Episode 306 Kelsey's Birth Center VBAC + Talk About Forceps

Our friend, Kelsey, shares with us today what giving birth is like in Canada. From moving and traveling between provinces, Kelsey had experienced different models of care and when it came time to prepare for her VBAC, she was very proactive about choosing a birth environment where she felt safest. From a scary Cesarean under general anesthesia to an empowering unmedicated VBAC in a birth center, Kelsey’s journey is entertaining, beautiful, and powerful. We love hearing the unique details of her story including giving birth at the same time as her doula just in the next room over! The personalized care she was given during her VBAC is so endearing and heartwarming. As her husband mentioned, it should be the gold standard of care and we agree! The VBAC Link Blog: Assisted DeliveryFetal Tachycardia in the Delivery RoomIs There Still a Place for Forceps in Modern Obstetrics?Forceps Delivery ComplicationsNeeded WebsiteHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details 07:36 Review of the Week09:27 Kelsey’s stories11:47 Logistics of giving birth in Canada14:38 A normal pregnancy17:50 Arriving at the hospital21:37 Stalling at 7 centimeters26:22 Asynclitic and OP positioning29:31 Kelsey’s Cesarean under general anesthesia34:50 Second pregnancy and VBAC prep41:07 Switching to midwives46:14 Beginning of labor51:07 Driving to the birth center54:49 Pushing baby out in two pushes1:00:24 Differences in care1:02:11 Enterovirus1:08:02 Risk factors for forceps and vacuum deliveriesMeagan: Hello, Women of Strength. We have our friend, Kelsey, from Canada. Is that correct? Kelsey: Yes. Yeah. Meagan: She’s sharing her story with you guys today. Something about her first story of her C-section that stood out to me was that she had a forceps attempt that didn’t work out. Sometimes that happens. I want to talk a little bit about forceps here in just a minute before we get into her story. Kelsey, I wanted to ask you that this is something that in our doula practice we will ask our clients. If it comes down to an assisted birth with forceps or a vacuum, what would you prefer? It’s a weird thing because you’re like, Well, I’m not planning on that, but a lot of people actually answer, “I would rather not do those and go straight to a C-section.” Some people are like, “I would rather do every last-ditch effort before I go to a C-section.” Did you ever think about that before? Had it ever been discussed before as their style? That’s another thing. Some providers are really vacuum-happy. Some are really forceps-happy. I know it’s a random question, but I was just wondering, had you ever thought of that before going into birth? Kelsey: So no. I didn’t think about whether I wanted a C-section or a forceps delivery. However, I was really staunchly against having a C-section. That was primarily nothing against it, it was just that I have a really huge fear of awake surgery so with my forceps attempt, the OB who was there because it wasn’t my provider. That’s not the way Canada works. The OB who was there who was called in said, “Are you sure you want to do forceps? You could tear.” I told her, “I would rather tear than have a C-section.” That was just a personal preference for me because I was so terrified of having a C-section. Meagan: Yeah. I think that is very common and very valid to be like, “No, I would rather try this.” Kelsey: Yeah. Meagan: So I did. I wanted to go over just a little bit. I mean, I have seen a couple of forceps and they are not happening as often these days, but there was an article that said, “Is there still a place for forceps delivery in modern obstetrics?” I’m trying to say obstetricians and obstetrics. We’re just going to stop. Kelsey: We know what you mean. Meagan: You know what I mean. There was an article and I was like, That’s a really good question, because I think a lot of people think they shouldn’t be done anymore or a vacuum shouldn’t be done anymore either. It talked a little bit about the background. it says, that nowadays we are seeing a decrease in instrumental deliveries and a continuous increase of Cesarean rates. That makes me wonder if we were to increase vaginal and help instrumentally if that would decrease, but one of the things that I thought was interesting is that it says, “The prevalence of forceps delivery was 2.2% and the most common indication for a forcep delivery was fetal distress.” It is very common where it’s really, really close, baby is struggling. Baby is so low and let’s get baby out. That’s 81.6% which is crazy. It says, “Among mothers, the most frequent complication is vaginal laceration,” which means we have tearing at 41% and third and fourth-degree perineal tears were noted. It says, “Regarding neonatal APGAR scores, around 8 around the first and the fifth minute,” which is around 91.2% and 98% of newborns which is pretty great. An 8 APGAR is pretty great. I think a lot of people worry about that. It says, “8.8% experience severe birth injuries like hematomas and clavicle fractures.” Those are probably shoulder dystocias. That’s probably why they were having. It says, “Although fetal distress is the most common indication for forceps delivery, the vast majority of newborns were actually in good condition and didn’t require NICU care.” That’s something that was kind of cool. Obviously, there are a ton of more studies and deeper studies on that. This was just one, but it was kind of interesting. It was like, all right. That is a good question to ask as we are preparing for VBAC is hey, if for some reason a forceps or a vacuum is necessary, that’s something to think about. What do we want to do at that point? I love how you were like, “Yeah, I didn’t want a C-section. I feared that more than I did that.” Anyway, getting off that topic now so we can get this review and get on to your story but I think it’s a topic we don’t talk about and it’s not something that we are thinking about so as you are preparing, Women of Strength, for your VBAC, it might be something that you want to discuss and learn more about both vacuum and forceps and discuss with your provider what their tool of choice is and just have that in the back of your mind. 07:36 Review of the WeekMeagan: Okay, so onto today’s review. It is from laurenswat and it was back in 2023. It says, “Thank You.” It says, “I listened to as many episodes as possible when preparing for my VBAC. The stories on here were so encouraging to me and Meagan is so knowledgeable and reassuring. I am happy to say that I had my unmedicated hospital VBAC last week and I caught my own baby before the doctor even got in the room.” Oh my gosh, that is awesome. Seriously, catching your own baby is so amazing. I loved it personally myself as well and highly encourage it to anyone that is sort of interested because it is a really cool feeling. Thank you for your review and as always, we are looking for reviews. It is what helps people find this podcast. It helps us grow as a community. You can leave it on Apple, Google, email us, or whatever but we are so grateful for your reviews. 