Ep 74: 10 Ways to Increase Vaginal Birth Rates

Many new mothers do not plan to give birth via cesarean birth, yet around 1-in-3 women in the United States give birth this way. When medically necessary, c-sections can save lives. However, when conducted as an elective procedure or when performed unnecessarily, the risks outweigh the benefits. 

In this episode, Doula Rachael and Dr. Shannon discusses evidence-based practices that can help increase the rate of vaginal births and decrease the rate of unnecessary cesarean birth. Our goal is to help more people view birth as normal so that birthing people can feel more confident as they navigate their unique and unpredictable path to giving birth. 

Seeing normal birth in the media and amongst our friends and family has the potential to have a ripple effect that can last for generations to come. In this episode we will discuss:

• Building confidence in the normal physiological birth process
• Choosing low risk providers for low risk birthing people
• Promoting awareness of birth options
• Avoiding laboring and pushing on your back
• Encouraging movement in labor
• Limiting induction and augmentation of labor
• Having a doula as part of your birth support team
• Taking an out of hospital childbirth education course
• Encouraging natural comfort measures
• Normalizing VBAC

Additional resources and podcasts episodes to listen to:

Episode 60: The Role of Pain and Hormones During Labor

Episode 58: Eating and Drinking During Labor

Episode 50: Hospital Based vs Independent Childbirth Class

Episode 40: Lamaze 6 Healthy Birth Practices

Episode 26: Due Dates and the Holidays

Episode 25: All Ab

Transcript

0:03

Hello, hello. This is the aligned birth Podcast. Today you have both hosts here. I'm Dr. Shannon and doula Rachel is here too. And she and I are chatting. Again, one of our favorite birthday topics is we're going to talk about ways to increase vaginal birth rates and why are we talking about ways to increase the vaginal birth rates and you know, in the birthing community here in the US, and even in that Metro Atlanta area where both Rachel and I live in and serve clients and patients. There, there's a pretty prevalent Syrian birth rate and so it really is about that one in three of that 3% of all births are Syrian births and so with those births come some different aspects. It's different than a vaginal birth not only for mom but for baby as well and it is a major abdominal surgery. I think sometimes that's that gets missed when we have one in three births that are done via cesarean. I think sometimes that gets forgotten. And so she and I wanted to chat today about some ways to and thoughts on increasing the vaginal birth rates, why it's important, and some of the support systems and mechanisms to go about doing that. Hello, and welcome to the Allied birth podcast. We are so glad you're here. I'm Dr. Shannon, a prenatal chiropractor

1:47

and I'm Rachel a birth doula and childbirth educator and we are the team behind the Alliance for podcast.

1:54

Between us we have experienced a cesarean birth a VBAC hospital birth and a home birth. Our personal experience has led us to where we are today we share a lot in common.

2:04

We are friends from high school who reconnected through our work. We've both changed career paths after the birth of our own children. We line up with talking about health and birth and we are both moms to two young boys.

2:16

This podcast was created to share conversations and interviews about topics from pregnancy and birth to motherhood and the importance of a healthy body and mind through it all. Our goal is to bring you fun, interesting and helpful conversations that excite you and make you want to learn more.

2:31

We believe that when you are aligned with body, mind and your intuition, you can conquer anything. We hope you enjoy the episode

2:49

so I'm excited to chat about this today with you, Rachel.

2:55

Hi, Dr. Shannon. Yes, this is an important topic that I think needs to be repeated and talked about over and over again. We, you know, in our country that that cesarean rate is double what it should be. So the World Health Organization does say that 10 to 15% of babies need to be born via Cesarean birth. But our country's rate is about 33% Like you said and even where we live, it could I think it's actually a little bit higher at some birth locations. And so understanding this is always a delicate line to walk because, of course everyone's like whatever keeps the baby safe and healthy and mom safe and healthy. But if we're having one and three women give birth via cesarean and only 10 to 15% of those are like truly necessary. Then we're putting the additional those additional women at risk of all the things that come with having a major abdominal surgery so some people feel like this is such a like one and done quick we get the baby out. It's like a it seems like an easier fix, but it comes with its own set of risks. So what you have to weigh out is Is it is it safer for baby to be born like right now than to wait on labor and birth to unfold on its own. And if it is truly safer for either mom or baby, for baby to be born right now than necessary and as necessary. Or if you've exhausted all things and tried all the things in its labor has had its opportunity to unfold and things just haven't worked out and you evaluate that with your provider and you make a decision about is this the best thing. We want you to make the decision with information so that you feel like I was one that I really didn't need. I needed this in order for my me or my baby to be saved versus wondering, was I one of the ones that had an unnecessary cesarean and then whatever complications might come from that or whatever down the line. It just might make you feel a lot of doubt or insecurity about how things went. So we want to help increase the rate of vaginal births so that we're keeping moms and babies healthy and safe and and helping them feel like however their birth unfolded is how it was supposed to unfold.

