Episode 299 Katie's Healing VBAC + Home Birth Transfer

Katie joins us today to tell us about her two birth experiences in Germany. Although she strongly advocated for herself during her first birth, Katie was extremely mistreated. Her labor and horrible C-section experience left her with intense PTSD straining her relationship with both her baby and her husband. Katie knew that if she wanted to have another baby, she had to plan for an out-of-hospital birth. She continued to advocate for herself by not only learning the evidence but by showing it to providers and defending it. Though she wasn’t able to find a supportive backup hospital, Katie labored beautifully at home with her husband, doula, and midwife until she knew it was time to transfer. When she transferred, Katie was able to go to the hospital she wanted to go to and was finally treated with respect. Her wishes were honored and she felt heard. Though this labor was also over 40 hours and had its own unexpected twists, Katie experienced so much healing from her VBAC. She was able to achieve the glorious feeling she hoped she would have from a home birth even in the hospital.  TOLAC in Germany ArticleEvidence-Based Birth Blog: Friedman CurveInformed Pregnancy - code: vbaclink424Needed WebsiteHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details 04:41 Review of the Week07:27 Katie’s stories11:14 Start of labor16:55 Going to the hospital20:22 Interventions29:44 Katie’s C-section32:06 Preparing for VBAC34:34 Second pregnancy42:01 Labor begins47:11 Getting support from her birth team50:12 Transferring to the hospital53:32 Feeling intense scar pain56:23 Asking for the vacuum58:42 Katie’s advice for listeners1:01:47 The Friedman Curve1:06:16 Trusting your intuition1:08:56 Doula supportMeagan: Hello, Women of Strength! We have a story for you today where a mama gave birth in Germany. So I love, love, love when we have out-of-the-country birth stories because we often get messages from people outside of the country wondering if VBAC is still possible and the answer is YES. 100% it is possible and we have our friend Katie today. Hello, Katie!Katie: Hi.Meagan: She is going to just be sharing her story showing that it is possible to VBAC. Now, one of the things that I actually really love about Katie’s story is that it shows that things can change, and even when things change it doesn’t have to be bad. I sit in that because I personally wanted to birth out of the hospital and when I was in labor, in my mind, if I had to transfer, I was for a little while telling myself that that was a bad thing. And that it wouldn’t happen, or people would be looking down, or whatever. I was spiraling. I was just going through a moment in labor. But something that stood out to me with Katie’s, is she talks about how after a really long labor at home, planned home birth, her intuition, which we talk about a lot, knew that she needed to make another choice in her labor and that was to go to the hospital. Right, Katie?Katie: Exactly. Yep.Meagan: And so I love that we can talk about how plans can change and that doesn’t mean it has to be the be-all end-all. Is that how you say it?Katie: Yeah.Meagan: It doesn’t mean it has to be over or it doesn’t mean your chances of VBAC are done. If you are planning a home birth and you make the choice, or even if it was medically necessary, like sometimes it is, right? That doesn’t mean that it has to be bad. And so I love that part about her story and that she listened to her intuition. And then also another highlight, is that intervention happened, right? And that sometimes in this community we fear the intervention. I understand why we don’t all usually want the intervention, we just want it to be left alone. But sometimes intervention comes into play and sometimes those interventions help us get the birth that we wanted. And so I’m just going to end there because I want Katie to be able to share her story but those were a couple of things that, for me, as I was reading her submission, stood out to me and I thought were really important topics to touch on because plans can change and even when plans change, it’s okay. 04:41 Review of the WeekMeagan: But I do have a Review of the Week so I want to review that and then I’ll turn the time over to you Katie. Okay, so this is from our Google reviews, which we absolutely love. Even our Google reviews help people find the podcast, our blogs, our course, our resources, all the things. If you wouldn’t mind heading over to Google. Google “The VBAC Link,” and leave us a review, we would absolutely love that. So this is from, I think it’s Eimear. Sorry if I am butchering this name. They gave a 5-star review, so thank you so much. But it says that, “This podcast was my constant source of reassurance and inspiring stories throughout my last two pregnancies. I achieved my VBAC in 2021 and was empowered with so much knowledge and mental strength going into this birth because of The VBAC Link. I had my second C-section in 2002 which was not what I wished for but I do plan on having more children and know that VBA2C (vaginal birth after two C-sections) is a possibility for me because of this podcast. I continue to listen to your inspiring stories each time I hop in the car and I’m so grateful for all that you share. I hope to share my own redeeming story with you in time, too.”Thank you so much for that review. I love that you said that VBAC after 2 C-sections is possible. We see that a lot in our Q and A’s. “If I’ve had 2 C-sections is it possible?” The answer is yes, absolutely, 100 percent. So if you want to learn more check out the podcast or head on over to thevbaclink.com and search VBA2C and you’ll get to find more about that. 07:27 Katie’s storiesMeagan: Okay, Katie! Welcome again. Thank you for being here. Katie: Thank you for having me. I’m so excited to share my story.Meagan: Oh my gosh, me too.  And I know you’ve got your little one by you. So how old is your little baby?Katie: My daughter, Scarlett, is just shy of 5 months.Meagan: 5 months. Okay, so you’re still pretty in the thick of it. Katie: Yes, still sleepless nights.Meagan: Yes, and you’re coming from Germany. I don’t even know what the time zone is there, but hopefully, you’re not up way too early or way too late.Katie: It’s like just late afternoon here.Meagan: Okay good, I’m so glad. Well I would love to turn the time over to you to share your stories.Katie: Okay, great. Well, I’ll just get started with my C-section story. My son, Charlie, is 2. He was born in 2021. I’m originally from the U.S. but as you mentioned, I live in Germany and I had been in Germany for about 5 years when I had him. And then as just some background, I’m actually an intensive care nurse and I worked in the United States as an intensive care nurse and then for a bit here and have since transitioned into the corporate world. I’m not like a labor and delivery nurse, but I have a lot of knowledge about birth from nursing school. I think there is a little bit of a misconception in the U.S. that everything is better in Europe, that they're more natural or that the healthcare is better, blah blah blah. I just want to say that has not necessarily been my experience especially working as a nurse. I can really see that the shortage of trained healthcare workers is significantly worse here. And