09:27 Kelsey’s storiesMeagan: Okay, Kelsey. Kelsey: Yeah? Hi. Meagan: Hello. Welcome to the show. Kelsey: Thank you. I’m super, super excited. Meagan: Me too. Me too. I would love to turn the time over to you. Both of your babies were born in Canada. That’s correct, right? Kelsey: Yes. Yeah. Meagan: Tell us the story. Kelsey: Yeah, so basically my husband and I got married in November 2019. Just prior to that, we had actually been living in New Brunswick. Just prior to getting married, we decided to move back because we are from Ottowa. We moved to Ottowa. We were living with his parents, his dad, at the time. We went to Mexico for our honeymoon and on our honeymoon, we decided to start trying to have a baby. We decided to start trying but not preventing it because we weren’t sure how long it was going to take and there was no indication that it could take a while but my husband is actually an IVF baby. It had taken 7 years for his parents to conceive him. Meagan: 7 years, wow. They are amazing. That’s a long time. Kelsey: He was actually their last attempt. When his mom got up to say our wedding speech, she was like my 1 in 7 or something like that and I was just bawling. So because of that, we decided to start trying and not preventing but there was nothing indicating it would take us a while. We started trying in December of 2019 and it just wasn’t happening for us so around the year mark, we had a lot of friends who started trying around the same time as us and were getting pregnant really, really quickly. I was going to so many baby showers and crocheting baby blankets that just weren’t for my baby. Actually, the year mark rolled around and I got my period the day of. My best friend gave birth the day of. I was trying so hard to be happy and stay positive and whatnot, but it was devastating. 11:47 Logistics of giving birth in CanadaKelsey: We ended up being referred to a fertility clinic. They did a full work-up on both of us and there was nothing. They didn’t come up with anything. So they said, “You could keep trying or we could start IUI.” My husband and I said, “Let’s do 3 more months of trying on our own, and then we will try for IUI.” Our fertility clinic was in Ontario and we ended up moving to Gatineau, Quebec in July 2020.The way it works in Canada is you have your healthcare which covers. You can go inter-provincially and give your card unless you are from Quebec. If you are from Quebec, it’s kind of like living in another country. If you have a RAMQ card, you actually have to pay for your care in Ontario. The Quebec government will reimburse you but only for 30%. It’s super weird. If you are from Ontario and go to Quebec, the Ontario government will cover you in Quebec. Meagan: What? So weird. This world is so weird. Kelsey: I know. It’s super bizarre. So essentially we moved to Gatineau because the housing market was a little less expensive. I was working in Gatineau at the time as a teacher. I was extremely stressed out in my job especially once COVID hit. We were sent back to the classroom before any of the other provinces were. Anyway, I was extremely stressed out in my job and I decided to switch to the Ontario side because you can go between the two. Where I lived, you cross a bridge and you can get to Ottawa so you are in Ontario. Essentially, we went through the fertility clinic. They said that nothing was going on but because the Gatineau government will cover you for IVF and any fertility treatments up to a certain price so we had to be referred back to Quebec for IUI. The month that we were referred back to Quebec for IUI, it was the day before my appointment that I found out I was pregnant. Meagan: Oh my gosh, yay! Kelsey: Yeah, on our own. It super just happened and some weird funny things happened. The day before, my husband and I went for a walk around our neighborhood. I found a quarter and was like If pennies are lucky, then quarters must be super lucky. I picked up the quarter and put it in my pocket and the day after, I found out I was pregnant. These weird things kept happening. My pregnancy made me oddly psychic too which I’ll get into after. 14:38 A normal pregnancyKelsey: I got pregnant in March. I was due November 28th. I had a super easy pregnancy. I was nauseous for the first little bit. I was working for a virtual school in Ontario so I didn’t have to go into the school which was really nice. I just got to hang out in my basement and yeah. I mainly had nausea as a symptom but I was also extremely anxious because it had taken us so long to get pregnant. It felt like it was so long. It was about 15 months. I was super anxious. I had heard so many stories of miscarriage and whatnot, but luckily, we were followed by the fertility clinic because we were with them so we had a scan at 5 weeks and we had a scan at 8 weeks and then at 12 weeks once we graduated which was really nice. It was a really, really normal pregnancy. I ended up going back into the school in September and I was working as a French teacher. I went off work at 36 weeks. It was pretty normal. The reason I say that I was psychic during my pregnancy is that I kept saying all of these things about my baby. I had this gut instinct that he was a boy and sure enough, it was a boy. Mind you, it’s because my husband’s family only really has boys but then with certain things, people would say, “When do you think he will be born?” I’d be like, “Oh, I think December 4th.” I would make off-hand comments like, “Oh, he’s going to have really dark hair.” My husband and I were both born at 5:00. I was born at 5:00 at night. He was born at 5:00 in the morning. I said, “Wouldn’t it be funny if he was born at 5:00?” I said, “He’s going to be over 9 pounds. I can just feel it. He’s going to be 9 pounds.” Then the other weird thing is that I said he would be born December 4th, but someone told me, “No, you don’t want him to be born on December 4th. He will share a birthday with your cousin.” I was like, “Okay, December 3rd.” December 3rd rolls around and I am 5 days past my due date. I wake up in the morning to go to the washroom and my water breaks. I had not been well-informed about birth. I was just going into it like, Yeah. Everything is going to be fine. I had a bunch of friends who just had babies and everything was smooth sailing. The only time I had heard of a C-section was when my aunt had two C-sections because she had a breech baby and a special scar and then they didn’t give her an option for a C-section. I was like, Oh yeah. It’s going to be fine. My provider told me, “If your water breaks, go straight to labor and delivery.” Meagan: Many do, by the way. Kelsey: Yes, I do know that. Meagan: It’s a very normal thing for people to say, but we don’t have to do that. Kelsey: Exactly. Meagan: I did the same thing, the same exact thing. 