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Episode 291 Meg & Julie + What is Cesarean Awareness Month?

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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.

“If you don’t know your options, you don’t have any!”

April is Cesarean Awareness Month and we hope this month is one of information, empowerment, and love from us here at The VBAC Link to you. Referring to the amazing resources provided by the International Cesarean Awareness Network (ICAN), Meagan and Julie break down the mission of Cesarean Awareness Month.

Whether you are a first-time mom, VBAC mom, CBAC, or RCS mom, there is space for all of you! This month is meant to not only reduce Cesarean rates overall. It is also meant to inform everyone about birthing options, hospital rights, and ways to make Cesarean births better. We need all of our experiences to make positive changes in the birthing world for future generations!

ICAN's Website

Cesarean Awareness Month Toolkit

Infant Mortality Statistics from 2022

Informed Pregnancy Plus

Needed Website

How to VBAC: The Ultimate Prep Course for Parents

Full Transcript under Episode Details

07:03 Review of the Week

09:29 Why we need Cesarean Awareness Month

13:12 ICAN’s Cesarean Awareness Month toolkit

16:00 Ways to make Cesarean births better

21:20 Common reasons for Cesareans

25:59 Your hospital rights

32:10 The safety of home birth

36:52 Lower Cesarean rates = lower infant/maternal mortality rates

40:38 A message to the CBAC community

Meagan: Hello, hello everybody. It is Meagan and I have Julie with us today. I always get so happy.

Julie: Hello, hello.

Meagan: We are going to be talking about International Cesarean Awareness Month. Now, this is sensitive. It’s sensitive. It can be sensitive. It’s a month, a whole 30 days or 29 days. I don’t actually know how long April is.

Julie: April is not 29 days you crazy. That’s just February once every four years.

Meagan: That’s just February. Maybe 30, maybe 31. I don’t know.

Julie: April is 30 days always every year.

Meagan: Is it? I don’t know my months apparently.

Julie: Apparently.

Meagan: It can be a long month for people and we’re going to talk a little bit more about that. But it stands for International Cesarean Awareness Month and it is a month that is truly just brought to create awareness around unnecessary Cesareans, around advocating for vaginal births after Cesarean, improving Cesarean recovery after, and really just spreading the word and getting the information out there because as someone who has been in the VBAC world before, we have been told many times that VBAC isn’t possible and Cesarean is a must.

You know, Cesarean isn’t desired by everyone, and a VBAC isn’t desired by everybody, but it’s important to know the options. One of the coolest things is that ICAN which is a nonprofit organization created this mission and I’m just going to read it. Does that sound appropriate?

“ICAN is a nonprofit organization whose mission is to improve maternal/child health by reducing preventable Cesareans through education, supporting Cesarean recovery, and advocating for vaginal birth after Cesarean for VBAC.”

We are really grateful for ICAN. They do a lot of amazing things and I know that they were a big part of my journey. I mean, wouldn’t you say yours too, Julie? I think that’s actually where we might have met is an ICAN chapter meeting maybe.

Julie: Where did we meet? Now I’m going to think.

Meagan: I feel like I can picture you in a living room in a chair up front. You were very involved with the presenter and I was just there.

Julie: Wasn’t it at your house?

Meagan: No.

Julie: Okay. Yeah, I remember that one.

Meagan: It was at someone else’s house and anyway, that’s the first day I remember seeing your beautiful face. Crazy, but we love ICAN and we support them. Julie was just looking and they had a t-shirt. One of the things it says is, “You have options.” That is going to be one of the things that we are talking about today.

Julie: Yeah. That was last year’s theme but they haven’t posted this year’s theme yet. I mean, we’re recording this in February so they haven’t gotten a lot of the information out yet, but I love last year’s theme.

Meagan: I know. You have options. And you do. You have options even though a lot of the time we don’t feel like it.

07:03 Review of the Week

Meagan: Julie, do you want to read a Review of the Week before we get going?

Julie: I was going to say, yeah. I feel like we are already getting going. Yes. Let me read a review and then we will do the intro and then we will go. Hold on. Now, I’ve got to get back to it. Perfect. This review is from unhappyggfan so hopefully she’s unhappy about GG and not The VBAC Link.

Unhappyggfan. She says, “Truy helped me achieve my VBAC.” She says, “I found and started listening to this podcast a couple of days before my due date.” Oh, that’s cool. “I was walking a ton every day to encourage labor so I just binge-listened to these episodes one after the other. My due date came and went and I got more worried about having a successful VBAC. I kept listening to these episodes while I walked for hours every day. Fast forward to 12 days past my due date,” oh, poor thing “when my water finally broke right at the beginning of a massive storm and flooding in my city. My doula was unable to make it to my labor and delivery due to flooding on her street and the stories from the women on this podcast truly acted as my virtual doula.”

Aw, that’s sweet. “As I labored for 16 hours, I thought back to the many stories I had listened to and the words of encouragement and wisdom from the podcast hosts and their guests. I thought of things I had learned and learned as I pushed for an hour and then my son was born. I truly believe that listening to the stories shared on this podcast helped me to have my VBAC. I wish I could thank every guest whose words gave me strength, but I will just say it here. THANK YOU. This podcast truly means so much to me now. A must-listen if you are preparing for a VBAC.”

I love that. Virtual doulas.

Meagan: I love that. Thank you.

09:29 Why we need Cesarean Awareness Month

Meagan: Okay. All right. I know the motor started and we were gently tapping on the gas before we started reading that review, but yeah. Let’s dive into it. So we kind of talked about ICAN and what their mission is, but Julie, when you hear Cesarean Awareness Month, what do you hear or feel? What does it mean to you?

Julie: I feel like here at The VBAC Link, it’s always Cesarean Awareness Month. Do you know what I mean? We are always focusing on that. But I feel like I love the collective call to action for the entire birth community and hopefully, even the world to focus on this. I was just thinking about this and ICAN hosts this big month for awareness to rally for donations and pushes for things like increased access to VBAC and lower Cesarean rates and things like that, but I was like, “Okay. What more is it? What more is it?”

I wanted to get into maybe a little bit more about why we need awareness about Cesareans. What’s the point? Why are we worried about this? Why are they worried about this? I really love that they have it on their ICAN website. It’s ican-online.org/cesarean-awareness-month-toolkit and I’m sure that will be updated for 2024. I will link it in the show notes, but it has a whole toolkit that you can use with all sorts of things you can do.

What I really like about their page is that they talk about why we need awareness for Cesareans in the first place. I love the bullet points that they show. Researchers estimate that almost half of the C-sections performed could be safely prevented. The next one is, “If families don’t know these options don’t exist, they can’t advocate for them.” Obviously, we are huge proponents of that here. If you don’t know about your options, you do not have them. You do not have options if you do not know what they are.

