Episode 274 "I Don't Know Who Needs to Hear This, But..."

The VBAC Link

I don’t know who needs to hear this, but…

You do NOT have to be induced at 39 weeks to have a vaginal birth.

You CAN have an induced VBAC.

Your cervix DOESN’T have to dilate by 40 weeks.

Home birth is just as SAFE as hospital birth, even for VBAC.

Your pelvis is PERFECT.

You are capable of doing MORE than you even know.

Tune in to today’s hot episode to hear Meagan and Julie dive deeper into these topics and many, many more!

Additional Links

The ARRIVE Trial and What it Means for VBAC

Home Birth and VBAC

Brittany Sharpe McCollum - Pelvic Biodynamics

Needed Website

How to VBAC: The Ultimate Prep Course for Parents

Full Transcript under Episode Details

Meagan: Hello, hello everybody. We are already a month into 2024 and we are ending the month off with a nice, spicy episode. I think it will be a little spicy. Julie is with me today. Hey, Julie.

Julie: The bringer of the spice.

Meagan: The bringer of the spice. You know, ever since you stopped doing doula work as well, you have picked it up a notch in your spice.

Julie: Because I’m tired of watching people get railroaded by the system.

Meagan: I know.

Julie: I have picked it up a little bit, yeah.

Meagan: I know.

Julie: You have to deal with the backlash by yourself if there is some backlash.

Meagan: Seriously. No, this episode is going to be a good one. Women of Strength, I think that this episode is going to be very empowering. Yes, it is going to be spicy. We are going to have passion because if you haven’t noticed over all of the years of Julie and I recording, we have passion. When it comes to like Julie was saying, people not being railroaded by the system or not taken advantage of and really knowing what information is true and not, we are pretty passionate about it.

So today, we have an episode for you that is going to be amazing. It’s titled, “I Don’t Know Who Needs to Hear This, But…” We are going to be telling you all of the amazing things.

Review of the Week

We have a Review of the Week so we are going to get to that and then we are going to kick it up a notch.

Julie: Perfect. All right, yeah. I’m really excited about this episode inspired by all of you really, all of us, and everybody in the birth community around the whole entire world. Anyways, this review is from Apple Podcasts and it’s titled “Highly Recommend.” It says, “Thank you, Meagan and Julie, for creating this podcast. It holds space for mothers with so many different birth stories and as we know, representation matters. After an unexpected emergency Cesarean with my first daughter, I found myself seeking stories similar to my own. I literally binged your show. It helped me process my own trauma and was incredibly healing. I have since become a labor and delivery nurse and I find myself recommending this podcast to my patients regularly.”

What? That’s awesome.

“I’m happy to say that this podcast gave me the courage and confidence to TOLAC and I had the most empowering and beautiful VBAC in November. Thank you a million.”

That is incredible. I love it.

Meagan: That is incredible. I love hearing when labor and delivery nurses or providers will hear the podcast and recommend it to their patients and their friends and their family. That makes me so happy. If you are like our reviewer and you would recommend the podcast, if you wouldn’t mind doing us a solid, pause right now but come back because it’s going to be great. Pause right now and leave us a review. Go to wherever you are– Apple Podcasts, Spotify, or if you are just listening on our website which you can at thevbaclink.com. You can even just Google “The VBAC Link” and leave us a review and recommend us there because your recommendations and your reviews are what help other Women of Strength find this and find these amazing stories and find the information like what we’re giving today.

Meagan & Julie

Meagan: Okay, Julie, I am so excited. I am so excited. This idea is amazing. We were talking about this before. This is kind of like a viral reel. This reel went viral. “I don’t know who needs to hear this…”, but Julie said this. Boom. That is what we are going to do. This is amazing. This episode is going to be so fun. We have actually scrolled The VBAC Link Community which by the way, if you are not in The VBAC Link Community on Facebook, we have a private Facebook group that is very safe and very welcoming to all Women of Strength no matter what type of birth they are wanting, vaginal or Cesarean. You can find us at The VBAC Link Community on Facebook. Answer the questions. You do have to answer the questions to get in because we are very, very strict with that and then we’ll get you in.

If for some reason, you have a weird decline because sometimes Facebook is declining them on their own, I do not know why, just message us at thevbaclink.com or on Instagram or wherever and just let us know, “Hey, I’m trying to get in,” because we have definitely been having issues.

