Ep 25 All About Vaginal Birth after Cesarean (VBAC)

Are you planning a VBAC? Have you had a VBAC and want to learn more? Are you pregnant or hoping to be pregnant soon with your first baby and want to learn more about avoiding an unnecessary primary cesarean?  Are you a birth worker looking for ways to effectively and compassionately support your clients who want a VBAC? 

Then this episode is for you!  In this episode we will share:

• The facts about VBAC
• Why VBAC is important
• The different types of providers to look for
• The importance of choosing a VBAC supportive provider and birth location
• Who is a good candidate for VBAC
• Ways to prepare (physically and emotionally) for a VBAC
• What to do during labor
• Plus lots of resources to help you along your journey.

Resources shared in this episode:

VBAC Link Podcast
ICAN - International Cesarean Awareness Network
VBAC Facts 
Shannon’s Blog “What I learned from my Cesarean Section”
LeapFrog Group (research hospital stats)
Lamaze Online VBAC Class
Spinning Babies
Miles Circuit
Postpartum Support International
Choosing a Birth Class (Pathways to Family Wellness article)
We believe that when you are aligned in body, mind, and your intuition, you can conquer anything!  If you like what you are hearing and you don’t want to miss our newest episodes, be sure and tap subscribe. Your support is greatly appreciated.

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Transcript

Hello hello allied birth podcast family and friends. You are listening to Dr. Shannon here and doula Rachel today and today is all about vaginal birth after C section VBACs. And don't leave just yet because this is for a lot of people so not even people that are just looking and wanting to have that VBAC. We've got a lot of information in today's episode so this is definitely geared for people that have had a C section before and you do want that vaginal birth after C section. So we're definitely talking about those tips there. But what if you have already had a VBAC? And then there's more resources that you could look into. So we're going to talk about that too. And our first time, momma's that, want more information and just hearing well, this is what happened to some folks. And this is what I can do to maybe avoid certain things. So we've got that information there and then birth workers. So this podcast and this episode is for everybody today. Now, here's the outline and we're going to try real hard to stick to it. Because we have so much information today. So we're going to go over the specifics of what is a VBAC? What are the stats with it? What are the stats for cesarean sections? Why is it important? Why are we having this conversation today? I'm looking at provider choice and where you're going to give birth and it was a good candidate for a VBAC. Everybody's different. So we're going to talk about that tips to prepare. That's a giant win. We've got lots of tips to prepare, and going over things to prepare before birth things prepare while you're in active labor and we have lots and lots of resources for today. So we're super excited that you are tuning in to talk all about V backs. Hello, Rachel.

1:55

Hi, Dr. Shannon, so excited to be on with you today. It's been a minute.

2:01

It has been a minute I know I was getting excited like we put the episodes out every week, but like we haven't actually recorded together in a bit. So

2:09

no, I know. So I've been very much refreshed. I know. I'm excited. I'm excited for today's topic. I think it's an important one. It comes up a lot in my work and I know it comes up a lot in your work and I think having some information to share with our listeners is really beneficial. So I'm stoked.

2:28

I know and when we come up so you know Rachel, I bounce ideas back and forth and we're like, okay, well what why don't we What about these four things? What could we talk about here and then we kind of feel them out and like okay, let's talk about this, maybe this and then we come up with our outline. And when we're doing the outline everything I feel like that's when all the pieces flow together. And we're like, oh my gosh, we have so much information to talk about with this. So I know today's going to be really good. Um, I want to start with and actually we talked about starting with some

2:58

statistics. Yes. What is it what,

3:01

what is it VBAC? And what's driving the C section rates and what's what are VBAC rates and all of those things. So what are some good statistics that you have for us?

3:14

Yes, well just redefining VBAC is that vaginal birth after cesarean, and that could be after one cesarean, two cesarean, three cesarean possibly, or sometimes, yeah, that is possible. So it's VBAC after cesarean. And I think it's important for people to know that that the Cesarean rate in our country, we have a national average of 33%. So that's one in three people will give birth via belly birth or via Cesarean birth. And the World Health Organization recommends that about 10 to 15% of people actually need a cesarean so reminder that when we need a Syrian we are thankful that we live in a country that has pretty accessible, safe medical care that can provide that for us, but also recognizing that our national average is almost more than double what it should be. Or what is considered reasonable and safe. So I think that's important for people to know and then also to know that within each city and hospital and provider that there are different rates. We live in the Atlanta area and we have rates from 50% all the way down to 11%. So you know, there's a big range out there. So being aware of that and understanding how that can impact your experience giving birth either for the first time or going for that VBAC. And I think something super fascinating and encouraging is that the average rate for having a successful VBAC is 74%. That's the average. Wow,

4:52

that's really good. That's I read that too. It is encouraging.

4:56

Yeah. And it can be upwards of 80%. I think the range is like 60 to 80%. So knowing and the recommendations to from all the big organizations like ACOG and NIH and the World Health Organization say that VBAC is a safe option for most birthing people. And so that is the recommendation and I think that's important to carry with you to your doctor's appointment, when they are stating that it's not safe. And obviously everyone's different, has individual needs and unique, you know, medical history and stuff. So it's not a broad stroke, but just knowing that that's a good place to start. And then that low and then the knowing that the low transverse sections if you've had a cesarean and it was a low transverse C section type of birth that bad decision Yeah, that is really reduces the risk of the uterine rupture and picks it down to below 1%.

5:56

And that's I was gonna say to that seems to be the big statistic that people talk about or the big concern Yes, with trying for a VBAC after a cesarean is that risk of uterine rupture. And so there's lots of things that go into that and we'll even probably address that as far as like the you know, being a good candidate or whatnot. But yes, I had the same thing that that risk of uterine rupture with that low transverse incision or scar is less than 1%. So

6:23

yeah, it's good to know that it is good to know that and that's a really low percentage, it is still a risk and it is still something that should be considered and taught and you should know that. Yes, yeah. And also knowing that rupture doesn't always mean effect, you know, fatality. With good monitoring and good care. ruptures can there's usually some signs leading into that that the care provider should be aware of and you should be aware of to have what that might feel like or look like and in time to have a safe to seryan birth to protect everyone's health. So it doesn't go from zero to 100 in a second. There's usually some indications there that that it's happening and you can get to the you know, have the the Cesarean safely. So talking through that, what that look like, you know, talking through that with your provider, I think it's really helpful and also knowing that having a trial of labor so I think it's important to talk about how if if your care provider is recommending a repeat cesarean automatically like, because you just because you had a cesarean the first time but knowing that the trial of labor letting your body start labor on its own, going through the process of laboring to see how things might unfold is advantageous and beneficial for both mom and baby instead of just like scheduling without letting labor start on its own and without giving your body a chance. So they call it till lack and that's trial of labor after cesarean. And a failed to lack doesn't mean you're you had a rupture. It doesn't mean there's an emergency event. It just means that, you know, you tried labor started it didn't progress as it should, or maybe the baby was having some distress, and therefore, during the course of labor, it's recommended that you have a cesarean and that doesn't necessarily mean that you had a rupture. It just means that the trial of labor didn't go successfully.