The next is, “Cesareans can be more or less family friendly depending on the practices and protocols of the facility and the support level of providers. Preventable Cesareans may be responsible for up to 20,000 major surgical complications a year including sepsis, hemorrhage, and organ injury.” I feel like sometimes we forget that C-sections are major surgery. They are a major surgery that comes with all of the risks that major surgeries come with.

The last one is, “The future risks to birthing people and their future pregnancies and children are not even mentioned when we are talking about Cesareans.” What are the future risks to these mothers and their kids and their families? I feel like that’s the big need to protect our women and the children that are being born and to reduce the amount of people suffering from major birth complications. It’s just a medical safety issue.

Yes. We probably should put a plug in here that we have literally seen C-sections save the lives of both moms and babies. We have seen it. We are not arguing that. We are not questioning that. What we are questioning is their frequent use, how overused they are, and how quickly they are jumped to for many reasons besides the true risk to life and health of the people they are trying to save.

13:12 ICAN’s Cesarean Awareness Month toolkit

Meagan: Yeah. Yeah. It’s so hard. I feel like there’s this line of– I think I still even have anger about how many unnecessary C-sections happen. I kind of want to talk about, okay. We have a large chunk. We are really high. 32% of Cesareans are happening and I want to know that percentage truly how many of those people didn’t desire it at all. I’m going to guess a large chunk of them didn’t desire it, but I’m also going to guess that a large chunk of those went on to have future Cesareans which again, is fine. But like she was saying, you have options, and a lot of the time, the options aren’t presented so if we don’t know that we have these options, we just keep having Cesareans. They might not be desired.

Julie: You’re right. It’s true. I feel like everybody listening right now should go and download this Cesarean Awareness Month Toolkit because I feel like there is so much value here. It gives you so much information even when it’s not Cesarean Awareness Month. Just go download it. They have obviously links to social media graphics that you can share for Cesarean Awareness Month. There’s a t-shirt that you can buy to support the cause. You can become a member of ICAN. It shows you how to donate to the cause. It gives you social media calendars, Facebook groups, and templates for writing a proclamation to your governor or mayor. There is a press release that you can tweet and adjust to send to your local media outlets. There are instructions on how to invite ICAN onto your podcast. We should do that by the way.

We’ve had someone on in the past, but it’s been a while.

Meagan: We should.

Julie: There are webinars that you can follow and listen to. There are ICAN chapters all across the world in 20+ countries. It talks about how to find supportive providers and supportive options. It gives you options. It gives you facts. It outlines things. It tells you how you can have a more peaceful and family-centered Cesareans. It talks about knowing your rights and ICAN and the whole organization there. It talks about how Cesarean can be a lifesaving technique and it’s worth the risks involved when it is a true lifesaving measure.

It goes into so much, so much. Go download it now. There is going to be a link to the ICAN website to go and download this but I feel like it is so helpful for all birth workers and families to have. I am just really, really impressed with how thorough this toolkit is.

Meagan: Yeah, me too. As I’m looking through it, I’m like, “Wow. This is amazing.”

16:00 Ways to make Cesarean births better

Meagan: Let’s talk about– okay. Their mission is to– they say Cesarean recovery and stuff like that. One of the missions here at The VBAC Link is that we want to make Cesarean birth better. So if you are wanting to have another Cesarean, let’s talk about ways that you can make it a better experience. We can make it a better experience by having more people in your OR and having your support people there.

Julie: Like your doula and your birth photographer.

Meagan: Yep. Yep. Having those people there so when baby is born and birth partner, dad or whoever is there, goes over with baby, you’re not just left alone. I mean, okay. You’re not left alone. You’ve got anesthesia there and stuff like that, but you don’t know that man or woman.

Julie: Yeah. You deserve a dedicated support person for you and there’s just not a dedicated support person for you in the OR when your partner has to leave and go with baby.

Meagan: Yes. One day in my life, I hope that I can somehow help that policy change because it drives me crazy.

Julie: P.S. Layton hospital is working to get doulas in the OR and birth photographers in the OR. It’s a steady thing. You can get into the U with no problem as a doula and as a birth photographer because I’m also a doula. But can we just talk about the whole partner thing though? Do you know how many times when I have been in the OR or as a birth photographer, do you see the partner or the husband when the baby is born and taken to the warmer? This is what happens every time, I swear. The husband looks at the baby and then looks at their wife, then looks at their baby, and then looks at their wife. You can see on their face. They want to go with their baby and they want to stay with their wife or their partner. They are making a decision, then the wife inevitably says or the partner, the birthing person always says, “Go be with baby, every time.”

Meagan: Yes, or I was going to say that the mom is saying, “Hey, when this baby is born, I want you to go be with baby,” but Dad is like, “Yeah. I want to be with baby, but I need to be with you.

Julie: I also want to be with you. I know that probably having an extra person in the OR is not going to alleviate that sense of obligation to two humans at once, but I do know that I have had partners come back and tell me that they are so glad that I have been there because they know that their partner is being watched over and cared for more so than just what the nursing staff can provide and the OBs obviously.

Meagan: Yes. Yes. So yeah, having that extra person, not strapping down our arms, right? That’s something–

Julie: I feel like that doesn’t happen too much anymore but sometimes.

Meagan: Really? I still see it, but I haven’t been in a birth for a minute.

Julie: Mm, in the OR.

Meagan: I usually see one arm.

Julie: That’s weird.

Meagan: I know. So yeah, there’s that and then a clear drape if you want, maternal-assisted deliveries are really, really uncommon but I really hope that we can keep advocating for them and make a change to see them happening. They are happening in Australia and they obviously have pretty strict protocols and reasons for how and why and when, but it’s happening. It’s happening and it is up to us to ask the question and say, “Hey.” Maybe if enough of us ask the question in our Cesareans for a maternal-assisted Cesarean delivery, maybe someone is going to be like, “Okay. This is being asked for a lot. This is desired,” and maybe someone out there will start making a change.

Julie: Sometimes, the way to make change is to keep asking for it. You might 1 of 1000 to ask for it before the change is made, but then with the next person, there will be change. I know that the next person getting the change and not you sounds like a bummer, do you know what I mean? But also, what if that next person is your daughter or your kid? So let’s help pave the way for future generations too by continuing to ask for these things.

Do you know what? Every time I have a client, regardless of whether it’s a doula client or a photography client, I always ask if it ends up that they need to go back to the OR, I always ask. I know what hospitals are going to say yes and I know what hospitals are going to say no. I still ask even the ones that I know are going to say no because you never know why. A few months ago, I got allowed in the OR for a C-section as a photographer in a hospital that I have never been allowed in in the past almost 9 years now and even in the hospital chain. There is a whole chain of hospitals that is notorious for not letting us do that, but they let me in. The doctor and anesthesiologist were on board and it was fine and it was beautiful. I had this image that I took that is one of my favorite images ever. I sent it to the doctor and she is really happy about it.