5:17

I've got I have so many. I have so many thoughts like my brain was just like going as you as you were talking because I love everything that you said because it really is that delicate balance between medically necessary ones. And then the other aspect of where is that disconnect and why we have so many more and you know, maybe we'll get into this in a minute. But it's I think sometimes there's it's like a two fold thing too because I sometimes feel that my emergency C section wasn't necessarily necessary, because I also had a cascade of events that tend to lead towards a C section that could have been avoided. Had I probably done some of the things on this list. Right. So I think it Yeah, I think of it in that aspect. And then there's another one of like we did, what about due dates in the holidays. Then there's the other aspect of the provider and their risk ability to take risks or their their desire to take risks or whatnot or scheduling, you know, because you want a specific doctor and so we're going to do the C section this way. Like I see a couple different things, right. So that's where my brain was going with some of those with some of our thoughts.

6:34

Well yeah, we hear I hear stories somewhat regularly of like, you know this this Aryan saved my life and I hadn't been in a hospital me or my baby would have died. And that is very real people's experiences are incredibly real. I just always lead like I'm my mind goes to if we appealed everything back. You know, like you were talking about the cascade of interventions. When people feel like the hospital, the doctor or the Syrian save them. It's like, Well, were they also the same people who, who said you should be induced for 39 weeks do to have a baby or were they the one that didn't support you going beyond your due date? So you were induced because you were 40 weeks in one day? Or you know and or were they the one that didn't explain the epidural and how that works or support movement during labor like all thing like you can we Yes. And so it's hard because it's not like oh, you there's something done wrong. It's just saying that there's a whole picture and that cascade of things does increase the rate of cesarean and decrease your chance of having that vaginal birth which is optimal for baby and mommy recover faster. for mom and it's it's really good for baby for getting all the liquid and fluid out of their lungs and getting all the healthy bacteria and flora into their gut. And so there's like there are true benefits from vaginal birth and the interfering of hormones. That Come With medicated birth versus stereo inverse. So not that that can't be overcome, but we just start kind of compounding the hard things to overcome. And so we really want to try and reduce that as much as possible. And there are some things that we're going to talk about here that can help reduce the risk. Of an unnecessary scenario based and

8:25

that's, that's kind of what we're doing is reducing the risk of that unnecessary one.

8:28

Yeah. Which is promoting vaginal birth right. Exactly. Either way.

8:33

Yes. Yes. And so we this is kind of based on so there was a blog written that this was originally published on and then the pathways to family wellness magazine also did an article on this as well. And so we're just gonna go through and kind of chat about the list that here and our thoughts on those

8:54

things too. Adding in some of our own Yeah,

8:57

adding in Yeah, and

8:59

our own theories. We do we like to talk. Um,

9:04

and so starting with a kind of looking at it as like, Okay, we want to increase the rates of vaginal births. So maybe understanding the normal physiology of birth. As someone who was going to give birth I think this is very important. I was not excited about I like to hospital childbirth education class and looking back on that see, maybe that was like step one of my cascade of like, where I got to and so I really wish I had taken an independent one that really understanding the normal physiology of birth and like building confidence in natural childbirth. I think that that's a beautiful place to start. And then again, too, we talked about like, think of the movies you think of you know, it's always someone pushing on their back and they are in extreme pain and it looks horrible.

9:58

That's how most people are learning about birth. Yeah, yeah, we aren't. We are no longer in the times of villages and communities where everyone watches people give birth or you watch your sister and you watch your aunt, or you watch your mom give birth to their other siblings like or that's not happening anymore, or it's not the norm. And movies and TV do not depict normal birth. And now that's TV, nothing human assume everything on TV is how it is in real life. But that's the only way you've ever been exposed to birth and it does implant or imprint on your brain even if you're like, even though you know, no, that's probably not how it is. It's still like, Well, that's all I've ever seen. That's all you know. Yeah, that's all you know, we've heard because people tend to share birth stories. They tend to share the scary, negative birth stories more than the positive ones. That's just how we are because it gets more of arise and it's just more interesting. And that tends to be what we're, you know, getting circulated around that fit of those experiences aren't real or valid, but it is if that's all you're hearing, I can't tell you how many clients I'm like, who are like all my friends, bad bad birth experiences, and that's all they want. That's all they share, but or whatever it's like, there's more, there's more potential social shedding light on the potential for this to not be a terrible experience for this to be a positive experience for it to be empowering. No matter drugs or not. That you still have autonomy here and teaching. So this is the part I think you're getting to when you normalize physiological birth. You're helping people and provider so helping providers, specifically like hospital based providers, and birthing people and their partners to learn about the normal process of birth and understand that it's not a linear process, that it zigzags, but that there is a process and that there's lots of things at play, hormones changes in your body. You know your baby growing, birthing, all the things that it's a physiological event, just like breathing and just like your heartbeat, so I always use this example to help people understand you. If you're breathing normally and your heart is beating normally do you go see a cardiologist or a pulmonologist? No, because your body is doing what it's supposed to birth, while it has a set of risks, but so does everything like happens on its own? Right? Obviously you'd have to conceive or you know, either

