. Meagan: And there were some downfalls about birthing back then too. Julie: Right. That’s what I’m getting at because there’s a reason why people transfer to the hospital. In the advent of the 50s, 60s, and the 70s, mostly the 70s, all of these new technological advancements and things like that provided ways that we could save lives that otherwise would have been lost. For that, we are incredibly grateful. We are so grateful. Like we talked about a little bit earlier in the hospital, with that, it has evolved into a system that tries to control the birth process so it’s a trade-off. I feel like an ideal situation would be where everybody births without intervention unless there are true emergencies. We’re not talking about emergencies like, “Oh, I was induced at 39 weeks and my body wasn’t progressing past a 4 and it’s been 48 hours. My baby’s heart rate is starting to go down so now I have to have a Cesarean.” That is a hospital-created, emergent Cesarean. That is a system-created circumstance where a Cesarean became necessary. That happens so much. It happens so much. We have been raised to go to the hospital and have babies. We get induced. My mother-in-law was induced on her due date every single time. She had her babies every time on her due date. She had five kids. Everything went perfectly well. She has no trauma. Who really knows? It’s been a while since those things but she speaks very fondly of her births and that’s okay. That’s good. But now, we are a generation of traumatized women from our birth experiences. You go into a room with four people that have had babies, I guarantee that two of them had a really rough experience. That’s another number I’m just making up. You’re not going to be able to find any resources for this. Meagan: What do they say? Two out of five people have unexpected Cesareans or something like that. Say at a restaurant and have everybody raise their hand that had a Cesarean. That’s the question. Have you ever had a Cesarean? A lot of arms are going to go up. How many of those Cesareans were planned? There are going to be some. Julie: Less than half I would say. Meagan: There are going to be some that stay up, but most of them were unplanned. Julie: I have a cousin that had four Cesareans. The first one was unplanned, the three other ones were scheduled. She says, “It’s the best way to have a baby. You go to the hospital, go to sleep” because she would go under general “then you wake up and have a baby.” She loves it. She speaks very fondly of it. That’s the way that she likes to birth and that’s okay. I don’t want to come off as romanticizing home birth because birthing at home is hard. Sometimes your baby is in a wonky position or sometimes your body might be not quite ready. It’s going to be a longer and harder process. Sometimes emergencies happen and you have to transfer to the hospital. Things like that happen. I don’t want to make it sound like that never happens because it does. I think there are three major home birth studies now that show it’s just the mortality rates for mothers and babies are similar in the hospital and at home, so there is not enough difference to say that one is better than the other, but also, at home, guess what is less? Less postpartum hemorrhage. Less chance of the baby needing resuscitation. Less chances of severe tearing. Less chance that baby is going to the NICU at home. It’s worth considering. It’s worth exploring and my gosh, if you are a 100% hospital birther, I think Meagan touched on this a little bit earlier, we encourage you to check out home birth resources in your area. Just check them out. Just go and talk to a home birth midwife. Ask her what she does in the case of an emergency, what would risk you out of birthing at home, and just talk to them. You don’t have to hire them, but talk to them and see what else is available. See if your intuition jives with that. If your partner is on board with a home birth because it’s going to freak them out, and you feel like it’s something that you want to explore more, it’s time to sit down and have a serious talk with that partner. Do not let your partner or your provider take away the chance of having the birth that you want because they feel uncomfortable about it. Meagan: Yeah, that’s a hard one. That’s a whole other–Julie: I know it is because it’s important. You should respect each other’s opinions. You should. You should respect each other’s opinions. You should respect your partner. You should understand where your partner is coming from. You should take their point of view into consideration. You should be able to come to a compromise, but if your partner is not willing to do that for you, then that’s a problem. Meagan: I want to just quickly before we end, plug in some numbers. Look, you guys. Are you so proud of me? Julie, you should be proud of me for talking about numbers. Julie: I am proud of you. Meagan: This is what you usually do. Julie: Before we get into that, I want to say one more thing. I understand that some of the things that we’ve said are probably going to be pretty emotional for some people. Maybe some people have gotten triggered. Maybe some people just hate us now and they’ve already unfollowed us on Instagram, who knows? I say us but probably me too. Probably a lot of VBAC Link people follow me on Instagram as well. Let me try and figure out how I’m going to circle back around and say this. If you have been triggered by this episode, I really, really encourage you to lean into that trigger. Don’t run away from it. Don’t slash The VBAC Link. Don’t unfollow us. Don’t