17:50 Arriving at the hospitalKelsey: Yeah, so we went into labor and delivery. Actually, we went slowly. My husband was like, “I’m going to take a shower.” I was under the impression that baby was going to be born in a couple of hours. I was like, “We’ve got to go.” He was like, “No, no. I’ve got to take a shower. First impressions are important.” I was like, “All right.” Then we went and we got Tim Horton’s because I was super hungry. I figured This will be the last time I eat.We got to labor and delivery. They monitored me for two hours and I didn’t have a contraction until 6:00 right as I was leaving and I was only a centimeter dilated. She was like, “Come back in 12 hours or sooner if your contractions get intense.” So I went home. I decided to go to sleep but I was having irregular contractions. I woke up probably around noon and I was starting to get uncomfortable. My contractions were starting to get closer together and they were more intense. I could feel them in my back and in my bum. I learned a lesson. Anyway, I’ll get into that after. I could feel them mostly in my back and in my bum. My husband was like, “You look like you’re really uncomfortable. We need to go to the hospital now.” He was afraid of getting stuck in traffic because I ended up giving birth in Ontario even though we lived in Quebec. The reason is the hospital I gave birth at actually takes your RAMQ card, the Quebec healthcare card so we weren’t going to be charged for it or anything. The Gatineau hospitals are not known for being super well-equipped for much so we preferred to give birth in Ontario. We drove to Ontario which was a 30-minute drive so not super terrible, but traffic can be bad going across the bridge sometimes. The whole way there, I had really uncomfortable contractions. We got to the hospital and the doctor had me in the waiting room for 30 minutes, not terrible. The doctor meets with us and immediately, I just was not into him. He just put me off. He made an off-hand comment about nurses. He was like, “I see pain. Do you want pain medication? Do you want Advil or Tylenol?” I was like, “Whatever you can give me, I don’t know.” I told him, “One of the things going into it is that my husband would really like to catch the baby. Can we do that?” He was like, “Well, do you think you can handle it?” I’m like, “Well, he was a firefighter so he’s pretty okay with that kind of stuff.” Yeah. I can’t even remember the comment now, but he made an offhand comment like, “Well, that’s what nurses are for,” or something like that. I just was super put off by him. We went into our room and I didn’t know at the time that maybe I could have asked for someone different or whatever. We go into our room and we get set up and they were like, “We have to monitor you for a little bit.” I was like, “I’d really like to labor in the tub. Can I get in the tub?” They said, “We need the monitor on you for an hour.” I’m like, “Okay.” They monitor me for an hour. They give me a shot of Demerol or whatever. I was under the impression and my mindset going into it was that when you give birth, you use pain medication as pain management. I hadn’t researched anything else. I was just like, “I want the epidural as soon as I can get it and whatever you can give me for the pain is great.” 21:37 Stalling at 7 centimetersKelsey: I was monitored for about an hour and they let me get in the tub. For two hours, I laid in the tub and that’s my best memory of my birth with my first. I laid in the tub and listened to music. My husband and I were in the dark. It was very calm, soothing, and relaxing. When I got out, the doctor was like, “We need to check you.” He checked me and I was at a 1 but he could stretch me to a 3. He said, “If you want your epidural, you can have it now.”I didn’t know any better so I said, “Yeah, okay. Give me the epidural.” Overnight, I was progressing 2 centimeters every 2 hours. We got to 3:00 in the morning. I told a nurse, “I feel a lot of pressure in my bum.” I said, “I feel like I have to push.” She checked me and she was like, “No, no. You’re only at a 7.” 5:00 AM rolls around. My nurse comes in again and she checks me and she’s like, “Oh, you’re at a 9.” Another nurse comes in right after and she says, “She’s not at a 9. She’s at a 7.”The two of them were like, “We need to get a doctor in here to confirm.” It’s 5:00 AM. The doctor didn’t show up until close to 7:45. He’s like, “I’m not going to check you because the changeover will happen in 15 minutes and the new doctor is going to check you. I don’t want to introduce any more bacteria.” The new doctor came in at 8:30. She checked me and she goes, “No, you’re still at a 7. You’ve been stuck at a 7 for a few hours. We really need to start talking about a C-section.” It was the first time she had seen me. I had been lying in a bed now for almost 12 hours. They gave me the peanut ball for 2 hours and then they took it away I think because my son’s heart rate had started to go funny or they lost it or something like that but he was doing fine. They lost it because he moved or whatever. They took the peanut ball away and nothing showed that he was under any distress at all but she was like, “You’ve been stuck at 7 for a while so I want you to talk about it with your husband.” I was in tears because again, the whole time, all I said to my own provider was, “I don’t want a C-section. I don’t care what happens. I don’t want a C-section.” So I’m in tears. She’s like, “Talk about it with your husband.” She comes back an hour later and we were like, “We want to wait a little bit longer.” She goes, “Okay, what we’re going to do is put you on the highest dose of Pitocin.” She was like, “We’re going to start you on Pitocin and every 5 minutes, we’re going to increase it until you’re at the highest dose. Then we’ll wait 2 hours, check you again, and if you haven’t gone anywhere, you’ll have to have a C-section.” I didn’t know any better so I was like, “Okay.” They started me on the Pitocin but I’m having intense pain and pressure in my bum. I’m like, “I feel like I have to push. My body feels like it is pushing.” I