Julie: Weird.

Meagan: I know, right? People are writing us like, “We’ve been trying four times and it’s just declining.” But okay, you guys. Julie, do you want to kick it off?

“I Don’t Know Who Needs to Hear This, But…”

Julie: Yeah, let’s kick it off. Okay, so I don’t know who needs to hear this, but you do not have to be induced at 39 weeks to have a vaginal birth.

Meagan: Correct. You do not.

Julie: It makes me so mad. It lights my fire. I have a friend who lives in Maryland. He is a major researcher. He researches everything and every topic– politics, home school versus public school, anything. He can give you a one-hour speech on demand because he is on a top-notch level. His head is in the papers. He is just there. But for some reason, we as a culture don’t like to do that amount of research when it comes to having our babies. Right? Why is that?

Anyway, so when his wife had their first pregnancy, it was right after the ARRIVE trial came out, and of course, she got induced at 39 weeks. They’ve had two other kids since then. They got induced at 39 weeks every time. Lucky for them, it was super great. They had pretty uncomplicated, straightforward deliveries and everything was fine, but I wanted to scream at him and say, “Friend! You research the heck out of everything. Why are you guys not looking into this for your own babies and your own children and your family, the most important thing in your life?” It’s always been interesting to me for that.

So we know by now that everybody is hungry to induce at 39 weeks. We also know by now– I mean, we knew early on, but the rest of the world is catching up now showing that the results of the ARRIVE trial are incredibly flawed. If you don’t know what the ARRIVE trial is, just Google “The ARRIVE Trial, VBAC” and our article on the ARRIVE trial will pop up, but basically it says that induction at 39 weeks lowers Cesarean rates and other complications for mother and baby but there are so many things wrong with that study.

There are so many things wrong with that study. I’m not going to get into it because we have a short amount of time, but go look into it. We know now that there have been several research articles from major universities doing research on giant, enormous population groups showing that it actually increases complications and risks associated with induction and it increases the risks of having a Cesarean for mothers.

So, guess what though? I hate how fast the ARRIVE trial took on. Everybody is like, “Woohoo! Induction at 39 weeks, let’s do this,” but guess what? Now that we are showing that it is actually harmful to families, everybody is looking away. It’s going to take 10-20 years for this trend to stop.

Meagan: But yet it took overnight for it to start. That’s what is frustrating to me.

Julie: Because it is more convenient. It is more money. It is easier to manage.

Meagan: I have so many feelings. You guys, we have a blog on the ARRIVE trial. We actually have an updated episode on the updates of the ARRIVE trial as well so if you are wanting to learn more about the ARRIVE trial or if you are being told that you need to be induced at 39 weeks in order to have a baby, go check out Episode 247 because we are going to talk more about that topic.

Julie: Yeah, absolutely. There’s lots to go into it, but I just want you to know. We want you to know that it’s okay to go past 39, 40, and 41 weeks and wait for your body to go into spontaneous labor. That is really your best chance of having a vaginal birth.

Now, there are reasons and times when a medical need for an induction arises that are true and are actually real. Having an induction doesn’t mean you are going to have a C-section, so if you need to go that route for whatever reason that is medically safe for you and your baby, it is safe to do that.

“I Don’t Know Who Needs to Hear This, But…”

Meagan: So on that topic, I don’t know who needs to hear this, but induction is okay for a VBAC and it is possible to have a VBAC with an induction. So yes, it’s more ideal to have spontaneous labor and for things to happen on their own and not to be intervened. But, if medically, there is a reason for an induction, it is okay. You do not have to just have a C-section because there is a medical reason to have a baby. You can be induced.

“I Don’t Know Who Needs to Hear This, But…”

And then sort of on the same topic, but I don’t know who needs to hear this, but your cervix doesn’t have to dilate by 40 weeks. It doesn’t have to. It can dilate after. It doesn’t mean it’s not going to. If you are not dilated or effaced by 40 weeks, it doesn’t mean it won’t, right?

Julie: Yep. I hate when people say, “I just left my 37-week check-up and I’m not dilated at all. My provider thinks I needed to schedule a C-section.” I’m like, “Your cervix is doing exactly what it needs to do before it’s time to let the baby out which is stay closed, stay tight, and keep that baby in.”

