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Episode 290 Hayley's Unmedicated VBAC + Epidural and Prolapse Talk

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Nội dung được cung cấp bởi Meagan Heaton. Tất cả nội dung podcast bao gồm các tập, đồ họa và mô tả podcast đều được Meagan Heaton hoặc đối tác nền tảng podcast của họ tải lên và cung cấp trực tiếp. Nếu bạn cho rằng ai đó đang sử dụng tác phẩm có bản quyền của bạn mà không có sự cho phép của bạn, bạn có thể làm theo quy trình được nêu ở đây https://vi.player.fm/legal.

Hayley joins the show today sharing her breech Cesarean and unmedicated hospital VBAC stories. Meagan and Hayley dive deep into the pros and cons of getting an epidural and why providers tell women so many different things when it comes to epidurals and VBAC!

While Hayley had the dreamiest birth she could have imagined and everything went according to plan, her postpartum experience with prolapse was not something she was prepared for. Hayley shares her symptoms, what she wished she knew, and what she has done since to recover and feel like herself again.

Needed Website

How to VBAC: The Ultimate Prep Course for Parents

Full Transcript under Episode Details

02:47 Just-in-case epidural

04:16 Dr. McGuire’s insight on epidurals

08:42 Using an epidural as a tool

10:44 Hayley’s first pregnancy and birth

12:00 Doing VBAC research before pregnancy

13:51 Hayley’s second pregnancy

18:15 Labor begins

20:16 Going to the hospital

24:20 Pushing

27:05 Hayley’s prolapse experience

32:01 Symptoms of uterine prolapse

35:29 Prolapse can happen

Meagan: Hello, hello Women of Strength. You guys, I am excited about today’s episode. I love talking about VBAC obviously, but specifically, we are going to talk a little bit about unmedicated versus medicated. Our friend, Hayley, from North Carolina has had a beautiful unmedicated hospital VBAC so I want to also talk about the opposite side of that and talk about medicated VBAC.

We have so many people in our community that I see type, “I want a VBAC, but I don’t want to go unmedicated and my doctor says I have to. I can’t have an epidural” or the total flipside of that where, “I really want an unmedicated VBAC, but my doctor says I can’t go unmedicated. I have to have the epidural.” Did I just say that correctly, Hayley?

Hayley: Yes, yeah.

Meagan: It’s either one or the other. We’ve got providers telling people they can’t have an epidural or they have to have an epidural. So I wanted to just talk a little bit today before we get going on those two topics.

First of all, let’s talk about unmedicated birth. Hayley and I are living proof today. We are on this episode that unmedicated VBAC is 100% possible, achievable, and safe. A lot of those providers come out and say that they can’t go unmedicated because they say it’s not safe. In the rare chance, we know that uterine rupture happens but it is rare. In the rare chance of a uterine rupture, that is where they say that is not okay.

Or they will say things like, “But you wouldn’t want to be knocked out for your birth,” which is scary. I don’t want to be knocked out for my birth and I know people have. A lot of the time, it is not the most pleasant experience. Yeah. Okay, so let’s talk about that.

Unmedicated vaginal birth is unmedicated vaginal birth. That’s what it is. I’m just laying it out there. Yes, we have a slight increase in uterine rupture. Yes. What happens if we have a uterine rupture and we are unmediated?

A lot of the time, we are noticing that there are signs of uterine rupture. When we get an epidural and a spinal, we go back and have a C-section. Simple as that.

Or if it is a true medical emergency, yes, there is that small risk of needing to be put under. Small risk and small risk equal risk of course, but it’s low.

02:47 Just-in-case epidural

Meagan: What about if we have the just-in-case epidural? I seriously sometimes just want to sock someone who says “Just in case”. We don’t need to be placing an epidural just to have it ready to dose because guess what? In the event that it is a true emergency and we really do need to go in for an immediate Cesarean, it’s the same thing. We get knocked out.

I know that these words are kind of big and harsh words. We get knocked out, but we get put under general anesthesia if we don’t have anything in our system.

Now, let’s talk about an epidural. You actually have an epidural placed. It’s running. It’s dosed and we have a uterine rupture. Guess what? Women of Strength, more than likely, it still has to be dosed further because an epidural is not like a spinal. It’s just not. They have to dose it further.

With my first Cesarean, I had an epidural. They had to come in, dose it to a deeper extreme so I wasn’t feeling my surgery and I had to wait. Right? We are still waiting. It’s the same thing. There is always a wait and it takes time. It takes about 15-20 minutes for any epidural to kick in deep enough.

04:16 Dr. McGuire’s insight on epidurals

Meagan: Dr. McGuire wrote for Yale Medicine. She talks about this epidural and is it safe and how are they different. She talks about how they truly are different than they were back in the day because they are dosing them lighter. We know that. We have seen that, but we still have some pretty serious risks as well with epidurals even though again, they are smaller. There are blood clots, spinal infections, spinal headaches, them not working, and things like that, and blood pressure.

I’m going to say as a doula, I’ve attended over 350 births. As a doula, I will say a large portion of any client, not just VBAC, who receives an epidural has a blood pressure dip. Even when they have a large amount of fluid because a lot of the time they will cram fluids in to try to help this, but there is some sort of blood pressure dip and baby seems to struggle when that happens.

Then it’s the cascade– rolling over, move, move, move, move. Baby doesn’t recover or mom’s blood pressure doesn’t recover and we are off to an OR.

One of the biggest questions that I think is a really hot debate in the medical world is does an epidural raise your chances of a Cesarean? Most people out there are going to say, “No, it doesn’t.” The studies are pretty low, though. I think in one study there were 2,000 people or something like that and they showed it didn’t.

But I mean, from a doula’s standpoint, I know I don’t see as many births as these OBs, but I definitely see it seems to do that– the blood pressure drop thing. So is it safe? Yes. Do you have to go unmedicated if you have a VBAC? No. Do you have to get an epidural if you have an epidural? No. Do what is best for you.

What she says is, “Those studies we know that have a higher concentration of epidural medicine was associated with an increased risk of Cesarean, though lower concentration we now use actually promotes normal, spontaneous vaginal delivery without assistance.” When she says assistance, a lot of the time when we have epidurals, we have vacuum or forceps assistance because we have lack of mobility.

That’s what she was saying here. I want to make sure to provide the link and some other links on our blog for epidurals so you can decide what is best for you. But for now, we are going to get into a story of an unmedicated, vaginal birth.

08:42 Using an epidural as a tool

Meagan: Okay, Ms. Hayley. Welcome to the show.

Hayley: Thank you for having me. It’s really crazy to be on here sharing so thank you.

Meagan: I talk about how it’s crazy to be full-circle where you are listening. You are preparing. All of the people in your ear are motivating and then here you are today sharing your story motivating others in your same space x, y, z months ago.

Hayley: Yeah. It’s crazy. It really is a full-circle moment like you mentioned.

Meagan: Yeah. Well, I am so honored that you are here. I would love to turn the time over to you.

Hayley: Sure. So yeah, I also love what you were saying really quickly on the epidural versus not. Full transparency, when I went into this, I definitely recognized that an epidural is a tool and I knew and wanted to prepare myself. If I am– obviously, birth is not pleasant. It’s not going to be a walk in the park. But I knew there was a difference between being in pain versus suffering. I really wanted to know that for myself. It if turned into that suffering, I wouldn’t have been opposed to helping my body to get my baby.

Meagan: To the next point, yeah.