unsubscribe. Don’t trash talk to your midwife buddy about us. I guess you can do all of those things. It’s really your choice. But I encourage you to really lean into that trigger because I wish that we were a society of owning our triggers instead of blaming other people for our triggers. Triggers are our own emotional responses caused by some sort of unresolved trauma or issue in our life. If you lean into that trigger and explore it and figure out why it’s happening and where it’s coming from, you’re going to be able to heal emotionally and become a better human. It’s going to affect your future pregnancies, your future births, and your future interactions with other people. How would it be to not ever feel triggered like that? It would be really cool. I wish that I was never triggered but I also know that when I get triggered, instead of running away from it, I have learned to really lean into it, explore it, figure it out, and resolve that. I encourage you that if something we said has triggered you, then lean into it. Maybe leaning into it is unfollowing The VBAC Link. Who really knows? But I bet you that there is a deeper issue there. I wish or I hope that you would take some of the things that we have said here and consider them. Maybe lean into that too and explore a little bit more some of the things that we are talking about and why we are feeling this way. I also encourage you to talk to a local doula or a birth photographer and ask about their experiences observing home birth and hospital birth. That’s my little parting piece. Meagan: Great, you’re right. A quick plug-in before we talk about these numbers, if you are not aware, The VBAC Link has VBAC-certified doulas all over the world. I’m serious, all over the world. So if you are looking for a VBAC Link doula or if you are looking for someone that’s really educated and knows their stuff about VBAC, knows how to support you, and also to help find a really solid provider and location and help you determine where is best for you, check out our directory at thevbaclink.com/findadoula. Search your area because seriously, these doulas are incredible. Julie and I a long time ago, back in 2018, started–Julie: 2018, 5 years coming up. Oh my gosh, in a couple of more months. Meagan: Yeah, back when we got together and started this company, our goal was to help change the VBAC world. We cannot do this alone as individuals, so we have all of these incredible doulas helping us out there. So if you are looking for a VBAC doula, I have to gloat about them because they are amazing. Julie: Really amazing. Meagan: But let’s talk really quickly before you go about success rates. There’s a study that has been done. It was published in 2015 but I believe that it was from 2004-2009 which makes me even wonder now after COVID what it would be because home birth and HBAC have skyrocketed since COVID because a lot of people were, just like we were talking about in the beginning, having their people stripped from them, having to wear a mask, having to deal with the fear of losing their baby if they tested positive and all of these things. But this was a while ago. The success rate was examined. It’s a lower number like 1050 or something like that but the rate of successful HBACs was 87%. Julie: That is pretty amazing. Do you know what I love? That’s higher than APA because APA says that 60-80% of people who attempt a VBAC will be successful. Meagan: Just in general, a VBAC, yes. Julie: That’s general. Hospital, home birth, movie theater birth, whatever. 60-80%. But this at home, did you hear that? 87%. Meagan: At home, 87%. Now, I want to talk about transfer rates. They had an average of 18% transfer rate. Julie: That’s kind of high. Meagan: It is kind of high but I want to talk about that because a lot of people might think of an 18% transfer rate and they automatically go to Joe Rogan’s page and hear, “Oh, what they are saying is so true. All of these terrible things are happening.” You guys, no. Yeah. Did you see it? Julie: No, send me a link.Meagan: There’s a video. You’ll have to check it out with Joe Rogan and this lady. I don’t even want to get into it. It was so annoying. I just rolled my eyes the whole time. Anyway, the majority of these people that were transferred, I want to preface. It was not because there was a crazy emergency. It was most common for failure to progress. Failure to progress we know has a lot of things. We know that sometimes failure to progress can be due to cervical scarring or maybe we’ve had really long prodromal labor and things like that. There are a whole bunch of different reasons why but failure to progress and they needed to go to the hospital to then benefit from some of the things that the hospital offers like Pitocin or something like that? But still, only 18% which I know sounds high but still, 87% had a successful VBAC at home, so an HBAC. Julie: Okay, so I also want to say two things. First of all, the study might have had certain protocols to follow for a transfer. That might have caused the transfer before it was necessary. I don’t know. I haven’t seen this study. But also, the second thing is that I heard somewhere, and it might be different with study protocols, but I heard somewhere and I feel like my circumstances support that most hospital transfers are due to maternal exhaustion. They are so tired. They have labored for so long but I don’t have a number to back that up. But that’s interesting that that study shows that. That’s really cool. Meagan: Yeah. There are things. We know that women at home can sometimes lack