You’ve got to keep asking. Ask every time. You’re going to get a bunch of no’s before you get yes’s, but you’ll get yes’s as you keep working and advocating for it. It takes a lot of us to make change.

Meagan: Absolutely. I agree. I agree.

21:20 Common reasons for Cesareans

Meagan: Yeah, that also goes for asking for that extra person, asking for assisted delivery, and asking for music to be played. Always asking. Okay, they might be like, “No,” but if you don’t ask, again, you don’t know you have options unless you know the options you have. Does that make sense? I’m saying that backward.

Julie: You are. If you don’t know your options, you don’t have any.

Meagan: That’s it. If you don’t ask the question, you might not have the option is what I’m trying to say.

Julie: Yes. Yes. Keeping baby, skin-to-skin, doing these things. We can make the Cesarean experience better. That doesn’t mean that a Cesarean is always bad or traumatic if we don’t have these things, but these are things that can help to make things better.

Meagan: Yeah, so doing that and then also learning how to avoid unnecessary Cesareans. What types of things lead to Cesareans? We know that we have 4-5 most common ways that Cesareans are suggested or happen. One is breech. If your baby is breech, then you are more likely to have a Cesarean. Now, we do have things like external versions and Spinning Babies and chiropractic care and things that may encourage that baby to rotate. They may just rotate, but a lot of the time, we have providers just scheduling a C-section and that’s it because we are not seeing people having babies vaginally with breech babies much anymore which is heartbreaking.

Maybe we are being told, “Well, you’re looking a little bigger and you’re close to 41 weeks so let’s just induce you.” Right? We’ve got due dates. We have breech fetal position. If you’re in labor and your body is not progressing at the timeline that someone wants it to, failure to progress. We have small pelvis. Maybe you’re at 10 centimeters and you’ve been pushing for two hours and your baby is having a harder time rotating, but instead of stepping back and looking at, “Hey, where is this baby’s position?” or “Maybe this baby is really high up and we need to rest and descend,” we’re just saying no. We’re cutting it off and we’re going to have a C-section.

25:59 Your hospital rights

Meagan: Let’s see. What else, Julie? What are some things that you feel like we can learn to avoid Cesarean?

Julie: I mean, all of those things you said are great, but I just want to pull it in a different direction for some reason. I’m so sorry.

Meagan: No, that’s fine.

Julie: But knowing your rights. Knowing your rights.

Meagan: That’s funny because that’s on this toolkit right now.

Julie: I know. I’m staring at it right now, but I love where they say, “Consent forms from the hospital or provider are not contracts.”

Meagan: I love that.

Julie: They are not a replacement for true, informed consent discussion. They are not a replacement for a true and informed consent discussion. They are not. They are not contracts. You can revoke your consent at any time. No one is going to sue you because you signed the consent form. Do you know what I mean?

Meagan: You can change your mind.

Julie: Gosh, my mind is reeling right now. I feel like consent forms might be another way of coercion.

Meagan: Mhmm.

Julie: I really do. They are a way of coercing you into feeling like you are locked into this decision or you are locked into whatever consequences might come from that decision. But also, I feel like hospital policies are the same thing. Hospital policies are not contracts. Hospital policies are not an excuse to not have a discussion and get true, informed decision-making. Hospital policies, a lot of the time, are not set up to help the patient. They are set up to cover the butts of the providers and the hospital.

I feel like when you are falling back on a consent form or when you are falling back on hospital policy, then that’s another form of coercion, of getting people of what you want them to do because it’s policy because you signed the consent form.

Meagan: Exactly.

Julie: Yikes. I can’t stand it sometimes how parents don’t feel like they can change their mind or how they don’t have all of the information and maybe they wouldn’t have made the same choices if they had all of the information or maybe not and it’s not anyone’s place to say what they would or would not have done. I’m not trying to vilify hospitals. I’m not trying to vilify providers or nurses or anybody who sticks to these policies and things like that because it’s not their fault. It’s the fault of the system that they have been born into. It really takes a lot, I think, for a provider and a nurse and an OB and a midwife or whatever to step up and go against the system.

“Hospital policy says you have to have an epidural, but you can do just really do whatever you want. I don’t care if you have one.” There is a midwife in our area, a hospital midwife who says that to every VBAC patient. She’s like, “The hospital wants you to have an epidural, but you can totally say no. I don’t care if you have one or not.” I’ve never had a client there who has an epidural placed just because they are a VBAC which is a whole other episode I feel like we are going to talk about at some point.

Yeah, anyway. That’s just where my mind was wandering. You have rights. Just because you are in a hospital doesn't mean you are in jail. You are not in jail. You are a human with rights and feelings that should be respected and talked to like an adult and not like a kindergartner who has to follow a strict schedule and go to recess at a scheduled time. Do you know what I mean? Anyway, sorry. I’m getting a little off-topic there.

Meagan: No. I think it really goes hand in hand. Here are the reasons why Cesareans happen. I mean, there are other ones too. These are common ones.

Okay, you’ve been pushing for 2.5 hours. Your baby is not making a ton of progress, but making slow progress. Your provider says, “All right. We’re cutting this off. it’s time. We’re having a C-section. It’s time. You have to have a C-section.”

What are your rights in that situation? If you are like, “I am totally down for that.” Then, okay. But if it’s like, “No, I don’t want that,” but a provider is saying, “You have to. You have to. You have to. It’s time. I won’t do this anymore.” What are your rights in that situation?

No one can perform a Cesarean, no one, unless you say, “Okay.”

Julie: But they can manipulate and coerce you and tell you that your baby is going to die. You’re not in your logical brain. You’re in labor land so of course you’re going to do a C-section.

Meagan: Yeah. Yeah, exactly. There are things like that or there are true emergencies. We don’t want to disregard those where it’s seriously true and to save you and your baby. But you can say no. You also can say, “Thank you so much for your time. I’m going to keep going. Can you get another provider in here? You’re fired.” That sounds crazy, but you can literally let your provider go in the middle of labor and in the middle of pushing. If it’s not working for you, you can let them go. You’re not in jail like she said. You can still make choices. It’s just so important. I love that you brought that up.

One, know the reasons why Cesareans are happening, but then really truly know your rights most of all. It’s hard. It’s so hard.

Julie: Ideally— it is so hard. It is super hard. It is especially hard when you are in that position in the first place for one reason or another. But the best thing you can do to avoid getting put in a position like that where you are pushing and pushing and a provider wants to do a C-section and now you have to fight for it is first of all, hire a doula, but second of all, don’t be in that position in the first place. Leave the provider. Surely there are red flags. There are things that are telling you that this is not a right fit and a lot of times, we hear people say, “Gosh, I knew I should have switched, but I didn’t.” Listen to that and honor that and honor things ahead of time because odds are by the time you get to that point, you’re just going to do the C-section.