8:09

Yes. And that's so I'm so glad you mentioned that too, because it's important. There's different definitions or scenarios that are taking place within those VBAC attempts. So yeah,

8:22

yeah, yeah. So I think the next thing too now that we've sort of given some of the numbers and definitions

8:27

Well, I have a good stat though, too, so Oh, good. So I know that it's really big that one in three women will end up with a C section or you know, Syrian, so that's, that's very surprising, but some of the stuff I was looking at too, and some of the goals that, you know, World Health Organization and big organizations have is that from 2016 to 2018, those VBAC rates in the US are increasing and they're increasing each year. So now we're reaching you know, about 13.3% in 2018. And so the goal is to get to you know, to have those higher VBAC rates. And so that's also something to be considered an encouragement. I think it's because we're talking about it, and we're realizing the importance of it, which is going to be next of what we're talking about why it's important. And so these statistics can help drive that and knowing why it's important can help drive those statistics to

9:20

Yes, yeah, I think that's super encouraging to hear that those that numbers on the rise. I love hearing that. Thank you for sharing that.

9:27

Mm hmm. So why is it important to have this conversation like why are we even talking about this today? Right?

9:36

Yeah. Well, I would love to hear you also share because we haven't revisited the fact that you are successful VBAC mama and so I would love to hear why it was important to you and then we can kind of talk about the global why we think it's important.

9:50

Oh, so this is fine, because I actually wrote out I had a whole little section that I was going to talk about on this on on my outline, because I put for this bullet point, what we're talking about here, I said, Why is it important that we're talking about C sections and what the I wrote a blog and I said what I learned my blog was what I learned from my Cesarean birth. And that kind of that's like the driving force. I think of like, why this is important and why it was important for me and looking at the different things I could do. And so my bullet points in the blog, I'll list out here and they'll probably come up later as we're talking about, you know, like tips to prepare and those types of things. But, um, my first one was that I am not less than because I had a Syrian birth. So that's a little bit of that, you know, mental aspect of things. But yes, it can feel like a failure, you know, yeah. And then there's even other things in there as far as the failure talk within the birth world is very unsettling. I know. I don't like his birth his birth birth. Like I didn't say yes so there's that whole I'm not less van. You know, these are this is like the process that I went through. So this is why we're talking about this. C section birth is different than a vaginal birth for mom and baby. There's no There's no way around that and so at different doesn't have to be bad but there are things to think about and sizes are different for mom and how is it different for mom and how is it different for baby as well?

11:21

And so there are known benefits. To vaginal birth over a cesarean birth. Yeah, and just being aware of that all this is about awareness.

11:28

Right. So you know, it's never to be like, Oh, you had three C sections. All babies are born like this, and this is what's going to happen and blah, blah, blah. No, no, I don't. Yeah, that's what again, we don't need. We don't need the finger pointing in that. But it's it is it's like what you said that awareness and so that's why I tried to write that blog and kind of say, Okay, this is the awareness but it is major surgery. It is a major surgery. I have to say that it really really is. So it's not something to be taken lightly. No, it doesn't have to be you know, I don't want to cause fear anxiety with it or stress or anything, but it is major surgery. So looking into that, researching that and then my last little bullet point on there was addressing the emotions, so and asking for help like and researching things and looking at things. So, to me, that's why it's important. That's why we're having this conversation.

12:22

Oh, I love that. I love it. And I think that what I hear you saying is like it's understanding that why it's important to consider and be aware of the benefits of having a VBAC is that in order to go from having a cesarean birth to a VBAC takes it's a journey. And it's a journey through all the things you just listed out and that's an evolution and that's how you can sort of heal previous trauma or heal. You know, any sort of emotion surrounding how you gave birth the first time and have that more empowering positive birth, even if it ends up in another scenario because I think what you everything you shared is all about growth. And and people can go through that if they just had a negative first birth, vaginal or cesarean and so understanding that going for that VBAC is a process and that it'll lead you on to there's no way to not go through that and feel growth and feel some evolution there that you didn't have before. Oh, yeah. How you laid that out and processing all that. And, and I think having a VBAC is important, too, in addition to everything you said is is to be aware of the fact that it used to be for years and not that long ago, where it was once a C section, always a C section. And that was just like, what if you had a cesarean like, they call it a primary cesarean so that's your first cesarean then every birth after that was an automatic, they just put you on the schedule, and they you know, that's what they thought and now we know better. And now we know that there are more risks to repeat Cesarean birth to an automatic repeat Cesarean birth versus a trial of labor or VBAC. And we know that vaginal birth has a shorter recovery, shorter hospital stay lower risk for infection and less blood loss and not to mention all the benefits that come to baby by getting the big squeeze. That helps remove all the fluids from their lungs and ears and nose and throat as well as getting that good bacteria coming through the vaginal canal. But there is an alternative to that called vaginal seating. So something I hadn't even thought about talking about till just now that you know, you can have vaginal seating through a cesarean birth and it's a whole thing but you should look it up.

14:39

And exactly well and here's the thing too, I think is um if if you look at all this information, and so you had a certain birth and you know, things didn't go according to plan or that was just the cards you're dealt and you're looking at all these things and you get all the information you're like you know what, I still feel best and most comfortable having another Syrian well that that is amazing because you are empowered and you have made that decision so you're not going to get to the end and be like ah shoulda coulda woulda, like I think that I want to say that because I deal with a lot of moms that, you know, kind of had that where maybe their provider didn't talk to them and say that this was an option. I mean, I'm fortunate that my provider did. But even without that, like it's it's knowing that this is an option and you've researched it and that is the decision you made and so again, you're not less than you're not before any of those decisions that you know because you were using your best interest in mind for you and your baby and what is best for you.

15:46

Yes, and that looks different for everybody. And I think that's really important to drive home this this is not a it has to be done a certain way to have that positive, empowering safest birth at all it is considering all the information considering your previous experience considering your unique circumstances, your individual medical history, your support system. How that first decision when that couldn't you know there's so many factors that have to be taken in and that if you have the room and space to do that and make the decision for yourself, that is different than being told by a provider that it just has to be a certain way without really giving you the chance to work through it on your own. Yeah, and I think that's what you're saying and that's the growth and that's the it's not a right or wrong.

16:31

It says thank you. That's That's what I was trying to say there is no right or wrong.

16:36

It's an awareness and that's all you ever want to do. And I think I'm with you and that's why we enjoy these conversations is that we always want to allow space for different opinions or different feelings or different decisions. And I've never want to make anyone feel like it has to be a certain way for it to be good or right. So just re emphasizing that and I appreciate that you met up.

16:59

Yes. Because that's the point of this podcast. And so again, that is why we are talking about this today. Yeah, bring awareness and light to those to the stats to this information.