Meagan: Yeah. Yeah. I don’t love that because if a provider is checking at 37 weeks and someone’s not dilated, they’re placing doubt that they are not dilated and placing thoughts of, “Oh, you’re not dilated yet. Oh, you’re 37 weeks.” If they’re already having that tune, that, to me, is a red flag because if you are 40 weeks and you are still not dilated yet, what do you think they are going to say then?

Julie: It’s just a sign of control. They want to be able to predict and control and yeah. It might not be the best provider to support you.

“I Don’t Know Who Needs to Hear This, But…”

Julie: Okay, I got one. I don’t know who needs to hear this, but home birth is just as safe as hospital birth even for VBAC. I think that a lot of people don’t know this aside from there have been several major studies in the last 10 years or so showing this, but I feel like what most people don’t realize is that home birth midwives, aside from the random rogue ones– you know, here and there you are going to hear a story– but most home birth midwives are incredibly educated and trained at similar levels as hospital midwives are.

Now, depending on whether they are certified or licensed, there are different regulations in every state, but midwives at home can carry Pitocin, methergine, and Cytotec. They can carry antibiotics if you are—

Meagan: GBS positive.

Julie: They can give you IVs. They can draw your blood. They can do all of the routine prenatal tests that you can do in the hospital. They have emergency transfer protocols in place. Every state is a little bit different, but in Utah, it is amazing. The seamless transition from home to hospital and transfer of care records and everything like that, a lot of people just don’t know that home birth midwives– like I said, it depends on the state and the regulations whether they are certified or licensed and that type of thing– have access to all of the things except the operation room that you have in a hospital.

Meagan: And…

Julie: Go ahead. You do the and.

Meagan: And if there is an emergency like she was saying, there is a transfer protocol in place. Usually, it doesn’t get to anything crazy because we are transferring based on XYZ before there is any true emergency.

Julie: Yep. And you know what? Paige is going to be going nuts here because she is going to have to drop so many links into the show notes, but like I said, there have been so many studies that show birth outcomes are similar and some of them are better at home than in the hospital, right? Like a decrease in hemorrhage at home and yes, we can sit here and say that home birth is safe.

Meagan: Home birth is safe and a reasonable option for a VBAC.

“I Don’t Know Who Needs to Hear This, But…”

Meagan: I don’t know who needs to hear this, but your pelvis is perfect.

Julie: Your pelvis is perfect.

Meagan: Your pelvis is perfect. Your pelvis is not too small, you guys. Yes, there are rare occasions where we have a pelvis that is going to be less ideal to get a baby out or harder where maybe they have gotten in an accident and they’ve had a pelvic fracture. We’ve talked about being malnourished as a child or things like that, but it’s really rare for your pelvis to actually not be able to get a baby out of it. It was designed to do that. It can do that. We all have different sizes and shapes and little ingredients to our pelvis–

Julie: Pelvic ingredients.

Meagan: It can do it, you guys. Sometimes it’s changing a position because sometimes our babies need to come out posterior. I learned this in a pelvic dynamics class from Brittany Sharpe. She is freaking amazing and we will drop her Instagram in here as well.

But you guys, our pelvises mold. They shape. They move. They form. Babies’ heads mold, but they are all different shapes, and sometimes, our babies have to come into our pelvis in a posterior position to get out vaginally, or sometimes they have to come in looking transverse because of the way they are shaped, but it’s really rare that your pelvis is too small.

So if your provider in your C-section said, “Yeah, well while I was in there, I looked and it’s way too small. You definitely should have a C-section here in the future,” just move on from that doctor. Your pelvis is perfect.

“I Don’t Know Who Needs to Hear This, But…”

Julie: Move on. All right. I don’t know who needs to hear this, but big babies are not a medical reason for induction and it does not mean that your baby can’t be born vaginally.

Meagan: And it’s not a reason for a scheduled C-section.

Julie: Yep.

Meagan: That goes with any previous C-section because I’ve seen so many people say, “I’ve had a C-section because my baby measured large.” First baby.

Julie: Even ACOG says that it’s not a good reason.

Meagan: I know. It drives me batty. Why? Why are we doubting our bodies’ abilities? Women of Strength, if you are one and you said, “Okay,” and that’s why you had a C-section, don’t shame yourself, but know that your body creates a perfect-sized baby.

