Episode 289 Karen's VBAC After Navigating an Unsupportive Provider

The VBAC Link - Podcast tekijän mukaan Meagan Heaton

Though Karen did research and took birthing classes before her first baby, she didn’t realize how much advocating for herself could change the course of her birth. She wanted to be the “good” patient and told herself she could do without the things her body told her she needed during labor. Karen ended up pushing for over four hours and consenting to what she was told was an emergency C-section, even though the actual surgery didn’t happen until hours later.Karen had some serious postpartum symptoms of swelling and difficulty breathing that were dismissed and even laughed at until things came to a point where she knew something was very wrong. She was diagnosed with postpartum cardiomyopathy, admitted to the ICU, and transferred to cardiac care. Doctors told Karen very different things about her condition. She went from being told not to have any more children to hearing that VBAC was absolutely safe. Karen discusses how her gestational hypertension came into play with the different advice as well. Karen found her voice. She advocated for herself. She knew what her body was saying and what it was capable of. Her labor was so smooth and she WAS able to birth vaginally!Informed Pregnancy PlusNeeded WebsiteHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details 3:46 Review of the Week06:27 Karen’s stories08:50 First labor10:47 Pushing for four hours15:11 Karen’s C-section17:43 Postpartum swelling and difficulty breathing21:03 Fluid in her lungs23:52 Moving to Florida and getting answers25:13 Getting pregnant again29:53 Advocating for a VBAC32:14 A spiritual dream34:34 Gestational hypertension39:36 Signing an AMA41:31 Going to the hospital45:20 Pushing for 20 minutes47:30 White coat syndrome51:59 Symptoms of hypertension and preeclampsia54:52 Tips for hypertension and preeclampsia 56:55 Karen’s final tipsMeagan: Hello, hello. We are getting into almost our 300th episode, you guys. Every single time I’m recording and I’m looking at these numbers, I am blown away. I cannot believe that we have almost put out 300 episodes. Oh my goodness. I am so glad that you are here. I have this energy this year. I don’t know what it is. You’ll have to let me know if you notice it, but I have this energy every time I’m recording this podcast. 2024 is vibing. I’m vibing with it. I’m really liking it. We have our friend Karen and are you from Florida, Karen? Karen: Yep. I’m in Orlando, Florida. Meagan: Florida. That’s what I was thinking. So if we have Florida mamas looking for providers, this is definitely an episode. I feel like probably weekly we would get 10 messages asking about providers and Florida is huge so Florida is actually one that is really common where we are getting messages for supportive providers. So Karen, along the way, if you feel to name-drop some providers that are supportive, feel free to do so but we are going to get into sharing her story in just one moment because we do have a Review of the Week. 3:46 Review of the Week Meagan: This is from louuuhuuuu. So louuuhuuuu, thank you for your review. They say that this is “very inspirational.” It says, “I knew I wanted a VBAC with my third pregnancy, but I wasn’t sure if it was possible. However, I knew I didn’t feel like being flat-out told, ‘No’ at the first appointment. Listening to the podcast was definitely the start of me really researching birth and looking into my options. I ended up with a successful HBA2C and I definitely don’t think I would have had the courage or believed it was possible without this podcast. Thank you, Meagan, for all of the work that you do to provide this information.” I love that review so much. I think that through time in my own research, I was told no. I wasn’t told, “No, no.” I was told, “Sure, probably yeah. You could VBAC,” but I never really got that positive vibe. I feel like this community that we have created with all of the people on the podcast and all of the people in the community on Facebook truly is something that I lacked when I was preparing for my VBAC. I’m so grateful that we have this community for you today. Thank you, louuuuhuuuu, and huge congrats on your HBAC, your home birth after two Cesareans. If you didn’t what HBA2C meant, that’s home birth after two Cesareans. Just like louuuhuuuu, you can too. Make sure to follow us in our Facebook community. You can find it at The VBAC Link Community on Facebook. Answer all of the questions and we will let you in. You can find out as well that it is possible. VBAC is possible. 06:27 Karen’s storiesMeagan: Okay, Karen. Welcome to the show and thank you so much for taking the time to share your story today, well your stories today. Karen: Yeah. Thank you for having me. It’s a little wild actually being on your show. I’ve been thinking about what I was going to say even before you invited me like, “What would I say if I finally get my VBAC? It’s crazy to actually be sharing my story now so I’m really excited to be talking to you today.” Meagan: Well I’m so excited that you are here and sharing your inspirational message. You know, going through your submission, it sounds so similar to so many of us. You went in for a totally planned unmedicated birth that switched to the complete opposite where you had a C-section. There are so many of us. When I was reading that, I was like, “I bet I could probably find hundreds of stories not even just in our own community that start out like that.” Karen: Yes. That’s why I love listening to your podcast so much because for the first time, I didn’t feel alone. But yeah. I can get into my story now if you’d like. Meagan: Yes. I would love it. Karen: Okay. So back in August– or, I’m sorry. My son was due in August 2023. This was our first baby and he was a little bit of a surprise baby, but he was very much welcome and we were excited for him. At the time, we were living in Virginia. My husband had just gotten out of the Navy and he was about to start law school. I did prepare for the