17:12

Yes. Can I add one more? Yes. One more thing that I think is an important reason to consider that VBAC is that if you've had one VBAC and then you go, I mean, I'm sorry, one cesarean and then the second time you're going for the VBAC, and you and you get that vaginal birth, your chance of having vaginal birth after that greatly increases and your risk of uterine rupture is much lower and so it with each subsequent vaginal birth after cesarean which again, depends on how many kids you want to have, but it does increase your chance for that even next vaginal birth. Whereas if you have a repeat cesarean, you know, it goes the other it goes the other direction. So, why it's important to go for that VBAC or have that trial of labor is knowing that it can be safer for subsequent pregnancies and births.

18:03

Yes, and so that's a good segue into what we want to talk about next because one of the first things you can do to try to set yourself up for success if you looked at the statistics and you are wanting to attempt a VBAC is looking at the potential like the choice of provider or where you want to birth and starting there and doing those interviews. Finding those people finding those locations, listening to how those providers are speaking to you and I know you have lots of really good information about this and the types of providers

18:44

Yes, I just as a birth doula and childbirth educator I all too often hear birthing people say you know my providers VBAC friendly, they've said I can do it. And then when it comes down to it, it ends up that they're not. They sort of, you know, they early on in pregnancy when mom's real eager to make sure she can have that VBAC. They're like, yeah, yeah, sure. We'll talk more about that later or it's early. You don't have to worry about that yet. And they kind of kick the can down and then you know, you're 3536 37 weeks pregnant. They're like, Okay, let's go ahead and get that cesarean scheduled and you're like, Wait a second. And not to say that happens all the time. But being proactive and your choice of care provider and making sure it is like, what they're telling you is the truth. And it is I'm not saying they're lying to you, but it's just I see it happen. And so just being aware that there are different types of feedback providers, there's the non supportive VBAC provider and that's when they're clearly encouraging a repeat cesarean over a VBAC or a try.

19:49

You know what I would rather than just come right out. Yeah, like, you know what, yes, this is not Yeah, I'm not worth this. Like I would much rather you just come out and say that, you know, and I actually just talked to a mom who was pregnant with twins. She's actually a local chiropractor. And she was pregnant with twins and wanted to have a vaginal birth because she'd already had one prior. And she went to see this real because one, I think one baby was breech. I don't know, you know, have twins are they just do their own thing in there. And, um, she was talking to the provider and he was very much just like, and he's, you know, well known, like in being able to deliver twins. And she was talking about how he just flat out said, it was like about the money like and the differences there and he just flat out told her and I was like, You know what, I'd be like Thank you. Thank you for telling me because I just, you know, like,

20:45

I ran around, shoot, shoot my brother. Right? Yeah. From the get go and I don't, that's the pressure washer. There's a problem there because they're not. They're not recognizing that the recommendation and the benefit to that trial of labor in the back but at least they're upfront, and you can kind of say, Okay, thank you, no, thank you and move on. But that's that's easily identified. It's the ones who are more they fall in the category of tolerant and they they quote unquote, allow me back. I don't love that Burbage. But they but they express many conditions that it like, make it allowable, like you have to have XYZ ABC 123 factors in order to have the VBAC, which makes it feel impossible to achieve. And they are if they have like a high Cesarean birth rate, so that would make you know, keep them under that they're more tolerant category. And that those are the ones where I feel like that's where moms get the sort of bait and switch as where where they're told in the beginning Yes, I support or I do or you're allowed whatever they choose to say to have a VBAC, but then they don't really support it or they spend the entire pregnancy fearmongering Yes, like if one thing goes sideways, then you aren't. You don't fall in the category that's quote unquote allowed to have the VBAC. So that's the least that's the ones that I think get people messed up the most, because they send mixed signals, and then they ultimately end up probably not not getting that feedback. And then there's be back supportive and this is what we're looking for. And this is what I think people deserve. And that's that fully supportive of VBAC and they work with you to achieve your desired birth as long as medically safe. Obviously, always keeping keeping mom and baby safe through the whole thing but really, truly supportive and doing everything possible to help you get there. And those kinds of providers are the ones that if you end up with that cesarean then you're more likely to feel like okay, I have that support during pregnancy. I tried all the things I gave it the time. This just isn't in the cards until you have a better peace of mind about knowing that it was truly needed versus that wondering, What if is this how, which is what I hear a lot when when primary Syrians happen and they feel like they weren't the quote unquote necessary or for the VBAC, who are going for the VBAC, but then they don't get that chance to even go through the process of trying. They are left feeling like well, what if and the goal is to not feel what if even if you end up meeting us this area?

23:36

Yes. All of that. All of that. It's so very true. And you even mentioned because something that's good to to look at is if you're dealing with someone or a practice that is more tolerant. And so if they're saying early on, oh, yeah, well, that'll be fine. We'll deal with it later. Blah, blah, go and check their stats. Mm hmm. Yes. Because I think that's going to speak volumes. You know, where are you birthing? Check that are you gonna do the hospital, you know, where are you going? Check those stats, especially if that practice because that's going to speak louder

24:16

than their words, for sure. And you can look up I mean, they should be able to tell you if you say, Okay, you're telling me you support VBAC, how what's your VBAC rate? what's your what's your overall cesarean rate? What's your primary cesarean rate? They know these numbers if they don't give them to you? That withholding like there are there they're saying they don't know that's not fully forthcoming. And there is a great website out there called Leap Frog group.org And we'll link it in the notes and you can go look up hospitals, you can't look up individual providers, but if you know your provider and where they give birth, you can look up that hospital and see their statistics under maternity services. And that can help you have an idea for what that looks like. Unfortunately, not all hospitals report there like one of the major ones in our area doesn't report there. Which makes it hard to be fully transparent. But that's also sort of indicative of of that particular place. Yeah, why? Why are you doing that? Reporting? Now? There's your There you go. That's funny.

25:32

Oh, yeah, no, no, no, go for it.

25:33

I was gonna add one more thing as far as choice of provider because like to just tag on to what you said as far as like if they say they're supportive. And you're gonna go look into their stats. That's, that's one component. I think the next is to look for either friends, family or even on you know, Facebook groups and stuff. Other people who have been under that providers care and given birth with them and or at the location that you're choosing to give birth. And look for ones who have had a VBAC or had a cesarean or whatever, and try and tap into their experience and let you know, find out from like, real life experience, and I know like, there's always gonna be the one off either super great or super bad experience. So I'm not saying to put all your weight in that but hearing from real life experiences can be more than just listening to the provider.

26:22

Yes. And that's putting you in a safe space of saying like, I'm going out and I am seeking this information rather just being sometimes you can just feel bombarded, you know, with stories or whatnot. So yes, being selective in that finding those people reaching out to those people and say, who has had an experience because I even work with moms don't like hey, you know what? I have this jeweler that I know she's done a couple of VBACs at this hospital. So she's got some clients that will probably talk to you like that is that is key, you know, of that. Yeah. And I had another thing with that because I had a mom and she was in a bigger practice where you're trying to, you know, each appointment you're trying to see a different provider there. And that can even within a practice, you can have huge differences because she was dealing with a couple that were like no no VBAC, no VBAC, and she had just had, it was just a breech birth so she was coming to me because her baby was breech before she had the sees that the Cesarean there and then now we're under chiropractic care babies in optimal position. You know, and so she finally found a provider within that practice and she was like, I love him, and he is, we're gonna do this. So it was, you know, that was kind of interesting, too. So really, again, we've talked about that in some of our episodes of like, Who do you align with, you know, what is your vibe and what makes you feel comfortable?