Hayley: But there is a difference between being in pain and suffering.

Meagan: As a doula, we talk about that a lot where we are like, okay. We are planning to go unmedicated. That is fantastic and then we talk about that pain versus suffering and that transition because when we are suffering, we start having things that come up later. We don’t think about it. We are suffering now, but postpartum depression, postpartum anxiety, and postpartum trauma. We have these things that are not worth it, so in the end, you have to do what’s best for you and keep you in that positive space and recognize pain versus suffering.

Hayley: Yeah. Exactly, so I love that.

10:44 Hayley’s first pregnancy and birth

Hayley: To start this whole story I guess, is back in April 2021, I had my daughter. She was breech. For me, I knew pretty early on that she was breech. She was so active. I knew that, “Oh, you are trying to flip in there.” I did all of the things. I did Spinning Babies and tried all of the things, but it was still COVID time so I just didn’t go to acupuncture. I feel like if it wasn’t COVID times still, I maybe would have tried more things. But with that being said, I felt like she was literally trying to turn because I’m like, “What are you doing? If you’re not flipping, then I’m not sure. Then you can’t.” I just felt in my body that there was a reason.

I didn’t try manually flipping her or things like that. To help with peace of mind, I opted for a Cesarean even though that was the last thing I wanted. I’m terrified of surgeries and needles. I was like, “I do not want this. This is the absolute last thing I want,” but at the same time, I was happy that I could mentally prepare for that instead of it being sprung on me. And honestly, I feel like I had a pretty good recovery with that.

At the same time, I knew for any future children, I did not want to have another C-section.

12:00 Doing VBAC research before pregnancy

Hayley: So fast forward. We moved across the country when she was about 9 months old. I was definitely not pregnant yet, but we were thinking about expanding our family. I had already started researching providers in the area, joining Facebook pages like the ICAN Facebook group in the area and literally preparing even though I wasn’t pregnant because I just really wanted to make this.

Meagan: That is important.

Hayley: Yeah. I just did my research. I really, really wanted to be not in a situation where I’m like, “Oh shoot. I’m pregnant and now I need to struggle to find a supportive provider,” because unfortunately, it’s hard to find VBAC-supportive providers. I wish that wasn’t the case, but I feel like that’s unfortunately the majority.

Meagan: The reality, it sucks. It’s stupid. I have a lot of words for that, but it is the reality. It is more often that it’s hard to find that true support than it is to find the opposite.

Hayley: Yep. I remember I made a couple of appointments just to talk with people to be like, “Hey, how do you feel about this? I’m looking to establish care.” I remember I went to two different places. One was an OB and they did have some midwives there, but yeah. They were like, “Well, you can or you can try that,” and I was like, “Cool. This doesn’t sound like 100%.”

I eventually found a group of midwives. I felt was a total 180 with the way that the care felt. Not that you can’t get that with OBs, but they were like, “Yeah. We’re going to do that.” It was just like, “Cool. We’re going to do that.”

Meagan: I love that. You’re like, “And great. I was almost not expecting you to say that so fantastic.”

Hayley: Exactly. I’m like, “Perfect.”

13:51 Hayley’s second pregnancy

Hayley: Fast forward, I then get pregnant with my second. I established care through them. I felt like the whole process was just so chill. Even just with anything, maybe it’s just the difference between your first pregnancy and second pregnancy where you are so nervous about everything with the first, but even the ultrasound that just felt very– with my first, they would really make me feel like they were really making sure, not that you shouldn’t make sure things are okay, but they just really made me feel like everything was so medical and things could go wrong or something.

With my second, they were just like, “Yeah, baby is great.” Okay, cool. Perfect. So that was awesome and definitely not what I expected. Again, it’s a different office and a different state. It was a totally different experience and amazing. But I was definitely in my head the whole pregnancy. I did not want this baby to flip. I just kept doing everything I could throughout my whole pregnancy, really working on my mentality and my mindset.

I found a doula. I went to a chiropractor towards the end of my pregnancy. I went to pelvic health, physical therapy, and I did all of the things because I’m like, “I want to do everything that I possibly can to make this happen.” That way if I didn’t, I would at least know, “Hey, I did everything and I totally prepared.” So mentally, that’s just what I needed. But yeah. I was definitely so in my head like, “What if this baby decides to be breech again? I would be so sad.” But luckily, that did not happen.

I also fell on my tailbone. I hurt my tailbone when I was 4 months before delivery so that was really not great either because one thing that once I would get into labor, I had so much tailbone pain and that was just something that I was not expecting.

So the pregnancy definitely had ups and downs. I feel like maybe you can answer if this is your experience too down the line with pregnancies, but I feel like your body just feels everything so much quicker with the second pregnancy. Like, “Oh, I’m already sore and it’s not even the second trimester. What’s happening?”

Meagan: I believe that.

Hayley: Yeah, so I found that really preparing is my number-one tip of doing your research, listening to podcasts, really get in that space of there was no doubt in my mind that I wasn’t going to be able to have a VBAC and I feel like that really helped me out when labor came because it wasn’t something that I even thought about. I can psyche myself out of I didn’t get worried.

Meagan: How amazing is that? I feel like that goes again, it’s like the full circle of, “Okay. I am educated. I have the support. I have the body and the baby ready to do this.” When we have gaps in our circle where it’s like, “Okay, well I’m educated so I feel confident in my ability,” but then we have a provider who is wishy-washy and shutting me down or I have a family member who is like, “Oh, you are really making a bad choice,” or starts questioning us and placing doubt, but then we are confident in our body. We are healthy and all of these things.

But when there are gaps, we can’t go into birth with that mentality. That’s something I wish for every single person going in to have a baby no matter what is just feeling confident and having that mentality of stress-free of the doubt. There are always the what-ifs and the wonders and every birth experience is different, but to not doubt ourselves or our ability and it comes with education, support, and all of those things.

Hayley: Yeah, exactly. Like reading my books and listening to stories and being like, “Yeah. My body can do this. This is what people have done for all of time.”

Meagan: Forever.

Hayley: We can do this. Yeah. Definitely, I agree. If you don’t have every single one of those aspects, it just makes things so much harder on yourself and everything.

18:15 Labor begins

Hayley: So fast forward, I never went through labor with my first, so I still felt like a first-time mom in the sense that I was like, “Will I know when I’m in labor? What’s it going to feel like?”

It was February last year. I don’t know, whatever day it was. I guess it was the 22nd. I guess I was having cramping. I don’t know. They were really mild so I didn’t really think about it. I was working and taking care of my firstborn.

Looking back, I’m like, “Oh, I guess it was maybe early labor.” But I didn’t really think about it. But I had pasta for dinner which I think is hilarious. I just ate pasta because fast forward, I am putting my little one to bed at 7:00 PM and I start getting really bad stomach pains. I’m like, “Is this from my dinner? Is my stomach just upset? I don’t know what’s happening.”

I remember I had to have my husband finish putting her to bed. I was really not feeling good. I was like, “Okay. Am I just really not feeling good? Is this labor? I’m not sure what’s happening.”

So I get in the shower and I’m like, “All right. Let me just get in the shower and see what’s up.” Then my husband comes back in and I’m like, “Hey, I don’t want to freak you out. I’m not sure if this is labor or not, but maybe it is.”