birth but I don’t think I prepared enough. I took a Hypnobirthing class and the doula who was leading the class was super supportive. She was just like, “You’re just going to birth beautifully. I can just tell.” The midwives, the nurses at the practice were like, “Oh, you’re going to birth beautifully. I can just tell.” I just kept hearing that over and over again. My ego was a little over-inflated and I was like, “I don’t need to do much. I’ve got this.” I don’t think I was prepared enough. I didn’t know what I was really getting into. 08:50 First laborKaren: So when I actually started going into labor, I got there way too early. I got to the hospital too early. Like you mentioned, I wanted an unmedicated birth. I got there, I think my contractions were about every seven minutes. Now I know that I definitely should have waited at home longer. But everything seemed to be going well. I arrived. They admitted me. They seemed a little bit hesitant, but they were like, “Oh, well she’s in labor. Let’s just bring her in.” My water broke on its own that afternoon. Things seemed to be going well until the pain really started kicking in. I had a really hard time working through the pain even with everything I learned in HypnoBirthing. I still hadn’t quite found my voice yet, my mama voice. I couldn’t tell people, “Hey, you’re distracting me. I’m trying to do HypnoBirthing.” I felt embarrassed about putting up the sign outside my door saying, “Hey, HypnoBirthing in progress. Please keep quiet.” I just didn’t speak up. I was just trying to be a good girl and just listen to what everyone says. I heard so many times in different episodes being a good girl and just doing what I’ve been told. Meagan: Right. We are people pleasers. I think a lot of us are people pleasers. We don’t want to ruffle feathers. We want to stay in line. We want to follow this path that we are being told we have to stay on. Karen: Yes. I mean, I just didn’t realize it was something I needed to form as a mama to be able to stand up for myself because pretty soon there was going to be a baby that needed me to stand up for them. Like I said, during the birth, there were just so many distractions, people coming in and out, nurses, and visitors. It was too much. I did end up getting an epidural because I just couldn’t hold out any longer. 10:47 Pushing for four hoursKaren: Around 2:00 AM, the labor and delivery nurse told me, “Oh, you need to start pushing.” I was on my back. I pushed for about two hours. I had some breaks but the baby was just stuck. For part of it, we could see that he was crowning but he just would not come out. During this entire time, no one really looked at me. I just had this one labor and delivery nurse. She was so sweet, but the midwife didn’t come by. The OB didn’t come by. No one really came by and I wanted to move into different positions. I felt my body telling me, “Hey, try this. Try this,” and they would tell me, “You can’t move. You have to stay like that.” I pushed for four hours. Baby was in distress. I felt fine but the midwife came in and told me, “You’re going to need a C-section.” This was the first time I had seen her. She told me. Meagan: Wow. Karen: Yeah. So she says, “You need a C-section. He’s not going to come out vaginally.” I didn’t know. I didn’t know what to do. I mean, I felt that was my only option. I got really upset. I started crying. I felt like a failure. I know now that I’m not a failure. That wasn’t it. But that’s how I felt at the moment and my husband was devastated. He was such an amazing birth partner and he felt like he failed me. I was like, “No. You didn’t fail either,” but at that moment, we just felt so let down that one, I had to ask for an epidural, and two that I was going to need a C-section. Karen: They told me. I don’t remember if the word “emergency” was used or not, but they made me feel like it was an emergency and it needed to happen immediately. When I look at the paperwork and all of that stuff, I’m like, “Where was the urgency?” Because the C-section didn’t happen until 10:00 AM. Meagan: Yeah. That’s not an emergency. This is another thing that I’m going to be honest– it irks me because there are so many of us who are told it is an emergency. When we hear “emergency”, what do we think? Panic. Scary. Right? We divert into asking– divert. I don’t know if that’s the right word. We stop asking questions and we say, “Okay. Okay. Okay,” because it’s an emergency and we are told that. Karen: Exactly. Meagan: I think a lot of times, truly that we are told it is an emergency and that offers some sort of– it’s weird, but some sort of validation where it’s like, “But it’s an emergency, so okay.” We just agree and then we are grateful. We look at them in a way because it’s an emergency so they are saving. Does this make sense? I don’t know. Karen: No, it does. To me, when I think about it now, it feels like manipulation. Meagan: Okay, yeah. Yeah. Yeah. It can be. Truly, there are real emergent Cesareans. Karen: Agreed. Meagan: We are so grateful for Cesareans that can help us and those are real, true emergent situations, but so many of us are told it’s an emergency and then like you said, it’s 10:00 AM or they come in and they’re like, “We need to shave you,” and it’s like, “Okay, that’s not an emergency.” If they have time to shave you, talk with you, and leave you for four hours, no. It’s not an emergency. Karen: Exactly. So if I had known what I know now, I would have asked for my options, asked to push and change positions. There are so many things I would have done but like you said, I thought it was an emergency. I was treating my baby in danger. I need to do this now even though there was nothing wrong with the baby. There wasn’t. Meagan: Or you. Karen: Mhmm, exactly. His heart was fine. Everything was fine as far as I could see as far as I remember, as far as the paperwork says, so it doesn’t make sense anymore to me. But yeah. 15:11 Karen’s C-sectionKaren: My husband was told to dress in scrubs while they prepped me and then I asked the nurse to make sure