Julie: Yeah. Don’t shame yourself because the system railroaded you. Blame the system. That’s who you blame.

Meagan: And don’t lose belief in your body’s ability to get your baby out. If your baby is on the larger side, be like, “Well, dang. I’m going to have a good sleeper and likely a good eater.” Be happy about that and not shame yourself and be like, “Oh, I made a big baby,” because also, what I have seen in next babies, I’ve seen Women of Strength stop eating and restrict themselves of the nutrients that they need because they are so terrified.

Julie: Scared that their baby will be too big.

Meagan: Yes, they are so terrified of having too big of a baby that they are actually not giving themselves the nutrients. We know, especially with all of the Needed prenatal information that I’ve learned, that we are already malnourished as a society today not even just with taking supplements but in our daily food, our soil has changed. Our food has changed. Our nutrients have changed. We don’t want to be withholding those nutrients and food because we are so scared of having too big of a baby. Do not let a provider– this is my “I don’t know who needs to hear this”, but do not let a provider do that to you.

Julie: Yeah, we all have stories that we can pull out of anything about these big babies. I was just at a birth last week. It was a scheduled induction at 37.5 weeks because of baby’s size. They thought the baby was going to be almost 10 pounds at 37 weeks. Baby came out at 8 pounds, 3 ounces. Now, that is a little large for a 37-weeker, but my goodness, it wasn’t a 10-pound baby. Okay?

This is one of the harder things about being a birth photographer sometimes is that you are not involved in their decisions prenatally so I don’t always have the opportunity to help them learn things. Some people just don’t want to learn and that’s totally fine, but I have another friend who just left an induction. It was a VBAC induction actually and it ended in a VBAC. It was great, but they suspected IUGR which is a small baby.

Meagan: Intrauterine growth restriction by the way for whoever does not know that.

Julie: Yes. They expected the baby to be super small and I forget. I think it was in the 39th week. They expected the baby to be smaller than 6 pounds. Baby was born at 7.5 pounds, just fine.

Meagan: Perfect.

Julie: These things are not accurate and if you are healthy, then I think it’s important to know that your body can do this. Now, okay. Okay. I do want to add a little nuance there that all of these things that we are going to be talking about today there are situations where induction is necessary. With uncontrolled gestational diabetes, for example, your baby might be bigger. But what I’ve found most often with gestational diabetes is that we put these women on really restrictive diets and we tell them to be careful about what they eat and to exercise and all of these things.

I find that my gestational diabetes clients usually end up having babies that are a little bit smaller than average because of all the restrictions we put on them like you were just talking about. So I just want to add a little nuance there that there are going to be some exceptions to what we are talking about.

What we have a problem with here at The VBAC Link is when people take those 1 in 100 or 1 in 1000 situations where extra help is needed and blanket-apply it to 100% of the people. That’s what we’re trying to combat here.

Meagan: Yeah. Absolutely.

Julie: All right, Meagan. What you’ve got?

“I Don’t Know Who Needs to Hear This, But…”

Meagan: I don’t know who needs to hear this, but it’s always okay to say no.

Julie: Yes!

Meagan: Always. If you are having someone and it doesn’t even need to be a provider, anybody who is telling you what you are going to do and you are not feeling good about that decision, say no. That is okay.

I was in another VBAC group during my own VBAC after two C-sections. I was in multiple VBAC groups. I was in a group and there was someone that wrote into their comment. They said, “My provider told me that I could not be induced. I could not do this. I could not do that,” and these things. Did it just irk you? I know you saw it, Julie. Did that just irk you, that comment?

Julie: Yeah. It irks me because why do we as doulas, birth photographers, and patients have to be the ones to show our providers what the evidence says? Why do we? Shouldn’t they be the ones practicing that evidence-based care? Shouldn’t they?

Oh, here’s my radical acceptance coming in, speaking of radical acceptance. I need to work on radical acceptance of the system, I think. But why? I don’t want to accept it. I want to change it. So there’s part 3 coming out soon. How to change it.

Meagan: Part 3 of radical acceptance. How to find radical acceptance through the system. This is the thing. We talked about this, I think, even before we pushed play but a provider or someone who wants to control you in this situation that you are going to be in– your birth. This is someone who wants to control your birth and is telling you what you are or are not going to do or what they are going to do to you.