32:10 The safety of home birth

Julie: I hate to say it, but I’m never going to dance around the issue or tell you a lie but if you are there and you’ve been pushing, you can’t be the only one that wants to keep pushing. Yes, legally you can say, “No”, and legally, they have to provide care for you, but it’s going to be a circus. It’s going to be really hard to do that.

Then what happens to your body? Your body is stressed out because it has to fight then that is not conducive to the natural labor hormones. I don’t know. It’s a hard fight. I feel like going back to I really like that ICAN is highlighting home birth as a safe and reasonable option after Cesarean because one of their graphics from 2023 highlights that there was a 2021 study that found home birth after Cesarean is associated with a 39% decrease in the odds of having a repeat C-section. 39% decrease, you guys.

Meagan: Pretty impactful.

Julie: I wish that more people would consider home birth as a safe and reasonable option. We were talking about this earlier before we started our episode. I was watching this show last night. You can tell me if you don’t want me to tell you this.

Meagan: You can tell it.

Julie: I was watching a show last night about mystery diagnoses where this provider is a doctor. She’s a legitimate doctor and she’s done lots of really cool things. She’s started outsourcing diagnoses for people who have these mysterious medical diseases to social media. She goes through all their medical records and she makes reports and she broadcasts it on a blog and then people send in videos from all over the world about what they think the diagnosis is. It’s really, really cool how she is using social media to help them when they are just baffled.

There was this girl who has had 9 years without a diagnosis and it turned out to be this really simple thing that she just had to change her diet for. Anyway, I don’t remember the name of the show but you can message me and I can tell you if you want.

The point is that this provider is a doctor so she’s been through all the schooling and everything. She said something that really stuck out to me. She said, “The goal of the hospital is to keep the thing that is trying to kill you from killing you.” I was like, “That is the goal of the hospital to keep the thing that is trying to kill you from killing you.” She said, “If you want solutions outside of that, you have to go outside of the hospital.” It just really hit home for me for birth.

I know you guys might get sick of hearing me talk about home birth because most women do birth in a hospital, but the hospital’s job is to keep you and baby alive. That is literally their job and it is their main focus. It is what they are going to be focusing on. It’s why we intervene so quickly. It’s why we rush to Cesarens so fast. It’s because it’s the easiest and fastest way to keep you alive.

Now, out-of-hospital births also really love alive moms and babies. I’m just going to say that. It’s not different. The goal is similar, but their focus is not on keeping the thing from killing you. Outside of the hospital, the goal is promoting the physiologic birth process and trusting the body to do the thing that it’s made to do.

Now, there are circumstances. I feel like we have to say this every time because there are circumstances where out-of-hospital birth is not a safe option for some people. There is a time when labor just needs a transfer to a hospital for additional care. But when the focus on out of the hospital, promoting the physiological birth experience and trusting the body versus the hospital where they are trying to focus on keeping you alive, you’re going to have completely different levels of care.

Those levels of care sometimes do more harm than good which is why out of hospital, when you’re going for a birth after Cesarean out of hospital, your chance of having a C-section is significantly lower. I say significantly in the literal way by the study but also in the way we all think of it. 39% decrease in Cesarean is a huge deal. How are we thinking about birth? How are we addressing it in-hospital and how are we addressing it out-of-hospital?

Not everyone is eligible for out-of-hospital birth and it’s unfortunate that not everyone has those options, but for women with healthy pregnancies without complications, it is a reasonable option and it’s worth looking into even if you just rule it out. There is my home birth soapbox.

36:52 Lower Cesarean rates = lower infant/maternal mortality rates

Julie: What are we talking about? Cesarean Awareness Month, yeah.

Meagan: My home birth soapbox. Home birth can be an amazing option. It can obviously reduce the chances of things like interventions and even Cesareans that are unnecessary and pushing those things on people. Typically, I feel like my clients who are in home births really do feel this sense of– I don’t know if awareness is right. Connection, maybe. They are more connected with their labor, their birth, and their team.

I’m not saying people in the hospital aren’t connected with their team or their labor or anything.

Julie: It’s so different.

Meagan: It’s different. It is. It’s very different and until you’ve experienced or if you’ve experienced it, you know what we are talking about. There is something different and it’s very unique.

Julie: One more thing, sorry, and then I promise I will close it off.

Meagan: No, you’re just fine.

Julie: I really like in here– I think it’s worth pointing out because I’m sure there are going to be a lot of people cringing about what I just said about how the goal is to keep the thing from killing you. It’s pretty well-known now. The United States has one of the highest infant and maternal mortality rates in the developed world. The highest in the developed world. Okay? But we have also the highest number of C-sections. One of the highest numbers of C-sections. Okay?

I love one of these Cesarean Awareness Month graphics from ICAN states that most places that successfully reduce maternal mortality have a lower Cesarean delivery rate. I’m not just spurting out garbage, you guys. There is information and there is information and statistics and evidence to support that higher Cesarean rates do not equal safer births. Higher intervention rates do not equal safety for mom and baby. It’s all over the place and I really love it since 2020 especially how there has been more information and more research coming out supporting the safety of home birth and home birth after Cesarean. It’s just wild how much the medical system– or not the medical system as much as the people who do these reviews and systemic reviews are getting on board with showing the safety there. I’m not just talking about my anecdotal views as a birth worker. I’m talking about actual evidence for these things.

I’m going to read that again. “Most places that successfully reduce maternal mortality have lower Cesarean delivery rates.” It’s science. It’s just science.

Meagan: It’s science.

Julie: It’s science. Okay, now I’m done.

Meagan: Okay, it was back in November 2023 and it says, “Infant mortality in the United States provisional data from 2022 period linked/infant death file.” Now, this is going to be a lot but I’m going to have Paige, our amazing transcriber–

Julie: Love Paige.

Meagan: –and poster of our podcast put this in the show notes for you guys. If you want to go there and read a little bit about where things have gone, it breaks it down between the methods, the gestational age, the maternal race, infant sex, state of residence, maternal age, leading causes of death, and more. It’s got a lot of studies and things like that and a lot of stats that could maybe be scary actually to find out, but also nice to know the information. We’ll have that in the show notes.

40:38 A message to the CBAC community

Meagan: Then next on the goal of ICAN’s mission is to help advocate for VBAC. I think this is one of the areas that a lot of the times our amazing CBAC community struggles with. I do not mean this in any– I don’t mean to say this rudely, but a lot of moms who have had Cesarean birth after Cesarean dislike April because of this. I feel like I see it every year. It’s a very tender topic and very hard. I mean, I’m going to always– for some reason, the radical acceptance episode that we did relates to so many things, but a lot of the time, we have unprocessed trauma, unprocessed guilt– guilt is a really big one. There is a lot to unpack and a lot of the time, that is not all processed or unpacked, and then April comes around and we’re like, “Ugh. Everybody is advocating for VBAC when I wanted a VBAC too but I didn’t have a VBAC. I didn’t have that option or I didn’t feel like I had that option” or whatever.