that no one was in the room when I got back. When we came back to surgery, they wheeled me over to the OR and they were just checking to see that the epidural was still good. I could feel them touching my belly. I told them and that’s the last thing I remember. The next thing I know, I just hear a baby crying in the distance. I was waking up in a different room and there were just these two nurses chatting about their day. To me, it was traumatizing. I couldn’t even process what was going on and what happened. That was just so, so scary. Meagan: I’m so sorry. Karen: Yeah. Sorry. So then they wheeled me out and that’s where my husband and our whole family were waiting. I was so frustrated because I told the nurse I didn’t want anyone here. I knew I would be upset after the C-section and there was everyone in the room waiting. I also found out that my baby got passed around so I didn’t even get to be the first to hold him. That was so extremely upsetting. I told my husband, “I want everyone out.” Everyone left and it was just me and my husband and our baby, Luke. We were there for about 15 minutes before they started to prep me to move the recovery room and I was like, “Wait a minute. I thought I got a golden hour where I would get to be alone with the baby for an hour.” They were like, “Oh yeah, you can do that in the recovery room,” and they just wheeled me over. I get so sad when I look at pictures of that time because my baby is so beautiful. I love him so much, but I felt so drugged up that I couldn’t connect with him. You can see it in the pictures. I just look like I don’t know where I am. I’m in pain. It’s just not what I imagined that experience to be. Meagan: Right. Karen: I definitely felt robbed of an experience. I felt extremely traumatized. That was hard in and of itself, but I was trying to come to terms with what happened. It was just a very rough time in the hospital. We had some family drama as well so that didn’t help. Meagan: No. Karen: I was discharged less than 48 hours later which now I know is way too early considering the symptoms I was feeling. 17:43 Postpartum swelling and difficulty breathingKaren: My legs were extremely swollen. My whole body was extremely swollen. It didn’t even look like I had given birth because I was just swollen all over. One nurse even made fun of my legs and she was like, “They look like baseball bats.” She was just tapping them.Meagan: That’s a warning sign. That’s something to think about. Karen: Well, I didn’t know that. Meagan: Well, of course, you didn’t, but as a professional, she shouldn’t be tapping on your legs. She should be like, “Hmm, was this like this?” Karen: I’ve told other medical professionals that story and they are horrified. They are like, “That was a big warning sign something was wrong,” but they discharged me regardless. I felt so completely unprepared. It was just a very bad experience all around. They didn’t have a lactation consultant working over the weekend so my baby was crying and crying and crying. He wasn’t getting enough to eat when he was breastfeeding. They were just laughing and saying, “Oh, all moms feel like that. He’s getting enough to eat.” Sure enough, my son was jaundiced and his pediatrician was like, “No, he needs formula. He’s not getting enough to eat.” He had a significant tongue tie so he was not getting enough to eat. When I got home, like I said, baby was starving. I’m not getting any sleep. When he does fall asleep, I can’t sleep. I remember explaining to different people like, “I’m having trouble breathing every time I lay down.” Everyone was just like, “Oh yeah. New mom, new baby. Totally normal.” Meagan: What? It is not normal to not feel like you can’t breathe. Karen: You’re going to love this then. At one point, I called the nurse hotline at the hospital because they gave it to me when I was discharged. I told the nurse, “When I lay down, I can’t breathe. It feels like I can’t breathe.” Her response was, “Oh, sometimes new moms don’t know how pain feels like.” I was just like, “Okay, I guess this is just me.” She was like, “Technically, we’re supposed to tell you to come to the hospital if you are having trouble breathing.” Meagan: Technically. Karen: Technically. So I was trying to be the good girl and trying not to ruffle any feathers and I was just like, “Okay. I’ll keep pushing through,” but the moment I realized things were not good, I was extremely depressed. I thought that I was going to die and leave my child alone. I was having horrible thoughts like that. Then I realized, “I’m starting to hallucinate.” So after three days of not sleeping, there was one incident where I heard my baby crying and screaming. I went over to the bassinet to look at him and he’s sleeping peacefully, but I can still hear him crying and screaming clearly. I’m like, “That’s not normal.” 21:03 Fluid in her lungsKaren: Once he woke up because I was trying to be a good new mom, so once he woke up, I packed myself up and my mom and I went to the ER. I explained to them, “I’m not getting sleep. I can’t sleep. Every time I lay down, I can’t breathe.” They were like, “Okay. Maybe you have a blood clot.” They took me back. They did an MRI scan and when I was lying down for the scan, I started taking these small quick breaths and the nurse was like, “Are you having a panic attack? What’s going on?” I go, “I can’t breathe.” She finally was the one that was just like, “There is something deeply wrong here. This is not normal at all.” I loved her. She really pushed to make sure that I got seen quickly. They determined that I was experiencing congestive heart failure. The way they explained it is my heart was not pumping strong enough I guess. It wasn’t pumping right so that’s why I was having trouble breathing because my lungs were filling up with fluid. They were able to give me medication. It was Lasix to help push out all of the fluid. I was kept at the ICU for two nights then they transferred me to the cardiac wing of the hospital. I was there four nights total because they just wanted to keep an eye on my