resources, but you can also talk to your provider if you’re birthing at home and talk about, “Hey if I’m not progressing, what kind of things can we do to help progress?” Sometimes that’s processing and sometimes that’s nipple stimulation. Sometimes that’s getting everyone out of a room, turning off the lights, and taking a nap. There are so many things that go into it but it’s a pretty small study relatively. But still, wow. It does represent something. It represents something and we can’t ignore it. But anyway, we are pro-choice. We are pro everybody making the best choice for them but we do. Julie: We’re also pro-not watching the system railroad people. Meagan: I was going to say that we do see so many things that are so avoidable. I’ve had clients in the past years. One client probably two years ago, she was 38 and 5 I want to say. I’d have to go back and look at my notes and the provider was like, “I don’t know. You look big. It looks like this baby is measuring big. It could be anywhere from 8-10 pounds. We should probably induce. I will totally support this VBAC but let’s induce.” The cervix wasn’t doing much. It just wasn’t an ideal spot to be walking in for an induction and they required breaking water. They wouldn’t put Pitocin in. When the water was broken, they needed Pitocin after that which is interesting. She got up to a 1 and started Pitocin, had an IUPC placed, an FSC placed, and all of these things. Boom, boom, boom, boom, boom, and it was just so hard because you guys, I adore this person. I adore this person but it was so hard to see these things and see the path that it was going down knowing that the end result was likely coming to a repeat Cesarean when that’s not what she was wanting. It was so hard texting my doula community, my resource group that we all have as birth workers saying, “You guys, pray. Pray. Pray that this is just one of those miracles because it’s one of those situations that we see too often.” It did. It ended in a repeat Cesarean. It was healing. It wasn’t an emergency. She did heal from it, but it didn’t need to happen. I can’t say that for a guarantee. I can’t say something wasn’t going to happen, but it didn’t need to happen that way. So women of strength, here we are. We love you. We know that you are in a hard situation. We’ve been there. We’ve been there. Julie’s been told by providers in the hospital that she would rupture. I was told that I would rupture. No. You were told that your baby would die. Julie: Me and my baby would die. Meagan: Yes. We were told these really scary things. Do we hate the hospital? No. Do we hate it? No. Do we hate what we see in it? Yes. Julie: Yeah, a lot of time. Meagan: We hate it. We hate what we see. I mean, not always. I can’t say that we always hate what we say but so many times we hate seeing things that are just avoidable. So here we are. Know that we’re here. We’ve got our course. We’ve got the blog. We’ve got this podcast. We’ve got our private Facebook community. We have Instagram. We have so many resources filled with evidence-based information. If you are wanting to up your VBAC game and learn the history of VBAC, learn about Cesarean, the history of Cesarean, learn about VBAC, learn how to find the right provider, learn how to tap into where you want to birth, and really tune into that, this course is going to help you walk through that path. Whether or not you choose a Cesarean, you choose a VBAC, you choose an induction, you choose home birth, hospital birth, midwife, OB, unmedicated, medicated, whatever it may be, we are here to support you but it is so important to us that you find that information that you are filled with the evidence-based information ready to take on the birth and have the birth experience. So if you want to learn more about all of these resources, check the show notes. They are all going to be listed. Go to thevbaclink.com and click around you guys. You’re going to get lost in there because there is a lot. There is a lot of incredible information. But yeah. Julie, anything you want to add before we let the listeners go? Julie: I do. I do have something we want to add. Listen. Me and Meagan want to do a birth together, a VBAC. Maybe at home, maybe at a hospital but if you are in Utah, Salt Lake or Utah County, Weber, Davis, Tooele, Park City, and any of those areas, reach out because we have a special bundle discount that we will give to you if you hire Meagan as your doula and me as your birth photographer. Meagan: Yes. We’ve done a birth together as doulas switching up. We’ve never done a birth as a birth photographer and a doula. Julie really wants us to work together. Julie: I do. We will be a package deal. We will take some money off of our services for you so that we can have that experience and then you get both of us at your birth which is a total win. Meagan: That would be really fun. It would be really, really fun. Okay, listeners, we love you. We love you so much. Happy Cesarean Awareness Month. It’s April. We’re going to be posting those stats and all of the things this month so stay tuned. If you have not followed us on Instagram or Facebook, check us out at @thevbaclink. You can find us anywhere and we are so grateful that you are here. Hopefully, after today’s episode, you’re not unfollowing us on all of this. We love you. We just have to say that. Julie: And you can follow me @juliefrancombirth.Meagan: Yes. You can follow Julie at @juliefrancombirth.Julie: Bye! ClosingWould 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/donationsAdvertising Inquiries: https://redcircle.com/brands