There are so many things. “My body couldn’t do it. I tried but it didn’t work” or “I couldn’t find the support despite looking for provider after provider.” I mean, there are tons of reasons why people have CBACs. I mean, I am a CBAC mom myself. I don’t know if anybody knows that, but I am. I’ve had two Cesareans and I did want a VBAC. I was going for a VBAC and I ended in a Cesarean.

Now, I didn’t want that Cesarean at all, not even close. That was not what I wanted. But I had it and I tried to make the best of it. It was a healing experience. I am grateful for that Cesarean which a lot of people don’t understand how I could possibly be grateful for the birth that I didn’t desire, but that’s something that I truly am.

Julie: You had to work for it though. You didn’t just get to be grateful. You had to work for that.

Meagan: Really, truly work, and let me tell ya. I was still working pregnant with my third. Really, I was reading my op reports. I was so frustrated. I was bawling. I was like, “Why? Why did this happen? This was not what I wanted. Why didn’t anyone tell me?” There were so many things so I get kind of wanting to feel angry about your unprocessed birth or your undesired outcome. I will promise you that in time– it might take years– it can come. It can. This healing can come and you can see Cesarean Awareness Month as a positive thing but also be an active participant in knowing that not only is it to help promote vaginal birth after Cesarean and lower the Cesarean rate, it’s also to make Cesarean birth better.

Julie: And safer.

Meagan: And not have traumatic Cesareans as often and to support the CBAC as well. So I don’t know. I feel like I’m talking in circles. I don’t know how to say it, maybe, but my message to you is if you are struggling with Cesarean Awareness Month and if you are hating to see all of the posts and all of the things saying, “Yes, I got my VBAC” and “Yes, vaginal birth is better” or whatever. We see those all in the month of April. It’s mid-April and again, we are recording this in February. I mean, I guarantee you that we’ve seen at least a dozen of these types of posts at this point when this is aired. Try your hardest to step back and also find self-healing within yourself so these months don’t trigger you.

April doesn’t have to be a triggering month. It can be an empowering, motivational month to stand up and be like, “Hey. I didn’t want that C-section either. It’s not what I desired, but here I am and I am here to help people know their options for Cesarean and have a better outcome and reduce the Cesarean rate,” because yeah. I didn’t want it either. Okay. I don’t really know. I maybe am just off-base, but I just feel so passionately about our CBAC community too and I know. I see them. I see them struggle through April. If you are listening, I don’t want you to struggle. I want you to hear a different message when you see Cesarean Awareness Month.

Julie: I agree. I agree because it’s hard. There is space for all of us here. There is space for all of us. Do you know what? Maybe, in April if you are really triggered with all of the Cesarean Awareness Month things, maybe the best thing you can do for your mental health is mute everything before they are talking about C-sections and VBACs and everything. Maybe you leave the group. Maybe you unfollow the page and then come back when it’s a healthier time for you. Maybe that’s the thing that you can do to love yourself the most if you’re not in the space to confront your triggers head-on. Maybe that’s the best thing for you and that’s okay. It’s okay to create space for yourself to grieve and heal and mourn that loss no matter what form that takes.

But when you’re in a more healthy spot, we absolutely want you to come back here and rally for us more. Rally with us, not for us. Rally with us more to improve access to better care options for our pregnant people to make Cesareans safer, to allow other support people in the OR, to increase evidence-based practices in hospitals, and things like that. It’s just more than just about reducing the overall Cesarean rate. It’s about so much more than that. We love you here. I mean, there is space for you here and we have all been there. We’ve all been there. Some of us are still in that journey and that’s okay. We’re all in all different spots of our journey and yeah. There’s space for you and we love you. But if you also have to take a step back for a little while, we still love you and we honor that journey and we honor that part of you.

Meagan: Mhmm, absolutely. Okay. We will leave this here and we will let you know right now. We love you. Just like she said, we honor your journey. We support you. Let’s rally together. This month, let’s build each other up and let’s spread the information, and let’s talk about our stories, and let’s talk about how someone else can have a better experience based on learning. Download the toolkit. Check out the links right here in the show notes and Happy Cesarean Awareness Month.

Closing

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“If you don’t know your options, you don’t have any!”

April is Cesarean Awareness Month and we hope this month is one of information, empowerment, and love from us here at The VBAC Link to you. Referring to the amazing resources provided by the International Cesarean Awareness Network (ICAN), Meagan and Julie break down the mission of Cesarean Awareness Month.

Whether you are a first-time mom, VBAC mom, CBAC, or RCS mom, there is space for all of you! This month is meant to not only reduce Cesarean rates overall. It is also meant to inform everyone about birthing options, hospital rights, and ways to make Cesarean births better. We need all of our experiences to make positive changes in the birthing world for future generations!

ICAN's Website

Cesarean Awareness Month Toolkit

Infant Mortality Statistics from 2022

Informed Pregnancy Plus

Needed Website

How to VBAC: The Ultimate Prep Course for Parents

Full Transcript under Episode Details

07:03 Review of the Week

09:29 Why we need Cesarean Awareness Month

13:12 ICAN’s Cesarean Awareness Month toolkit

16:00 Ways to make Cesarean births better

21:20 Common reasons for Cesareans

25:59 Your hospital rights

32:10 The safety of home birth

36:52 Lower Cesarean rates = lower infant/maternal mortality rates

40:38 A message to the CBAC community

Meagan: Hello, hello everybody. It is Meagan and I have Julie with us today. I always get so happy.

Julie: Hello, hello.

Meagan: We are going to be talking about International Cesarean Awareness Month. Now, this is sensitive. It’s sensitive. It can be sensitive. It’s a month, a whole 30 days or 29 days. I don’t actually know how long April is.

Julie: April is not 29 days you crazy. That’s just February once every four years.

Meagan: That’s just February. Maybe 30, maybe 31. I don’t know.

Julie: April is 30 days always every year.

Meagan: Is it? I don’t know my months apparently.

Julie: Apparently.

Meagan: It can be a long month for people and we’re going to talk a little bit more about that. But it stands for International Cesarean Awareness Month and it is a month that is truly just brought to create awareness around unnecessary Cesareans, around advocating for vaginal births after Cesarean, improving Cesarean recovery after, and really just spreading the word and getting the information out there because as someone who has been in the VBAC world before, we have been told many times that VBAC isn’t possible and Cesarean is a must.

You know, Cesarean isn’t desired by everyone, and a VBAC isn’t desired by everybody, but it’s important to know the options. One of the coolest things is that ICAN which is a nonprofit organization created this mission and I’m just going to read it. Does that sound appropriate?

“ICAN is a nonprofit organization whose mission is to improve maternal/child health by reducing preventable Cesareans through education, supporting Cesarean recovery, and advocating for vaginal birth after Cesarean for VBAC.”