27:49

And so attention to that those bits and I think that's really important and I will also give a little bit of caution though, is that you might find one out of 10 providers that you love in a group but that may not be who's there when exactly and who's there and you get the guy who or gal who was like a hard No, you're gonna have some resistance to overcome and I'm not saying up and switch but being aware like okay if it Provider A is on call, and that's who I wanted. What's my plan and I think advocate being prepared to advocate for yourself having a doula having your partner on board, you know, going through that plan. is even more important in that scenario.

28:31

Yes, I love all of that. Now, that kind of leads us like I want to talk about tips to prepare, but we also have there are good candidates for a VBAC. And there's lots of different indicators. There's lots of different histories that go in to who is a good candidate for

28:57

a VBAC? Yes, and I think it's really important to note here that there's no one size fits all there's no hard and fast rules. I think it has to be addressed on an individual level. Even if you have all the meat out, you check all the boxes, it doesn't mean you know that there's not other factors at play. Or if you have you don't check all the boxes, it doesn't mean that you're completely ruled out. But there are just some things that can increase I guess, the chance of being successful VBAC and I think there's a VBAC calculator out there. I've heard about it. I've never actually looked it up and I don't know how accurate it is. Are you familiar with I have not heard of that. Okay. But it would kind of take into account some of these primary things and then there's another image so I'll look that up and see if it's worth including I was going to ask you if you had heard about that, but um, so yeah, I think it's on a case by case. What else do you think makes a good or have you learned in your research process makes a good candidate?

29:57

i It really is case by case because and I think some of the things that we'll talk about in the tips are rare can be, you know, case by can be a part of that case by case, you know, because sometimes, I mean, the big ones that come to mind and what I hear mostly it has to do with SCAR issues. So if you've had that previous Cesarean birth, there are certain types of incisions that are pro VBAC friendly, and then some that most offices, hospitals, obese are not going to want to work with and so it's really asking those questions. Okay, well, why does this scar what does the scar present and why does it present this way? And why did you have that type of incision, it really goes through those questions, because that is all different for everyone. Because and that dealt with lots of different lots of different scars. And so again, I think it's not just that scar because it could be why did we have a horizontal cut instead of a low transverse or those types of things? So it really is going into that personal history there. And then again, another big one for me is the baby positioning. That seems to be there's not too many providers who will burn birth allow the birth of a breech baby vaginally,

31:17

right. I mean, they won't do even a trial of labor. Breech baby in a VBAC. Is that what you're saying? Yeah.

31:24

Yeah. So

31:26

those types of things. Yeah. And I think

31:28

kind of present to me as far as the ones that come to mind. Yep. And yeah,

31:33

so I think that low transverse cesarean I know, we know that's the optimal, the optimal cut to for having a successful VBAC for future pregnancies and births. And so I think that's important to note here. For our listeners who haven't had a cesarean that if they give birth, and it is via cesarean to be sure that their care provider so long as it's good for mom and baby, that they get that low transverse cut, and that they double suture. There's like a way to also close up the the incision to make sure that it's extra secure. And so talking with your care provider before before your birth in the event that you need a surgery and about how they do it, so that you can express how you want it done. So you can have that be back down the road if needed. And so that's a lot of being proactive, but it's worth it. If you can have that be back down the road. So for those moms who haven't given birth yet, then that's important to to consider and then I think a couple other things that they talk about is only having one prior cesarean yes an indication for you know, so it's not impossible at all. I know mamas who have done and after two or three scenarios that can be done, but it's like the risk factor sort of increases at a certain rate, and then finding a provider who will support you know, multiple Syrians trying to go for that VBAC. So that just puts you more in the good candidate side. It doesn't mean it's impossible. And then if you've given vaginal birth before, let's say like number one was vaginal birth number two was to seryan. And you're going for number three, like the fact that you've given birth vaginally puts you in a good place to have a VBAC. It just improves that sort of if we're like talking about boxes to check. Yes,

33:20

and I think one box two is I mean, maybe I said this I guess it was I mainly set it in like why did you have that certain type of incision but like, what led to that section? Yeah, you know, like that. plays a huge, huge part. And I'll share my whole story with the two because they're almost everything we're talking about. I have something in my mind of, Oh, yeah. This is how it went for me. This is how it went. For me. This is how it went for me and like it's very interesting. Kind of going back through this as well. And in that process, and so like what led to that C section because there are going to be certain health and aspects of it because I've even had moms where they were in a very serious car accident as a youth and they had severe spinal trauma. And so like, we they went that route because this is there was just that risk, birth versus benefit and those things so take it all in the computer have to take all of that into consideration and understanding those things. So that's part of who was a good candidate as

34:29

well. Yeah. Knowing that medical debt medical history Yeah, the the base the health of baby mom, current and, and history have all be taken into account. And I think we've been we've can it's easy by how we've sort of gone back and forth to say that it's it's not a one size fits all.

34:48

No, no, we're all so different. Yes. Well, yes.

34:52

Take a moment to share a little bit about your experience since well,

34:58

I don't know if I want to do it here or towards the end because there's still some things coming up that okay, we'll talk about and I feel like maybe that could I would kind of bring everything home because I can kind of go through it because I've just kind of in my head thinking of that. So yeah, let's do that. Let's do let's do that towards the end because I have some more things but so if you you've gone through this, like who is a good candidate and you've analyzed this and you've talked about this with your provider, you've looked at the provider location, like what are some other tips that you can do to prepare? So in this prenatal timeframe of what can you do to prepare and to give yourself the most successful route of having a VBAC? There are no guarantees in life, there's no guarantees and birth. So you just got to put that out there. You can do everything and do everything perfectly right. There's no right or wrong, but you know what I mean, you can do everything. I did all the things and did everything that everybody told me and I still ended up with it. So right so we've got you know, we'll talk about that later. But what are some things that you have seen? I'll talk about what I've seen, that have helped moms empower themselves have helped them have a successful VBAC?

36:13

Yes, and there are many there are many and a lot of them kind of go side by side with just preparing for birth. In general. But one of the things that I think is uniquely different for a VBAC is the the addressing of previous trauma or negative experience or just addressing face forward the birth you had the first time and if we're talking about back then it was necessary in birth, and maybe it wasn't necessary, but it was more of a trauma filled or negative experience. So it kind of applies to both if you've given birth before and wasn't what you wanted and you have some trauma surrounding it or you have a hard time like going there like you have a hard time talking about it. Maybe you have a hard time looking at or touching your cesarean scar. You know, I think addressing the emotional needs of it is really important because you've got to look for that first for the rest of the things that we're about to share to make a solid impact to be as beneficial and effective as it can be if you haven't worked through the and it's an ongoing process. It's not like a one and done. But start there. I think you got to start there. What do you think?