It’s getting closer to 8:00 PM or so and things are really starting to ramp up. I’m like, “Okay, this is probably labor.” I do remember having a thought of, “Shoot. If this is how early labor is and I’m already feeling it like this, I’m worried. I don’t know that I can do this.” I had those thoughts. I feel like I quickly got out of that, but it freaked me out. I wasn’t prepared for that. I know you can have those thoughts down the line in active labor, but I was like, “If I’m already feeling this and I don’t even know if I’m in labor yet, shoot. I’m in trouble.”

20:16 Going to the hospital

Hayley: Fast forward, we started timing the contractions around 8:30 or 9:00 at night so only an hour and a half or so after I first had that contraction that I felt. They were already lasting over a minute long and coming 3-6 minutes apart. It got really intense really quickly.

I was like, “All right.” We put on Harry Potter. I was like, “Let’s just try to get some sleep. Let me rest here.” Jokes on us. We did not rest. We did not get sleep. I ended up calling our midwives and our doula. They were like, “Okay. You should probably think about coming in.”

We left our house at 11:00 PM. We live an hour from the hospital or 40 minutes. I was freaking out because one of the concerns I feel like everyone has is, “I don’t want to have my baby in the car,” but you don’t want to get there too soon. It’s one of those things. I really, truly believe though for me-- people say it’s nice to labor at home because you are comfortable and I do get that but for me, I wanted to get to my place of birth and I feel like that was a huge thing for me and my mindset.

Once I got to my place of birth, I was like, “Okay. This is where I’m giving birth. I don’t need to travel.” I relaxed a lot. That was also something I assumed I wanted to be at home longer, but for me, I was like, “No. I need to feel comfortable and in my space.”

However, when I got there, I was already 100% effaced, 0 station, and 7 centimeters.

Meagan: Nice!

Hayley: So I was already pretty far along.

Meagan: You pretty much labored at home very well.

Hayley: Yeah, exactly. So I was like, “Okay.” But I just really wanted to get to the hospital. I was like, “Get me to my people because I need support.”

Meagan: Yeah.

Hayley: So we finally get to the room. They had a bathtub which was great so they filled the tub up. I did have an IV placed but they didn’t have it hooked to anything. They just had it placed. What was annoying about that was they forgot to tape it when I got in the tub so of course, it fell out. So they literally I think, tried to stick me like 10 times. I’m not even exaggerating. It was a whole situation so that was not fun.

Yeah. Laboring in the tub was great and on the toilet was great. But it really, yeah. Once I was there and had my people, I just felt like I was in the zone and everything seemed a lot better than when I was at home in my head just being like, “What’s happening?”

So yeah. Everything moved really quickly but I wasn’t prepared for tailbone pain. Then I mean, I guess I probably should have. It was kind of in my head that this should be a thing because of when I fell, but man. The back pain and the tailbone pain so even things like the double hip squeeze that I thought, “Oh yeah, that’s going to help me” were like, no.

Meagan: And sacrum, oof. Yeah. No wonder the toilet felt really good because you were able to sit without pressure open and release that.

Hayley: Yeah, exactly. That was perfect or hands and knees in the tub because yeah. I couldn’t sit. It was a whole thing.

I don’t remember honestly from when my labor started at home, I don’t remember honestly peaking and getting any worse. It just honestly felt the same. Intense from the beginning all the way until the end which was also something that I was not prepared for. I think obviously it is different for everybody, but that was something I was like, “Oh.” I was pleasantly surprised in the sense of at least it wasn’t like, “Shoot. I’m totally screwed later,” but also, it was intense very quickly early on and throughout.

24:20 Pushing

Hayley: So fast forward, I feel like now it’s 7:00 AM. We get to the hospital at basically 1:00 AM. At 7:00 AM, I’m at 10 centimeters and I feel the urge to push so we start pushing in different positions. One thing I really wanted for myself was to not push lounging on a bed. However, with my tailbone, I felt like everything hurt so it ended up where we tried so many positions but I was kind of semi-reclined just because I felt like I needed that support. I don’t know.

I told myself to be okay with ultimately pushing in the position that I “didn’t want” and being okay with that was something that I was like, “You know what? Listen to what I need in this moment and do what’s best.” So it was one of those moments where it was like, “All right. I need to just let go of what I was assuming and do what’s best for me.”

We pushed for a while. It was 60 or so minutes which was–

Meagan: That’s actually not bad for a first-time mom.

Hayley: Really? I think it was 60, maybe 70 or so. But I do remember pushing being harder than I thought. That was not something that I had prepared for. I feel like for any mamas out there listening, prepare for pushing.

Meagan: Yeah. Pushing is hard work.

Hayley: It’s hard. I think that tired me out honestly more than the labor. It was pushing and I think it was half because I did not prepare as much for it and because obviously at the end of it, you’re already tired and exhausted. But yeah. I did not prepare for pushing to last as long either. I feel like I did know that, but mentally, I feel like, “Wait. This is still happening,” and it being intense.

But then he finally was born and I just literally grabbed him. My husband was helping catch him, but I literally just took him right away.

Meagan: Aw, cute.

Hayley: It was great. So then I had this huge high of like, “Wow. I did this VBAC unmedicated. This is great,” then fast forward to postpartum, the nurse had kind of mentioned or my midwife had kind of mentioned, “Oh, you have a slight uterine prolapse.” I was just like, “I don’t know what that means. Cool.” They mentioned it as we were in the hospital and it wasn’t until afterward that I still was like, “No one is telling me what any of this means. What is this? I don’t even know what this is.” They were being so casual about it and I wasn’t getting any information.

27:05 Hayley’s prolapse experience

Hayley: That was something that was frustrating because then postpartum, a couple weeks in when I was starting to have some symptoms of prolapse, I was like, “Well, no one is giving me answers. Nobody told me what this is. Now I’m postpartum feeling confused and in the dark.”

It was really interesting to go from this high high of, “Wow. I had an amazing birth, successful VBAC, unmedicated” to now questioning, “Well, what did I do?” You question yourself. Did I do something wrong? Could I have done something differently? Why did this happen? Because no one else apparently had this which is actually not true. It’s just not talked about.

So that was a very big part of postpartum that I was not at all prepared for.

Meagan: Yeah. That’s hard. Let’s talk a little bit about the symptoms that you were receiving. What symptoms did you have?

Hayley: Yeah. So at the beginning, I felt like I was like, “I don’t know what this means. I’m not really feeling it. You just said I have a slight uterine prolapse. We’ll check that later.” Then you don’t go to your visit until however many weeks postpartum. So I was like, okay.

But then when I was home a couple of weeks later, maybe two or so weeks, I was feeling heaviness or uncomfortable or pain a little bit. This doesn’t feel normal. I felt bulging in the beginning. That emotionally and mentally really got to me. I was like, “Why is my body doing this?” Then I would remember messaging my midwife on the little portal and they were like, “You’re really early postpartum. We will talk when we see you,” and no help. I’m like, “Well, that doesn’t help me now when I’m not feeling great. It doesn’t help me when I’m just like, yeah.

They were like, “Most of the time, it will resolve” or whatever. It’s like, okay but I’m not happy right now. I’m not feeling great now. So finally, as soon as I did have my pelvic floor PT from before, I emailed her like, “Hey, is there anything you can recommend because I’m not seeing my midwife for a while? No one is really helping me out.” She was like, “Yeah, you can come in. I can’t really do an exam yet because you are still so early, but I can see you. I can talk to you. I can look at things and see what is happening.”

So that was really helpful. What’s interesting is now, I’m however many months postpartum, but even I feel like a month or two when I could go onto my pelvic floor PT, she didn’t see any sort of uterine prolapse, but I think I have a slight bladder cystocele so I’m not sure where the uterine thing happened in the beginning of when I delivered and they had said I had uterine prolapse, but now, it looks like it’s just a slight cystocele.