We are really grateful for ICAN. They do a lot of amazing things and I know that they were a big part of my journey. I mean, wouldn’t you say yours too, Julie? I think that’s actually where we might have met is an ICAN chapter meeting maybe.

Julie: Where did we meet? Now I’m going to think.

Meagan: I feel like I can picture you in a living room in a chair up front. You were very involved with the presenter and I was just there.

Julie: Wasn’t it at your house?

Meagan: No.

Julie: Okay. Yeah, I remember that one.

Meagan: It was at someone else’s house and anyway, that’s the first day I remember seeing your beautiful face. Crazy, but we love ICAN and we support them. Julie was just looking and they had a t-shirt. One of the things it says is, “You have options.” That is going to be one of the things that we are talking about today.

Julie: Yeah. That was last year’s theme but they haven’t posted this year’s theme yet. I mean, we’re recording this in February so they haven’t gotten a lot of the information out yet, but I love last year’s theme.

Meagan: I know. You have options. And you do. You have options even though a lot of the time we don’t feel like it.

07:03 Review of the Week

Meagan: Julie, do you want to read a Review of the Week before we get going?

Julie: I was going to say, yeah. I feel like we are already getting going. Yes. Let me read a review and then we will do the intro and then we will go. Hold on. Now, I’ve got to get back to it. Perfect. This review is from unhappyggfan so hopefully she’s unhappy about GG and not The VBAC Link.

Unhappyggfan. She says, “Truy helped me achieve my VBAC.” She says, “I found and started listening to this podcast a couple of days before my due date.” Oh, that’s cool. “I was walking a ton every day to encourage labor so I just binge-listened to these episodes one after the other. My due date came and went and I got more worried about having a successful VBAC. I kept listening to these episodes while I walked for hours every day. Fast forward to 12 days past my due date,” oh, poor thing “when my water finally broke right at the beginning of a massive storm and flooding in my city. My doula was unable to make it to my labor and delivery due to flooding on her street and the stories from the women on this podcast truly acted as my virtual doula.”

Aw, that’s sweet. “As I labored for 16 hours, I thought back to the many stories I had listened to and the words of encouragement and wisdom from the podcast hosts and their guests. I thought of things I had learned and learned as I pushed for an hour and then my son was born. I truly believe that listening to the stories shared on this podcast helped me to have my VBAC. I wish I could thank every guest whose words gave me strength, but I will just say it here. THANK YOU. This podcast truly means so much to me now. A must-listen if you are preparing for a VBAC.”

I love that. Virtual doulas.

Meagan: I love that. Thank you.

09:29 Why we need Cesarean Awareness Month

Meagan: Okay. All right. I know the motor started and we were gently tapping on the gas before we started reading that review, but yeah. Let’s dive into it. So we kind of talked about ICAN and what their mission is, but Julie, when you hear Cesarean Awareness Month, what do you hear or feel? What does it mean to you?

Julie: I feel like here at The VBAC Link, it’s always Cesarean Awareness Month. Do you know what I mean? We are always focusing on that. But I feel like I love the collective call to action for the entire birth community and hopefully, even the world to focus on this. I was just thinking about this and ICAN hosts this big month for awareness to rally for donations and pushes for things like increased access to VBAC and lower Cesarean rates and things like that, but I was like, “Okay. What more is it? What more is it?”

I wanted to get into maybe a little bit more about why we need awareness about Cesareans. What’s the point? Why are we worried about this? Why are they worried about this? I really love that they have it on their ICAN website. It’s ican-online.org/cesarean-awareness-month-toolkit and I’m sure that will be updated for 2024. I will link it in the show notes, but it has a whole toolkit that you can use with all sorts of things you can do.

What I really like about their page is that they talk about why we need awareness for Cesareans in the first place. I love the bullet points that they show. Researchers estimate that almost half of the C-sections performed could be safely prevented. The next one is, “If families don’t know these options don’t exist, they can’t advocate for them.” Obviously, we are huge proponents of that here. If you don’t know about your options, you do not have them. You do not have options if you do not know what they are.

The next is, “Cesareans can be more or less family friendly depending on the practices and protocols of the facility and the support level of providers. Preventable Cesareans may be responsible for up to 20,000 major surgical complications a year including sepsis, hemorrhage, and organ injury.” I feel like sometimes we forget that C-sections are major surgery. They are a major surgery that comes with all of the risks that major surgeries come with.

The last one is, “The future risks to birthing people and their future pregnancies and children are not even mentioned when we are talking about Cesareans.” What are the future risks to these mothers and their kids and their families? I feel like that’s the big need to protect our women and the children that are being born and to reduce the amount of people suffering from major birth complications. It’s just a medical safety issue.

Yes. We probably should put a plug in here that we have literally seen C-sections save the lives of both moms and babies. We have seen it. We are not arguing that. We are not questioning that. What we are questioning is their frequent use, how overused they are, and how quickly they are jumped to for many reasons besides the true risk to life and health of the people they are trying to save.

13:12 ICAN’s Cesarean Awareness Month toolkit

Meagan: Yeah. Yeah. It’s so hard. I feel like there’s this line of– I think I still even have anger about how many unnecessary C-sections happen. I kind of want to talk about, okay. We have a large chunk. We are really high. 32% of Cesareans are happening and I want to know that percentage truly how many of those people didn’t desire it at all. I’m going to guess a large chunk of them didn’t desire it, but I’m also going to guess that a large chunk of those went on to have future Cesareans which again, is fine. But like she was saying, you have options, and a lot of the time, the options aren’t presented so if we don’t know that we have these options, we just keep having Cesareans. They might not be desired.

Julie: You’re right. It’s true. I feel like everybody listening right now should go and download this Cesarean Awareness Month Toolkit because I feel like there is so much value here. It gives you so much information even when it’s not Cesarean Awareness Month. Just go download it. They have obviously links to social media graphics that you can share for Cesarean Awareness Month. There’s a t-shirt that you can buy to support the cause. You can become a member of ICAN. It shows you how to donate to the cause. It gives you social media calendars, Facebook groups, and templates for writing a proclamation to your governor or mayor. There is a press release that you can tweet and adjust to send to your local media outlets. There are instructions on how to invite ICAN onto your podcast. We should do that by the way.

We’ve had someone on in the past, but it’s been a while.

Meagan: We should.

Julie: There are webinars that you can follow and listen to. There are ICAN chapters all across the world in 20+ countries. It talks about how to find supportive providers and supportive options. It gives you options. It gives you facts. It outlines things. It tells you how you can have a more peaceful and family-centered Cesareans. It talks about knowing your rights and ICAN and the whole organization there. It talks about how Cesarean can be a lifesaving technique and it’s worth the risks involved when it is a true lifesaving measure.

