Episode 260 Jessica's Precipitous HBAC After Vasa Previa

The chances of having vasa previa in a spontaneous pregnancy is about 1 in 2500. Our friend, Jessica, shares her experience with vasa previa during her first pregnancy which led to a scheduled Cesarean. While Jessica’s Cesarean experience was difficult and traumatic, she knows it is what her intuition was telling her to do. Meagan gives important advice about listening to that intuition with every pregnancy.When the anatomy scan results showed that Jessica’s second pregnancy was completely normal, she went all in to achieve the HBAC she deeply desired. Jessica didn’t expect her birth to be so painfully intense and wildly fast as it was, but now she says that she “would love to do it again!” Additional LinksThe Lactation NetworkHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details Meagan: Hello, hello you guys. This is Meagan and today I am recording in a very different spot. Normally, I am in my office at my home, but today, I am recording from my car. We have our friend, Jessica, and she is from California. She is going to be sharing her HBAC story with you guys today. If you don’t know what HBAC is, if you’re new to all of the terms, it’s a home birth after a Cesarean. She has a unique situation with her first C-section so I am excited to talk a little bit about that and have her share more information and then with her home birth, it was precipitous. Jessica, was it a planned home birth? Remind me, or was it so precipitous that it ended up being a home birth? Jessica: It was definitely planned. Meagan: Definitely planned. Review of the Week Meagan: She will be sharing that story but of course, we have a Review of the Week. This review is by Ashley and it’s actually on our doula course. So birth workers, if you’re listening, if you didn’t know, we have a birth worker course to become certified in VBAC. It says, “TOLAC/VBAC should be treated just like any other birthing person, but there is a certain preparation and information that needs to be offered to them. Your course covered that. The value is held in your careful recognition of how best to support our client who is doing a TOLAC. I cannot praise you two enough for the fear-release activity. Honestly, it is something I can apply to even myself before and after birth and even in life in general. Thank you for that. It has already helped me with three of my VBAC clients.” That is so awesome. That is one of the biggest things we do in our course. We do a fear release. If you didn’t know, listeners, a fear release is so impactful really processing your past births and working through any trauma. Even if you don’t recognize it as trauma, it may resonate as trauma so working through those fear-release activities is super amazing. Jessica’s Stories Meagan: Cute Jessica, thanks for joining me from my car today. I kind of had a crazy day where my husband got thrown into coaching another team and we had soccer tryouts. As we are recording right now, it’s actually May so we are in the thick of soccer tryouts and all of the chaos of the last week of school. I ended up being at the soccer field so that’s why I am coming from my car. So yeah, Jessica, I’d love to turn the time over to you to share your beautiful story. Jessica: Yes. Thank you. Thank you so much for having me. I’m very excited. I’ll just get to it. Basically, I got pregnant with my first son and he was due in July of 2020, well actually, the beginning of August. He was a COVID baby. My husband didn’t get to go to any appointments with me. But that was supposed to be at a birth center. I watched The Business of Being Born. I got down that rabbit hole. We decided we wanted to be at a birth center. Everything was fine, then I had my anatomy scan and they found vasa previa. I had never heard of it. I never really even considered something being– you know, you worry about something being wrong with your baby. You never think about you having something wrong. So we were very shocked and all I remember was the sonographer saying, “It’s detrimental to your baby.” That was very devastating because I had no idea what that meant. I had to wait to get a referral to see a specialist. It was, I think, 4-6 weeks away. In that timeframe, I had to basically just sit and wait and not know what was going to happen. I joined a Facebook group, did research in the meantime, and I realized, “Holy crap. This is a big deal.” I went to the specialist and they said, “Yeah. You have vasa previa but it could still move.” I left with no answers. It didn’t feel any better hearing that. So basically vasa previa is you know, you have your placenta and your umbilical cord. It was explained to me that typically with a placenta and an umbilical cord, the umbilical cord is like a tree trunk. But when you have vasa previa, it’s like tree roots. So basically it’s an