blood pressure and this obviously wasn’t normal what was happening. My blood pressure was through the roof. That was a really, really difficult time because one, I was away from my new baby and then I had three different doctors tell me, “There is something wrong with your heart. You won’t be able to have more children. Your heart can’t handle it.” That was distressing because my husband and I dreamed of having a big family and we were thinking, “This might be our last child.” But weirdly enough, my OB– the one who performed the C-section– disagreed. I don’t like how he said this, but he was like, “Oh, don’t be dramatic. It was just a little extra fluid. You’re fine.” I was like, “Okay.” He said, “You can have a VBAC. You can have as many children as you want. You’re going to be fine.” I wasn’t a fan of him but that was interesting that he had told me, “You’re going to be a great VBAC candidate.” He kind of put that idea in my head. He said that the only reason my son got stuck was because he was 9 pounds, 15 ounces so basically a 10-pounder. I was like, “Okay.” I didn’t know what I know now, but that’s the reason they gave me. 23:52 Moving to Florida and getting answersKaren: Eventually, we moved to Florida because I’m from Florida so I felt more comfortable with the medical care there. I just kept finding out different ways that I was failed by the medical system back in Virginia. My primary doctor determined that I had postpartum depression. My son was already two years old when she discovered that. It was just like, “Oh, okay.” Here’s some medication. Now I feel like myself again. It made me realize, “Okay, what else do I need to look into?” I got a cardiologist. She was saying, “There is nothing wrong with your heart.” She can’t definitively say because she wasn’t there, but she was like, “They put too many fluids in your body. You are fine. There is nothing wrong with your heart.” She was just like, “You’re good to go. You can have a VBAC. You can have another C-section. You can do whatever you want. You’re fine. We can keep an eye on you, but you’re okay.” I started seeing an OB and I told her everything that happened and I was just like, “I want a VBAC.” I told her everything the cardiologist said, gave her all of the paperwork and she was like, “Yeah. You can totally have a VBAC.” So with both of their blessings, I was like, “Okay. Let’s try for baby number two. I’m okay. I’m healthy. I’m fine.” 25:13 Getting pregnant againKaren: So I got pregnant with baby number two and that was very exciting. I thought everything was going well then at 20 weeks, my OB said, “Unfortunately, I can’t be your doctor anymore. This practice cannot deliver you. You are too high of a risk for this office.” Meagan: For the office. Karen: Yes. Yes. They only delivered at these smaller boutique hospitals so they said that I needed to deliver at a high-risk hospital or a hospital that accepts high-risk patients. Meagan: Okay, got you. I got you. Karen: I got a little tongue-tied. They told me I needed to deliver at a different hospital that I didn’t want to deliver at. I was like, “If I’m going to deliver at a big hospital, it’s going to be Winnie Palmer in Orlando.” I’m a huge fan of theirs. So I was just like, “Okay. I can’t deliver with this office even though they’ve been aware of all my situations for a while. I’ll find a different office.” But I was already 20 weeks so it’s really hard to find a provider at 20 weeks. Meagan: It can be, yeah. Karen: The other disappointing thing they told me is, “Oh, by the way, you can’t have any more children. You really shouldn’t because, with everything that is going on with you, your body can’t handle it.” It was just like, I don’t understand where this is coming from. You’ve been telling me I’ve been okay. My cardiologist says I’ve been okay. I didn’t really get what was going on. Karen: I called around and only one clinic would take me when I was that far along with this high-risk label on me. Meagan: I was going to say the label. That’s exactly the word I was going to say. Karen: Yeah. I didn’t feel like it really fit, but that’s what they said I was. I found a big practice that had lots of doctors. It is a very prominent practice here in Orlando and I felt like I just had to settle. The first doctor I met with I was already frustrated because I asked for a female doctor and they gave me a male doctor. I don’t have anything against male doctors, I just feel more comfortable with a female doctor but he was just like, “Oh. You can’t VBAC at all. You had a vertical incision so you have to have a repeat C-section.” I was like, “I don’t– I’ve never heard anyone say that. Where does it say that in my medical records?” He was just like, “I don’t see it in your records, but this other doctor said that you had a vertical incision.” I’m like, “Well, how does she know that?” So I had to go and start pulling all of these records and got the surgical notes for my C-section and everything and finally, I found something that said I did not have a vertical incision so once I showed it to him, he was just like, “Oh, okay. Well, you still can’t VBAC. Your hips are too tiny. You can’t deliver a baby.” Meagan: Oh my goodness, just pulling them all out. Let me just shift this jar around and pull out the next reason. Karen: Yes. I was just like, “Are you serious? Okay.” Meagan: Goodness. 