It goes into so much, so much. Go download it now. There is going to be a link to the ICAN website to go and download this but I feel like it is so helpful for all birth workers and families to have. I am just really, really impressed with how thorough this toolkit is.

Meagan: Yeah, me too. As I’m looking through it, I’m like, “Wow. This is amazing.”

16:00 Ways to make Cesarean births better

Meagan: Let’s talk about– okay. Their mission is to– they say Cesarean recovery and stuff like that. One of the missions here at The VBAC Link is that we want to make Cesarean birth better. So if you are wanting to have another Cesarean, let’s talk about ways that you can make it a better experience. We can make it a better experience by having more people in your OR and having your support people there.

Julie: Like your doula and your birth photographer.

Meagan: Yep. Yep. Having those people there so when baby is born and birth partner, dad or whoever is there, goes over with baby, you’re not just left alone. I mean, okay. You’re not left alone. You’ve got anesthesia there and stuff like that, but you don’t know that man or woman.

Julie: Yeah. You deserve a dedicated support person for you and there’s just not a dedicated support person for you in the OR when your partner has to leave and go with baby.

Meagan: Yes. One day in my life, I hope that I can somehow help that policy change because it drives me crazy.

Julie: P.S. Layton hospital is working to get doulas in the OR and birth photographers in the OR. It’s a steady thing. You can get into the U with no problem as a doula and as a birth photographer because I’m also a doula. But can we just talk about the whole partner thing though? Do you know how many times when I have been in the OR or as a birth photographer, do you see the partner or the husband when the baby is born and taken to the warmer? This is what happens every time, I swear. The husband looks at the baby and then looks at their wife, then looks at their baby, and then looks at their wife. You can see on their face. They want to go with their baby and they want to stay with their wife or their partner. They are making a decision, then the wife inevitably says or the partner, the birthing person always says, “Go be with baby, every time.”

Meagan: Yes, or I was going to say that the mom is saying, “Hey, when this baby is born, I want you to go be with baby,” but Dad is like, “Yeah. I want to be with baby, but I need to be with you.

Julie: I also want to be with you. I know that probably having an extra person in the OR is not going to alleviate that sense of obligation to two humans at once, but I do know that I have had partners come back and tell me that they are so glad that I have been there because they know that their partner is being watched over and cared for more so than just what the nursing staff can provide and the OBs obviously.

Meagan: Yes. Yes. So yeah, having that extra person, not strapping down our arms, right? That’s something–

Julie: I feel like that doesn’t happen too much anymore but sometimes.

Meagan: Really? I still see it, but I haven’t been in a birth for a minute.

Julie: Mm, in the OR.

Meagan: I usually see one arm.

Julie: That’s weird.

Meagan: I know. So yeah, there’s that and then a clear drape if you want, maternal-assisted deliveries are really, really uncommon but I really hope that we can keep advocating for them and make a change to see them happening. They are happening in Australia and they obviously have pretty strict protocols and reasons for how and why and when, but it’s happening. It’s happening and it is up to us to ask the question and say, “Hey.” Maybe if enough of us ask the question in our Cesareans for a maternal-assisted Cesarean delivery, maybe someone is going to be like, “Okay. This is being asked for a lot. This is desired,” and maybe someone out there will start making a change.

Julie: Sometimes, the way to make change is to keep asking for it. You might 1 of 1000 to ask for it before the change is made, but then with the next person, there will be change. I know that the next person getting the change and not you sounds like a bummer, do you know what I mean? But also, what if that next person is your daughter or your kid? So let’s help pave the way for future generations too by continuing to ask for these things.

Do you know what? Every time I have a client, regardless of whether it’s a doula client or a photography client, I always ask if it ends up that they need to go back to the OR, I always ask. I know what hospitals are going to say yes and I know what hospitals are going to say no. I still ask even the ones that I know are going to say no because you never know why. A few months ago, I got allowed in the OR for a C-section as a photographer in a hospital that I have never been allowed in in the past almost 9 years now and even in the hospital chain. There is a whole chain of hospitals that is notorious for not letting us do that, but they let me in. The doctor and anesthesiologist were on board and it was fine and it was beautiful. I had this image that I took that is one of my favorite images ever. I sent it to the doctor and she is really happy about it.

You’ve got to keep asking. Ask every time. You’re going to get a bunch of no’s before you get yes’s, but you’ll get yes’s as you keep working and advocating for it. It takes a lot of us to make change.

Meagan: Absolutely. I agree. I agree.

21:20 Common reasons for Cesareans

Meagan: Yeah, that also goes for asking for that extra person, asking for assisted delivery, and asking for music to be played. Always asking. Okay, they might be like, “No,” but if you don’t ask, again, you don’t know you have options unless you know the options you have. Does that make sense? I’m saying that backward.

Julie: You are. If you don’t know your options, you don’t have any.

Meagan: That’s it. If you don’t ask the question, you might not have the option is what I’m trying to say.

Julie: Yes. Yes. Keeping baby, skin-to-skin, doing these things. We can make the Cesarean experience better. That doesn’t mean that a Cesarean is always bad or traumatic if we don’t have these things, but these are things that can help to make things better.

Meagan: Yeah, so doing that and then also learning how to avoid unnecessary Cesareans. What types of things lead to Cesareans? We know that we have 4-5 most common ways that Cesareans are suggested or happen. One is breech. If your baby is breech, then you are more likely to have a Cesarean. Now, we do have things like external versions and Spinning Babies and chiropractic care and things that may encourage that baby to rotate. They may just rotate, but a lot of the time, we have providers just scheduling a C-section and that’s it because we are not seeing people having babies vaginally with breech babies much anymore which is heartbreaking.

Maybe we are being told, “Well, you’re looking a little bigger and you’re close to 41 weeks so let’s just induce you.” Right? We’ve got due dates. We have breech fetal position. If you’re in labor and your body is not progressing at the timeline that someone wants it to, failure to progress. We have small pelvis. Maybe you’re at 10 centimeters and you’ve been pushing for two hours and your baby is having a harder time rotating, but instead of stepping back and looking at, “Hey, where is this baby’s position?” or “Maybe this baby is really high up and we need to rest and descend,” we’re just saying no. We’re cutting it off and we’re going to have a C-section.

25:59 Your hospital rights

Meagan: Let’s see. What else, Julie? What are some things that you feel like we can learn to avoid Cesarean?

Julie: I mean, all of those things you said are great, but I just want to pull it in a different direction for some reason. I’m so sorry.

Meagan: No, that’s fine.

Julie: But knowing your rights. Knowing your rights.

Meagan: That’s funny because that’s on this toolkit right now.

Julie: I know. I’m staring at it right now, but I love where they say, “Consent forms from the hospital or provider are not contracts.”

Meagan: I love that.

Julie: They are not a replacement for true, informed consent discussion. They are not a replacement for a true and informed consent discussion. They are not. They are not contracts. You can revoke your consent at any time. No one is going to sue you because you signed the consent form. Do you know what I mean?