there’s kind of like, we have our issues in the U.S. too about making sure we’re providing evidenced-based care. We try but it’s hard to keep up and stuff. I would say it’s even harder here and then doctors here are super paternalistic. So when I was pregnant with my son, I had that impression as I was going into it. And also, the way it works here is, you just go to a gynecologist for your pregnancy care and then you just go to the hospital to have your baby. You don’t get to pick your doctor. There’s just staff, so you just get who you get. I didn’t really like that when I was planning my birth for my first pregnancy, but I was kind of like, well what else am I gonna do? That’s the way it is. But I felt at the time really confident about my knowledge and that I’m pretty tough and well-informed, and I’ll manage to get through it. This is just like the way it’s going to be. Didn’t have any thoughts about trying to do a home birth or another out-of-hospital environment, it was just like you go to the hospital and baby and go home. So my pregnancy was pretty good. I had the normal kind of aches and pains. There was some concern with my son’s placenta. It wasn’t functioning great but we didn’t have issues from it, just extra growth scans and there were really no problems. He was due December 27th, so around Christmastime. I think if I had known I would have never gotten pregnant to have a baby around Christmastime because my impression was with the hospital, that they were really short-staffed when I ended up having him. 11:14 Start of laborKatie: So I ended up going into labor– he was born on the 22nd, so I went into labor on the 20th of December. I woke up around midnight with really bad back pain and I felt like I was going to have diarrhea. That’s probably TMI.Meagan: I totally get that. Katie: Yeah I kept going to the toilet thinking I had food poisoning, and nothing would happen. I would go and sit down, and as soon as I would sit down I’d feel like I'd have to go to the toilet again and I would run back there. This kept going on and then eventually after a little while I had some bloody show and my mucus plug came out. And I was like, “Oh! This was the contractions.” I was not expecting it at all. It was just this stabbing pain in my back and I didn’t feel like my uterus was really doing anything so I was kind of surprised. I was like, “I guess I'm in labor,” and it hurt so bad. People always talk about how it starts out kind of light and builds up, and it was really full force. Like I said, I kept going to the couch and trying to sit down and trying to get comfortable and I’d have to keep running to the bathroom. It just kept coming. I was like, “Oh my gosh, is this baby going to be born really fast? This seems pretty intense.” I was like, “No, no I probably have a long time to go so calm down.” I took a shower and got my birth ball out and started trying to work through it. At some point, my husband woke up and I was like, “I think I’m in labor. Go back to bed and I’ll get you if I need you.” I labored throughout the night. But around 4:00 or 5:00 in the morning, I started noticing contractions. They weren’t quite as painful and it was spacing out a little bit and I was like, “Oh, maybe I should try to sleep.” So I laid down on the couch and I was able to kind of sleep in between these contractions. My husband woke me up a few hours later because I had my 39-week doctor's appointment. And I was like oh well we can just go to the doctor and have them check me there and just see how we’re going. We walked to the doctor because I was afraid my water would break in the subway so we just decided to walk. But that didn’t happen and by the time we got to the doctor, they had spread pretty far apart. I had waited in the waiting room for a while and I only had a couple while I was waiting.My doctor checked me and she said I wasn’t dilated and then they did put me on the CTG there for just a little bit to just see what was happening and I didn’t have a single contraction while I was hooked up on the CTG. But the second they took it off and I stood up again, it started again. But it was more how people describe early labor. It came every few minutes. It was totally manageable. I just had to take a few deep breaths. We ended up walking home and the rest of the day, that went on. I labored in the afternoon and I thought at some point I should try to take a nap, but every time I tried to lay down it would be really uncomfortable so I got up. Then my husband and I decided, “Well, this baby is probably coming. Let’s go do some grocery shopping, get some snacks, and be prepared.” Katie: So we went grocery shopping and my parents were visiting. They were staying in a hotel, but they came over. We all had dinner together. I was convinced that it wasn’t labor, and I was like, “This is probably just fake labor,” so I didn’t want to tell them. My mom later told me, “We totally knew you were in labor. You did not fool us for a minute.” We made dinner, we all ate, and they left.It was only 7:00 or 8:00 PM and I was like, “Let's sit down and watch some TV and try to relax.” As soon as I sat down, the intensity really picked up and the frequency. I wasn’t timing them, but I really saw that they were coming quite often and it wasn’t comfortable to sit down anymore. I thought, “I’ve been doing this all day, almost 24 hours now. I think I deserve to use some of my coping mechanisms that I’d planned for.” So I had planned to listen to these hypnobirthing tracks and had bought a ton of really nice bath supplies to make nice hot baths. So I got in the bath and was just using this app to do the HypnoBirthing tracks and I found it really helped me and I was doing really well. And then after a while, my husband came in. I think he felt like he should be doing something too. I was like, “You can press start and stop on this app because it’s really annoying to dry my hands off,” so he was like, “Okay.” He was there for 10  minutes and something popped up on the app that was like, “You should go to the hospital now,” and he started panicking. I was like, “I’m fine.” In my mind, compared to the contractions I had the first part of the previous night, my contractions were going to have to be at least like that or worse because I hadn't dialed at all, so I was like really mentally prepared this is going to be so bad. Right now I still feel fine. They were just coming close together, but I had no feeling the baby was coming. I felt fine.But he was just like, “Oh my gosh, this app is telling us we should go to the hospital,” and ugh. After a while of him freaking out, I thought, “Okay, let's just go to the hospital and do a check. They’ll reassure him that I’m tops 2 centimeters dilated and he can relax and I can continue to labor in peace at home.” 16:55 Going to the hospitalSo we get packed up and drive to the hospital. They put me on the CTG and checked me. I’m 2 centimeters. Then after half an hour, they come in and say, “Well, we don’t have any beds so we’re going to have to send you to a different hospital.” I said, “Whoa, hold the phone.” In my mind, I'm thinking that I have at least 12 more hours of labor to go. I’m a first-time mom. And I was like, “I want to go home and labor. I don’t want to labor in the hospital. I want to go home. Can’t I come back at like 6:00 