But what’s frustrating about what I’ve noticed with people with prolapse is a) the grades don’t seemingly matter in that you can be a grade 1 prolapse which I think technically I probably am, but if you are having symptoms, then let’s get that figured out because so many times, people would be like, “Well, it’s not bad” or “I don’t even see anything,” but it’s like, “Okay, well I am feeling these symptoms and it is mentally causing me– it’s making me in my head. It’s making me depressed. It’s making me upset about my body so let’s find someone to actually work on that with me instead of dismissing that was huge because yeah. I don’t have a grade 4 prolapse or grade 3 or whatever it is that you consider back, but if it’s making my day-to-day and me not be able to do things, then that’s a problem.

Meagan: Yes. I love that you are talking about that. Women of Strength, at least here in the U.S., take way too long to be checked in on after having a baby. Six weeks is mind-boggling to me. A lot happens in six weeks. We have a lot of hormones shifting. We have a lot of recovering. We have a lot of things that may need to be addressed earlier on or that can start helping us with our mental health. There are so many things.

I agree. If you are experiencing any type of these symptoms and your heart is like, “This isn’t good or this is affecting me,” reach out to someone. If you’re OB or your midwife's office is like, “We’ll see you at six weeks,” go to that pelvic floor PT. Review with them.

32:01 Symptoms of uterine prolapse

Meagan: I want to talk about some of the symptoms of uterine specifically and what it is. Uterine prolapse occurs when the muscles and tissues in your pelvis are weakened. We know that through childbirth, that happens. We push and sometimes when we push longer hours or whatever, we can weaken that.

But most people with uterine prolapse are a little older. They are 50-80 years old but it can happen in childbirth. So here are some of the symptoms.

Leaking of urine, inability to completely empty your bladder– so you go to the bathroom, you stand up and you’re like, “Oh, there’s more,” or you start leaking more. That heaviness down there– so I had a cystocele as well. It’s so weird, but I remember wanting to sit on the corner of the couch or on the edge of the couch just to put some counter pressure. Do you know what I mean?

Hayley: Yep. Yep.

Meagan: That bulging, lower back pain which a lot of the time we are like, “Oh, back pain. We are nursing. We are recovering. We are hunched. Yeah, that’s normal.” Lower back pain is not necessarily normal. Aching or feeling that in your lower abdomen or down in your pelvic area and even severe constipation. We know that after childbirth, especially if we have an epidural or we’ve had a lot of intervention and stuff like that, constipation can happen. A lot of people get iron supplements and stuff like that to have that be lessened, but these are symptoms that truly need to be discussed and not ignored for six weeks because like Hayley was saying, it can start wearing on our mental health. I remember wanting to go out and walk around the block with my kids and just wanting to hold myself down there because it was so bulgy and achy.

Hayley: Yes.

Meagan: According to a study, it said that around 35% of women who have recently given birth suffer from prolapse. 35%. That’s a lot of us, you guys. A lot of people. The cystocele is when the wall between the bladder and the vaginal wall weakens so we can’t kegel. It’s not tight. It’s weakened so it comes down.

Again, if you are experiencing any of these symptoms, know that it’s not necessarily something you have to just deal with. And yes, it will probably resolve in time, but you could also probably get some help sooner rather than later and help yourself mentally not worry about that.

I have a friend who had a pretty high-grade prolapse. She ended up scheduling which is totally fine. She ended up scheduling C-sections for the rest of her births because she was so terrified of having that issue because she did have bladder and fecal issues. When you are peeing and pooping yourself, that’s not fun. It’s not fun, but you can get the support out there and you deserve the support and you do not need to be pushed off for six weeks.

Make sure to follow your heart and get the help you need.

35:29 Prolapse can happen

Hayley: Yeah, exactly. I think another thing that I would have loved to have known, I feel like no one talks about prolapse. When I went through my pregnancy classes or even just with the doctor or with my midwife, no one ever mentioned, “Oh, this could happen. This could be a complication. This could happen after birth.” No one ever mentioned that to me, so I was like, “I don’t even know what this is,” then I felt really alone like, “Why am I the only postpartum person who has this happen?”

Meagan: Right or that’s just talking about it.

Hayley: In reality, I’m not.

Meagan: No, you’re not. Yeah. There are a ton of risk factors, but giving birth is easily the highest risk. Think about the amount of pressure that we are putting on our pelvic floor and our organs when we are pushing out a baby. I think that is another reason. I know you did this. I know you went to pelvic PT beforehand, but especially if you’ve had this in the past or you are thinking about this, talk to your pelvic floor PT and say, “Okay. Can you give me some guidance on pushing? Can we talk about how to try to avoid this?”

I actually had another client– my other one was just a friend. I wasn’t her doula, but this was a client. She had some pretty rough PT things and had to go through a lot of PT. That was her thing and they said, “As soon as you feel this, I want you to change positions. I want you to push differently. I want you to breathe differently.” She believes that her work before and her work during and her different style of pushing helped. Baby came out really fast. She actually didn’t have any pelvic issues which was a really grateful thing for her because she had a pretty severe complication.

Yeah. It doesn’t always have to be that so that was another message. If you have it, it doesn’t have to be like that next time or it doesn’t mean it’s always going to be like that next time. But know that if you are having that, you’re probably not the only one. 35% of us, that’s a large chunk of people. That’s right up there with the Cesarean rate. It’s quite high.

Hayley: That’s true.

Meagan: So know that it’s okay to talk about it. It’s okay to open up. You do not have to deal with it. You can get help and you deserve it.

Hayley: Yeah. Yeah. Exactly. I feel like for a while, I just cried to my husband and he was like, “It’s okay to feel this way.” Stop blaming yourself. Really getting out of your head. You didn’t cause this and yeah. You can absolutely get help. If people are pushing you off, let’s find somebody else then who will talk to you in the meantime because your mental health matters. How you are feeling matters because yeah. Now, here I am getting close to a year postpartum and I’m feeling so much better, but it’s because I’ve been listening to my body and I’ve been working with a PT doing exercises and supporting myself and working on drinking water, not getting constipated like you said and all of these things.

Again, were there times in my postpartum journey when I was like, “This is not what I want to be dealing with?” Yes. But you can absolutely– it does get better. If you’re feeling this way, it sucks and you feel like it’s never going to get better. I get it. I was there, but it really does and you’re not the only person.

At the same time, I don’t want to scare people. This may not happen to you either for sure. But if it does, listen to yourself and you can get help.

Meagan: And that’s the message, right? It’s not going to happen to everybody but it does happen and it’s important to know that you don’t have to ignore it. You don’t have to suffer in silence. You can get help and have a better postpartum. There are tons of things– I think I’ve talked about this– in my postpartum journey where I was like, “I got the birth I wanted, but I’m so frustrated that these things are happening.” You can also have both of those feelings. You can be super happy for your birth but also really frustrated with your postpartum journey or vice versa where you’re like, “I had a really crappy birth, but man, I’m so grateful for this postpartum journey.” You can have those feelings together. You don’t have to be quiet because you had the birth that everyone knew you wanted.

Hayley: Right, exactly. It doesn’t diminish how proud I am of having a natural VBAC and doing that even though at times in the beginning, I did question that.

Meagan: Oh yeah. Yeah. That’s natural.