I’m hearing providers saying, “I’m going to strip your membranes at your next visit.” No. No. That is not how it works.

Julie: Or they walk into the room while you are laboring, “Okay, we are going to break your water now.” What?

Meagan: It is okay to say no. It is okay and I know that it is hard. I know. I have been there. I have been there just in life in general where I’m in a situation and I’m like, “Oh, I just don’t want to cause contention and is it really that big of a deal? Maybe I should just say yes.” No. If your gut– and you’ll know. If someone is coming in like Julie said and is saying, “We’re going to break your water now,” and you’re like, “Ugh,” immediately, that is your intuition saying no.

Julie: No.

Meagan: It is okay to say no. It is okay for you to say, “I do not want a cervical exam right now. I had one two hours ago. Not much has changed. I’m good, thanks.” It’s okay. Women of Strength, please, please, please. This is how we change the system. We have to be strong and we have to stand up for ourselves. We do and it’s stupid that we have to bring the evidence to the table, but we have to say no. We have to stop letting the system or the world, the world, railroad us especially when it’s to our own body.

We would never go down the street to the gas station and walk in and tell someone in that store what we’re doing to them. Never. Would you? I would never. Maybe some would.

Julie: I need you to drop those prices of the gas for me.

Meagan: Yeah, right now because I’m about to pump my gas. I need you to drop it down 50 cents cheaper. You guys, no. We should not, just because we are in birth and just because we are in labor and just because we have a provider that went to a heck of a lot more school than us, right? I’ll give them that. They went to a heck of a lot of school. I’ve never gone to medical school. It is not okay for them to tell us what you are or are not going to do.

Okay, that’s my rant.

Julie: Oh, I’ve got one that I just came up with.

Meagan: Okay.

“I Don’t Know Who Needs to Hear This, But…”

Julie: I don’t know who needs to hear this, but you can gain information from Google– accurate and good legitimate information from Google that is similar to information that other people are getting through school. Oh ho, ho, ho.

Meagan: Oh ho, ho, ho.

Julie: Yeah, take that. This is going to be a little spicy one here. I hate it. I hate it– okay you’ve seen this sign. I know everyone has seen them before or little bugs that are like, “Don’t confuse your Google search with my medical degree,” then be like, “Why the heck not?” If it’s so easy to pull something up on a Google search, then why should I trust your medical degree then? Okay, that’s a little extreme, but what I’m trying to say here is that we have access to the largest collective database of information to ever exist in the history of the world, right?

We can literally sit on our computer and order dinner, put in a grocery order, and have it delivered to our house in an hour. We can find information on anything we want to know from legit, credible sources. Right? I could find out how to build an electric outlet into my fireplace above. That’s my project right now. I need an outlet on my fireplace.

Meagan: YouTube University.

Julie: Exactly. Now, is there a lot of misinformation out there? Sure. But listen, if you know how to find credible sources like Google Scholar, Google Scholar legit has studies and sources and references that university databases pull from. There is accurate information and studies available at our fingertips, so why? The same studies that people are accessing at their universities towards their medical degrees are at our fingertips so I hate when people say, “Don’t confuse your Google search with my medical degree.”

Yes, are medical degrees valuable? Incredibly, especially when you can collectively put pieces of information and everything like that together. I feel like there is lots of worth there as well, but when we are talking about individuals, you know your body better than any provider with any level of medical degree is going to know your body. You know it better. Your intuition will guide you better than any provider with any medical degree.

I know I’m going to get a lot of cringes right now by talking about this, but your Google search is worth a lot when it’s pulled from a credible source so I hate when people say. That’s one thing I can’t. I usually scroll past the trolls and comments on Facebook now. I just don’t let it be worth my time. I have radically accepted that there are trolls and it’s fine and I’m going to live my life, but when I see someone using those words, “Don’t confuse your Google search with my medical degree,” that is when I’m going to get on there and say, “Why? Why discount these billions and billions and billions of research articles and things like that that we have access to?”

Meagan: I think that’s one of the big passions between why Julie and I created The VBAC Link Parent Course and Doula Course because we wanted you to be able to find that information in one spot. It is confusing and it is overwhelming. Those providers, yeah. There are some BS things out there on the internet. It’s really hard to decipher.

Julie: Like the ARRIVE trial, right?