37:24

Um, I think that's huge. It's addressing the trauma, and I wrote that down as well too. And, you know, or it doesn't have to have been traumatic is just addressing that previous birth, you know, so it can be addressing that previous Cesarean birth how you felt afterwards. I love Postpartum Support international because I think that's a great organization is a great place to start. There's free resources there stuff and then you can hook up with like local people in your area like support groups, other moms that have had birth similar to you like all of those types of things, addressing it, because that's kind of like that mindset aspect of things like we we need to be in that good mindset space. For I think the other things to fall into place easier.

38:16

Yeah, that's what I agree with that.

38:18

So I think I know I think that's, you know, I think that's, I think that's step one and part of

38:24

it. And that resource is really helpful as well as the ICANN has an international cesarean awareness network and they have good resources on preparing for your VBAC. And I think that involves working through some of the emotional mental holdups that she might have and maybe you have that you're not quite aware of, but it can help you sort of, you know, unearth them so that you can work through them so that you can have that, that awesome birth experience that you deserve.

38:54

Yeah. And I know that that's such a good place to start, though. You know, with that, I think, too, and you even talked about the issues with the cesareans

0:01

Got it. Maybe there's stuff there too, like I have being aware of what's going on with that cesarean scar is huge too. And so like that healing process too. So I think that's part of addressing the trauma and addressing the motions is looking at not only that mental space and that mental health part, but that maybe that psychosomatic aspect of things too. I see that a lot. I deal with that a lot in the office, our body holds can hold emotions can hold things and so sometimes that scar work, whether it be massage therapy, or some of those therapeutic aspects of working with the scar and helping people is a big part of of that as well.

0:51

Yeah. I think he'll in many ways after that first birth if it didn't go how you want it and and seeing your scar as as beautiful and what brought your baby into this world and that your baby you know, birth his birth and birth as an emergence whether it be from your belly or vagina and so just working through that and getting to that place and it is not easy. And I think having someone like a perinatal mental health counselor on your birth support team, someone who can help you process so we all have friends and family who love us and have good intention, but they may not be able to really help us process in the way we need to process and so maybe it's one conversation maybe it's every week you're talking with a counselor but really someone who can help you work through that. And and I think that that they can even help you address scar issues and not the NASCAR mobility so that might be someone separate but even just your feelings about your scar and seeing it as as beautiful. I don't know if that's

1:52

yes, it's like it's multifactorial there. It can be several different issues with the scar but you even mentioned, I think it's like our favorite word on the show is the birth support team. And I think so I you know, I don't know whether it's what comes first, whether it's like addressing the trauma or like that birth support team because I do think that people that can help you address the trauma can be part of that verse 14, so it kind of goes hand in hand but that's really looking at we have several episodes on that before. And we've interviewed people that can be part of your birth 14, which is fun, but that's looking at those people that can support you. So remember, we talked about even that choice of provider looking at are they tolerant or are they really supportive, right? And then even obviously, the doula support too. Yes. And having that be a big part. Of your VBAC first support team.

2:43

Yeah, and I think a doula is a good place to start as well as chiropractor and I'm not saying that because that's what we do. But you know, sometimes you're see Mama's before maybe they've had their primary cesarean and they're not even yet pregnant with the second and then they become pregnant with the second so maybe you're the first line of of provider who is going to help begin supporting them and providing resources and especially someone like us, who has that emphasis on on the prenatal care and postpartum care and providing resources and information so just even alone being like in in line with a care provider, like yourself, who is going to be providing all those extra resources might be the first place to start. And if you're not seeing a chiropractor, then you can maybe look for one who who can help you like focus on those things that you need to focus on. And then obviously, a doula and I think that's another great place to start like if you if you know you're going for that VBAC, and you know, you're obviously pregnant, like start there because they can help you find they know, the VBAC supportive truly VBAC supportive providers, hospitals, so they can kind of help give you recommendations and I know there's so many options in our area and I'm you know, people are listening from other areas. It's different for everyone, but it can be overwhelming when you go to look and you don't know they don't put it on their website. They're not like VBAC supportive or Yeah, like it's usually not there. And so a birth doula can help you maybe narrow down to a handful where you can then go and have conversations with them and help you help you find a provider you align with because it's not like they're gonna say, Oh, you must choose this one provider. They're the only one they're going to give you options. That's our as a doula, that's what we do. We're like, Okay, here's an option for this hospital, this hospital or home birth, and here you go. And then you can go do the research and find which one aligns with you. So, again, hiring a doula is a great place to start. They're going to have books and resources and online groups and online websites to point you to so that's already curated, it's already organized. And then you can just hit the ground running instead of going to Google and being like, Okay, what now? They can just help along that path. And

4:50

I want to add to that, I feel like doulas have such a different perspective than what I'm going to have because you are there during the birth. And so you see the interaction. You see what happens with the provider and us watch it all unfold, you know, on my end, you know, I'm not typically there at the birth right. So it's that I hear from the mom like this is how I felt or I felt supported, not supported those type of things, but you is that deal you can see that interaction. So you have that insight as well to to know how to best support someone that's looking at a VBAC.

5:33

You know, yeah, we can share those real life experiences and talk to them about what might come up and, and their options and yeah, so and

5:41

you have clients that might be willing to share too and like, Hey, I've had a client that birth year and I've had this one of them. Yeah, and that way, because I know a lot of times I can try to do that too. Or you know, just kind of say, hey, cuz you know that that gives them a safe space to reach out and ask those questions, someone who's just a lot like I can't,

6:01

yeah, and you've blocked it too. So you're also like, when you speak to your patients, you are speaking from experience too. So you have that, that you offer as well. And again, that's invaluable real life experiences, and then someone who's walked through the steps and done these things like you know, like, it doesn't just happen, I mean, it could for some, but for the most part, it doesn't just happen, especially in our medical care system. You have to be proactive. You have to consider walking through these things we've said here and knowing that each time you you do one of these things, it's going to unfold something else you've either learned about yourself about your provider about something else you can try or consider. And I've never had a client or a student or a friend who's been like, I just wish I had known less. You know, so even if you go through all that, and X y&z doesn't come up like okay, or or goes a direction you weren't hoping it's like okay, well, I know at least I knew about what was going on, you know, I am so that leads me into talking about like the birth planning process for a VBAC is very, very important. Because it walks you through all the potential things that might come up, especially specific for for VBAC. And so with a VBAC and trial of labor. You they're going to want to and especially if you're in a hospital setting, do continuous monitoring. And so do you know that that's what they're going to do and have you considered how you're going to labor and stay active while on continuous monitoring? Like what what is different, that will come up in that hospital birth when you're doing the trial of labor? For for a VBAC, versus, you know, a normal labor or So just being aware and the birth plan can help you walk through those things, and it's a great, great communication tool with your care provider of like, okay, well how does induction work? If I'm a VBAC? How do you feel about going beyond 40 weeks? What what other interventions occur for me in the hospital setting once labor has started? What will necessitate another cesarean because it might look different for you than someone who hasn't had a cesarean before and so knowing what those are, and so that if they come up during labor, you're like, Okay, well, we've already talked about this. I know this might have happened. So now what? So having those conversations with your care provider beforehand, is really, really helpful. And so I like to encourage walking through the birth plan, not because we need to plan birth, but because we want to be aware of the options along the journey to giving birth, and we're really going for that VBAC. So it's gonna be very specific. And then also very important is that Cesarean birth plan. And so I have a lot of clients who are like, well, I don't want to give a lot of energy to planning for this area because I don't want that and I'm always like, I hear you. I'm all about positive mindset and staying focused on the things you want. However, if you need a cesarean, which there is a chance you might need it, don't you want to be aware of your options, having that cesarean and and what can make it a positive and empowering experience? And so and then they're usually like, Well, yeah, and so it's likely that we're going to make a plan B, and you're going to talk to your care provider about what this looks like and know your options for that birth location. And boom, you are like, Okay, I feel like if this comes up, I'm not as scared of like, well, what's going to happen? How's this gonna feel? You're like, Okay, I'm going to put that in my pocket or in my hospital bag, put it away. And only bring it out if I need it.