29:53 Advocating for a VBACKaren: So me and my husband were like, “No. I want to try. We want to try.” I’m so glad my husband was there because he is always so good at being an advocate for me. He was just like, “No. She wants a VBAC. What can we do to make it happen?” So he said, “Well, your weight is one thing because your baby was so big the first time because you gained a lot of weight. We can help you try but if after two hours of pushing you can’t get that baby out, we’re going to give you a C-section.” It was very frustrating, but I felt like I really had no choice. Meagan: Yeah. Karen: I hadn’t discovered you yet so I was just like, “Okay. I guess it is what it is. I will try my best to have a VBAC, but this guy’s going to stop me.” So I was very blessed that due to a scheduling issue, I had an appointment with a totally different doctor. She was this young female doctor. She was around my age and I felt like I could relate to her. I just really enjoyed talking to her. I don’t know if this has something to do with it, but my background is I am Japanese and Colombian and she was Asian, so it was just like, “Okay. I have someone else who is a person of color who understands at least the cultural differences.” So I don’t know if that really had anything to do with anything, but it did make me feel more comfortable with her.Meagan: Which is important. Karen: Yes. After years of different doctors telling me there was something wrong with me, it was so nice to have her say to me, “Oh. You want a VBAC? Yeah. You are super healthy. You are going to be fine.” It was just like, “Oh my gosh. You think I’m healthy? Every doctor had been telling me that I’m overweight. There’s something wrong with my heart. There’s something wrong,” and she was telling me that I was healthy. That just made me so inspired and I just became a lot more proactive with my health. I didn’t feel like things had to happen to me. I felt like I had a lot more control over my situation. 32:14 A spiritual dreamKaren: There was also one other event that happened and this was around Christmas. I’m a Christian, so we’ve been going to God a lot with prayers and I have been asking for a successful VBAC. So Christmas morning, I woke up to a dream but it didn’t feel like a dream. It felt more like a vision and I was giving birth vaginally to a little girl. In the dream, I had the knowledge that this was going to be my third child. I was like, “Wait a second. But I’m pregnant right now with my second child. How did that birth go?” I just was told by God, “Oh, that birth went well too. You’re going to be fine. You’re going to be happy. You’re going to have many children.” So I woke up so happy that Christmas morning. I told my husband with everything I’ve been battling and all of these negative thoughts, there is no way that this could have been something I produced myself or just dreamed of myself because it was such a positive, happy dream when before that, I had just been having constant nightmares about C-sections.It was just this moment of, “Okay. God really is with us and he’s going to make sure everything is okay.” So yeah, between having this great doctor and then having that dream, I just was more motivated to really take control of the situation like, “Okay. I don’t have to let things happen to me. What can I do?” Which actually led me to The VBAC Link. I was already 33 weeks pregnant when I found you guys so it was kind of late in the game, but I’m so glad I did. I listened to The VBAC Link obsessively in the car, when I was walking my dog, all the time and I would just hear these different stories and notate, “Okay. This is what she did. This is how she got results. This is what happened to her.” I started taking all of these notes about how I should respond in different situations and I’m so glad I did because I did use some of that later on. 34:34 Gestational hypertensionKaren: Unfortunately, I did develop gestational hypertension but I’m still not completely convinced that I actually had it. They diagnosed me the week I had to put down my dog and I had her since I was 15 so it was just devastating. I was under a lot of stress and I tried to explain that to them. They were like, “No. This is gestational hypertension.” I’m like, “Okay. Here is another label.” But I kept on top of my blood pressure readings. I never had high readings. I ate well. I tried to do exercise as much as you can when you are in your third trimester. Unfortunately, this practice had a policy that patients with gestational hypertension must deliver by 37 weeks. Meagan: Whoa. Karen: Yes. They said that if you are a VBAC patient, they won’t induce you. So there’s another timeline. I had to deliver by 37 weeks. But yeah, things seemed to be going really well. Once I reached around 36 weeks, I actually started having prodromal labor. I’m like, “Okay, yes. Things are going really well.” Because I had gestational hypertension, I was going 3-4 times a week to the doctor at that point. Meagan: For non-stress tests and stuff? Karen: Yes, exactly. They could see that I was already 3 centimeters dilated so I was like, “Great. Everything is going great.” At the 37-week appointment, there was a scheduling issue and instead of being able to see my regular doctor, they assigned me to a different doctor and that just made me really, really nervous. I was just like, “I don’t want to go. I don’t feel right. Something is going to go wrong. It’s not my doctor. I don’t want to go.” My husband was like, “No. It’s going to be okay. It’s going to be okay. Let’s go.” He canceled work so he could go with me. He was like, “Everything is going to be okay.” The other thing that happened that morning was my sister who was going to be in the room with us woke up with strep throat. I was like, “This is not a good week. This is not a good day. I don’t want to go in.” So when I went in, my blood pressure was 160/113 which was extremely high. This doctor told me, “You need to get a C-section today.” So I was just like, “Okay. I don’t want to hurt my baby. That’s fine.” I was really, really upset. I was crying and I told her I was scared and she was like, “Why are you scared?” My husband was pretty blunt and was like, “Because the doctors almost killed her last time.”She was like, “How did they almost kill her?” He was like, “They put too much fluid in her body and they caused heart failure.” She laughed and she said, “That’s not a thing.” I was like, “Well, my cardiologist said it was a thing. How could you say it’s not a thing?” I went to the hospital. I was really upset but the nurse there was amazing. She was like, “What happened?” I basically told her everything like my life story basically up until that point. She was like, “I checked your blood pressure when you