knew that if you pushed too soon, your cervix would swell. That’s one of the few things I did know. They put me on Pitocin and I was crying because I was panicking. My husband was having to push my bolus every 15 minutes when it came on because I could feel everything through the epidural. The nurse was not super kind about it. She was like, “You need to stop pushing. If I check you now and you’re not an 8, then you’re going to have a C-section.” She just was not overly compassionate or anything. Well, finally, she suggests, “Why don’t we put you on your hands and knees?” She put me on my hands and knees and I felt immediate relief. Something changed in baby’s position. I sat there and I was able to talk. I was comfortable and I was fine. I think we got to an hour and a half and then they checked me because what happened was they put me on my hands and knees and my feet lost circulation and turned purple and went numb. Yeah, so then they put me on my back again. They checked me and they were like, “Oh, you’re at a 9.5.” I’m like, “Yes.” I progressed. 26:22 Asynclitic and OP positioningKelsey: Finally, we got to 10 centimeters and I was a typical you push on your back type of thing. The doctor said, “We cannot wait to let baby descend. Your water has been broken too long.” Then she checks me and she’s like, “Oh yeah, and baby’s OP.” I should have learned. Had I done my research, I would have known all that pressure was my OP baby. So she said, “Baby is OP. We’re going to start pushing.” I was so frustrated by her because she would leave the room and then she’d come back and she’d sit there just with her hand inside of me and checking her watch and stuff. She was just waiting for the hours to pass. I’m doing everything I can. Once they told me that I could push, I was like, “Yes. Let’s get this baby out.” I pushed for 3.5 hours and then they said, “We’ll give you 30 more minutes and if you cannot get baby out in 30 minutes, we’ll try forceps but we’ll need an OB to come in because if forceps fail, you will have a C-section.” I decided to push for 30 more minutes and the nurse came in and said, “Let’s flip you.” They flipped me again and I lost all of my progress. They had also told me that not only was baby OP but he was asynclitic so his head was tilted to the side. They said, “That’s probably what’s happening.” But when I flipped, I lost my progress. There was a new nurse who couldn’t figure out how to get the monitor on me so I couldn’t push in that time. They were like, “Well, we’re going to stop pushing because whatever.” 30 minutes passed and I had lost all of my progress. They’re like, “Okay, we’re going to get the OB in.” She comes in and she says, “You could tear.” I said, “I would rather tear than have a C-section. I don’t want to have a C-section.” Then I said, “What are the chances that this will work?” She said, “I wouldn’t do it if I didn’t think it would work.” As she tried to get the forceps on, I could feel my body pushing. I’m like, “Can I push? Can I push?” She’s like, “No, don’t push right now.” My body is doing it for me and she can’t get the forceps on so she’s like, “I can’t do it.” As she was trying to put the forceps on, baby started getting tachycardic so they said, “Things are going to get really scary for a minute because this is an emergency C-section. A lot of people are coming in here and we have to turn on alarms in the hallway because we have to get you to the OR really quickly.” Meagan: Wait, so baby’s heart rate is high not low, and just because baby’s heart rate went a little high, they treated it as a true emergency. Kelsey: Yes. Meagan: Okay. 29:31 Kelsey’s Cesarean under general anesthesiaKelsey: They start throwing clothes at my husband. There were people piling in. I’m in a hospital that is French-speaking. I can speak French but not medical terminology. Nobody is talking to me. They’re all just talking around me and they’re rushing me down the hallway. I’m bawling and I’m like, “I don’t want this.” I have no idea where my husband is. They’re trying to push my legs together but baby is so low that it hurts to do that. I’m telling them to stop and whatnot. We get into the OR and I was inconsolable because I was terrified. They gave me my spinal which didn’t take. They gave me the pinch test and I was like, “I can feel it. I can feel it.” I’m crying, “Please just put me out. I don’t want to be awake for this. I’m scared.” They’re not talking to me and that’s the last thing I remember is saying, “I can feel that,” and they put me out. I was under general anesthesia and I woke up 2 hours later in recovery by myself. It was COVID. It was in December 2021. My husband couldn’t be there. I asked where he was and they said, “Oh, he’s in your room with your baby. Everything is fine.” I was sobbing. The first thing she said to me was, “Everything went great. You are a great candidate for a VBAC.” That stuck with me. The whole way back to my room, I was staring at the ceiling. I couldn’t look at anyone. I was just devastated by how everything had gone. I didn’t think I could ever look at my husband or my baby ever again. I was just like, What happened?I hear my husband. He is like, “You need to see. Our baby is here. You should see him. He is so beautiful. He has the most beautiful eyes.” He came around to my bed and he passed me my son and nothing mattered. None of it mattered. He was 9 pounds, 8 ounces so I was right. He was born on December 4th which I had said at 5:11 PM. Meagan: Oh my gosh. Kelsey: Yeah. He had a full head of dark hair. He was born in a snowstorm. That was the other thing. I said, “He’s going to be born in a snowstorm,” because my husband and I were both born during a snowstorm and he was born during a snowstorm. Yeah, he was perfect. He was huge and he was chunky and he looked exactly like me. Normally, they look like their dads is what I’ve heard but he looked exactly like me and was so beautiful. Throughout my pregnancy, I don’t like being pregnant because I don’t like sharing my body I’ve learned. Throughout my pregnancy, I said, “I don’t want another. I don’t think I want another.” When he was born and I held him, I was like, “I will do this again in a heartbeat.” 