AM and check me again?” It was about midnight at this time. And they were like, “Oh no, you’re not going to make it to 6:00 AM. Your baby is coming and will be here by morning.” And I was like, “Seriously?”Meagan: “It’s midnight, I’ve got some time.”Katie: And I was like, “I really don’t believe that.” But they were so insistent that I had to go to the hospital and they were even like, “We called an ambulance to take you to the other hospital.” Meagan: Oh my gosh.Katie: I was like, “I don’t need an ambulance. I’m not dying, I’m just having some contractions. This is crazy, guys.” They were like, “Are you sure?” I was like, “No, I don’t want to be separated from my husband and go in an ambulance. Absolutely not.” They were like, “Well, we’re going to send you to this other hospital.” I said, “No. This particular hospital has a really bad reputation.” I said, “No, I don’t want to go there. I want to go to–” my second choice was blah, blah, blah. They were like, “Oh, they’re full.” I was like, “Okay well, my third choice is blah, blah, blah.” “Oh well, they’re full too.” And basically, every other hospital in our city was full. I was just like, “Okay, great.” My husband’s freaking out. I really don’t want to go to this hospital but they’re telling him I need to stay. I was like, “Okay, we’ll go over there and I’ll just get registered and I’ll tell them that I want to go home and labor.” So we drive over and the whole time I’m like, “I don’t really want to go to this hospital, but okay.” And then I told my husband that I had no idea where the labor and delivery ward was at this hospital. I had never been there. So I said, “Okay, let’s park at the emergency room because usually this late at night, hospitals' other entrances aren’t open.” We parked in the emergency room and nobody at the emergency room could tell us where labor and delivery was. And I was like, “What the heck?” I was the one looking at the map on the wall figuring out where it was, having these contractions. We walked there and we finally arrived. I had such a bad feeling there. It was kind of icky and old and gross, this hospital. They also hooked me up to a CTG and checked me. They told me that my cervix was completely closed and so I said, “Okay, great! I’m going to go home.” They started trying to put an IV in. And I was like, “Whoa, whoa, whoa. Why do I need an IV? I want to go home.” They also said, “No, your baby is coming imminently.” I was like, “That doesn’t really make any sense.” In that kind of labor land you’re so easily kind of–Meagan: Persuaded and convinced.Katie: Persuaded. And I also observed that I didn’t have the support of my husband anymore. He was losing it basically. I thought, “Okay, I guess.” They had a bathtub and I thought, “Well, maybe I can take a bath here for a couple of hours and go home after that.” So we got in the bathtub and I really didn’t like it. I’m not really a big water person so it really wasn’t for me. So after awhile I got out. 20:22 InterventionsKatie: And oh, I forgot to mention. Before that happened, before they brought my husband back, the midwife was like, “Your cervix is like steel and we want you to take some medication to soften it.” She was like, “Don’t worry. It’s homeopathic.” I was like, “I don’t want to take anything homeopathic. That’s fake medicine. I don’t want to take that.” She was super insistent. I was like, “Okay, let me see what this is. I’ll look it up online and tell you if I want to take it or not.” She handed the pill to me and it was Tylenol with codeine. Meagan: What?Katie: And I was like, “Excuse me?” I was like, “This is not homeopathic medication. This is a narcotic.” She was like, “No, no. This is homeopathic.” I said, “No no. This is a narcotic.”Meagan: Like, “I’m not dumb.”Katie: That really shut me down. Also with this labor land, I was like, “Maybe codeine means something else in German?” I got super confused, do you know what I mean? In hindsight, I’ve given patients Tylenol with codeine hundreds of times. I know what Tylenol with codeine is. But in that moment, I got confused about it. I was in this labor land kind of thing. Meagan: Yeah. Katie: But it totally set off my fight-or-flight reflex because it freaked me out. “Is she lying to me? Or does she just not know? I don’t get this.” I really told my husband that I wanted to leave and he was like, “Where are we going to go? Everywhere else is full.” And I was like, “Well, I’ll just stay in the bath. I don’t know.”At some point, I got out of the bath and I had been up basically the entire night before, just trying sleeping in between contractions. I wanted to lay down and rest. She came in and was like, “Oh no, you need to get up and move around.” She made us go for a walk around the hospital. This was probably 4:00 or 5:00 AM. I just felt so uncomfortable, I didn’t want to be walking around the hospital. I wanted to be in my own little cave. So we went back and then she told me, “Well, you haven’t had your baby yet so we’re going to have to discharge you to the antenatal ward.” I was like, “Okay, at midnight when I got here, you said my baby was coming imminently and I had to stay and now you want to discharge me. If you’re going to discharge me, I’m going to go home. I’m not going to go labor on an antenatal ward.” She was like, “Oh, let me talk about it with my staff at our staffing meeting,” blah blah blah. I don’t know whatever came of that but I was so weirded out by it. Meagan: Yeah.Katie: And then like at 6:00 or so in the morning, she came in and they were again like, “Your cervix is as hard as steel. You need something to relax it.” Again she said, “I have something homeopathic for you.” It was Demerol.I again was like, “This is not homeopathy. These are narcotics.” I got really mad and I even said to her face. I looked her in the eye and I said, “It’s appropriate to give patients narcotics or birthing women narcotics if they want them but you can’t lie about it.” That’s so unethical. That’s not okay. I was so shocked by it. I had thought about it and I didn’t really want to take narcotics. I’m intolerant of them. I’ve had some dental procedures and they make me really confused and I didn’t want them during labor. But I thought at this point, it had been like 30 hours, and I thought, “Well, maybe it’s time to try something.”My mom had always said when she had us that she would get a shot of Demerol and dilate to 10 centimeters in an hour from that. “Well, maybe I need that too. Maybe I’m like my mom.” I did consent to it but I felt like pushed into it. I kind of more consented to it because I wanted them to leave me alone. I told her again, “I’m really sensitive to narcotics. They make me confused. Please give me like the lowest dose.” I got my records later and I know now that it was the max dose and she had mixed other things into it so I totally became delirious. I could not cope with the contraction pain anymore because I didn’t have this ability to be like, “Oh, I’m a flower, my cervix. Every contraction brings me one step–.” Being able to work my way through it was gone and it was sheer pain. They don’t help me. It was just downhill from there. I didn’t have the strength anymore to leave. At some point, they tried to make me take another walk. I was so dizzy that I kept falling over. Oh my gosh, if my patient was this dizzy, I