Hayley: But looking back, I’m like, “That’s amazing.” I’m so proud of myself that I achieved a VBAC and had an unmedicated one. It’s just crazy to me.

Meagan: Absolutely. Well, thank you for sharing your story today.

Hayley: Thank you for having me. I know I can talk a lot.

Meagan: It was wonderful.

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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Hayley joins the show today sharing her breech Cesarean and unmedicated hospital VBAC stories. Meagan and Hayley dive deep into the pros and cons of getting an epidural and why providers tell women so many different things when it comes to epidurals and VBAC!

While Hayley had the dreamiest birth she could have imagined and everything went according to plan, her postpartum experience with prolapse was not something she was prepared for. Hayley shares her symptoms, what she wished she knew, and what she has done since to recover and feel like herself again.

Needed Website

How to VBAC: The Ultimate Prep Course for Parents

Full Transcript under Episode Details

02:47 Just-in-case epidural

04:16 Dr. McGuire’s insight on epidurals

08:42 Using an epidural as a tool

10:44 Hayley’s first pregnancy and birth

12:00 Doing VBAC research before pregnancy

13:51 Hayley’s second pregnancy

18:15 Labor begins

20:16 Going to the hospital

24:20 Pushing

27:05 Hayley’s prolapse experience

32:01 Symptoms of uterine prolapse

35:29 Prolapse can happen

Meagan: Hello, hello Women of Strength. You guys, I am excited about today’s episode. I love talking about VBAC obviously, but specifically, we are going to talk a little bit about unmedicated versus medicated. Our friend, Hayley, from North Carolina has had a beautiful unmedicated hospital VBAC so I want to also talk about the opposite side of that and talk about medicated VBAC.

We have so many people in our community that I see type, “I want a VBAC, but I don’t want to go unmedicated and my doctor says I have to. I can’t have an epidural” or the total flipside of that where, “I really want an unmedicated VBAC, but my doctor says I can’t go unmedicated. I have to have the epidural.” Did I just say that correctly, Hayley?

Hayley: Yes, yeah.

Meagan: It’s either one or the other. We’ve got providers telling people they can’t have an epidural or they have to have an epidural. So I wanted to just talk a little bit today before we get going on those two topics.

First of all, let’s talk about unmedicated birth. Hayley and I are living proof today. We are on this episode that unmedicated VBAC is 100% possible, achievable, and safe. A lot of those providers come out and say that they can’t go unmedicated because they say it’s not safe. In the rare chance, we know that uterine rupture happens but it is rare. In the rare chance of a uterine rupture, that is where they say that is not okay.

Or they will say things like, “But you wouldn’t want to be knocked out for your birth,” which is scary. I don’t want to be knocked out for my birth and I know people have. A lot of the time, it is not the most pleasant experience. Yeah. Okay, so let’s talk about that.

Unmedicated vaginal birth is unmedicated vaginal birth. That’s what it is. I’m just laying it out there. Yes, we have a slight increase in uterine rupture. Yes. What happens if we have a uterine rupture and we are unmediated?

A lot of the time, we are noticing that there are signs of uterine rupture. When we get an epidural and a spinal, we go back and have a C-section. Simple as that.

Or if it is a true medical emergency, yes, there is that small risk of needing to be put under. Small risk and small risk equal risk of course, but it’s low.

02:47 Just-in-case epidural

Meagan: What about if we have the just-in-case epidural? I seriously sometimes just want to sock someone who says “Just in case”. We don’t need to be placing an epidural just to have it ready to dose because guess what? In the event that it is a true emergency and we really do need to go in for an immediate Cesarean, it’s the same thing. We get knocked out.

I know that these words are kind of big and harsh words. We get knocked out, but we get put under general anesthesia if we don’t have anything in our system.

Now, let’s talk about an epidural. You actually have an epidural placed. It’s running. It’s dosed and we have a uterine rupture. Guess what? Women of Strength, more than likely, it still has to be dosed further because an epidural is not like a spinal. It’s just not. They have to dose it further.

With my first Cesarean, I had an epidural. They had to come in, dose it to a deeper extreme so I wasn’t feeling my surgery and I had to wait. Right? We are still waiting. It’s the same thing. There is always a wait and it takes time. It takes about 15-20 minutes for any epidural to kick in deep enough.

04:16 Dr. McGuire’s insight on epidurals

Meagan: Dr. McGuire wrote for Yale Medicine. She talks about this epidural and is it safe and how are they different. She talks about how they truly are different than they were back in the day because they are dosing them lighter. We know that. We have seen that, but we still have some pretty serious risks as well with epidurals even though again, they are smaller. There are blood clots, spinal infections, spinal headaches, them not working, and things like that, and blood pressure.

I’m going to say as a doula, I’ve attended over 350 births. As a doula, I will say a large portion of any client, not just VBAC, who receives an epidural has a blood pressure dip. Even when they have a large amount of fluid because a lot of the time they will cram fluids in to try to help this, but there is some sort of blood pressure dip and baby seems to struggle when that happens.

Then it’s the cascade– rolling over, move, move, move, move. Baby doesn’t recover or mom’s blood pressure doesn’t recover and we are off to an OR.

One of the biggest questions that I think is a really hot debate in the medical world is does an epidural raise your chances of a Cesarean? Most people out there are going to say, “No, it doesn’t.” The studies are pretty low, though. I think in one study there were 2,000 people or something like that and they showed it didn’t.

But I mean, from a doula’s standpoint, I know I don’t see as many births as these OBs, but I definitely see it seems to do that– the blood pressure drop thing. So is it safe? Yes. Do you have to go unmedicated if you have a VBAC? No. Do you have to get an epidural if you have an epidural? No. Do what is best for you.

What she says is, “Those studies we know that have a higher concentration of epidural medicine was associated with an increased risk of Cesarean, though lower concentration we now use actually promotes normal, spontaneous vaginal delivery without assistance.” When she says assistance, a lot of the time when we have epidurals, we have vacuum or forceps assistance because we have lack of mobility.

That’s what she was saying here. I want to make sure to provide the link and some other links on our blog for epidurals so you can decide what is best for you. But for now, we are going to get into a story of an unmedicated, vaginal birth.

08:42 Using an epidural as a tool

Meagan: Okay, Ms. Hayley. Welcome to the show.

Hayley: Thank you for having me. It’s really crazy to be on here sharing so thank you.

Meagan: I talk about how it’s crazy to be full-circle where you are listening. You are preparing. All of the people in your ear are motivating and then here you are today sharing your story motivating others in your same space x, y, z months ago.

Hayley: Yeah. It’s crazy. It really is a full-circle moment like you mentioned.

Meagan: Yeah. Well, I am so honored that you are here. I would love to turn the time over to you.

Hayley: Sure. So yeah, I also love what you were saying really quickly on the epidural versus not. Full transparency, when I went into this, I definitely recognized that an epidural is a tool and I knew and wanted to prepare myself. If I am– obviously, birth is not pleasant. It’s not going to be a walk in the park. But I knew there was a difference between being in pain versus suffering. I really wanted to know that for myself. It if turned into that suffering, I wouldn’t have been opposed to helping my body to get my baby.

Meagan: To the next point, yeah.

Hayley: But there is a difference between being in pain and suffering.

Meagan: As a doula, we talk about that a lot where we are like, okay. We are planning to go unmedicated. That is fantastic and then we talk about that pain versus suffering and that transition because when we are suffering, we start having things that come up later. We don’t think about it. We are suffering now, but postpartum depression, postpartum anxiety, and postpartum trauma. We have these things that are not worth it, so in the end, you have to do what’s best for you and keep you in that positive space and recognize pain versus suffering.