9:20

Yes, I love all of that, that you said with the birth planning process. It's, it's still important to do. If you are wanting that VBAC. And it might look different, then, you know, that birth plan you had first time around, you may have different questions and it's exactly what you said. So I think that's so important and that plan B just to seryan plan, just it's not that you have to put energy towards it towards it, right. Like it really is looking at your intentions with it. So and saying okay, I want to be prepared. So I cuz I too, I mean, my gut reaction is I don't want to put energy towards that like that literally is my gut reaction with it. And so you know, going into my store a little bit I definitely didn't look into anything about you know, that was not an option for me because my first birth as is not going to happen. Nobody says everybody else is gonna be amazing birth. So I didn't put any energy towards it, but maybe I could have been more intentional, you know, and looking at that birth plan. So I love what you said there. And, you know, on my notes I had like, understanding those risks versus the benefits for the interventions. That's all part of that birth plan. So those are those questions that you're asking and saying okay, so I mean, that's important to know. And it's good to know you have to ask those questions. Because again, we've talked about everybody is so different. So every birth is different. There's no no one size fits all. So I want to know why specifically for me, is it this statistic or this one and that type of thing, too, so

10:44

and you can learn that through childbirth education, so maybe

10:48

you're saying Did you read my mind? Because that was the next thing on my thing was childbirth education.

10:53

Yeah. Well, you went into it perfectly as far as like well, about the risks and benefits of the interventions. No better place to learn that then childbirth.

11:02

Yes, and there's um, I feel like I have shared before I'm going to put it I want to link it in the show notes. There was a I love this magazine pathways family wellness, they talk a lot about birth, and there was one article they did about hospital childbirth education classes versus independent childbirth education classes, and I know we've talked about that you've talked about that, you know, as well, too. So, um, that's important to look at though. There's lots of different types of childbirth education classes. So

11:36

yeah, and I was gonna did an episode on that. Yes, I did. And I obviously have childbirth education classes, but I also refer to Lemov has a VBAC specific e learning class that I can link in the show notes that I you know, I teach about general childbirth education, and I don't have like a dedicated section for VBAC. So I always refer to the Lamaze because I'm Wilmont certified. So I refer to their Lumos course that's specific to VBAC. So you could do a childbirth class and then add that as like a a bonus learning session that I highly recommend that you get, you're going to walk through the whole you know, normal stages of labor, intervention pros and cons. You know, the emotional hormonal connection of everything, physical mental recovery, all that stuff, and then into the postpartum. So yeah, you definitely that's a good place to a good thing to add to your you know, birth support team.

12:36

Yeah. Great. And I was gonna say, too, we even had educators on there, at least on my support team, and then that's what I roll up into that aspect too. Is that childbirth education. So,

12:49

and I think you mentioned this earlier, but I wanted to add to for the birth support team is a physical therapy for that scar mobility. And there's a great I mean, there's some great physical therapists in our area, we can include those in our resources, but also online there is that Mama stay fit. I don't know if you follow her but she's a VBAC. Mama and she talks a lot about scar mobility and physical like how to take care of the physical body and recovery and core and pelvic floor and all that but she talks she has a special like section for scar mobility and I know physical therapist and pelvic floor therapist can also help with that. So

13:32

yes, I mean, it's gonna be discriminability but then you also got to think just because you did have a prior Cesarean birth doesn't mean that your pelvic floor didn't take a beating. I don't know. I don't know how to put it any other way. Like didn't wasn't impacted. You know, like it is definitely impacted because you were carrying this baby. Right for, you know, that gestational time. So there's also aspects to maybe in your journey for that reasoning for this section was some pelvic floor dysfunction. So it's always something to look at there too. And I like to go with that as well. So it can be the to like looking at the scar work and looking at the abdominal muscles, and then also looking at any of that muscular pelvic floor dysfunction.

14:21

Yeah, well, what do you do with your feedback? Mama's like, I know you'd like to talk about baby's positioning and obviously, chiropractic care. What how does that help and tell us more about that? I mean, I know how it helps, but like, Yeah,

14:35

I know that was on my list too. So with chiropractic care in that prenatal realm, you I mean, it is advisable to find a Webster certified chiropractors. That's one who has taken certification in working with pregnant women and working in that postpartum aspect, too. I think so it's kind of all in there, but it's with chiropractic. You're really looking at the function of moms. So it's like nervous system of mom rolling at pelvis and sacral alignment, balance and nervous system aspect and that Brain Body Body brain connection, because you do have the uterus, suspended by all these amazing ligaments, the broad ligament and uterus, sacral ligament and round ligament and those ligaments are attached to bony structures. And so if we can ensure that the bony structures in mom are aligned, and have that optimal shape and optimal function and optimal nervous system function, then that can allow for optimal fetal positioning. So that's really it with like Webster techniques. So again, it's never, you know, breech baby flipping or any of those types of things because it's not I mean, I love babies, but it's not about the baby in that aspect. It's about mom and can we help mom? And, of course, there's limitations to matter. I'd work with quite a few moms that have by khornate uterus, and so there's all kinds of things and you have a way higher chance to have a breech baby with that. So again, you know, obviously I'm not gonna be able to just shape the uterus. If you've got anatomical issues. There. But generally speaking, if we can make sure pelvis and sacrum are aligned and that that birth canal is in that optimal, you know, functioning alignment, then it can help set mom up for that VBAC success. Absolutely, yeah, and especially to if you know, first time around baby was breech. I'm looking at some of the things and I know what a lot of times it depends on what my VBAC moms because, again, it goes to Why did you have a C section for so we go into all of that. And so it really does depend on what was the issue before and if there was breached before, then definitely they're under care. And that hopefully they come in a little bit earlier in their pregnancy too. But then it's looking at I like spinning babies a lot. And there's the mile circuit, isn't it the mile circuit Yeah, it's the Ninth Circuit. And so and you know, what's amazing is I recently had a mom who was in a big practice, and they were giving her the mile circuit recommendation. Like it was really nice to hear these providers like using those things. I know I was really excited because I'm like, I I'm not used to hearing I'm not used to hearing that for more reg OB practices, right, you know, so those are some of the things that you know, I go over with moms but again, it's just so different for for each individual person.