unprotected umbilical cord and vessels that could potentially be ruptured with a vaginal birth. Meagan: Yeah. They’re very exposed. Jessica: Yes. Very exposed. I did also learn that I had a velamentous cord insertion which goes hand-in-hand I think. So yeah. Basically, the moral of the story was that it was a big deal on how I was going to birth this baby even more so because his life was at risk. I eventually saw three doctors at the same practice just for follow-ups. They eventually cleared me for vaginal birth. You think that you would be super excited about that, but everything that I was reading was saying that it has to move a big amount for it to be safe. The vessels could still rupture and all of that stuff. So then I got two second opinions at different practices. They also cleared me. I don’t know. Everything that I was reading, I was reading different stories on this Facebook group. I just felt in my gut that I needed to still have a C-section. That is not what I wanted. I still stayed with the specialist because I was still considered a high-risk pregnancy. She said that I could deliver vaginally, but I told her, “I feel like I would feel safer doing a C-section.” She said, “Okay, but we are going to wait until 39 weeks.” With vasa previa, you deliver much earlier than that just because they don’t want your body to go into labor at all. Basically, that whole pregnancy was full of anxiety and fear. I was worried every single time I went to the bathroom. I was worried there was going to be all of this blood. I felt invalidated and like I was silly for still wanting a C-section by this doctor. Yeah. It was really hard and then my husband couldn’t even be at the appointments to hear what was being said. So yeah, it was really hard. Meagan: Yeah. That is a really hard thing to hear. Especially when you are not even planning on giving birth in a hospital. It’s like, “So wait, wait, wait. I have to completely shift all gears.” But what I love was that your intuition was like, “I need a C-section. This is what I feel is best for me and my baby.” You followed that. That is so important. One of the messages here at The VBAC Link is that we strive to say that we don’t shame anyone for having a C-section. We know that they are happening a lot, but especially when your gut is saying, “This is what I should do,” we have to follow that. Women of Strength, we have to follow that. Jessica: Yep. Yep. So ultimately, yeah. I followed my gut and I’m really glad that I did. The nurse who was by my side in the C-section said that she had never seen a placenta like mine. The doctor, of course, said that it looked normal, but every person that I’ve shown, and some of them are birth workers, are just like, “Wow, yeah. I’ve never seen a placenta like that.” I had a ton of exposed, very fragile-looking vessels. I don’t know where they were in my belly, but still, they were very fragile-looking. I feel like I made the right decision. My doctor said that it was normal, but I don’t think that it was. Meagan: Was your baby IUGR at all with the velamentous cord on top of it? Jessica: No. Meagan: Okay, sounds good. Let me just– there are lots of abbreviations in this episode. IUGR is intrauterine growth restriction and that can be a baby that is being restricted of growth. Sometimes with a velamentous cord, a baby can be on the smaller side or have growth restrictions so it’s awesome that your baby didn’t. Jessica: Yeah, he was 7 pounds, 3 ounces at 39 weeks. Yeah. I mean, it was a fine C-section. Nothing eventful happened, but it was still traumatic being strapped. I wasn’t even strapped down. My arms weren’t, but still, the experience was. I didn’t get to hold my baby for an hour and when I did, I was super shaky. I was nervous to hold him.I looked up at the monitors and I feel like my blood pressure was super low at one point. I thought I was dying. It did not feel great. It was traumatic for us. I know that trauma looks different for everybody, so for us, the whole experience was traumatic. My doctor did say, “You know, I’m giving you this incision so that if you do have another baby, you can have a VBAC.” It was always in my head that when we did have another baby, it would be a VBAC. Jessica: So yeah. Fast forward to April 2022, my husband and I were trying and I got pregnant. It was kind of a surprise but kind of not. I toyed with the idea of possibly giving birth in a hospital, but it was for a very short while like maybe five minutes, then I was like, “No. I think I need to do a home birth this time.” Just because of our experience at the hospital, I don’t know. I didn’t want to have to fight to have a vaginal birth. I didn’t want to be held to the hospital policies and whatnot. I follow a lot of birthworkers and see physiological birth and whatnot so we just decided to have a home birth. We found our midwife and she was a