wouldn’t let them get out of bed but they were forcing me to go for a walk. They told us to leave the hospital and walk around outside. I remember standing at a red light and totally swaying back and forth clutching onto my husband so I wouldn’t pass out. I was like, “I should not be outside. This is ridiculous.”So we went back and I’m not exactly sure what happened all afternoon. I forgot to mention we had a new midwife now. At some point in the afternoon they come in and say, “Well, you haven’t had your baby yet. You’re only a couple of centimeters dilated. We’re going to start you on Pitocin.”Katie: And I said, “No, no. I don’t want Pitocin.” They said, “Too bad. We’re giving it to you anyway.” And I again was not in any kind of state to fight or protect myself. They started it and I didn’t have any pain management at all. This was like 4:00 or 5:00 in the afternoon so it had been like 10 hours since I had that Demerol. My contractions were always that really bad back pain. It was so bad with the Pitocin. I ended up getting an epidural which was such a bad moment for me because I actually had more anxiety about getting an epidural. I have a fear of being paralyzed and I thought, “I absolutely don’t want an epidural.” I ended up getting one and it didn’t really work. They just kept turning the Pitocin up. And I kept telling them, “This isn’t working. Can you get anesthesia here? There are things you can do to fix it.” They wouldn’t do anything.They kept telling me, “If it doesn’t work, it just doesn’t work.” I was like, “That’s not true. I know a lot about epidurals and there are a lot of things you can do.”At some point, I had realized that I hadn’t peed in 12 hours and tried to go to the bathroom and nothing came out. I asked them in they could put a catheter in so I could pee. This midwife just kept ignoring me. I was like, “I really need a catheter.” I had felt really hot. I was like, “Can you take my temperature? I’m worried I have a fever.”Meagan: Oh my gosh. Katie: I also kept asking her if she would help me because I was laying in the bed, halfway falling out of it and I needed some help to reposition myself. I kept pushing the call light and she would come in and yell at me for pressing the call light. And after a few hours of this I finally had a little bit of fight back in me. I remember screaming at my husband, “You need to get me another midwife right now!”They must have heard us fighting outside because somebody else came in. I was like, “I need a catheter. I need someone to take my temperature and I need some help moving around.” So she catheterized me and there was like 500 milileters of urine in my bladder. She took my temperature and luckily that was normal. She helped me get up out of bed so I was sitting on a ball. At that point, I realized that the pump for the epidural was sitting right there. I remember turning to look at it and the pump wasn’t even on. I was like, “I’ve been complaining. I have no idea what happened if it had been off the whole time or something, but it was supposed to be a patient-controlled epidural and it wasn’t even on. I was like, “What is this?”At this point, it was midnight. I had been going on 48 hours now and only at like 4 centimeters dilated. They just kept telling me, The only way you’re ever going to have this baby is if we keep turning the Pitocin up.” I kept asking them, “Are there positions we can do?”I also forgot to mention in the beginning that the people in Germany told me, “You don’t need a doula in Germany because the midwives do all of that kind of stuff.” I never got a single suggestion on how to maybe reposition the baby or if there was anything. I kept asking, “Is he posterior? Is something weird going on?” “No, no. Everything’s fine.” With these Pitocin contractions, I felt this pull in my pelvic floor. It felt like my body was fighting against it. I can’t believe this is working. I can feel my muscle close with that. 29:44 Katie’s C-section Katie: They told me that wasn’t a thing, blah blah blah. My cervix had started swelling. And they were kind of like, “The only way you’re going to have this baby is having a C-section,” and you know, that’s just what happened. I ended up consenting to it because I was so afraid that they were going to do something to harm me. There had been like so much–Meagan: Weirdness.Katie: Weird stuff. I’m not going to die because childbirth is dangerous but because these people don’t know what they’re doing and they’re somehow going to hurt us. And the C-section was just awful. I could remember on the way down, they knocked a bunch of the equipment over that was attached to me. When they started operating, I had a strip on my right side where I could feel everything. I was like, “I can feel what you’re doing there. I was screaming.” The birth of my baby was the worst moment that I could imagine. It not joyful or happy at all. What has happened? What has happened to me? How did this happen to me? I just like couldn’t believe it. Meagan: Yeah.Katie: What else could I have done differently? I don’t know. How did everything get out of control? It was just crazy. I ended up having really bad PTSD afterward that I would have nightmares about the surgery. Postpartum was so rough because I had no connection to my baby and I honestly resented him almost in some ways where it was like, “If I hadn’t had you, I wouldn’t have gone through this.” It was just really hard to work through.I was also so mad at my husband. I really thought, “How could you? Where were you? You were supposed to be my support. You were supposed to help me.” I don’t think he really got it. I kept telling him how much he was going to have to help me. “I really needed you to be strong in that moment and you just weren’t.” It was a really low point in our relationship, too. 32:06 Preparing for VBACKatie: But he promised me that if we ever had any other kids, he would try to make it up to me. “Let’s try to work through this.” And I got some treatment for my PTSD and I ended up taking Zoloft. I obviously listened to the stories on VBAC Link and other podcasts and I realized this is not unique. This is happening to a lot of people. I really knew that I wanted to have a VBAC. I never really thought there was something wrong with me. I thought it was the way I had been mishandled and that they didn’t follow guidelines and that it was really inappropriate care I received. If it had been better, maybe I would have been able to do it. Anyway, I had a lot of anxiety about doctors and I didn’t think, “If I have another baby, I want to go to the hospital. What am I gonna do? If I ever have another baby, should I go back to the United States to do it? Can I review clinical literature from my job?” And just from listening to podcasts and your story, Meagan, and the others, I realized an out-of-hospital birth is probably the best option for me if I ever have another baby to have a VBAC. I found a paper from 2019 about birth in Germany, about VBACs in Germany. And the success rate was like 40% in the hospitals to 60% in the birth center and 80% if you planned a home birth. They said that the outcomes for mom and baby were similar. So I said, “That’s it. We have real literature that we’re going to have a home birth if I ever have another kid.” Before I even got pregnant, I researched home-birth midwives in the city. I started speaking to a doula before I even got pregnant. And I had signed with her and she said that even if she wasn’t available when I got pregnant again, she would help me find someone who was. I actually ended up getting pregnant really fast. We got pregnant on the first try and that was about– my son was 14 months when we got pregnant again. They’re 22 months apart. 