12:35

right there or whatever going back to

12:40

IVF or, you know, the other writers conception of sexual reproduction. Like, okay, assuming that's happened, yes. And like everything else happens on its own. Just like breathing and just like your heart beating, even labor starting and your body can even expel the baby without you pushing, really, if to get down to the nuts and bolts of at all. And so understand that it is this normal physiological process and how it works. What's happening is underway. So learning about that process. And learning how to support it, not fix it. So this is like wading into that low risk providers for low risk mothers. So like number one here, which I think you and I both firmly agree with is learning about the process. And this is providers, partners and birthing people like learning about the actual process. And how to support it. That's number one. And then part of that is then having a provider that needs you where you're at in your pregnancy. So this would be like low risk providers for low risk birthing people. And so that means typically midwives should be the ones supporting most birth because midwives are highly trained and educated in supporting normal physiological birth, even with some risk factors. By faith not even fully 100% free of like issues they still have the ability to support some risk factors to and then seeing the obstetrician when you have risk factors that that deem that necessary. And we are in a society where that is reversed. We have most people seeing obstetricians, which and obstetricians are the high risk doctor. They are the trained surgeon and some people might say, Well, why wouldn't I want to see the most trained person here? Or why would I want to do the doctor? They're the safest, and the reality is, is while they are really, really probably intelligent and smart and have learned a lot, most of their schooling was about pathology, and identifying and treating problems and issues that arise during pregnancy, which we need that right. We need people to be able to do that. So we value that work. And then they're also trained in delivering babies via cesarean whereas midwives are not. So midwives are trained in identifying problems and then knowing either they can treat them or referring out and then they are they are more trained and they have seen a normal normal process. Whereas some people who are obese might go through all of their schooling and not actually see a vaginal birth. That's really hard to comprehend. Because then they're the ones providing your care and you're wanting. Most people go in wanting a vaginal birth, but most some people, small percentage. Yeah, I know. You know, we're like, Yeah, I know. I want to say most people are assuming they're going to have a vaginal birth, but then they're choosing a provider who, you know, what are their cesarean rates? How often are they seeing normal birth and normal birth, maybe even being unmedicated or moving during labor like so we're trying to help you feel competent to seek the provider that is right for you. So low risk provider for lowers broken people. So midwives are really suited well suited for that. And they'll be as you're great to like I'm a I know many, many wonderful OB and we need them as part of the team. Yes, it should be midwives providing most of the care and then OB is there when we meet them.

16:04

Yeah. And I, you know, even with and we talked about that, okay, building that competence in natural childbirth and understanding and doing that childbirth education and then going and saying, Okay, well, I am a low risk, you know, Mom baby seeking out that midwifery care, but even looking at the next another one they have on this list is Promoting Awareness of birth options. So like even then looking at where do you want to give birth? You know, and understanding it doesn't have to be a hospital. You know, let's go here to the Atlanta area. We have, you know, a birthing center. We have some hospitals that are able to accommodate waterbirds. So you know, those aspects of things. All depends, but then there's even like that. home birth aspect, right, and that option as well to do like homebirth midwives. So, all of those things, because if you are, I mean, I don't know, does anybody really feel comfortable in a hospital like, I don't know. It hospitals usually has that, that stigma with it as far as was just a place where you're going where there is a problem, right? And so then if you're going in there and trying to give birth, if you can go and tour it and kind of maybe get out of that headspace and see it maybe differently. So that's why I do love like the birthing center that centered around creating that, that birthing space and creating that environment that makes you feel comfortable. That can all this is how it can help increase that vaginal birth rate by maybe eliminating some of that fear and some of that that can take place in that cascade of events that can lead towards an unnecessary Cesarean birth.