34:50 Second pregnancy and VBAC prepKelsey: Postpartum was good. I ended up starting therapy 5 days after my C-section. He latched and he did not have breastmilk for his first feed which makes me really sad. I was devastated from the C-section because I didn’t get to see my baby be born. I didn’t get to hear his first cry. I didn’t get to touch him first and my husband wasn’t there. He wasn’t allowed to be in the room. Postpartum was fine. I was seriously anemic. I was incredibly swollen. I had no knees because I was on fluids for so long and getting around was awful, but I just focused on our baby. He was perfect. He was so easy and 6 weeks rolled around and I was like, “Let’s have another.” But we waited. We decided around 9 months to start trying again and loosely trying because again, we were wondering how long it would take. Meagan: Right. Kelsey: We ended up trying got 6 months and I got pregnant in April of 2023. My due date was December 29th. Again, super, super easy pregnancy throughout. Immediately after my C-section, I decided to look into VBAC because that stuck in my head. I had been listening to a different birth story podcast. I searched for VBACs and there weren’t many and then I searched VBAC in general on Spotify and came across you guys.I started listening to VBACs before getting pregnant and I started doing lots of research about it. I learned about the cascade of interventions and how my case was really typical. I started learning about OP babies and how the pain I was feeling correlated with that. I wanted to try for a birth in a birthing center. Now, when I got pregnant with my second baby, I was living in Gatineau but we had a bunch of stuff happen. My mother-in-law ended up splitting up with her husband. We said, Hey, let’s buy a house in Ontario together and we’ll move in. I found out I was pregnant about 2 weeks before we put in an offer on a house and we moved in in July when I was 15 weeks pregnant. At the time, my GP was my provider for my first and I started off with her with my second as well. The thing was when I found out I was pregnant, I went to her. Sorry, I should have said. After my C-section, I went to her and said, “I was told I was a good candidate for a VBAC.” She said, “Yes, but you cannot go over your due date. We’re going to monitor your baby to see how big it is because you had a big baby before. You cannot be induced. You need to have 18 months between pregnancies.” Typical. Meagan: All of the red flags. Kelsey: Yeah. This was before I started listening to your podcast. Then I started listening to your podcast and when I went in to see her when I found out I was pregnant before I had gone into a birthing center, I said to her– and I’m not an outspoken person. I struggle to advocate for myself. I said, “I want to try for a VBAC, but I do not want you to put limitations on me.” I said, “I know that I can safely have a VBAC even if there is less than 18 months between my pregnancies. From birth to birth, it was 2 years and a bit so it didn’t matter. I said, “I know that big babies are 10 pounds+. That is macrosomia. I know that.” I said, “I know that I can’t be induced.” In Canada, they generally don’t do Pitocin for VBACs at all. They don’t generally induce for VBACs at all. I said, “I do know that there are safe ways to induce though and I do know that I can safely go past my due date.” She said, “I believe in informed consent and if you understand all of this, I think that you are well prepared and we can move forward with a VBAC.” I said, “Great.” I had applied for birthing centers prior to this but it is really hard to get into them here. I ended up being able to get into one in Gatineau. I was concerned about moving over cross-provinces again. It ended up working out. I did stick with my GP until I was about 20 weeks pregnant just in case. It didn’t work out with the birthing center after my move. What happened was, she was super, super supportive, but she would say things like, “Do you want me to book you an appointment with an OB just in case?” or “Do you want me to book you a C-section at 40 weeks just in case?” I was like, “No, I don’t want you to.” She said, “Okay,” but around 20 weeks, my midwife was like, “We can keep you on even though you live in Ontario. It’s no problem.” I said to my GP, “My midwife will keep me on.” My GP said, “You sound like a really good candidate so go ahead. I really hope it works for you. I hope that it’s everything that you want.”Meagan: That’s good. Kelsey: She was very supportive of it so I felt really good about it. 41:07 Switching to midwivesKelsey: I switched to the midwives full-time. My pregnancy was super smooth again, but there were little hiccups. I didn’t pass my one-hour gestational diabetes test. They said, “If you have gestational diabetes and it can’t be managed, we will have to transfer care.” Around 37 weeks, I started measuring large and they said, “We think we want to send you for an ultrasound just to be sure of how big baby is.” I said, “I know that those ultrasounds aren’t super accurate so I’m not sure that’s what I want.”I ended up getting a doula through The VBAC Link. I found a doula. Meagan: Yay!Kelsey: Yeah, what was funny about the doula is she was pregnant too and her due date was a week after mine and we found out that we were giving birth at the same place. Meagan: Oh my gosh. Kelsey: So she was like, “I’ll keep you on and I’ll do your prenatal appointments, but I probably won’t be at your birth. I have a partner who is a nutritionist.” She ended up being amazing. My son was in daycare. I got sick a lot and I couldn’t take anything for it so she would help me find natural ways of dealing with a cough. I think I had pregnancy rhinitis for the last trimester. I was constantly congested. I had terrible acid reflux. She originally had prescribed chest openers, but my midwife ended up putting me on medication for it because of the trigger to cough. She was afraid that my cough could trigger my water breaking too early. I couldn’t give birth at the birth center if baby came before 37 weeks. I had to make it past 37 weeks. Yeah, so pregnancy was smooth. I was extremely nauseous in the beginning. It was really hard with a less-than-two-year-old. I kept him home because I’m a teacher. I’m home over the summer. I kept him home over the summer and it was rough because he just is needy and my 9.5-pound baby continued to stay in the 99th percentile for height and weight. He wanted to be carried everywhere but he is so heavy and he is still so heavy. I was a lot more active during this pregnancy than I had been prior. I tried really hard to walk and whatnot and do lots of stretches. Around 30 weeks, baby was still breech and I started to panic a little bit. I started doing Spinning Babies exercises and lots of inversions and whatnot.When I first met with my doula, I talked with her about everything. I was able to just spit out facts that I had learned from you guys. She was like, “I’ve never met someone who is this prepared or who knows this much.” She was like, “I have all of this stuff to go over with you, but you already know it.” She ended up as well