came in. You are fine.” She was like, “This is ridiculous. It just sounds like you are stressed out.” At that point, my blood pressure was–Meagan: Reasonably so.Karen: She checked my blood pressure and it was 117/83 so it was great. It was so funny because she kept the blood pressure cuff on me and the doctor who was working that day was the same doctor who told me I’d never be able to VBAC and kept coming up with excuses. My nurse was just like, “Look, her blood pressure is fine.” Then she took my blood pressure again in front of him and it went back up. She was like, “Can you step out?” She took it again and then it was fine. She started advocating on my behalf. She was like, “You guys are causing her heart pressure to go up. You guys are stressing her out. She does not have high blood pressure because of herself. It’s you guys.” The doctor was just like, “Oh, well I guess it’s fine, but wouldn’t you rather just have a birthday today?” I’m like, “No. I would not like to just have a C-section for no reason.” He’s like, “I really don’t want to send you home though,” but you really should consider this C-section just in case your blood pressure goes back up. I was like, “Look. I can check it repeatedly and if it goes up, I will come back. I’m not going to be stupid and put my son’s life in danger. I will come back.” He just kept trying to convince me and finally, we were like, “No. We’re leaving.” I told them, “If I’m going to have a C-section, it’s going to be with my regular doctor. I trust her. I’m going to have control over this situation somehow. Even if I have to have a C-section, it’s going to be by someone I trust. It’s not going to be by you.” 39:36 Signing an AMAKaren: He was not thrilled about hearing that but he said, “Okay fine. You have to fill out this paperwork saying you’re leaving against medical advice, but it will be fine.” I was like, “Okay, fine.” I filled out this paperwork. I was scared like, “They’re probably going to kick me out afterward, but whatever.” I filled it out and I went home. They did make me schedule a C-section for two days later when my regular doctor was on call. I was like, “You know what? If it has to happen that day, it’s fine. I did everything I could. I took control of whatever I could. It’s my doctor.” She made me feel seen and heard and she had my best interest at heart, so we are going to pray and just do what we can. The next two days, I walked 10 miles. I drank raspberry leaf tea. We had sex. We did basically everything you can do to get labor going. I was still having prodromal labor so we would get our hopes up and then it would stop and then get our hopes up and then it would stop. Around midnight the night before I was supposed to get my C-section, I was so upset. I was just like, “It’s not going to happen. I’m just going to have to get a C-section.” I just gave up completely. My husband was just like, “No. God told you this was going to be fine. You’re going to be fine. Let’s just get some rest because it’s already midnight and we have to leave at 3:00 AM so let’s just get a little bit of rest and it will be fine. We will talk to the doctor in the morning.” I was like, “Okay.” So we went to sleep at 1:00. The alarm rang at 3:00 and I was in labor. Meagan: Yay! Karen: I was so excited. 41:31 Going to the hospitalKaren: We went to the hospital. They still prepped me for a C-section. They were like, “Just in case,” but I was having regular contractions. It wasn’t going away. My doctor came in. She checked me and she was like, “Okay. If you want to TOLAC, I’ll send you over.” I was just like, “Oh my gosh, yes. This is my dream!” We were so happy. They wheeled us over and it just felt so surreal. We just kept waiting for the rug to be pulled out from under us and someone came in and was like, “No, you need a C-section now. You’re not allowed to be over here,” or something. We were just waiting. I wanted this to be another unmedicated birth, but our midwife came in and she told me her plan. She said she wanted to try a small bit of Pitocin to see if I could make the contractions a little bit stronger and then she saw my hesitation and told me, “It’s only a small amount to help move things along, but you are not on a time limit. You can take however long you need to labor. It’s just to help move things along. The max is 10. We won’t ever get to that point.” I was just like, “Okay. I’m going to put my trust in you because my doctor trusts you.” She also asked if she could break my water to help move things along and I felt at ease so I was just like, “Okay. That’s fine.” My husband was really surprised I was consenting to the Pitocin and to the water breaking. I told him, “I don’t know. All this time, I’m always fighting against my gut and my gut is telling me I can trust them fine and this is going to be okay.” I listened to her plan and I said, “Yeah, let’s do it.” They also kept a really close eye on my fluid levels– the thing that the other doctor said was not a thing. It felt good to know that they were actually paying attention to me and listening to me. Karen: The other thing that happened was at 10:00 AM, my sister completed 48 hours of antibiotics so she was able to join us and I was like, “Okay. Everything is going to be okay.” My husband and I were finally able to relax. Meagan: Good. Karen: Yeah. Again, I wanted to go unmedicated but I noticed something about my body which was that I could not relax my pelvic floor. I was so tired. I was so exhausted from the last 48 hours, from the walking, from not sleeping, and from everything. I was just like, “I’m trying, but I cannot relax it.” I was just like, “I think I want an epidural. I think that will relax my pelvic floor and just relax in general.” They gave me the epidural so I was finally able to get some rest. Without even having to ask them, the midwife would come in, put me in different positions, and just do different things to help me get the baby down on its own instead of last time where they just left me lying in there with no instructions. Then around 4:00 PM, they told me I was fully dilated and they were like, “Let’s do some practice pushes. Let’s just make sure you know what you’re doing with your body. We can troubleshoot and then when you’re ready, you know what to do already.” I was like, “Yeah. That’s fine.” They get everything ready, start doing some practice pushes, and the midwife goes, “Oh, these aren’t practice pushes.” 