Meagan: Yes. I think we have three pages of studies and citations and all of these things in our VBAC manual and in our VBAC course so you can take that and take it to your provider and say, “This is what I have found. This is the evidence. Can we have a discussion about this?” Women of Strength, it is okay to have a conversation with your provider. You can ask questions.

A lot of the time, you walk in and they are like, “Hey, do you have any questions?” You’re like, “Maybe. Should I have any questions?” You should be encouraging these conversations with your provider. It’s going to help you get to know them. It’s going to help you guys have a better understanding of each other and you’re going to be able to learn about these studies.

Julie: I want to cut in here for just a minute before you change gears. I know that when we were putting our course together, this was something that was super important to me and Meagan. You don’t have to take our word for it. I remember uploading lots of studies, the pdf versions of studies and bulletins, and things like that into the course because we wanted you to be able to go and dig deeper on the parts that you wanted to dig deeper from right from these credible sources.

I love when I can find a Cochrane review because a Cochrane review is a review of several studies studying the same thing so you can just gather so much more information. We have a Cochrane review in there. We have links to everything. That’s why we are so careful to be so meticulous and cite our sources and where we found this information so that you can go on your own journey to the other parts that resonate with you a little bit more.

Meagan: Absolutely. Okay, well we are wrapping up. Is there anything else, Julie, that you are like, “I’ve got to let these guys know”?

“I Don’t Know Who Needs to Hear This, But…”

Julie: Yeah, I think one more thing without having to really expound on it too much. I don’t know who needs to hear this, but sometimes trusting and believing your body doesn’t work. I don’t know how to say that the right way. Maybe I’m going to expound on it. I loved this affirmation so much because I used it on my home birth and my first VBAC. It was like, “I trust my body to birth my body,” and things like that. I had a lot of trust, but I feel like reframing it to, “I trust my body to know what to do,” is better because what happens when some emergency comes up and your body doesn’t push it out? What happens when you have a traumatic pelvic floor injury and your pelvis really doesn’t know how to push out a baby?

I mean, what happens if your baby’s heart starts tanking and baby has to come out right now? That’s not your body failing you. I feel like sometimes that’s what sets people up for failure. They believe so much in their body, but sometimes emergencies happen. There is some nuance there, so yes. Trust your body, but trust it to guide you on the right journey.

Sometimes it sets us up for trauma afterward. You’ll be like, “Oh my gosh, my body is broken. How come trusting my body didn’t work?” I feel like trusting your body is a big part of it, but trusting your body to guide you on the right journey for a nice, healthy delivery is more important than trusting your body to be able to push a baby out. I don’t know. What do you say to that, Meagan?

Meagan: Yeah. I love that. That, I think, is where a lot of postpartum issues come because we were like, “But, I knew that I could do this.” It’s not that you couldn’t, it’s just that something else happened. Right?

Julie: The circumstance.

Meagan: Yep. The circumstances changed and that’s hard. That’s hard, yeah. I love that. I love that you said that.

“I Don’t Know Who Needs to Hear This, But…”

Finally, last but not least, I don’t know who needs to hear this, but you are amazing. You are a Woman of Strength. You are capable of doing more than you even know. Than you even know. I truly believe that. I think through life and experiences, especially when things are hard, it feels like you can be at a loss, like you are alone, and like you couldn’t possibly do these things, right? But Women of Strength, VBAC is possible. VBAC after multiple Cesareans– possible. VBAC with twins, VBAC with big baby, VBAC with diagnosed small pelvis, VBAC with medical induction needed, VBAC is possible.

If you don’t want to have a VBAC, that’s my final, final. If you don’t want one, that’s okay.

Julie: Yeah.

Meagan: That is okay. Vaginal birth is not always desired and that’s okay. But you need to learn. You need to find the information and that is what these stories are here for. That is what Julie and I are here for and other birth professionals here that we have on this podcast. That is what the course is for. That is what the community is for, for you to learn, for you to grow, and for you to know that when you are told some of these things, they are necessarily true.

Okay.

Julie: I love that, yes.

Closing

Would you like to be a guest on the podcast? Tell us about your experience at thevbaclink.com/share. For more information on all things VBAC including online and in-person VBAC classes, The VBAC Link blog, and Meagan’s bio, head over to thevbaclink.com. Congratulations on starting your journey of learning and discovery with The VBAC Link.

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