34:34 Second pregnancyKatie: I was like, “I’m going to do this. This is super important to me. I really need to do this.” I listened to VBAC Link stories and other VBAC stories every day. There’s some other podcasts that I listened to. I read all the books like Ina May’s Guide to Childbirth and Childbirth as a Rite of Passenger by Rachel Reed and I was just only thinking and talking about birth. That was the only thing I paid attention to in that time.I read all the guidelines from every major organization and I read a lot of the literature that they used to come up with the recommendations. I had pretty strong opinions then that I would be okay with. But mostly I just wanted to be left alone. I didn't want any interventions because in my mind, with my sons birth, the intervention is what had ruined it. Katie: I worked out a lot with my first pregnancy, too. But with my VBAC baby, I did the Mamastefit fitness program.Meagan: Love Gina.Katie: And at the end, there’s a lot of focus on relaxing your pelvic floor. I started seeing an osteopath. We really worked on trying to relax my pelvic floor. I mostly focused on stretching. I kept doing the HypnoBirth stuff. The pregnancy went on. I registered at a hospital just as a backup just in case we needed to transfer. I went to the registration appointment at this hospital. They were supposed to be the best VBAC hospital and they claimed to be the best VBAC hospital in the city, but the doctor there was so anti-VBAC and just talking about, “Oh, you are causing all of this risk if this happens.” I was really kind of shocked by it and at one point, she was like, “Oh, we need to do this ultrasound,” and I was like, “Whoa, whoa, whoa. What do you want to do this ultrasound for?” She was like, “Well, we need to make sure your baby isn’t too big and that your scar is thick enough.” I said, “Well, I know that those growth scans, you might as well flip a coin so I’m not interested and also, there is not any research supporting the use of ultrasound measurements of the scar with predicting the risk of rupture so no, I decline.” She said, “Well, no you have to do it.” I said, “No, I don’t and I’m not doing it unless you can tell me what evidence you use to come up with these recommendations and what are the cutoffs? How thin is too thin is too thin for the scar? You have to be able to tell me that and you have to tell me what evidence you’ve used to come up with that definition and I will not consent to the ultrasound until you tell me that.” She just couldn’t do it. She kept just going on about like, “Well, you have to. You have to.” I said, “I don’t have to do anything. I don’t consent. If you don’t know the answer, find someone that does.” My doula was with me and she ended up going. This doctor ended up going and getting their boss. She came in and my doula had told them something about how we were just planning this as backup for a home birth. They were like, “You absolutely cannot have a home birth.” I was like, “I absolutely will. That is my choice and you can’t tell me what to do. I’m doing that.” They were just like, “No, no. You can’t do that. You can come here and have the birth.” I said to them, “I know I’m going to need a long time to labor. I was in labor for 48 hours with my son. I need a lot of time. There was nothing medically wrong with my with my son. It was just this pure, bureaucratic nonsense. I was pressured into it because I took too long. I know that and I need support to get through a long labor and it’s safer for me to be at home and it’s safest if there is a midwife at home with me that can check on the baby and make the recommendation when it’s time to transfer. That’s the best course of action.” They were like, “No, no. You can only plan to birth here.” I was like, “Well, if that happens, then I’m going to be home alone without anybody there to check on the baby. How is that safe?” They just kept saying, “You can’t do that. You can’t have that here.” Katie: We ended up not having a backup hospital. That was kind of a tough conversation but I was really proud of myself that I had stood my ground so much. Just a lot of women talk about how you always want to be polite and non-confrontational. I was like, “I’m not going to be that way. I’m going to demand answers. I’m not going to do things just to be nice.” I was very proud of myself that although I was basically banned from that hospital, I was proud of myself for sticking up for myself. I really felt and the literature also supported that homebirth was a safe option for me, but we went into it not having a backup hospital. 42:01 Labor beginsKatie: I’ll move on to the actual labor and birth with my VBAC baby. So that also started around midnight. I woke up feeling kind of funny. I went to the bathroom and a little bit of amniotic fluid came out. I was like, “Oh, great.” I wasn’t quite sure what I wanted to do in that situation so I got on my birth ball and bounced. I listened to an episode from Evidence-Based Birth about the premature rupture of membranes. I listened to that and was like, “No, no. I feel best about waiting for labor to start on its own.” I kept having some mild cramping throughout the night and then around 5:00 AM, I went to the bathroom again and I had some bloody show. Around 9:00, I texted my doula and my midwife just to let them know. My midwife, Julia was like, “Let me come over. I have a lot going on today. Let me just come over and see how you are doing.”I was like, “You can, but I’m not really having any contractions. I’m just having some cramps.” She came over and we chatted. She offered to do a vaginal exam to see where I was at. I said, “No, I’m not really in labor yet. I don’t want to risk it.” She left and then a few hours later, I started having “contractions”. I was so excited because they were actually contractions, this wave feeling in my uterus because with my son, it had always been this stabbing pain in the back. I’d never felt my uterus doing anything. I was like, “Oh my gosh. Everything I did worked. I’m having real contractions.” I was so excited. We just kept working through them. We made a plan to have my son go over to my sister-in-law. I was convinced that oh, maybe labor won’t really start. I don’t know what I was thinking, but my husband and I made a plan to just have a nice dinner together and send our son off so if I went into labor, he would have somewhere to stay and if not, we would have one more nice evening together before the baby came. But I was in denial. The contractions kept ramping up throughout the day. Finally, at dinnertime, we were eating our dinner and my husband was like, “Do you want me to call Johanna?” Johanna is our doula and I was like, “No, it’s way too soon. It’s only been a few hours.” He was like, “Are you sure?” Then I realized. I took that as a sign that he needed the support. I was like, “Great. Let’s have her come over.” I totally thought she would come over and be