midwife. She’s been a midwife for 46 years so had lots of experience. She’s had lots of VBAC babies and it was just really exciting. It felt right to book her as our midwife. I had her, I think, from 9 weeks on and nothing exciting happened in my pregnancy. I was nervous about the anatomy scan, but they did a very thorough check and I could have cried hearing the news. I was just very confident knowing that the placenta was good, the umbilical cord looked good, and all of that. We went on to have an uneventful pregnancy. I would say from 37 weeks on, I would have cramping and whatnot. I always had Braxton Hicks from 15 weeks on, but around 37 weeks, it changed to that more period-like cramping. I tried not to read into it. I was just like, “This is my body preparing.” There were a couple of times where I was like, “Oh my gosh. Is this happening?” I was listening to lots of podcasts and birth stories and stuff to just kind of prepare myself for every scenario. I think I went to my midwife at an appointment the day before I turned 40 weeks. I was toying with the idea of getting checked or not because I didn’t want to be disappointed or get my hopes up. Ultimately, we– I keep saying we. My husband was a big part of this. I decided to get checked and I think I was a 2 and 70% effaced or something. I was in the right direction but I also knew, “Okay, that doesn’t really mean anything. It could be a week.” But they did want to schedule me for a membrane sweep the following week just in case because you can’t give birth at home past 42 weeks. I really did not want to do that, but I also really wanted to have the baby at home. I was just really anxious. Now I felt like I was on a timeline. My due date came and went. I was disappointed. I knew that it’s totally normal for your baby to not come at or before 40 weeks, but you have that hope that maybe they will. Your body is starting to have all of these symptoms so you’re hoping that this is it. My midwife had said, “Make plans because babies like to come when you have plans. They don’t like it when you’re waiting around for them.” Meagan: I love that. Jessica: Yeah. I tried to get out of the house and then one day, I was like, “Okay, do you know what? We have to go do something.” I planned for me and my toddler to go to the aquarium. We had to buy tickets. The day after my due date, I lost some of my mucus plug so I was very excited about that. Two days after my due date, I listened to Bridget Teyler. She has an induction meditation on YouTube. I just did it because when my husband was putting my toddler to bed, that was my time to get in the zone, drink my red raspberry tea, and prepare for birth. I just did it because it was something to do. I didn’t expect it to work. I thought, “You know, if nothing else, I’m bonding with my baby.” It was really great. The next day, I woke up and I was pregnant still. My mucus plug still kept coming out. It was pink and I was like, “Oh, is this my bloody show?” but my midwives were like, “No, that’s still your mucus plug.” I was kind of disappointed about that. I talked to my husband about all of the anxiety and how people were wondering where the baby was and all of that stuff. We had a steak dinner that night. That was the meal that I envisioned that I would have before I went into labor. That was 40 weeks and 3 days. The next day, at 40 weeks and 4 days, I woke up still pregnant with no signs. I was emotional about it but that was the day I was supposed to take my son to the aquarium. We get ready and we’re driving. On the way there, I’m starting to get cramps every four to every 30 minutes. They were 30 seconds long. I was like, “Oh my gosh. What the heck?” We get to the aquarium and my son wants me to hold him. Meanwhile, I’m having these contractions. I’m just like, “Oh my gosh. I wasn’t timing them because obviously, I had my hands full.” We ate at the aquarium and I remember feeling dizzy and nauseous at one point. But then we went home and my toddler fell asleep in the car which is pretty rare. That means it’s going to be a short nap, so I was like, “Oh if he takes a short nap, he’s going to go to bed earlier. Maybe this is meant to be. Maybe if I go into labor tonight, this is meant to be.” I had always envisioned that I would give birth at home while my toddler was sleeping just because he’s a very sensitive little guy. I figured that my being in labor would scare him. So I was just like, “Oh my gosh. He’s going to go to bed earlier than normal.” I got home and my husband got home from work. I was like, “I’m going to go rest and lay down to try and take a nap in case.” I couldn’t sleep, but I did lay in bed for an hour and a half. I went downstairs. I tried to make dinner and I kept having to stop and lean on the counter. My husband was like, “Do I need to turn the lights down? You’re going inward.” I’m like, “No, I’m