Hayley: Yeah. Exactly, so I love that.

10:44 Hayley’s first pregnancy and birth

Hayley: To start this whole story I guess, is back in April 2021, I had my daughter. She was breech. For me, I knew pretty early on that she was breech. She was so active. I knew that, “Oh, you are trying to flip in there.” I did all of the things. I did Spinning Babies and tried all of the things, but it was still COVID time so I just didn’t go to acupuncture. I feel like if it wasn’t COVID times still, I maybe would have tried more things. But with that being said, I felt like she was literally trying to turn because I’m like, “What are you doing? If you’re not flipping, then I’m not sure. Then you can’t.” I just felt in my body that there was a reason.

I didn’t try manually flipping her or things like that. To help with peace of mind, I opted for a Cesarean even though that was the last thing I wanted. I’m terrified of surgeries and needles. I was like, “I do not want this. This is the absolute last thing I want,” but at the same time, I was happy that I could mentally prepare for that instead of it being sprung on me. And honestly, I feel like I had a pretty good recovery with that.

At the same time, I knew for any future children, I did not want to have another C-section.

12:00 Doing VBAC research before pregnancy

Hayley: So fast forward. We moved across the country when she was about 9 months old. I was definitely not pregnant yet, but we were thinking about expanding our family. I had already started researching providers in the area, joining Facebook pages like the ICAN Facebook group in the area and literally preparing even though I wasn’t pregnant because I just really wanted to make this.

Meagan: That is important.

Hayley: Yeah. I just did my research. I really, really wanted to be not in a situation where I’m like, “Oh shoot. I’m pregnant and now I need to struggle to find a supportive provider,” because unfortunately, it’s hard to find VBAC-supportive providers. I wish that wasn’t the case, but I feel like that’s unfortunately the majority.

Meagan: The reality, it sucks. It’s stupid. I have a lot of words for that, but it is the reality. It is more often that it’s hard to find that true support than it is to find the opposite.

Hayley: Yep. I remember I made a couple of appointments just to talk with people to be like, “Hey, how do you feel about this? I’m looking to establish care.” I remember I went to two different places. One was an OB and they did have some midwives there, but yeah. They were like, “Well, you can or you can try that,” and I was like, “Cool. This doesn’t sound like 100%.”

I eventually found a group of midwives. I felt was a total 180 with the way that the care felt. Not that you can’t get that with OBs, but they were like, “Yeah. We’re going to do that.” It was just like, “Cool. We’re going to do that.”

Meagan: I love that. You’re like, “And great. I was almost not expecting you to say that so fantastic.”

Hayley: Exactly. I’m like, “Perfect.”

13:51 Hayley’s second pregnancy

Hayley: Fast forward, I then get pregnant with my second. I established care through them. I felt like the whole process was just so chill. Even just with anything, maybe it’s just the difference between your first pregnancy and second pregnancy where you are so nervous about everything with the first, but even the ultrasound that just felt very– with my first, they would really make me feel like they were really making sure, not that you shouldn’t make sure things are okay, but they just really made me feel like everything was so medical and things could go wrong or something.

With my second, they were just like, “Yeah, baby is great.” Okay, cool. Perfect. So that was awesome and definitely not what I expected. Again, it’s a different office and a different state. It was a totally different experience and amazing. But I was definitely in my head the whole pregnancy. I did not want this baby to flip. I just kept doing everything I could throughout my whole pregnancy, really working on my mentality and my mindset.

I found a doula. I went to a chiropractor towards the end of my pregnancy. I went to pelvic health, physical therapy, and I did all of the things because I’m like, “I want to do everything that I possibly can to make this happen.” That way if I didn’t, I would at least know, “Hey, I did everything and I totally prepared.” So mentally, that’s just what I needed. But yeah. I was definitely so in my head like, “What if this baby decides to be breech again? I would be so sad.” But luckily, that did not happen.

I also fell on my tailbone. I hurt my tailbone when I was 4 months before delivery so that was really not great either because one thing that once I would get into labor, I had so much tailbone pain and that was just something that I was not expecting.

So the pregnancy definitely had ups and downs. I feel like maybe you can answer if this is your experience too down the line with pregnancies, but I feel like your body just feels everything so much quicker with the second pregnancy. Like, “Oh, I’m already sore and it’s not even the second trimester. What’s happening?”

Meagan: I believe that.

Hayley: Yeah, so I found that really preparing is my number-one tip of doing your research, listening to podcasts, really get in that space of there was no doubt in my mind that I wasn’t going to be able to have a VBAC and I feel like that really helped me out when labor came because it wasn’t something that I even thought about. I can psyche myself out of I didn’t get worried.

Meagan: How amazing is that? I feel like that goes again, it’s like the full circle of, “Okay. I am educated. I have the support. I have the body and the baby ready to do this.” When we have gaps in our circle where it’s like, “Okay, well I’m educated so I feel confident in my ability,” but then we have a provider who is wishy-washy and shutting me down or I have a family member who is like, “Oh, you are really making a bad choice,” or starts questioning us and placing doubt, but then we are confident in our body. We are healthy and all of these things.

But when there are gaps, we can’t go into birth with that mentality. That’s something I wish for every single person going in to have a baby no matter what is just feeling confident and having that mentality of stress-free of the doubt. There are always the what-ifs and the wonders and every birth experience is different, but to not doubt ourselves or our ability and it comes with education, support, and all of those things.

Hayley: Yeah, exactly. Like reading my books and listening to stories and being like, “Yeah. My body can do this. This is what people have done for all of time.”

Meagan: Forever.

Hayley: We can do this. Yeah. Definitely, I agree. If you don’t have every single one of those aspects, it just makes things so much harder on yourself and everything.

18:15 Labor begins

Hayley: So fast forward, I never went through labor with my first, so I still felt like a first-time mom in the sense that I was like, “Will I know when I’m in labor? What’s it going to feel like?”

It was February last year. I don’t know, whatever day it was. I guess it was the 22nd. I guess I was having cramping. I don’t know. They were really mild so I didn’t really think about it. I was working and taking care of my firstborn.

Looking back, I’m like, “Oh, I guess it was maybe early labor.” But I didn’t really think about it. But I had pasta for dinner which I think is hilarious. I just ate pasta because fast forward, I am putting my little one to bed at 7:00 PM and I start getting really bad stomach pains. I’m like, “Is this from my dinner? Is my stomach just upset? I don’t know what’s happening.”

I remember I had to have my husband finish putting her to bed. I was really not feeling good. I was like, “Okay. Am I just really not feeling good? Is this labor? I’m not sure what’s happening.”

So I get in the shower and I’m like, “All right. Let me just get in the shower and see what’s up.” Then my husband comes back in and I’m like, “Hey, I don’t want to freak you out. I’m not sure if this is labor or not, but maybe it is.”

It’s getting closer to 8:00 PM or so and things are really starting to ramp up. I’m like, “Okay, this is probably labor.” I do remember having a thought of, “Shoot. If this is how early labor is and I’m already feeling it like this, I’m worried. I don’t know that I can do this.” I had those thoughts. I feel like I quickly got out of that, but it freaked me out. I wasn’t prepared for that. I know you can have those thoughts down the line in active labor, but I was like, “If I’m already feeling this and I don’t even know if I’m in labor yet, shoot. I’m in trouble.”