17:47

Yeah, and I think what we see is when people I think they assume because I mean, like 95 and a half percent of people give birth in a hospital or something like that. But a lot of people assume that that's where they're going to have their baby and then if they've had an opportunity to do childbirth education, like you're saying an out of hospital, childbirth education focused on normal physiological birth, they learn and all of a sudden they're having some aha lightbulb moments of like, the hospital doesn't really align with supporting normal physiological birth because we have to do it there are certain things that have to happen to support the hormones like he really for most people, this is a little bit of a broad statement but you know, quiet spaces, private spaces, dim lighting, access to comfort tools like tubs and beds and space. Fresh air, you know having family and friends nearby if you want them, like so many things that help support the flow of birth aren't accessible or available in a hospital. It's quite the opposite. Bright lights for the most part, sterile environment strangers, beeping sounds, announcements over the PA like, all kinds of things. Now, as a doula, we know all the ways to make a hospital room feel like a birth cave. So not to say it's not possible but it is something you have to be ready to overcome. But where I was going with that is that when you learn about the neurophysiological birth process, that's usually when people begin like, things are firing and they're like, Okay, well, what are my options now? So this feels like I might want to be at home or a person or home sounds great, but maybe I'm not comfortable comfortable with him. What are my other options? So it's like the paper center might be great or a smaller hospital or you know, because there are hospitals that like maybe there's a more burfi hospital that has fewer rooms and offers waterbirth or something that maybe it's closer to the vibe you're wanting all of a sudden you're like, I didn't even know I could look at different hospitals or I didn't even know we have our center or, you know, gosh, homebirth wasn't even on my radar and I'm like well, we'll just have a conversation with a homebirth midwife, you don't have to hire them. But just having conversation, every little thing is a little bit more enlightening. And so understanding like birth location and provider are really one of the greater influences over your outcome. So trying to focus on that

20:04

Yeah, and we did a whole episode on choosing on ways to choose a care provider. I loved how you went through that and you reverse engineered and it kind of went like okay, well how do we want to feel, you know, and I think some of that too, kind of starts with like understanding that birth process and that normal physiology of birth and that if you're low risk, mom, okay, well, how do I want to feel and what's going to support that feeling? And so sometimes it can be another, another place to give birth. I know and I didn't I mean, I didn't research any of those options. I thought you just you know, you had an OB you went to the hospital, and you lay on your back for birth. I want to there was one in here one of the things that says avoid maybe I'm even jumping out of order on some like the flow of things but avoid labor and pushing on your back and like I guess I just want to tackle those are the stigmas that I remember the most as far as like okay, oh well, you you have birth in a hospital you have an OB and you are on your back. So, obviously right and so that's the feeling optimism thing I know. So that's where if we can open our minds a little bit into that normal physiology of birth and using gravity to help and maybe looking at well laying on your back really helping the doctor but not really helping the given birth. So it's looking at those types of things and kind of reverse engineering that thought process here too and kind of going back okay, well, if I had back labor like because both of mine were, you know, sunnyside up, so occiput posterior, and you're on your way, and then you're on your back. So it's kind of like, you know, you're like setting me up for failure now, not not failure, but you know what I mean? Like, it just makes it really, really, really, really hard to Oh, looking at understanding and I think too when we understand the normal physiology versus taking that childbirth education classes and saying, Oh, wow, there are I can kneel, I can squat. I can be in a tub and get ya.

22:02

On your watch. If you watch any sort of uninhibited birth, most people are upright, or in gravity neutral like hands and knees or gravity friendly, like a squat or even sideline if they're like in a bed like you can be more sideline than on your back. That's the like, that's the direction most people assume or like, take when they're uninhibited and free to move around. So it's like, Well, why would we trust that and let that be the norm because that's that tends to be what you follow your body's intuition. And then you gotta have a provider of birth space that supports that freedom of movement. But the thing is, is people I think people assume I need to push on my back because that's how they do it in hospitals, and that's what the doctor says. And so that must be the safest best way and the reality is, is that position, the supine position was designed to, like you said, it's more convenient for the doctor because they can sit in a chair at the bottom and watch or do what they need to do to help deliver the baby. And so it's really it is more about them. So, one of the questions we always encourage when choosing a provider is how do you support the pushing stage, and understanding that gravity helps the baby come out movement helps facilitate the baby navigating the pelvis and it just overall helps shorten the length of pushing and helps reduce tearing and helps reduce overall pain experience. Now it's still intense and it's painful, but it's, it's easier than lying on your back and pushing and that way when you lie on your back, you close your pelvis by 30%. I will give a caveat so that because I don't like to always paint one way of giving birth. I've witnessed the unmedicated births with first time birthing people that the back being kind of on their back and almost like curled up, work for them. That's where they felt most grounded. That's where they were able to push most effectively and that's where they delivered their baby. So it's not a hard not