becoming certified in HypnoBirthing so I took a HypnoBirthing class. I was really concerned about doing an unmedicated VBAC because I didn’t know if I could handle the pain of it. I had originally wanted to VBAC in the hospital, but I watched– what is that documentary with Ricki Lake? Meagan: Um, okay, hold on. Kelsey: The Business of Being Born. Meagan: Yes, that’s all I could think of was Born. The Business of Being Born. Kelsey: My entire perspective on birth completely changed. My husband watched it with me and he was blown away by it. He was just like, “I want that. I want that for us. I want to be a huge part of this. I want to help you through it and be an active participant. Let’s do this.” We did the prenatal classes with my doula. He learned all of the pain management techniques. He was so excited for counterpressure and he wanted to be active. He was fully supportive and he wanted to catch our baby. This time around, we didn’t find out the sex of our baby. We wanted it to be a surprise. I was 100% sure it would be a girl. I didn’t even pick out a boy name. Anyway, we get to December 21st. I get checked and she can’t even reach my cervix. It was so posterior. I was super discouraged, in tears discouraged because I was afraid of going past my due date and they were afraid that this baby was going to be so big because I was measuring large. 46:14 Beginning of laborKelsey: Overnight, I started to have contractions. They were kind of regular, but they were manageable. December 22nd rolls around and I’m still having contractions on and off and I start feeling sick. I had pulled my son out of daycare to prevent getting sick. I started to get a cough and I was really congested. I wasn’t feeling well at all. I was supposed to go to Costco with my mom that day. I texted her in the morning, “I’m having contractions. Not feeling great. Let’s cancel,” but because my son was home, things started to slow down with the contractions. I said, “You know what? Never mind. I need something to do today.” My mom picks me up and my husband and her are joking that I’m going to go into labor at Costco. We walked the entirety of Costco as I was having contractions. My 18-year-old brother is in the back of the car. I’m breathing through them and he’s like, “What is happening right now?”I get home. I started timing them and they were 6 minutes apart. My husband decides that he is going to take our son. He was kind of off work so he took over care of our 2-year-old. I ended up going and taking a bath and all of the contractions stopped. That night, they started again and then on the 24th of December, they were still pretty inconsistent but my doula was suggesting things like, “Oh, if you’re comfortable, have sex, then take a shower. Sit on the toilet and do nipple stimulation for 15 minutes on each side and see if that gets things going.” We had sex and then it all stopped. We kept trying things and then my doula was like, “I just think that maybe your body needs to rest and relax so let’s try resting and relaxing.” Well then, the 25th is Christmas Day and I decided to host Christmas. Meagan: Because that would be a really good distraction. Kelsey: Yeah, I was like, “It’s going to be fine.” My mother-in-law was like, “I’ll cook Christmas dinner.” Prior to that, I had all of these ideas. I’m going to make bread by myself. I’m going to make all of these desserts. I’m going to make puppy chow. I’m going to wrap all of my kid’s Christmas gifts. I’m going to put together his Pikler Triangel we got for him and wrap that. Just all of these things that I wanted to do for Christmas. By the 24th, I was so exhausted from the contractions that I didn’t bake anything. There was no way. But I did host Christmas dinner and everyone told me, “Why? Why are you doing that?” I was like, “Well, it will be easy,” because my husband and I are both from divorced families. We’ll just have everyone over for Christmas, and then we won’t have to worry about going to anyone else. We had my mom and my brothers came over and his step-mom came over and my step-dad came over. It just was not great. Meagan: Like Christmas Vacation where the door keeps opening and all of the family members keep showing up. Kelsey: I know. I was still having contractions. I couldn’t stand up or sit down without having a contraction. I was just exhausted and uncomfortable and felt huge. People are like, “How are you doing?” I’m like, “I’m surviving. Right now, I’m just surviving.” So anyway, finally Christmas Day is over and Boxing Day, I wake up at 7:30. I had a weird contraction. I went to the washroom and I had my bloody show. I was like, “I’m just going to try to go back to bed,” because my son and my husband weren’t up but my back started to hurt. I was like, “Okay, I’m actually just going to get my son up and go downstairs.” My husband got up with me. We go downstairs. We started getting my son ready. I’m like, “I’m going to get in the bath and see if my contractions stop because I’m really uncomfortable.” I called my midwife from the bathtub and I said, “They are 5 minutes apart and they haven’t stopped, but I’m scared to come in because what if this isn’t real?” She said, “If you’re in the bathtub and they are still going, this is real labor. You need to get here now.” 51:07 Driving to the birth centerKelsey: We get all of our stuff in the car. It was a 50-minute drive to the birthing center. Meagan: 50? 5-0?Kelsey: 5-0. Meagan: Okay. Kelsey: The good part was that they were regularly 4 minutes so I could look at the clock and know that I was going to have a contraction and I could breathe through it. I was managing pretty well at that point, but before we had left, my mother-in-law decided to stop me at the door. She was like, “So where are you feeling them?” I’m like, “I just need to go. Please just let me go. I can’t talk to you right now.” My husband is trying to get me out the door too because he knows. We get to the birthing center. It was nice because I could choose the color of my room. They had options for the color of your room so I chose purple. I get into my room. It’s now 10:00. I could hear in the next room a woman screaming, literally screaming. I start panicking. I can hear her yelling, “Get out of me already!” Meagan: Aww. Kelsey: My vagina is on fire! I’m panicking. My midwife says, “I need to monitor you for a little bit, so can you get on the bed? I’m going to monitor your baby’s heart rate and then I’m going to monitor your contractions.” She could get baby’s heartbeat and she couldn’t get my contractions on the monitor. At this point, I’m starting to panic because I can still hear the woman screaming. My husband’s like, “I’m going to