not.” I was in total denial. He eventually took over because I was just like, “Yeah, I’m trying to cut raw chicken here and I’m not feeling too hot.” They still were pretty inconsistent. I still hadn’t really been timing them. They were probably every 4-20 minutes for 30 seconds. So then we ate. I think I ate on my birth ball and then I texted my doula who was also a student-midwife with my midwife. I saw her at every appointment which was pretty convenient. She was just like, “You know, don’t really worry about timing them. Just try and rest. Eat some snacks and let me know when they pick up in intensity.” It was 6:00 PM and I was just waiting for bedtime because I knew that once my toddler went to bed, I could really focus and not have to hide that I was in labor. But I still don’t think I realized how far along I was. So we did the bedtime routine. I do want to note that I was leaning over on a pillow and my toddler was rubbing my back and saying, “Baby brother, I help you.” It was the sweetest thing. Meagan: Aw, that’s adorable. Jessica: Yeah. So finally put him in bed and I told my husband, “Maybe you should just go to sleep with him just in case. Well, I don’t know. I’ll text you.” I didn’t know if he should go to bed or if he should come downstairs and act as my doula. So he was putting my toddler to sleep. I tried to get in the bath. I could not get comfortable. Our bathtub is so tiny and they were definitely picking up in intensity. I just could not get comfortable. That didn’t last long. I texted my doula and told her, “I feel like they’re on top of each other, my contractions, but they’re not quite a minute long.” I think I texted her, “I’ve had four in a matter of five minutes, but they’re short.” She was just like, “Try different positions. Maybe try a shower.” At that point, I had already gone downstairs to try something else. I could not find a comfortable position. So my husband texted me, “What’s the situation?” I don’t know. All I said was, “Come.” Yeah. I was just like, “Come,” because it was just so uncomfortable. I could not find a comfortable position. I could see him on the monitor because we already had the monitor set up but he was just lying in bed taking his time. I’m like, “What is this man doing?” He did not realize how intense things had gotten. He came downstairs and we tried different positions– laying down on my side and on all fours on the couch, on the ball, and I just couldn’t get comfortable. So after 15 or 20 minutes of him trying to help me, I had him text the doula. She got over there around 8:30 and she was helpful with having me take sips of water and giving us ideas for different positions. She tried doing the Spinning Babies side-lying release and that was unbearable, but we did it. Then she had me move to the ball. Actually, I think while we were on the couch and I was lying down doing the side-lying release, I felt something come out. I had a diaper on at this point because I just kept having bloody show. I was like, “Something just came out. What was that? What was that?” It kind of felt like I pooped but it was out of my vagina, so I was just like, “Was that the baby? What just happened?” She looked and it was my bag of water, but it was still intact. It looked like a boob implant to me. Meagan: Yeah, like it was bulging out of you. Jessica: Yeah, but it came out in a bulge, so that was wild. So that was cool. I knew that because she was the student midwife, she would be the one to tell the midwives to come. We weren’t even worried about that. She was timing contractions, but I had no idea how fast they were coming. I said at one point, “Why are they coming so frequently?” She was like, “Well, you’re in active labor.”Then we moved to the ball and that was unbearable. I felt him move down which was so wild and then I had a birth pool. It was already blown up, but we hadn’t even added water or anything. I was like, “Should we start setting that up?” My husband went and got the pool and tried to start putting water in it and whatnot. I was like, “I feel like I need to move to the couch,” so I did. I got on all fours and I had pillows up by my face. It was just so intense. I just remember thinking, “I’m never doing this again.” I asked my husband, “Whose idea was this?” meaning to have another baby and to do it vaginally because I was like, “This is awful.” It was so painful. Then you know, I just stayed in that position. I knew that once I was in that position, there was no way that I was going to be able to move. My husband was setting the pool up for no reason because I was like, “I don’t know how I’m going to make it in that pool.”I think one of the midwives showed up around 9:30ish. At that point, I was having the fetal ejection reflex. I was making these guttural noises. You hear about what that feels like and how you just can’t control it and it’s so true. I