like, “Yeah, she’s fine. Let’s go to bed and we’ll take care of this later.” She came over and supported me through some contractions and was like, “Hmm, how would you feel about having your midwife come over?” I was like, “it’s way too soon. It’s only been 7 hours. The contractions are too far apart and too short.” She was like, “No, I’ve been timing them and they are over a minute long and three minutes apart.” I was like, “I guess you can call her if you want to.”They called her and she listened to me having some contractions on the phone and was like, “Yep, that sounds like active labor. I’m coming over.” She came over and we all labored together. Katie: At some point, I started having back labor again. During the day, it had been this really nice wave feeling, but then the back labor started to come in. Around 11:30ish, my midwife checked me and she told me that my cervix was really posterior and that the baby was actually just pressing on the lower segment of my uterus. I didn’t want to know how much I was dilated, but I knew that it was probably not much based on what she was saying from that.Later, after the birth, I found out I hadn’t dilated at all. She actually manually moved the cervix down and held it under the baby’s head and had me do a couple of contractions like that. It was awful. She really recommended that I try to lay down as much as possible during contractions because her theory was that something was pulling my cervix back so if I was moving around too much, it would keep pulling it back. It was so painful to lay down. She ended up leaving to go get some sleep. I kept laboring like that throughout the night. I got super nauseated. I was throwing up. It was just the only way I could get through contractions was to sit on my birthing ball. I had hung a sling up and I would hold onto the sling because I just could not have anything touching my pelvis. It felt like along my SI joints, they were going to just split in two.We labored throughout the night like that and they really did a really good job supporting me. They made sure– I had told my husband that his one job was to make sure I was eating or drinking and that after every contraction he should offer me something to drink and he did that to the point of annoyance during labor but he kept doing it and they did a really good job. 47:11 Getting support from her birth teamKatie: Around 7:30, throughout the night, the back pain was getting worse and worse. Around 7:30, we decided to call the midwife and have her come back. This is probably the first moment that I realized, “I think I’m going to need some help here.” I had read so many books talking about how childbirth is a physiological process and everyone can do it. You can do hard things. I really believed that, but it was really that I was starting to realize that, “Yeah, the majority of women are going to get through it fine, but I’m in that minority that really maybe does need some help.” I didn’t say anything at that point. My midwife came over and again, I didn’t know it at the time, but she checked me and I hadn’t progressed at all throughout the night. My cervix had slipped back again into a posterior position. She did that thing where she held it in place again and really had me try to be laying down as much as possible to again with her theory about how my cervix was being pulled back. It was just so painful but it worked.I started progressing which was really exciting, but at the same time, I started having this weird contraction. It felt like my body was doing a kegel uncontrollably and involuntarily doing kegels during contractions. I could feel my pelvic floor closing up on itself. I was like, “I thought that was just because the Pitocin was on too high for my first birth, but this is my own natural oxytocin and I’m having this feeling again.”I kept laboring throughout the day. They somehow found a TENS machine for my back pain, but anyway, around 11:00 or noon, I said to them, “I think I’m going to need some help. I’m not sure anymore.” I had been so adamant during my entire pregnancy that I absolutely do not want to transfer to the hospital. Only if there is a medical reason and they were like, “No, you are doing so good. Let’s stay home.” They really kept working with me, but by 4:00 or 5:00, I was like, “I think I really just need to accept that I need help.” We did a lot of massage and position changes. We did all of the Spinning Babies stuff. I could not get my pelvic floor to relax. It had been at this point 30 hours and I was like, “I did everything right this time. I feel safe. I set up a beautiful birthing space. I’m not scared. I want to have this baby and it’s just not working. I just need to accept that. I don’t know. I need some help.” 50:12 Transferring to the hospitalKatie: We went to the hospital and I thought I was going to be treated like crap because I was a home birth transfer and I didn’t register ahead of time. We were just so lucky. We got the greatest people and I remember– I’m going to cry. They placed the epidural and I was finally doing some intake paperwork with the midwife that was going to be taking over and I was like, “I know you think I’m crazy, but this is so important to me. I have to do this.” She said, “Of course, you’re going to do it.” It just felt like, I don’t even know. It was just like, “Yeah, I am going to do it.” We talked to my anesthesiologist and I was telling him about what had happened at the last hospital. We talked about how I was really scared about another C-section because I had felt it during my first one and I didn’t want another C-section. We talked about it. I was like, “You know if I need to have another C-section, I want to be put under. I don’t need to experience that again. As much as I want to be awake for meeting my baby, I don’t need that to feel it.” We had an agreement that if it ended up going toward a C-section, he would put me under. I felt like it was such a night and day difference. The staff at this hospital was again, way more modern. The staff was so respectful and always asked my permission to do things. We always talked about the plan and what we were going to do and explained the benefits and risks and all of those things.I had to get a Pitocin drip. I understood that with getting the epidural but they were like, “We won’t turn it up too high. We will go slow. We’ll probably have to break your water at some point, but we’re going to wait until as close to the birth as possible.” They really laid out a plan. They checked me 2 hours after I had gotten the epidural and I had progressed to a 7. I just burst into tears. I had just gotten the epidural. At that point, I wasn’t sure if it was the right choice or if I had just basically signed up for a C-section by going to the hospital. I didn’t know at that point, but since I was at a 7, I was like, “Oh my gosh. I am going to make it.” It took another 10 hours, but I made it to 10. Throughout the night, I had the same issues with the epidural not working, but this anesthesiologist worked his butt off. He came in and he tried so many things like repositioning it and trying different medications, trying different types of concentrations. He tried so many things to help me and I could really tell that he felt bad that he couldn’t totally take the pain away. Just that alone was enough. I