get you your headphones.” He gets me my headphones. Meagan: Very good call. Kelsey: He gets me my headphones and puts on my birth playlist. I’m laying there and things start getting really intense really fast. I was panicking that the same thing that had happened with my son was happening again. But I started getting irate and my midwife still couldn’t get the contractions on the monitor. I remember flinging my headphones off and just being like, “I need to go to the bathroom. Let me up. I can’t lay here anymore.”She’s like, “Okay. If you need to go to the bathroom, go to the bathroom.” I’m sitting there on the toilet. I’m crying and I’m telling my husband that I can’t do this. In the back of my head, I know what that means, but I couldn’t ration with myself at that point. My midwife hadn’t checked me yet at all so she goes, “I really want to check you because we haven’t done that.” I had to get off the toilet. I didn’t want to and as I was getting off the toilet, I was so hot. I’m flinging my clothes off. I get to the edge of my bed and I’m like, “It’s not me. It’s my body. I’m pushing.” I saw my stomach contort. It was just like my whole body was not me at all. It was so wild to me. My midwife gets me on the bed finally and she checks me and she goes, “You’re at the 7th centimeter.” She said, “You’re a second-time mom so if your body feels like it, it remembers. You can start pushing whenever you want.” It was such a different experience from being told in the hospital, “Do not push,” when I’m at 10 centimeters to my midwife being like, “If your body is pushing, it’s fine.” 54:49 Pushing baby out in two pushesKelsey: So she put me over a ball and then she called in the assistant midwife because she was like, “This is happening very soon.” The assistant midwife comes in and that was funny because she goes, “My name is Gabrielle.” I had a friend who had gone to the birth center who had Gabrielle. I turned to her and said, “You know my friend, Kelly.” She was just like, “Yeah.” I’m like, “I heard you’re really good.” She’s like, “Okay, let’s–.”So over the ball, my husband tried to do counterpressure on me and I was like, “Don’t. Don’t do it.” But he pressed my tailbone down and that made a huge difference and I just kind of let my body do its thing. They had to flip me a couple of times and I ended up being put on my back to push for the final little bit because they needed to keep monitoring baby’s heart rate. It kept going down every time I had a contraction so they were a little concerned. At one point, they said, “Don’t panic, but we are going to call an ambulance just in case just because we keep seeing this. We’re going to call an ambulance just so that they are here.” Yeah, so I pushed on my back for a while and I remember at one point, she said, “The head’s right there. If you reach down, you can touch it.” I was like, “I’m going to have my baby vaginally.” My husband was like, “Yeah, you are.” I was just so excited. In one push, his head came out and she goes, “Ope, he’s OP.” He was sunny-side up. My husband was like, “He’s looking at me.” Well, sorry. That’s a spoiler. “They’re looking at me. I can see the baby. Their eyes are open. Their mouth is going.” And then she said, “Okay, next time, one really big push,” and he came out on the second push. My husband caught him and put him right on my chest. I was like, “What is it? What is it?” It was another boy, so spoiler alert. We didn’t have a name. I got to hold him on my chest for 2 hours. We did delayed cord clamping. My doula made it in the last 15 minutes and she said to me, “I think Victoria is in the next room having her baby.” Meagan: Nuh-uh. I wondered when you were saying that. I was like, I wondered if that was her doula. Oh my gosh. Kelsey: Literally, our babies were born 2 hours apart. Meagan: Oh, that’s so cool. Kelsey: We were in the birthing center at the same time which was wild. I got to see her on my way out which was really nice. Meagan: That’s so special. Kelsey: Neither of us knew what we were having and we both had little boys. They weighed him and my super big baby was 8 pounds, 3 ounces. Meagan: Perfect. Kelsey: Perfect. Yeah. People were like, “That’s a good-sized baby.” I’m like, “My first was 9.5 pounds. He’s tiny.” My husband got to tell me the sex of the baby which was another thing I really, really wanted. We did delayed cord clamping. We had the golden hour. We just got to sit there and compared to my prior experience, I just felt so cared for. I remember a midwife putting a cold cloth on my head and I thanked her. Her response was, “I know you are grateful. Save your strength.” She was just like, “You don’t need to tell me thank you at this moment. Just don’t talk at all. I know you are thankful.”Meagan: Enjoy. Kelsey: Yeah, I was given water in between pushing. My doula sat there and rubbed my eyebrows so I wasn’t tense because I learned about the fear/tension/pain cycle. My husband got to be a huge part of it and he got to cut the cord. He didn’t get to do that with our first. He got to hold our baby. He touched him before anyone. It was just– my husband and I talked about it for a while afterward and he was just like, “You know, why is this not the gold standard for birth? Why is this not what we do every time? This is the most incredible thing.” We recorded the entire thing. Meagan: Yay. If you decide you want to share, post it in the community. Kelsey: There is a 30-minute video out there because my son was actually, so my first birth was 38 hours total. My second birth, I had my first real contraction at 7:30 AM. My son was born at 12:38 PM. There were 5 hours. Meagan: Another five, by the way. Kelsey: I know, so weird. I was not psychic for this birth because I had a boy. I was so convinced I was going to have a girl but he was a little boy and he was baby no-name for four days. We ended up naming him Oliver. 1:00:24 Differences in careKelsey: Yeah, I just felt so cared about and looked after. There were differences like my husband had to go out and search for food after I gave birth after my first. He was so exhausted, he couldn’t get out of the parking lot so my mother-in-law had to drive in to bring us food. I ended up scarfing down Popeye’s but I had been intubated and my throat hurt so badly. I ate the world’s driest biscuit and thought I was going to choke and die. But with my second birth, they had a postpartum doula who was there. She offered me lentil soup and a grilled cheese so that was my first meal. Meagan: So much better. Kelsey: Yeah, lovely lentil soup and grilled cheese. My son had been placed on my chest but I still had my bra so they washed it for me before I left. Just small things like that, I felt like I was cared for. Meagan: Yeah, absolutely. Kelsey: We ended up leaving at 5:00 PM. We were home in time to eat dinner at home. Meagan: Yeah. Yeah. Kelsey: That postpartum experience was incredible. We literally, I was able to get up and walk and I wasn’t dizzy or anything. I barely felt like I had a baby. I did have a second-degree tear but for some reason was just completely unbothered by it. My midwife came to me postpartum which was really lovely. 