17:43

Can I think being aware again, being aware seeking that care, knowing that you can have, do some daily activities, have routine care under a carpet or a pelvic floor but a physical therapist, like add these things to your like, to your activities leading up to the birth can all help with that optimal fetal position and not just where the baby's at, but then, like you were talking about, the alignment of the pelvis and all of that, getting that in as best place as possible. I mean, everyone still has variation like you've said, but again, awareness that that is helpful right having baby in that optimal position, head down left side is gonna certainly improve your chance of having a VBAC versus having any other position. Yes,

18:25

exactly. Um, you said something that kind of stuck with me and I'm going to segue into a little bit of my story, and then I want to go back and hit all of these things. We've talked about because I think I have something that applies to me in every single one of these areas. And, you know, moms, probably other other moms probably do too. But um, you said, be proactive. It doesn't just happen. When you are meeting as far as that'd be back like you're gonna get just an effort, right or do something there but I have to say I think with my first is, um, I was kind of thinking it would just happen like it was I went to I was in a OB practice, but they had midwives there, and I I liked the midwives better. I mean, again, I knew nothing about birth at this point. I may or may not have known that you also have diverse the placenta at that point in time. Do you know what I'm saying? So I'm talking like I said, a lot of stuff learn so I just listened to you know, I saw the obese I saw the midwives I really liked the midwives. And I stay there. So as far as like towards to provider like, I liked the provider that I had, everything was good there. But then I only I took their hospital, you know, birthing classes. I was birthing in a very big hospital in Atlanta. And so that was just that was just the route. That's what, that's what I knew from that time. And I think we've even talked about this in a lot of other episodes, too, as far as like, where do we learn about birth? You know, mom is probably based a lot on media presence, and this is what you do and you're in the hospital and you're back and you're screaming, everything's horrible. Like it was kind

20:05

of your only that was it.

20:07

I didn't have I know, I know. So. Um, so that first time around, I feel like I could have been more proactive. I don't should on myself, I should have been more productive or whatever, but I could have right so um,

20:24

you see the areas in there where Yeah, there was you could have done something slightly Yeah. So

20:28

you but that's where you go, you learn from that. So then I did end up with what you know, is termed my emergency C section because I did labor for 27 hours or someone in there and I did end up pushing for about two and a half. They did vacuum all of those types of things. And then I still ended up with that emergency C section. And so I think I've said recently in something where like, I felt like I had given birth, vaginally and through this area and because I've been through a lot Oh my God, so that recovery was in St. And I felt so unprepared because I that was not part of my birth plan. I didn't put that energy towards looking into what is the C section what is done there and how is it done? So that was I think that was part of the trauma for me is and that why I wrote that blog? Because I did feel less than I did need to address the emotions, holy crap. It was major surgery and it took forever for me to recover. And it was a different it's different than a vaginal birth for me and for my baby. So those were those big nuggets that I kind of took away and I get to read the blog because it's not all doom and gloom like you know, I did learn a lot from it. So I do put in there things I wish wish wish wish wish. And then I have other things in there as you know what I what I did with it. So second time around. Um, you know, this was really funny. This is what I don't remember this time the midwife after I I don't even remember when it was in Actually no, it was after I had the C section and I mean, we were in the hospital for five days. It took me forever to get out of there. And the midwife was like, Oh, you're a perfect candidate for a VBAC.

22:09

What an amazing thing to say the I know

22:11

so that was amazing. My first thought was like, Excuse me, lady, I am doing this again. I have a bike. Oh my god, Zoom too soon. And I'm like, hearing that like that. She spoke that into me. And I was like, oh, there's no other option. We're totally see planted that seed and so it was amazing. Exactly. And so I think that's why, because I didn't, there wasn't a failure. It was just maybe I didn't do the things that I could have done to really make it easier. You know, he wasn't too big. My pelvis wasn't too small. It was you know, he was sunny side up all these little things that kind of I had a lot of fear. I had a lot of fear. I've talked about that before, too. So there were all these little things where she saw and knew and was like, No, it you are a good candidate because of these things. And I think to that, I think they proactively were thinking of those things for their moms because I think everything they did helped lead me up to having that because I did have a low transverse scar and have to worry anything about the scar. Um, so that choice of provider you know, hearing that from them I was I didn't go anywhere else. However, I was still birthing at that same hospital that probably has the highest dissection rate in Georgia. So there's that as well too. But I felt so comfortable with your private providers. So you know, at the heart of it, that's part of it. So that was part of you know, like they told me I was a good candidate. So I was like, Okay, I could do this now. Um, well, I still think of the things that I could have done. I still did not have a doula first time around, and I wish I had and I did not have a doula second time around. I don't know why. I think i i The only thing I really did differently. I didn't even take different childbirth education classes. Like, I kind of wish I had taken some independent ones and learn some other techniques because I went medicated with both births. So yeah, it would I didn't necessarily want to but I also didn't set myself first up for success for that either, right doing some of those things. So these are the things this is why I talk about this to my mom's but I wish I had had the doula with that with both births, because I know I could have I could have had some different tips and so could have done that unmedicated birth. I know I know that was out there. But that's okay. I went and got I got adjusted. I've heard from friends and family. And so I went at 36 weeks and started under care and follow the care plan and that was the pivotal change for me. So that was that 20 hour difference in labor and delivery and I did have my VBAC now I mean, there's there's other things, obviously that that people can do. And I know second time births are always are always different, right? Every birth is different. So it's not like oh, just because I was under care. Everybody's gonna have a VBAC. But you're not it was. It was very big, but that was the one thing where I was more proactive that second time around I think I had a little bit more awareness so it didn't just happen. I did put in some work, I probably could have put in more work and so that's why I always talk about that to my moms. Because sometimes it isn't just doing and changing one thing, but and sometimes it is sometimes yes, sometimes it is. I mean,