23:53

like definitely don't do this. Yeah, do everything else but no, but if it's not serving you, you know,

24:00

you live as soon as not one way movement. Movement. Movement is the key. So say you end up there you were probably in a few positions before that. Whereas if you're in one position, so every time you move your hips, you change the shape of your pelvis and your baby would have to rotate the seven Cardinal movements to come through your pelvis. It's not a straight line. It's a movement and you have the relaxing hormone pumping, which is giving allowing lots of movement in space in the pelvis every time you move. So you know changing positions every 30 minutes really helps the baby turn if they're posterior or or make their way through and so you know when you can do all the positions and still have a hard time but it does make it overall easier and you have a better chance at having that vaginal birth which is the point of this.

24:49

Yes, no and I that and then we kind of like touched on a couple of different way of movement. Yeah, movement and you know, not just being in that one position. And what's, what's tough is that sometimes too, if you're coming in to a hospital birth, and maybe you've been induced, which you know what, there's this like the other one on your limit induction augmentation of labor because now you get into the aspect of okay, I'm OB is for whatever reason, you know, suggesting and saying okay, we need to schedule this induction So, we are now then kind of limited on movement because now maybe we do have Pitocin going or something or maybe we've you know, our filtration remembrance, maybe you can move around like it just depends on what's been done, but there are certain augmentations to labor and there's certain induction methods that are done where it's like, no, we we do need to stay and we can't move as much now, I think understanding that if saying okay, what happens with an induction, you know, how am I going to be induced or and what happens with that and that how does that limit your movement then and then your ability to use other comfort measures for pain or use other of those movement aspects to help baby shift into a better position and to move the pelvis and so I think sometimes people kind of forget like, Okay, we may be tied to the bed or the day and having you know, internal fetal monitoring and those aspects of things that kind of Cascade together. I don't know if we need to define the cascade.

26:30

Yeah, well, that duction is a good example of where the cascade of interventions can begin and the reality is, is induction happens a lot. I don't have the number in front of me, but it's the rate of induction is very high and induction of the artificial start to labor. So like using Pitocin or breaking in the water or using, you know, medicine, so serve until Saturday to to get labor going. Now, the important thing here is to to increase the rate of vaginal birth and decrease the rate of cesarean. Right. We need to support the normal process of giving birth, which means not artificially starting labor unless it's medically necessary. So earlier I said is it important? Is it safer for baby to be born now or in the next few days versus staying in the womb? And if that is definitively Yes, then a medical induction is necessary and you have to say, Okay, I'm gonna I need to be induced, it's been determined X Y and Z. I've asked all the questions. I've determined with my provider support that this is necessary. Okay, how do I support the rest of the normal physiological process? Right, so I'm getting Pitocin. Can I have wireless monitoring because now that you have Pitocin, you need continuous monitoring. So that's for most hospitals to bands around your belly, that have wires that attach to a big thing next to the bit. So what are my options for monitoring can I do wireless so that I can only then be tethered to the Pitocin and the fluids and that whole moves around with you? That's a little bit easier. And what else what other options do I have down the line because that is a good example of the Cascade. So you get Pitocin and you really don't want an epidural, but Pitocin makes contractions stronger and longer and so therefore harder to cope with. So it does increase your rate of using either narcotics or an epidural. So therefore, then you're then you have a reduction in movement, which we know reduction and movement might make it you know, labor longer might make pushing longer, it can increase the rate of having a cesarean. So all the things that come along the way or, you know, you get the epidural and that slows labor down and then you need Pitocin to speed things get contractions going again, and now the contractions are too close and too strong and baby is stressed. So therefore, you either end up with an instrumental deliveries because they gotta get the baby out or you end up unnecessary and there's a lot of different ways that cascade of interventions go but what it is when you get one intervention that miss that kind of leads to another, that then leads to another that then leads to the outcome that maybe you weren't expecting or hoping for. And so it's saying, Okay, how it's trying to reduce or avoid those interventions in the beginning that maybe aren't as necessary so that you can I don't think old people always put the picture the whole picture together. That one thing means another thing that then might mean another thing that then might mean another thing and before you know it, you're you're all hooked up. Well yeah, what I

29:37

wanted exactly and that was very much like, oh my gosh, these things are happening to me like what is happening to me, you know, kind of get out of that birth space and if something's happening to you, it just it really does take you out of that mental headspace and it makes it very difficult to then navigate the birth that you had envisioned