was like, “It’s okay. As long as my pelvic floor is relaxing, I can get through it.” 53:32 Feeling intense scar painKatie: At some point, around 4:00 AM, they gave me a really big bolus because they wanted me to get some sleep but I couldn’t feel anything. I was completely numb. They said, “Okay, why don’t you labor down a little bit? Your baby looks fine on the monitor. Everything is okay.” Around 6:00-6:30, I woke up and that bolus had completely worn of. This back pain that I was having was in that moment a thousand times worse because her head was down in the birth canal. I could feel. I remember checking and I could feel. I could only go about a fingertip in and could feel her head. It was so intense. My pelvis felt like it was on fire. I thought I was going to burst into flame. They had me start pushing and she was right there, but she was just not descending anymore. At some point, I remember they had me try to get onto my hands and knees. I was like a wild animal so I can’t really remember everything, but they had me get on hands and knees. I realized, “Oh, I don’t want to be on hands and knees because I can’t brace my scar when I’m pushing,” then I realized, “Oh, my scar is kind of hurting.” Then I was like, “Why is nobody else worried about my scar hurting?” I was like, “Oh, I haven’t said anything to anybody that my scar was hurting.” It was getting more and more painful. I was finally like, “Oh my gosh, my scar, my scar. It hurts so bad.” The midwife got a doctor to come in and they did an ultrasound and the doctor said, “Your scar looks fine.” It just kept hurting and it was hurting more and more. They were cleaning up the ultrasound machine and the pain wasn’t going away in between contractions. Even though they were saying everything was fine, I just felt like things weren’t fine. I almost had an out-of-body experience where I envisioned a future where my uterus ruptured and I got rushed out to the OR and it was really nasty. I was like, “No. I can’t let that happen,” so I started yelling at them. I was like, “A vacuum, I need a vacuum.” They were like, “Are you sure?” I was like, “Yeah, yeah. I really need a vacuum. I need a vacuum right now.” I remember the doctor asking the midwife, “Well, how long has she been pushing?” In my mind, it had been 10 minutes and they were like, “Oh, it’s been over 2 hours.” I was like, “Yes. Yes. Now. I need my baby to be born now, like right now.” 56:23 Asking for the vacuumKatie: They got a vacuum and pulled her out. I can’t describe it. Although there was so much intervention and stuff, I felt like it was this home birth experience that everyone talks about because I got this crazy flood of oxytocin and I just bawled my eyes out for an hour and I felt like you know when you are a kid and it’s Christmas morning and you’ve been waiting for weeks to get your Christmas present and you finally get to open it and you’re so excited? It was like that feeling times a million. It was just an incredible feeling. She was there. I didn’t know at that point if she was a girl or a boy so I got to look and I was like, “Oh my gosh. It’s a girl.” It was just a really incredible moment. Meagan: Yes. So amazing that you were supported and that they listened to you. Katie: Yeah. I mean, my husband and I have talked about how this is the hospital that I should have had my son at. I don’t know if I would have had a different outcome. I might have still ended up with a C-section there, but I don’t think I would have had the same amount of trauma because the staff was so respectful and they were very capable and competent. It made just such a huge difference. Meagan: Absolutely. It sucks that a lot of the time, it comes to that– where we are and who is in that space. Katie: Exactly, yeah. Meagan: You know, we can’t always control that which is a little nervewracking sometimes. We’ve just got to trust, but I love that you– I mean, honestly even with the first birth, like you said, you got to a point where you weren’t in your brain-brain because you were in labor land, but you were really amazing at advocating for yourself overall. I just want to say congrats on that because that’s really, really hard to do. Katie: Thank you. 58:42 Katie’s advice for listenersMeagan: I don’t know if you have any advice for listeners to be able to have your voice be heard or find that space inside of your soul that can come out and say what you need when you need it, and how you need it, but that’s a really hard thing to do in labor. Katie: Yeah, I would say that I think it really made a difference that the doula was there. I think it created another layer of protection where she could run interference too and take on some of that burden. I think it was a little bit of her. I was like, “A vacuum, a vacuum, I need a vacuum.” She was the one like, “Yes, yes. She is asking for a vacuum. She wants that baby to come out now.” I didn’t have to carry on the fight anymore because there was a moment in that when they said, “Everything on the CTG looks good.” I could have said, “Well, if they are saying that everything looks fine, maybe I could keep trying,” but I felt so strongly in myself that the baby needed to come out. Since I didn’t have to keep fighting for myself, I verbalized what I needed and she carried the torch basically I would say, it really made a big difference that she was able to keep saying, “Yeah, yeah. She wants the vacuum now. Let’s get it.” I guess preparing for a VBAC, you have to read all of the stuff and know because people will come and tell you things. You really need to be able to come back and say, “Actually, the guidelines don’t support that.” I think it helps too if you have real citations. Do you know what I mean? You can actually say, “There is a paper that is supportive of this or not supportive.” You have to be able to have that knowledge almost and feel really confident that you know it to have those discussions with people as well. Meagan: Yeah, having the evidence is– not only knowing the evidence but having the evidence. That was something​​ that was really important to Julie and I when we were writing the course was not only giving the evidence but sharing the citations for those. Yeah. I mean, going back to the scar thickness and this and that. You were like, “Listen, no and no. I’m not going to do either of these things,” and they really couldn’t come in with the evidence. That was so clear that the evidence wasn’t there. They just wanted to bully you into making the decision that they wanted you to make. Katie: Right. Meagan: So having that knowledge and of course, having the evidence in general, but having those actual sites within links on your phone or in a manual or whatever. Katie: Exactly yeah. Meagan: So then you can be like, “It says this right here. Do you see anything different? Do you have anything new and updated?” Katie: Right. 