45:20 Pushing for 20 minutesKaren: She starts getting suited up and the room starts filling up with people and 20 minutes later, my baby was out. Meagan: 20 minutes! Karen: Yeah, 20 minutes of pushing. He was 9 pounds so he was still a big baby and perfectly healthy and beautiful. It was wonderful. One thing that my husband noticed was that the whole room was all women. It was such a cool girl power moment. They were all cheering and so happy for me getting my VBAC and it was just a total girl power that we were all like, “Yes. We did it. Girl power! The doctor is a woman. The pediatrician is a woman. We did this.” It was such a cool, surreal moment and then they had other nurses coming in and they were like, “We heard your story. That is so cool you got your VBAC.” It was so, so amazing. It was just such a huge difference having this supportive environment. I don’t know. In that moment, it was like an instant feeling of relief because I felt like all of this trauma that I had been carrying with me for so long was just lifted. I felt like I was finally healed and I was able to forgive myself for the C-section and realize, “Okay. You didn’t fail at anything. Things happen. You didn’t know. It’s okay.” Finally, I didn’t have this label that I was defining myself with for so long which was traumatic birth. I finally just got to have the birth I wanted for it to be pretty smooth after the drama of the earlier morning. Everything just went perfectly and it was so, so beautiful. I was crying. We were all crying. The doctor was just like, “Okay, is this pain crying or is this happiness?” I’m like, “This is happiness!” Meagan: Pure joy.Karen: That’s my story. 47:30 White coat syndromeMeagan: That is awesome. I love that you truly got to end that way surrounded with women and somebody that you really like and just having everyone rejoicing and happy and crying together and having that space be such a drastic change in your first birth. That is amazing. Thank you so much. Did you have any blood pressure issues during your labor at all? Karen: No. My blood pressure was fine. They were keeping an eye on it the entire time and I was getting nervous because I thought, maybe if it should up they would wheel me over to a C-section, but no. It was fine the entire time. Meagan: I love that. It’s kind of interesting because there have been times where I’ve had clients where they don’t have any signs of hypertension or preeclampsia or anything like that, but then they go to their visit and then they are like, “Oh my gosh. My blood pressure was just through the roof.” They go home and they are checking it at home and they are like, “It’s fine.” But then they go and it’s through the roof every time they go. We just had a client just the other day. She’s 34 weeks and she went and her blood pressure was pretty high. It really was. It was high. The reading was high and they did a couple of readings. They said things like, “Well, we might have to go to an emergency C-section.” This and that. Anyway, she was like, “Whoa, whoa, whoa, whoa. Hold on.” She was like, “I want to go home.” She went home and relaxed and had food. Her blood pressure was fine. White coat syndrome is a real thing and it’s something to take into consideration like, “I never have blood pressure issues. I don’t have any signs. I don’t have protein. I don’t have these things. What may be going on?” I love how your nurse was like, “Hey, can you step out? Go out.” She was very able to relate to that. Then sometimes, we have it and we don’t know why. With your first pregnancy, did you have any high blood pressure at all? Karen: No. It was just a very uneventful pregnancy. Everything was perfect. It was very strange for these blood pressure problems to happen afterward.Meagan: Yeah. I think it’s called peripartum so it could happen before or postpartum cardiomyopathy. Karen: Yes. Yes. Meagan: That’s what I was thinking it was going where the heart muscles weaken and can lead to heart failure progressively. The symptoms include fatigue, hard to breathe, and feeling your heart rush. Those are common. Karen: Yeah, so that’s actually what is on my medical records is that I had peripartum cardiomyopathy but my cardiologist was just like, “I don’t believe that for a second. Your heart is fine.” She kept an eye on my heart the entire pregnancy and after the pregnancy. Nothing else happened. Meagan: I almost wonder if your heart was under stress. You talked about fluids. We get an astronomical amount of fluids during a C-section too. I’m just wondering if your body just went under a lot with a Cesarean. There was a lot of shifting and a lot of things happening and then of course a Cesarean. It just made me curious because sometimes if you have hypertension before, it can be a risk factor in that. Interesting. Karen: Yeah. That’s something that the cardiologist said is that sometimes it gets confused with fluid overload. She thinks that’s what happened. Part of the labeling that was happening is throughout my second pregnancy, I kept having to tell people that I did not have blood pressure issues with the first because they kept going, “Oh yeah, well you had blood pressure issues with your first pregnancy,” and I’d be like, “No, I didn’t. Stop assuming that.” Meagan: I mean, I am no medical professional by any means, but it makes me wonder if it could have been related to the birth itself. 