0:00

And then you get in, you know, then you have all these other interventions and then you get the cascade. Did not that does that does that will happen, it's, it seems to be something that does happen, you know, and they're gonna increase the rate

0:15

of those other really does. And then some people don't realize that they were with Pitocin. That means you have to get IV fluids and you'd have to be continuously monitored. So with one you get three, yes, right, or that getting Okay, so you don't have any of those other things but then you get an epidural. Okay, well, now you need fluids, continuous monitoring, and now you have a greater chance of needing Pitocin because it's kind of slow. It could slow things down. So it's like just learning and that's childbirth education is going to help you understand okay, what intervention necessitates another intervention and so, and how do I protect my space through all that it is not an end all be all if you need some interventions. I'm all about knowing that interventions when used judiciously save lives, so I'm not here to be and I'm not anti intervention at all. It's about figuring out what and when, and kind of taking it one at a time. And knowing

1:01

the process of it. Yeah. And kind of, I think what you said there to understanding like, yeah, with the induction also comes these two other things like not a cascade, it's just these are have to be included to it, you know, we have to be, you know, monitored and the IV fluids so it's not that's not even the you know, a cascade aspect of things. So, but again to that's where that education part comes in, and now you can even you kind of segwayed into this other one I wanted to go into as far as ways to increase vaginal birth rates. And you you just talking and speaking here about this. I'm hoping people can hear like the level of doula support that can be evident with a birth and so having a doula so someone there that Good grief, can provide that labor and birth support but has been there for this pregnancy to some provide childbirth education, others don't, but they do at least encourage you know, looking at childbirth education, and that can this can set you up for more success and having that vaginal birth.

2:18

Yeah, thankfully, we've got the evidence on our side. So as a doula is statistically proven that continuous labor support from a doula can help increase the rate of vaginal birth and decrease the chance of that unnecessary cesarean. There's lots of benefits to having a doula we definitely have touched on this in many of our episodes, but it can help increase the satisfaction of your overall birth experience and helps reduce the risks the use of pain medication, which can reduce the risk of downline interventions, right, help reduce the risk of Cesarean birth help increase your overall confidence and self esteem and also helps increase your rate of breastfeeding for six weeks. There's like so many great things, that having a doula can help and just in general, the birth support team, like we consider ourselves as part of a team and we want doulas to be the norm and but we also want the birth team to be the norm. So having providers along your way and journey to support you in a meaningful way so that that you have all the things you need and all your needs met and all your care met so that you can have the best birth available to you.

3:25

Exactly, and so that that's where this comes in with helping to increase that vaginal birth rate and then if you can be supported and providing you and your partner's support, you know, doulas can do that in that aspect because when you are supported and cared for then your partner can even feel more comfortable and confident and even caring for you and supporting you as well during so it's and we like I said, we've touched on this in lots of our episodes, but we will link those like all the ones in the show notes. I don't know. There's a lot that we that we go through with the doula support. Now with and this kind of putting together so we've talked about the childbirth education aspect of things, normalizing the physiology of birth, looking at that doula support and having someone there continuously for you. You really can look at all that aspect of encouraging natural comfort measures. And so those feel like those the those things together can then lead to because when we can do more natural comfort measures and we have less interventions, then we can have the potential less of that cascade, and so hopefully increase that vaginal birth rate

4:57

100% And I think like you said, when you list out like those, those components, lowers provider doula support for support team childbirth education, you're going to learn about natural comfort measures that are going to help facilitate labor progress and help reduce interval need for intervention. And it's just going to help you have an overall better experience. I mean, I think some people are like, Yeah, I'll just figure it out. When I'm in it. And it's like, well, no, you've got to practice you have to prepare. I mean, anyone who's done any sort of major event in their life and you can speak to this to like physical event, climbing a big mountain doing a big race, really testing yourself, like you've got to practice mentally and physically kind of prepare your body for this main event, and learn about the ways that you can move breathing techniques, vocalization, mindset practices, and then positional things that can help reduce your pain perception or how you're actually feeling that because the thing is, is birth is is two thirds relaxation and 1/3 intensity. Like when you can really flip the script and understand like, you have one contraction of that entire one minute about 20 seconds of it is intense, and then you get a 345 minute break. So it's like okay, what am I going to do for that time? And then what am I gonna do between the contractions and you learn this in all of this? childbirth education, doula provider, like, they can help you with that. And so when you're when you're open to it, and you understand that it's important for you to get through this major event. If you want to do it in this kind of way. Then you've got to be prepared to take those steps. And