felt like when you feel like you have to puke and you puke uncontrollably. It felt like that in my vagina. The noise I was making was totally uncontrollable. There were some intense sounds. The midwife showed up and before I knew it, she was saying, “You’re going to feel the ring of fire.” My husband, in hindsight, was like, “I thought she was just saying that. Of course, she’s going to feel the ring of fire.” He didn’t realize she was saying it because the baby was crowning. He was up by my head holding my hand and stuff. Finally, he realized that the baby’s head was coming out. My baby’s head popped out and then you heard a tiny little cry, but then it went back in. She had me get in the runner’s lunge to try and help him out. I think I pushed maybe three times. She had to remind me to breathe because the fetal ejection reflex was taking over. I just couldn’t stop having that feeling to push, so she reminded me to breathe. He came out. He was born at 9:58 so I had, I guess, 12 hours of labor, but I think active labor probably started around 4:00 or 6:00. Again, I’m not really sure because we weren’t really timing contractions. He was 8 pounds, 7 ounces. Yeah. It was insane but in the best way. It was so empowering. I couldn’t believe that I had done that. One of my affirmation cards was like, “You’re a badass for having an HBAC.” My husband was just like, “Yeah. You’re a badass. I can’t believe you just did that.” Yeah. It was just wild. So amazing. Meagan: Absolutely. I’m sure it was very different for him, too just with the whole situation. “Okay, I’m going to set up the birth pool. She’s telling me to come but I’m going to take my time.” It’s just a very different experience. Then he’s like, “Okay, wow. We’re in labor. Let’s go.” Then it’s like, “Yeah, of course she’s going to feel that. Oh, you mean that now she’s going to feel that.” Jessica: Yeah, I think neither of us knew how far along I was and how quickly things were progressing. It just happened so fast. Meagan: Yeah. I want to talk about this too because sometimes we get diagnosed with failure to progress. We get to 3 or 4 centimeters and we’re told that we’ll likely never progress and whatever, then we go to have a C-section. Then we fear having a VBAC sometimes because we are like, “Well, maybe we won’t progress past what we’ve progressed.” But a cool factor about your story is that you never even went into labor, right? You had never even dilated or gone through that whole process. This whole birth, this whole HBAC was essentially like you’re a first-time mom. Your cervix was doing this the first time.When we’ve already progressed in maybe previous labor, that’s an even greater chance of a VBAC. You went in and your body did exactly what it needed to do to get this baby out even though you hadn’t had any labor previously. Jessica: Yep. Meagan: Pretty cool. Jessica: Yeah. I was very excited to see how it was all going to unfold. Meagan: Mhmm. Well, it sounds like it unfolded beautifully. Now you’ve got two cute babes and a beautiful home birth under your belt. So now– you were explaining that you were like, “Wow. Why did we do this? Why did we choose to get pregnant? Why did we choose to give birth vaginally?” After it is all said and done, are you like, “Yeah. I would do it again. I’m super happy we did it”?Jessica: Yeah. I actually want to do it again just because it was amazing. At the moment, yeah, it felt like the most painful thing of my life, but after that baby’s out and you do it, it’s like, “Wow. I did that. I am capable. My body isn’t broken. Just because this happened one time doesn’t mean it’s going to happen again.” It was very empowering. Yeah. It was just amazing. I would love to do it again. Meagan: I love that. Well, huge congrats. Huge, huge congrats. I want to talk a little bit more about vasa previa because I don’t think we’ve had anyone on the podcast who have actually had that before. Usually reasons for a Cesarean– we talked about this before we started recording– are “big baby”, small pelvis, failure to progress, or breech. We don’t see these because it is really, really rare. It actually only occurs in 1 in every 2500 deliveries. I don’t know if you said anything about IVF but it’s more common in IVF which is about 1 in 200 but even then, it’s a pretty rare chance. It can happen randomly or if IVF was going on, there is definitely a chance that it could increase your chances. Did you do any IVF at all or was it a spontaneous pregnancy? Jessica: It was spontaneous. I didn’t have any of the risk factors for vasa previa so it was totally random. Meagan: Totally random. You were just one of the really rare cases, but it worked out really well. Jessica: Mhmm, it did. Meagan: Well, thank you so much for sharing your stories with us today. Jessica: Thank you for having me. 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