20:16 Going to the hospital

Hayley: Fast forward, we started timing the contractions around 8:30 or 9:00 at night so only an hour and a half or so after I first had that contraction that I felt. They were already lasting over a minute long and coming 3-6 minutes apart. It got really intense really quickly.

I was like, “All right.” We put on Harry Potter. I was like, “Let’s just try to get some sleep. Let me rest here.” Jokes on us. We did not rest. We did not get sleep. I ended up calling our midwives and our doula. They were like, “Okay. You should probably think about coming in.”

We left our house at 11:00 PM. We live an hour from the hospital or 40 minutes. I was freaking out because one of the concerns I feel like everyone has is, “I don’t want to have my baby in the car,” but you don’t want to get there too soon. It’s one of those things. I really, truly believe though for me-- people say it’s nice to labor at home because you are comfortable and I do get that but for me, I wanted to get to my place of birth and I feel like that was a huge thing for me and my mindset.

Once I got to my place of birth, I was like, “Okay. This is where I’m giving birth. I don’t need to travel.” I relaxed a lot. That was also something I assumed I wanted to be at home longer, but for me, I was like, “No. I need to feel comfortable and in my space.”

However, when I got there, I was already 100% effaced, 0 station, and 7 centimeters.

Meagan: Nice!

Hayley: So I was already pretty far along.

Meagan: You pretty much labored at home very well.

Hayley: Yeah, exactly. So I was like, “Okay.” But I just really wanted to get to the hospital. I was like, “Get me to my people because I need support.”

Meagan: Yeah.

Hayley: So we finally get to the room. They had a bathtub which was great so they filled the tub up. I did have an IV placed but they didn’t have it hooked to anything. They just had it placed. What was annoying about that was they forgot to tape it when I got in the tub so of course, it fell out. So they literally I think, tried to stick me like 10 times. I’m not even exaggerating. It was a whole situation so that was not fun.

Yeah. Laboring in the tub was great and on the toilet was great. But it really, yeah. Once I was there and had my people, I just felt like I was in the zone and everything seemed a lot better than when I was at home in my head just being like, “What’s happening?”

So yeah. Everything moved really quickly but I wasn’t prepared for tailbone pain. Then I mean, I guess I probably should have. It was kind of in my head that this should be a thing because of when I fell, but man. The back pain and the tailbone pain so even things like the double hip squeeze that I thought, “Oh yeah, that’s going to help me” were like, no.

Meagan: And sacrum, oof. Yeah. No wonder the toilet felt really good because you were able to sit without pressure open and release that.

Hayley: Yeah, exactly. That was perfect or hands and knees in the tub because yeah. I couldn’t sit. It was a whole thing.

I don’t remember honestly from when my labor started at home, I don’t remember honestly peaking and getting any worse. It just honestly felt the same. Intense from the beginning all the way until the end which was also something that I was not prepared for. I think obviously it is different for everybody, but that was something I was like, “Oh.” I was pleasantly surprised in the sense of at least it wasn’t like, “Shoot. I’m totally screwed later,” but also, it was intense very quickly early on and throughout.

24:20 Pushing

Hayley: So fast forward, I feel like now it’s 7:00 AM. We get to the hospital at basically 1:00 AM. At 7:00 AM, I’m at 10 centimeters and I feel the urge to push so we start pushing in different positions. One thing I really wanted for myself was to not push lounging on a bed. However, with my tailbone, I felt like everything hurt so it ended up where we tried so many positions but I was kind of semi-reclined just because I felt like I needed that support. I don’t know.

I told myself to be okay with ultimately pushing in the position that I “didn’t want” and being okay with that was something that I was like, “You know what? Listen to what I need in this moment and do what’s best.” So it was one of those moments where it was like, “All right. I need to just let go of what I was assuming and do what’s best for me.”

We pushed for a while. It was 60 or so minutes which was–

Meagan: That’s actually not bad for a first-time mom.

Hayley: Really? I think it was 60, maybe 70 or so. But I do remember pushing being harder than I thought. That was not something that I had prepared for. I feel like for any mamas out there listening, prepare for pushing.

Meagan: Yeah. Pushing is hard work.

Hayley: It’s hard. I think that tired me out honestly more than the labor. It was pushing and I think it was half because I did not prepare as much for it and because obviously at the end of it, you’re already tired and exhausted. But yeah. I did not prepare for pushing to last as long either. I feel like I did know that, but mentally, I feel like, “Wait. This is still happening,” and it being intense.

But then he finally was born and I just literally grabbed him. My husband was helping catch him, but I literally just took him right away.

Meagan: Aw, cute.

Hayley: It was great. So then I had this huge high of like, “Wow. I did this VBAC unmedicated. This is great,” then fast forward to postpartum, the nurse had kind of mentioned or my midwife had kind of mentioned, “Oh, you have a slight uterine prolapse.” I was just like, “I don’t know what that means. Cool.” They mentioned it as we were in the hospital and it wasn’t until afterward that I still was like, “No one is telling me what any of this means. What is this? I don’t even know what this is.” They were being so casual about it and I wasn’t getting any information.

27:05 Hayley’s prolapse experience

Hayley: That was something that was frustrating because then postpartum, a couple weeks in when I was starting to have some symptoms of prolapse, I was like, “Well, no one is giving me answers. Nobody told me what this is. Now I’m postpartum feeling confused and in the dark.”

It was really interesting to go from this high high of, “Wow. I had an amazing birth, successful VBAC, unmedicated” to now questioning, “Well, what did I do?” You question yourself. Did I do something wrong? Could I have done something differently? Why did this happen? Because no one else apparently had this which is actually not true. It’s just not talked about.

So that was a very big part of postpartum that I was not at all prepared for.

Meagan: Yeah. That’s hard. Let’s talk a little bit about the symptoms that you were receiving. What symptoms did you have?

Hayley: Yeah. So at the beginning, I felt like I was like, “I don’t know what this means. I’m not really feeling it. You just said I have a slight uterine prolapse. We’ll check that later.” Then you don’t go to your visit until however many weeks postpartum. So I was like, okay.

But then when I was home a couple of weeks later, maybe two or so weeks, I was feeling heaviness or uncomfortable or pain a little bit. This doesn’t feel normal. I felt bulging in the beginning. That emotionally and mentally really got to me. I was like, “Why is my body doing this?” Then I would remember messaging my midwife on the little portal and they were like, “You’re really early postpartum. We will talk when we see you,” and no help. I’m like, “Well, that doesn’t help me now when I’m not feeling great. It doesn’t help me when I’m just like, yeah.

They were like, “Most of the time, it will resolve” or whatever. It’s like, okay but I’m not happy right now. I’m not feeling great now. So finally, as soon as I did have my pelvic floor PT from before, I emailed her like, “Hey, is there anything you can recommend because I’m not seeing my midwife for a while? No one is really helping me out.” She was like, “Yeah, you can come in. I can’t really do an exam yet because you are still so early, but I can see you. I can talk to you. I can look at things and see what is happening.”

So that was really helpful. What’s interesting is now, I’m however many months postpartum, but even I feel like a month or two when I could go onto my pelvic floor PT, she didn’t see any sort of uterine prolapse, but I think I have a slight bladder cystocele so I’m not sure where the uterine thing happened in the beginning of when I delivered and they had said I had uterine prolapse, but now, it looks like it’s just a slight cystocele.