1:02:11 EnterovirusKelsey: However, one thing I did want to touch on was I had a cold during labor and this is something I wanted to mention because it is not something I knew about. I had a cough and five days postpartum, on New Year’s Eve, my doula came. Not my doula, my midwife. As they do, she temped my baby and he was measuring a little hot. She temped him a second time and he was normal. Around 4:00 AM on New Year’s Day, I realized he was very warm. I temped him and he had a fever. I only know Celsius but it was 39.9 which is really high. I temped him a second time and he was 39.2. Anything over 38 is a fever. I ended up having to take him to the hospital and I didn’t know what the protocol was if your baby gets a fever below two months. We were pretty much admitted on the spot. He had the full workup. He had bloodwork done. He had a lumbar puncture done. He didn’t have a birth certificate and had to have a lumbar puncture done because the problem was that they were looking for infections. When they did his lumbar puncture, they did find something. He had a virus called an enterovirus. In adults, it’s just a common cold, but if you get it while you are pregnant, you can pass it through your placenta to your baby just before you deliver and your baby can be born with the virus. It can just present as a fever, but it can also progress to viral meningitis. Meagan: Oh, scary. Kelsey: My son was kept in the hospital for two nights. Because of the fever, he stopped nursing. He was super sleepy and they make you stay for two nights even if they perk up and are nursing and everything seems fine. They will keep you for two nights because they are looking for things to grow on the lumbar puncture. If a fever indicates an infection and because the blood/brain barrier is so thin, infections can spread super quickly to the brain. Meagan: Scary. Kelsey: He ended up being okay. He didn’t have viral meningitis and I had the most incredible angel nurse while I was there. I was so grateful for her. I forgot my Peri bottle at home and she made me one. She did everything she could to prevent my son from being put on an NG tube while still getting the fluids he needed. She managed to get him nursing enough that we didn’t have to switch to an NG tube. We didn’t have to switch to bottle feeding. He continued to nurse. She stuck up for me when a resident came in and was like, “Well, what’s his urine output like?” I was like, “I don’t know. I have no idea.” She was like, “All of that is in his chart if you just check it. She’s obviously very tired. Leave her alone.” I had a lovely angel nurse but it is something I wanted to touch on because I had never heard of enterovirus. I did know what to do if your baby got a fever, but it definitely is that you take them right to the emergency room. Generally, they will admit you for two days. But yeah, otherwise, my postpartum experience was night and day compared with my C-section. I was up and moving and I did experience baby blues with my first. I cried for weeks. With my second, I was just so over the moon. But yeah, that’s my VBAC. Meagan: I love it. Thank you so much for sharing that. I had actually never heard of enterovirus.Kelsey: Enterovirus.Meagan: Enterovirus. I was like, What the heck? That’s actually with an E. I didn’t know that. I just Googled that so it’s really, really good to know that’s a thing. It does look like it’s pretty rare but it’s something to take seriously. Sorry, my dog was barking in the background. He’s got something to say too.I’m so happy for you and I’m so happy that you could see that it was a very similar situation with an OP baby and things like that and you were still able to deliver vaginally. Maybe it was a little bit of that asynclitic position that maybe made it a little harder to get under that pubic bone. It sounds like in ways they were willing to help you, but they also didn’t help you too much either. Kelsey: No. Meagan: Yeah. I just love that you were able to prove to yourself too. Not that we have to prove anything to ourselves or anybody, but it is definitely nice when you are like, This is the same situation and look, I did it. Yes, my baby was a little smaller, but it probably wasn’t the size more than it was just a slight bit of position and probably the cascade. I love that.1:08:02 Risk factors for forceps and vacuum deliveriesMeagan: Okay, so before I let you go, I wanted to touch a little bit more on those risk factors for forceps and vacuum because we talked about that in the beginning and tearing. Tearing is definitely a risk. You even said with your VBAC baby that you tore a little bit which is really common with a posterior baby coming out vaginally too just to let listeners know. Tearing can happen. It can happen with any baby. We can get rectal pain. Posterior babies, oh my gosh. Amazing to not only labor with one but push one out. It is hard work. You did an amazing job. Yeah. It may have a lower chance or a higher chance of coming out vaginally just in general. For baby, that bruising to the head or even nerve damage. It’s really rare but it is a thing. Temporary swelling, skull fractures– again, it’s rare but it is a thing so these are all things to take into consideration. For vacuum, we’ve got weakened pelvic floor, tears as well, possible even larger tears weirdly enough so that’s a thing and then yeah, for baby, the suction can pop off and need to be replaced or cause hematomas there. Just all things to take into consideration. In the show notes, I know this wasn’t a complete forceps delivery, but because it was something within your story, I wanted to touch on that today and make sure we included links. If you guys want to learn more, check out the show notes. Also, I just think it’s so fun that you and your doula were at the birth center at the same time giving birth at the same time. There are so many fun things about this story. Amazing support it sounds like from your husband, from your family, and from all of the things. I just loved your story and appreciate you so much. Kelsey: Thank you. Thank you so much for having me. Meagan: Absolutely. It’s been such an honor. 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