1:01:47 The Friedman CurveMeagan: So talking about new and updated within your story, one of the things you mentioned that you wanted to talk about was the outdated and poor quality research that was done by the Friedman curve that is still being used. Do you want to talk about that at all? Katie: Yeah. That was something I came to the conclusion when I read a lot of papers and in my first birth and in my documentation, the diagnosis was “prolonged labor and failure to progress”. I was like, “What does that even mean?” I couldn’t really find a definition in the literature of what prolonged labor was and what I realized was that it’s way more that there are economic reasons to speed up labor, not clinical reasons. That’s why it was so important to me. I was like, “If I need to have my baby by C-section, I will proudly walk into that OR if there is a medical reason or a clinical reason, but not a bad management reason or not because it’s just taking too long.” I just couldn’t find anything really convincing and one of the big criticisms of the research that Friedman did was that it was only a very narrow population at one hospital in the 50s. In the 50s, everyone was getting twilight sleep and all of the babies were being pulled out with forceps. It really can’t be applied to us as modern birthing women. Yeah, there’s an idea of on average, women take so long, this 12-24 hours. That’s about true, but there are corner cases like mine or if I remember correctly from your story. You were also in labor for a long time. Meagan: Mine too, yep. Katie: Just because you’re in labor for a long time doesn’t mean that it’s bad. The question is how is Mom doing? Is she healthy? Is baby healthy? If the answer is yes and also if Mom is up to keep going, because I think there are a lot of stories on The VBAC Link Podcast too of women who decided, “I’m only going to labor for so long and if I’m not dilating, then I’m going to call it.” I also think that’s great that some women make that judgment call of, “I really want a VBAC, but I just don’t want to do it for days and days.” I had the opposite decision for myself where I was like, “I’m going to do this until my baby comes out unless there is a clear medical reason that we need a C-section.” Meagan: Right. Katie: Yeah, I think it’s just important to know that there’s actually not great research for what is normal and just because you are outside of normal doesn’t mean it’s bad or dangerous. Meagan: Yeah. I agree. We’re going to provide the little bit of a risk factor in Germany specifically with the different locations and then Evidence-Based Birth who we love and adore, they actually have a blog on the Friedman’s Curve. They talked about how in 2014– you guys, it’s 2024 so 10 years ago– ACOG came together with the Society of Maternal-Fetal Medicine, so MFM, and they published new guidelines on labor progress. They said their new “normal” of labor is longer than the Friedman definition. There is more room for flexibility such as when an epidural is being used. In addition, new timelines were developed to define when labor progresses abnormally slowly. They are recognizing that sometimes labor does progress abnormally in their minds. That’s abnormal to them. New terms were defined with purpose and they talk about how it’s changed from 4 centimeters to 6 centimeters and things like that. I mean, this is a really wonderful blog. I’m going to drop it in here but I love how you talked about that. Just because it doesn’t go as someone thinks it should go or the lack of really true evidence all around shows it should go doesn’t mean it’s bad. It doesn’t mean something is wrong and it doesn’t always mean you have to do something different. It just means you may need more time. 1:06:16 Trusting your intuitionMeagan: Now, you may want to do something different. You may feel you need to do something different like transfer to the hospital. These are things where we have to tune into that intuition and think, “Okay, what is my body telling me? What am I supposed to be doing?” But long labor, you guys, kind of sucks sometimes to have to keep going and keep going but at the same time, it’s so amazing that your body can do that and is doing that. We have to trust that. We have to trust that process and trust our intuition. Katie: Yeah, and I have to say my first labor was 48 hours and I had the C-section. It’s a trauma and this one was 45 hours and it was super intense the entire time basically for at least 38 hours of it I would say, but I can barely remember it or even connect to it anymore because I was just so happy to have the VBAC. I always had this attitude that it’s just a day for me or a few days that it’s going to be tough, but it’s going to be so great afterward and that’s really the attitude that I had. For me, that’s been true. Postpartum is always hard, but I have so much more resilience this time and I really had that attitude that “I can do it. I can do hard things,” and I can. Meagan: You can. Yes. I love that you pointed that out. Yeah, it’s a few days but it’s a few days that led to this cute little baby that’s joining us today on the podcast. Well, we will make sure to have the links for those two blogs that we mentioned and the study. I just want to say congratulations. Amazing job. Katie: Thank you. Meagan: Really good job of advocating for yourself. To the point of having a doula, even when those doulas aren’t speaking out loud for you, they have this space that they hold that makes you feel like you can and then they support you and rally behind you. I love that you mentioned that because I mean, even with myself with my own birth as a doula at that point, having doulas, I truly felt like that, like I was able to have the extra voice that I wanted to speak. It came out so I’m so happy that you had your doula and I’m so happy for you and congratulations again. 1:08:56 Doula supportKatie: I just wanted to mention too with my doula if she ever hears this, she was with us for 38 hours and just– Meagan: Oof, so long. Katie: We had a contract. There was an exchange of money, but at the same time, I would have understood if she had said, “I’ve been away from my own children for so long. I need to go check on them.” She really stayed with us and helped us that entire time. It has just been the biggest gift that somebody would set aside their own needs to make this difference in our family. I don’t know– I wasn’t very good at expressing that to her. I feel like in the moment, I didn’t have the words for it, but I hope if there are any other doulas listening, the work that you are doing makes such a huge difference. Meagan: I love that. Thank you for sharing. Katie: I also wanted to say thanks to everyone who has ever shared a story about actually having a uterine rupture because listening to those stories, they all always mentioned that they felt that something wasn’t right and having heard those stories really gave me the confidence to say, “Things aren’t right. I need to get my baby out.” I know it’s scary, but if anyone is planning a VBAC, I think it’s important to also hear those stories as well because it really empowered me to get the help that I thought I needed and to stand up and advocate for that. Meagan: Yeah, I love that you touched on that because those stories, even with repeat C-section stories, are really hard to listen to or allow in your space when that’s not what you are wanting, but a lot of those times, if you can find the space to join in on those episodes, they really do bring a lot of education as well. I think if it does end in a C-section or something like this, it can also bring some validation and healing weirdly enough by knowing these episodes. Katie: Yeah, I agree. Meagan: Yeah.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