But what’s frustrating about what I’ve noticed with people with prolapse is a) the grades don’t seemingly matter in that you can be a grade 1 prolapse which I think technically I probably am, but if you are having symptoms, then let’s get that figured out because so many times, people would be like, “Well, it’s not bad” or “I don’t even see anything,” but it’s like, “Okay, well I am feeling these symptoms and it is mentally causing me– it’s making me in my head. It’s making me depressed. It’s making me upset about my body so let’s find someone to actually work on that with me instead of dismissing that was huge because yeah. I don’t have a grade 4 prolapse or grade 3 or whatever it is that you consider back, but if it’s making my day-to-day and me not be able to do things, then that’s a problem.

Meagan: Yes. I love that you are talking about that. Women of Strength, at least here in the U.S., take way too long to be checked in on after having a baby. Six weeks is mind-boggling to me. A lot happens in six weeks. We have a lot of hormones shifting. We have a lot of recovering. We have a lot of things that may need to be addressed earlier on or that can start helping us with our mental health. There are so many things.

I agree. If you are experiencing any type of these symptoms and your heart is like, “This isn’t good or this is affecting me,” reach out to someone. If you’re OB or your midwife's office is like, “We’ll see you at six weeks,” go to that pelvic floor PT. Review with them.

32:01 Symptoms of uterine prolapse

Meagan: I want to talk about some of the symptoms of uterine specifically and what it is. Uterine prolapse occurs when the muscles and tissues in your pelvis are weakened. We know that through childbirth, that happens. We push and sometimes when we push longer hours or whatever, we can weaken that.

But most people with uterine prolapse are a little older. They are 50-80 years old but it can happen in childbirth. So here are some of the symptoms.

Leaking of urine, inability to completely empty your bladder– so you go to the bathroom, you stand up and you’re like, “Oh, there’s more,” or you start leaking more. That heaviness down there– so I had a cystocele as well. It’s so weird, but I remember wanting to sit on the corner of the couch or on the edge of the couch just to put some counter pressure. Do you know what I mean?

Hayley: Yep. Yep.

Meagan: That bulging, lower back pain which a lot of the time we are like, “Oh, back pain. We are nursing. We are recovering. We are hunched. Yeah, that’s normal.” Lower back pain is not necessarily normal. Aching or feeling that in your lower abdomen or down in your pelvic area and even severe constipation. We know that after childbirth, especially if we have an epidural or we’ve had a lot of intervention and stuff like that, constipation can happen. A lot of people get iron supplements and stuff like that to have that be lessened, but these are symptoms that truly need to be discussed and not ignored for six weeks because like Hayley was saying, it can start wearing on our mental health. I remember wanting to go out and walk around the block with my kids and just wanting to hold myself down there because it was so bulgy and achy.

Hayley: Yes.

Meagan: According to a study, it said that around 35% of women who have recently given birth suffer from prolapse. 35%. That’s a lot of us, you guys. A lot of people. The cystocele is when the wall between the bladder and the vaginal wall weakens so we can’t kegel. It’s not tight. It’s weakened so it comes down.

Again, if you are experiencing any of these symptoms, know that it’s not necessarily something you have to just deal with. And yes, it will probably resolve in time, but you could also probably get some help sooner rather than later and help yourself mentally not worry about that.

I have a friend who had a pretty high-grade prolapse. She ended up scheduling which is totally fine. She ended up scheduling C-sections for the rest of her births because she was so terrified of having that issue because she did have bladder and fecal issues. When you are peeing and pooping yourself, that’s not fun. It’s not fun, but you can get the support out there and you deserve the support and you do not need to be pushed off for six weeks.

Make sure to follow your heart and get the help you need.

35:29 Prolapse can happen

Hayley: Yeah, exactly. I think another thing that I would have loved to have known, I feel like no one talks about prolapse. When I went through my pregnancy classes or even just with the doctor or with my midwife, no one ever mentioned, “Oh, this could happen. This could be a complication. This could happen after birth.” No one ever mentioned that to me, so I was like, “I don’t even know what this is,” then I felt really alone like, “Why am I the only postpartum person who has this happen?”

Meagan: Right or that’s just talking about it.

Hayley: In reality, I’m not.

Meagan: No, you’re not. Yeah. There are a ton of risk factors, but giving birth is easily the highest risk. Think about the amount of pressure that we are putting on our pelvic floor and our organs when we are pushing out a baby. I think that is another reason. I know you did this. I know you went to pelvic PT beforehand, but especially if you’ve had this in the past or you are thinking about this, talk to your pelvic floor PT and say, “Okay. Can you give me some guidance on pushing? Can we talk about how to try to avoid this?”

I actually had another client– my other one was just a friend. I wasn’t her doula, but this was a client. She had some pretty rough PT things and had to go through a lot of PT. That was her thing and they said, “As soon as you feel this, I want you to change positions. I want you to push differently. I want you to breathe differently.” She believes that her work before and her work during and her different style of pushing helped. Baby came out really fast. She actually didn’t have any pelvic issues which was a really grateful thing for her because she had a pretty severe complication.

Yeah. It doesn’t always have to be that so that was another message. If you have it, it doesn’t have to be like that next time or it doesn’t mean it’s always going to be like that next time. But know that if you are having that, you’re probably not the only one. 35% of us, that’s a large chunk of people. That’s right up there with the Cesarean rate. It’s quite high.

Hayley: That’s true.

Meagan: So know that it’s okay to talk about it. It’s okay to open up. You do not have to deal with it. You can get help and you deserve it.

Hayley: Yeah. Yeah. Exactly. I feel like for a while, I just cried to my husband and he was like, “It’s okay to feel this way.” Stop blaming yourself. Really getting out of your head. You didn’t cause this and yeah. You can absolutely get help. If people are pushing you off, let’s find somebody else then who will talk to you in the meantime because your mental health matters. How you are feeling matters because yeah. Now, here I am getting close to a year postpartum and I’m feeling so much better, but it’s because I’ve been listening to my body and I’ve been working with a PT doing exercises and supporting myself and working on drinking water, not getting constipated like you said and all of these things.

Again, were there times in my postpartum journey when I was like, “This is not what I want to be dealing with?” Yes. But you can absolutely– it does get better. If you’re feeling this way, it sucks and you feel like it’s never going to get better. I get it. I was there, but it really does and you’re not the only person.

At the same time, I don’t want to scare people. This may not happen to you either for sure. But if it does, listen to yourself and you can get help.

Meagan: And that’s the message, right? It’s not going to happen to everybody but it does happen and it’s important to know that you don’t have to ignore it. You don’t have to suffer in silence. You can get help and have a better postpartum. There are tons of things– I think I’ve talked about this– in my postpartum journey where I was like, “I got the birth I wanted, but I’m so frustrated that these things are happening.” You can also have both of those feelings. You can be super happy for your birth but also really frustrated with your postpartum journey or vice versa where you’re like, “I had a really crappy birth, but man, I’m so grateful for this postpartum journey.” You can have those feelings together. You don’t have to be quiet because you had the birth that everyone knew you wanted.

Hayley: Right, exactly. It doesn’t diminish how proud I am of having a natural VBAC and doing that even though at times in the beginning, I did question that.

Meagan: Oh yeah. Yeah. That’s natural.

Hayley: But looking back, I’m like, “That’s amazing.” I’m so proud of myself that I achieved a VBAC and had an unmedicated one. It’s just crazy to me.

Meagan: Absolutely. Well, thank you for sharing your story today.

Hayley: Thank you for having me. I know I can talk a lot.

Meagan: It was wonderful.

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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