51:59 Symptoms of hypertension and preeclampsiaMeagan: I’d love to talk about hypertension and preeclampsia and things like that because hypertension is something that happens during pregnancy and it can be associated with lots of different reasons, but sometimes hypertension during pregnancy can lead to preeclampsia or HELLP or things like that. I want to give a little educational tidbit here. Talking about just hypertension. High blood pressure or hypertension does not necessarily make us feel unwell all the time. You can have that and not know. So you walking into your visit and them being like, “You have hypertension.” You’re like, “Oh.” It’s not completely abnormal to just walk in, but sometimes we might have headaches or not feel super great. If you are feeling crummy or especially if you are feeling like you can’t breathe when you lay down or have shortness of breath, do not think that those are all just normal pregnancy symptoms that people who told you, “Oh, yeah. It’s a new mom.” You’re like, “No.” So follow your body. Trust your body. Preeclampsia is a condition that does affect pregnant women and can sometimes come on after that 20-week mark where we are having some of that swelling. We are having the high blood pressure. We have protein in our urine. That’s when it turns into that preeclampsia stage. It’s really hard. It’s still unknown exactly why preeclampsia or hypertension come, but it’s believe to be placenta-related so sometimes our placenta doesn’t attach in the full-on correct manner and our blood vessels are pumping differently so we can get high blood pressure. I want to note that if you are told that you have high blood pressure or if you have preeclampsia, that doesn’t always mean you have to schedule a C-section. It just doesn’t. It doesn’t mean it’s always the best decision to not schedule a C-section if that makes sense, but that doesn’t mean you have to have a C-section because you have hypertension or blood pressure. I feel like time and time again, I do. I see these comments in our community where it’s like, “I really wanted my VBAC, but I just got preeclampsia. The doctor says I have to have a C-section.” That just isn’t necessarily true. They can be induced. I know you mentioned your one hospital was like, “No, we can’t induce because you are a VBAC,” which also isn’t necessarily true. 54:52 Tips for hypertension and preeclampsia Meagan: Sometimes we also want to be aware of hypertension or preeclampsia getting worse because labor can be stressful on our body and all of the things. I wanted to just give a couple of little tips. If you have high blood pressure, increase your hydration. Go for walks. Cut out a lot of salts so really eating healthy and then you can get good supplements to help. If you are in labor and you are getting induced or something like that, sometimes you may want to shift gears. Maybe an epidural can be a good thing to reduce stress or a provider may suggest that it’s not abnormal. But know that if you were told you have hypertension or you have preeclampsia, it doesn’t always mean it’s a for sure absolutely have to have a C-section. Even your provider was like, “Oh yeah. We’ve got this high blood pressure stuff. I really wanted to keep you.” You were like, “No.” Then your other doctor was like, “We’ll kick you over here to 38 weeks,” because everything really was looking okay. Yay for that doctor for not making you stay and have a C-section that day. Know that you do have options. Time and time we talk about this. Don’t hesitate to ask questions. Ask questions. Can I get a second opinion? Can I go home and relax and take a reading there? Is there something I can take to help with my blood pressure? Those types of things and then following your heart. What does your heart say? That’s just my little tidbit. Do you have anything to add? I know you didn’t have high blood pressure in the first pregnancy and then you kind of did sort of maybe have white coat syndrome or blood pressure with the second but do you have any tips on this situation? You were exactly in that space of they are telling you you have blood pressure. He is telling you he doesn’t want you to go home and that type of thing.Do you have any messages to the audience?56:55 Karen’s final tipsKaren: One thing I started doing during this pregnancy was meditation and that helped a lot. Whenever I felt like, “Okay. I’m going to go into a stressful situation,” which was most doctor visits, I would meditate before the doctor came in and that would really help a lot. Meagan: Yes. Exercising, eating, hydrating, meditation, and doing something to bring yourself back down can help. It doesn’t always help. Sometimes we have high blood pressure and we do not understand it. We cannot control it as much as we are trying to. It just doesn’t want to listen to what we are trying to do or receive the things we are trying to do, but all of these things can help. I am just so happy for you that you found good support, that you found the true bubble of love in your hospital room at the very end, and that you were able to have your VBAC. Karen: Thank you. Yeah. I do want to make sure. I’m not trying to send a message of, “Ignore high blood pressure! Do what you want!” It absolutely can be a very scary thing. If you need to have a C-section because of it, totally understandable. It’s just that my big message that I tell new moms is to listen to your body and you are allowed to say no. You are allowed to say no to people and ask for options. But the big one is to listen to your body. Listen to your gut. You know what is really, truly going on with your body. Meagan: Of course, right. And typically, birth is actually the full cure for things like preeclampsia. Getting baby earthside is typically the end of that preeclampsia and the stop. That doesn’t mean you shouldn’t say, “No, I’m not going to do anything,” but just know that you have options. Induction is still okay typically. Ask those providers about your individual needs. Talk about your individual case but yeah, I would agree. I’m not trying to say, “Don’t listen to your provider.” I’m just saying that you have options and you often will have options if they say one thing or another. Don’t hesitate to ask questions. Karen: Exactly. Exactly. 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

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