6:37

when with this, it's also you know, like you can still have that vaginal birth and and you've touched on this too, and like and have a medicated birth, you know, and it doesn't mean that having an epidural, you are any of those you know, IV narcotics, you are going to end up with that cascade. But having that education piece can make a difference as far as like understanding some of the comfort measures or even saying okay, I know those things. I am good with an epidural and then knowing what you can do there how you can support yourself how you can advocate for yourself and be that active participant instead of the this happening to you. And

7:25

doesn't have to be that all of a sudden you're stranded in the bed and now everything's for not getting about if you're like oh no, I know I want an epidural. We're like okay, well, we need to you need to learn about laboring early to get you to like four or five, six centimeters to get to that optimal time for the epidural and then also, how do you move with an epidural when you can move with an epidural? Yes, most people have at least some movement and with some assistance can change positions. If not going at least rotating side to side with the peanut ball. Like then you can set up and thrown position some people can get in hands and knees squatting with the bar like sideline with the peanut ball so like moving doesn't stop when you get an epidural or it shouldn't. So again, having a provider and a birth team that supports that kind of movement is going to be important because getting an epidural doesn't mean it's an end all be all at all.

8:18

But and that's why I wanted to kind of you know, touch on that too. Just that understanding of that's where that that education roll can come in as well like an understanding that it isn't that end all be all. So you can still have that great birth experience and

8:35

have hopefully a vaginal birth. An epidural is not a stamp of like oh now now you're definitely gonna have a C section. at all like, no, there's a high high rate of epidurals and it's not near as high as the ceiling. Right. So, lots of people have epidurals and Hebert give birth vaginally now understanding that having an epidural and staying on your back can increase your pushing stage. So that again movement and being as upright as possible with that epidural so that you know again knowledge knowing that and having a support system and due to there, and then the last thing I think we should talk about too and you can speak to this, this will be like our number 10 thing that we've touched on is normalizing VBAC to help increase the rate of vaginal birth because once you've had a cesarean, some people assume every subsequent birth is going to be via cesarean. And that is not evidence based.

9:26

Exactly. And this I mean, this can be big too. So you know I don't know I'm very thankful that I was able to have baby back and that I was with a practice that supports it and supported it and my desire for that as well. And so that kind of comes to that birth support team because I remember when I was pregnant and wanting to have that VBAC, and I got to a point where I was like, Oh my gosh, if I want to have a different birth than last time, I'm gonna have to do something differently. Like, yes, you know, and so I was like, Okay, what, you know, I did really only do one thing, but yeah, I kind of wish I had done a little bit more but it's still okay, at least I did something. But and I know for me, it was kind of seeking that chiropractic care, that really helping to make sure like my pelvis and sacred balance my nervous system were taking care of and I remember that just being so different and life changing now I still had that epidural. And so when I look back, and I'm like, oh, man, maybe if I had had like, better childbirth education classes, or understanding comfort measures a little bit more, you know, and kind of having maybe that doula support, maybe that would have led to that so that's why I talk about those things in the office. But still, I guess it's just the aspect of the C sections have been for whatever reason, and we've talked about that, too. So again, mine, you know, was deemed that emergency C section, but when I look back on it, I just think that there was a lot of cascade of things that led to that. And so when I look at it like that, that's where I go with my care of moms. And why I talk about certain things so much as far as who is on our support team, where are you giving birth? How do you feel about that? You know, what does this make you feel? What is your birth plan? Do you have a birth plan, like all of those little things, because that gives insight into how we're approaching birth? You know, have you done childbirth education? Have we prepared and I come at this a lot from like, I realize what I didn't do and so I don't I want it to be different for you if you are looking for that different birth and so again, that's where it comes into. Gotta do something differently, depending upon what that C section reason was.

11:46

Sure. Yeah, I mean, everyone we're talking VBAC. Like, not everyone is a candidate for a VBAC. And so you work closely with your provider. And you look at the reasons for the first feedback and the challenges in the labor or anything that happened with the babies that might indicate like okay, we should probably do another cesarean that that is the better, like, better choice or a trial of labor is safe. So you, you know, not everyone can go for or it's not safe for everyone to go for a VBAC. But for most it is, and it is recommended that you at least have a trial of labor for vaginal birth after cesarean. And so I just wanted to speak to you Shannon because I hear you saying a lot of like, regret, coulda, shoulda woulda and I think you need to be celebrated because you took ownership. of your birth after having your first decision. And you had a VBAC. And maybe you didn't get out with education, but you still were on a path of empowerment and gaining knowledge and doing the best you can what you had and what you knew. And of course, I think we can all look back at situations and say, If I had no like, I've only known this one thing, maybe I would have chosen it differently, no matter how it went. So I just want you to know that your experience is should be celebrated and like you should feel like you did a great job to overcome that first birth and do what you did to have the VBAC because that is no small feat. And everything you've learned from that you continue to share with other people and that's changing lives and so I don't want you to feel like you didn't do something right because I from my everything right right