25:39

my that was you were in tune with yourself in your body and you trusted yourself and you did exactly what you needed to do and that benefited you. And I think that's a takeaway. Instead of feeling like there's always something else to do. There's always I mean, you could do 10 of the things you said and there could still be something else to do, but recognizing that you sort of were in tune with more in tune with yourself, being more aware of your options, you know, trusting your care provider, getting the chiropractic adjustments and that I mean, that has been a bit and recognizing making even one change. So that's also I think that's an important thing to drive home to is like we're listing all these like tips to prepare. That doesn't mean you have to go out and do them all. That doesn't mean you have to hire a doula take a childbirth education class, have a chiropractor and a physical therapist, and whatever else I don't even know what other like extra thing to do other spinning classes. It's, it's find what aligns with you find what resonates with you and start there and do that. And if it leads to more doing more things great, but it's sometimes it's just one shift, one that can launch you in the right direction. So just being aware of the potential and knowing that you can you can have some openness there it doesn't mean you have to do all the things to be like I did all the things. No, it's just that overall awareness and just mindset of being proactive mindset of being an active participant in your care. over like that passive receiver I think is is what we're aiming for. And so we share these not to say oh, do them all and you'll have a VBAC. No, like your example, if you did one of those major things to you know, trusted your provider more proactive in your care, and you got chiropractic adjustments, and that's amazing. Like it doesn't you know, it doesn't have to be all the things for it to be a transformational or positive or even successful feedback. But I think what's cool about what your experience is that it launched you into becoming a chiropractor, and now you channel all that in with your your clients, especially ones who are trying to get pregnant pregnant or going through that VBAC. And that's a tremendous benefit to our community. So that one positive birth has a ripple effect of number, a number of positive birth experience that are coming from your care. So I hope you feel like that that happened, exactly how it should and that now you are changing people's experiences giving birth. I love

27:57

it. I know and so it's I love everything you said because I I felt like a passive participant in that first birth. I'm just doing a read tells me I don't know. I have a lot of fear. I don't know what's going on. I don't know what's going to happen. And then I did feel more of that active take and things and having those discussions and hearing okay, you're a good candidate. We're gonna do this, why don't you try this and okay, this aligns with me and I'm going to do this and, you know, because it's easy to get overwhelmed. So it's like, okay, one thing at a time and so, but yeah, like you said, kind of being aware of that potential. Now, again, I have worked with moms who are VBAC hopeful, and they do end up with a repeat C section. So I mean, I think it needs to be at least discussed and talked about because again, there's no guarantees in life. There's definitely no guarantees in birth. I will say that the moms that I have worked with, they have the the general consensus and what I feel from them and when I talk to them, and then when they come in for like, you know, postpartum care is that they felt so heard, and like seen and informed and respected and empowered that like they felt good with how everything happened and went down and I think it's because they they were that active role instead of it just happening to them. I definitely feel like that first second, like, Oh, my God, what the hell's out it's just happening to me. It was totally out of body experience. So I you know, and even with one mom recently, she said the recoveries been 10 times easier than last time. So I'm super grateful overall. So like, having those I don't know that's the part of like, being intentional with that. birth plan, and having that plan B. And trying to address some of that beforehand,

29:48

being an active participant and I think I gave me chills when you said that and that's what I see with with clients who hire me. Going for a be back is almost always when they get to the other side. of it. And this is always my goal is that you feel good about it, no matter how it unfolds. And I work real hard with my clients. I'm not we're not going to pretend that Cesarean birth isn't going to happen here. Like we need to walk through that and work through fears and work through the emotional barriers and work through any resistance you have to having another cesarean because it is a reality. It is a reality. And I want you to feel good about it no matter what when you are on the other side of this. That's always my goal. And so unusually that is what happens because they were that active, you know, they they participated in in a more meaningful way. That doesn't mean that there haven't been experiences where they did all the things they participated meaningfully. They were active in the decision making and they still had a negative experience. So I am never going to say that it doesn't happen. It certainly does and and there is you should be allowed to space and time for disappointment. The any sort of emotions you spill about it, you know, and I say just if you have a doula or your chiropractor or your provider or even a counselor, seat, you know, talk through that with somebody because it's important to process and it's okay if you don't feel great about how your birth went. Even if you did all the things to try and have a positive birth.

31:15

And I that I'm glad you brought that up because it's it goes back to addressing those emotions and stuff too because it sounds like and what I'm hearing is, if we can help mom in that like mental aspect of things and that feeling empowered and feeling seen and heard, then it can directly impact those thoughts and feelings pertaining to how the birth went. Whether it was that you know, cesarean or whether you know whether things were happening to you or you were part of it. And I think that's, I think that's a big, that's a big part of it with addressing that mental health aspect of things too.

32:00

Yeah. Yeah, for sure.

32:02

Now, I know you had a few during labor tips to think about because we talked about tips to prepare. Do you want to share a few things? Yeah, these are during labor

32:13

pretty short and sweet. Just to keep in mind that once you know you've done all this work during pregnancy that you're in those late weeks of of your pregnancy and anticipating going into labor soon. But some ways to increase your, your chance of having a successful VBAC is to let labor begin on its own. That's the number one thing you know, give your body time to go into labor on its own, avoiding that medical induction if possible, can really increase your chance of avoiding like those downline interventions, as well as that repeats this area and move around and stay active and change positions regularly during labor and so you most likely will be monitored more often or if not continuously. So finding ways to stay in gravity friendly or gravity neutral position. So standing next to the bed, hands and knees on the bed leaning over a yoga ball. So staying active, changing positions regularly, and then when you need to rest Resting, resting quote unquote smart and so that's where you lie on your side. So you would lie on your left side and then your right side, putting a peanut ball between your knees to help keep your pelvis open, and then change sides every 30 minutes or so. Again, you're resting but yet you're staying active and you are able to keep your hips and pelvis open and then avoiding unnecessary interventions that can disrupt the flow of labor. So you know asking good questions about if the, you know, pros cons, if you can do it, or if there are alternatives, you know, asking those questions before doing a procedure or tips can just help you feel like okay, I know what's going on here. I know my options and trying to avoid anything that's not necessary. So those would be my tips for labor.

33:55

Though those are good, and those are good to know. Because what you can bring those to your provider and say, This is what I'm thinking of doing. This is what I want to do. Is it Is this allowed? I mean, you don't want to say Allow but under that says no, this isn't allowed. It's like okay, well now I know.

34:13

Yeah, we're under supportive. Yeah, and I definitely say if they're using terms like allowed and not allowed, I'm like, you know, red flag, but i The how I encourage my clients to ask questions is How do you support? So instead of asking, Is it allowed to how do you how do you support going beyond 40 weeks? How do you support? Laboring freely from and monitors and stuff during labor like being like, how do you support that? How do you support upright pushing? How do you support pushing out of the bed instead of saying Am I allowed to push out the bed? It's like how do you support it and either they say I do or I don't like okay, there you go. And open ended questions like that, like how do you support gives them a chance to give more than a yes or no? Because if you say Do you allow and I'd usually Yeah, a yes or no answer. It's like if you say how do you support then they're gonna probably give an extended sort of our answer that might give you some insight into how they how they support and you're not asking permission. You're not asking permission period you're asking to you're trying to learn more about them. So how do you support is how I start a sentence instead of Do you allow? I love it. I love it. We have so many good tips in this episode. I know lots

35:30

of good information I know so I mean we went through all the stats why is it important choosing the provider good candidate or not? How to Look at that tips to prepare before during labor, addressing trauma addressing all the things we have lots of good resources and we will link all of those in the show notes. So yeah, if I'm talking to you today, my friend

35:52

you to Dr. Shane and I look forward to our next conversation.