13:27

now. No, I was super pumped with it. Because I remember, after my second was born, I even said I was like, oh, that's what it was supposed to be like, ya know? So, ya know, I like to have that little bit of Alonzo because I've gotten to a point, you know, 12 and nine years, almost probably 10 years postpartum. I've gotten to that point where sometimes it takes a minute to come to terms with your birth story, right and so sometimes and that's I even had that listed on here as like sharing birth stories. I don't mean sharing birth stories is like passing down generational trauma and trying to like, I don't I don't mean that. I mean, sharing the birth story is like kind of what we're doing here in like, I was really excited about that feedback that I had, and it doesn't mean just because I had mine and yours failed that that yours is less than or I did have an epidural on you. You didn't and yours is more than mine. Like it doesn't mean that it's more of that like when we share those birth stories and you can kind of normalize that physiology of birth. That's what I mean, not the like the movie version of it, you know, kind of saying this was my story. This was my birth story. This is how my birth unfold and this is how it changed me and this is what I learned from it. I learned so much I learned you know, I learned my strength and then I won't African learned a new profession, you know, from it. Career Yeah, and so I do honor that, but I like to look at it as like, ah, that's kind of cool. And that's where some people like, Oh, you're gonna have another one.

14:57

Right? Like yeah, I think about that. No, no, I think you're good. I think thank you. I do appreciate Of course, I just want you to feel like I see you and I think what matters and it's not to be negated, but what you didn't do and I think that yeah, yeah, because I do want to say you can do all the things and still end up with a bird that wasn't what you were thinking it was gonna be like maybe Aryan, or maybe an epidural or something. And so it's not the doing all the things is the answer. I think what you see and doing all the things Excuse me. I think what you see and doing all the things is the potential for other opportunities for growth or like the potential for just knowing and understanding more about the process, not necessarily like a different outcome.

15:43

And I've had moms who really like they're like, You know what, I did all the things. And I was informed and I knew it. But and I still you know, I've had moms who repeat C section they were going through that weave and she was like, You know what, like, I felt fully supported. She's like, I gave him all the different that it was. That's kind of the difference and even was talking to Latoya yesterday about a shared patient and we were talking about some things and she was you know what, she's had all the answers or you know, all the information available to her and this decision has come from a certain place and it feels good, you know, so that's, that's

16:22

Yeah, I haven't client that was switched providers at 37 or 37. Weeks. gone for a VBAC. Like just dead set on it and really focused and determined and advocating and then I think got to like 41 and was like, you know, I'm ready to do the C section and like made it made her own choice to do the repeats this area. And with all these all that effort, and there was way more peace about it than have she stayed where she was

16:55

and you know what that is going to impact. Oh, yeah, birth that's going to impact baby that's going to impact after work hard everywhere. All of this comes down to and rightly really increasing that vaginal birth rate is like what you said we can do all the things and we can still need a medically necessary Cesarean birth. But when we are coming from that place of like, Wow, I did everything I could with the knowledge that I had at that time. You know, like, freaking awesome. And I did you know, I did what I could and so just kind of understanding and exposing yourself to some of those things and having a little bit of an open mind to say okay, maybe I can learn this. Maybe I can do that or look at it and saying you know what? That is? That is not what I want or what I need from my brain, but at least you made an informed decision.

17:48

Yeah, yeah. We hope that that we can help plant some seeds. share something with you that maybe you hadn't heard before and encourage curiosity and seeking alignment with your path and your journey your provider, your people, and giving yourself Grace along the way. Being firm and flexible. There's, it's all about this sort of approach. And then there's not one one way to do it, and we're here to sort of support all the different ways and hopefully provide some information that helps maybe shed some light on a new thing that might point you in a direction that might might change things in a good way for you. Yes,

18:26

information overload. Sometimes I sent emails like that and I titled it like, Here I am, again, information overload.

18:33

We're gonna give information and let some of it maybe some of them lands and some of it doesn't, you know, take what works leave the rest behind. You know, just Yeah, Washington. Pete. Yeah, exactly. Well, we'll link the,

18:46

the articles or at least the back of that either,

18:52

as we mentioned, yeah, and

18:53

the other episodes which be great to know, we've talked about a lot. But we'll put those in the show notes for this to make it easy for everyone to kind of access all the information, information.

19:08

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