Meagan: You can change your mind.

Julie: Gosh, my mind is reeling right now. I feel like consent forms might be another way of coercion.

Meagan: Mhmm.

Julie: I really do. They are a way of coercing you into feeling like you are locked into this decision or you are locked into whatever consequences might come from that decision. But also, I feel like hospital policies are the same thing. Hospital policies are not contracts. Hospital policies are not an excuse to not have a discussion and get true, informed decision-making. Hospital policies, a lot of the time, are not set up to help the patient. They are set up to cover the butts of the providers and the hospital.

I feel like when you are falling back on a consent form or when you are falling back on hospital policy, then that’s another form of coercion, of getting people of what you want them to do because it’s policy because you signed the consent form.

Meagan: Exactly.

Julie: Yikes. I can’t stand it sometimes how parents don’t feel like they can change their mind or how they don’t have all of the information and maybe they wouldn’t have made the same choices if they had all of the information or maybe not and it’s not anyone’s place to say what they would or would not have done. I’m not trying to vilify hospitals. I’m not trying to vilify providers or nurses or anybody who sticks to these policies and things like that because it’s not their fault. It’s the fault of the system that they have been born into. It really takes a lot, I think, for a provider and a nurse and an OB and a midwife or whatever to step up and go against the system.

“Hospital policy says you have to have an epidural, but you can do just really do whatever you want. I don’t care if you have one.” There is a midwife in our area, a hospital midwife who says that to every VBAC patient. She’s like, “The hospital wants you to have an epidural, but you can totally say no. I don’t care if you have one or not.” I’ve never had a client there who has an epidural placed just because they are a VBAC which is a whole other episode I feel like we are going to talk about at some point.

Yeah, anyway. That’s just where my mind was wandering. You have rights. Just because you are in a hospital doesn't mean you are in jail. You are not in jail. You are a human with rights and feelings that should be respected and talked to like an adult and not like a kindergartner who has to follow a strict schedule and go to recess at a scheduled time. Do you know what I mean? Anyway, sorry. I’m getting a little off-topic there.

Meagan: No. I think it really goes hand in hand. Here are the reasons why Cesareans happen. I mean, there are other ones too. These are common ones.

Okay, you’ve been pushing for 2.5 hours. Your baby is not making a ton of progress, but making slow progress. Your provider says, “All right. We’re cutting this off. it’s time. We’re having a C-section. It’s time. You have to have a C-section.”

What are your rights in that situation? If you are like, “I am totally down for that.” Then, okay. But if it’s like, “No, I don’t want that,” but a provider is saying, “You have to. You have to. You have to. It’s time. I won’t do this anymore.” What are your rights in that situation?

No one can perform a Cesarean, no one, unless you say, “Okay.”

Julie: But they can manipulate and coerce you and tell you that your baby is going to die. You’re not in your logical brain. You’re in labor land so of course you’re going to do a C-section.

Meagan: Yeah. Yeah, exactly. There are things like that or there are true emergencies. We don’t want to disregard those where it’s seriously true and to save you and your baby. But you can say no. You also can say, “Thank you so much for your time. I’m going to keep going. Can you get another provider in here? You’re fired.” That sounds crazy, but you can literally let your provider go in the middle of labor and in the middle of pushing. If it’s not working for you, you can let them go. You’re not in jail like she said. You can still make choices. It’s just so important. I love that you brought that up.

One, know the reasons why Cesareans are happening, but then really truly know your rights most of all. It’s hard. It’s so hard.

Julie: Ideally— it is so hard. It is super hard. It is especially hard when you are in that position in the first place for one reason or another. But the best thing you can do to avoid getting put in a position like that where you are pushing and pushing and a provider wants to do a C-section and now you have to fight for it is first of all, hire a doula, but second of all, don’t be in that position in the first place. Leave the provider. Surely there are red flags. There are things that are telling you that this is not a right fit and a lot of times, we hear people say, “Gosh, I knew I should have switched, but I didn’t.” Listen to that and honor that and honor things ahead of time because odds are by the time you get to that point, you’re just going to do the C-section.

32:10 The safety of home birth

Julie: I hate to say it, but I’m never going to dance around the issue or tell you a lie but if you are there and you’ve been pushing, you can’t be the only one that wants to keep pushing. Yes, legally you can say, “No”, and legally, they have to provide care for you, but it’s going to be a circus. It’s going to be really hard to do that.

Then what happens to your body? Your body is stressed out because it has to fight then that is not conducive to the natural labor hormones. I don’t know. It’s a hard fight. I feel like going back to I really like that ICAN is highlighting home birth as a safe and reasonable option after Cesarean because one of their graphics from 2023 highlights that there was a 2021 study that found home birth after Cesarean is associated with a 39% decrease in the odds of having a repeat C-section. 39% decrease, you guys.

Meagan: Pretty impactful.

Julie: I wish that more people would consider home birth as a safe and reasonable option. We were talking about this earlier before we started our episode. I was watching this show last night. You can tell me if you don’t want me to tell you this.

Meagan: You can tell it.

Julie: I was watching a show last night about mystery diagnoses where this provider is a doctor. She’s a legitimate doctor and she’s done lots of really cool things. She’s started outsourcing diagnoses for people who have these mysterious medical diseases to social media. She goes through all their medical records and she makes reports and she broadcasts it on a blog and then people send in videos from all over the world about what they think the diagnosis is. It’s really, really cool how she is using social media to help them when they are just baffled.

There was this girl who has had 9 years without a diagnosis and it turned out to be this really simple thing that she just had to change her diet for. Anyway, I don’t remember the name of the show but you can message me and I can tell you if you want.

The point is that this provider is a doctor so she’s been through all the schooling and everything. She said something that really stuck out to me. She said, “The goal of the hospital is to keep the thing that is trying to kill you from killing you.” I was like, “That is the goal of the hospital to keep the thing that is trying to kill you from killing you.” She said, “If you want solutions outside of that, you have to go outside of the hospital.” It just really hit home for me for birth.

I know you guys might get sick of hearing me talk about home birth because most women do birth in a hospital, but the hospital’s job is to keep you and baby alive. That is literally their job and it is their main focus. It is what they are going to be focusing on. It’s why we intervene so quickly. It’s why we rush to Cesarens so fast. It’s because it’s the easiest and fastest way to keep you alive.

Now, out-of-hospital births also really love alive moms and babies. I’m just going to say that. It’s not different. The goal is similar, but their focus is not on keeping the thing from killing you. Outside of the hospital, the goal is promoting the physiologic birth process and trusting the body to do the thing that it’s made to do.

Now, there are circumstances. I feel like we have to say this every time because there are circumstances where out-of-hospital birth is not a safe option for some people. There is a time when labor just needs a transfer to a hospital for additional care. But when the focus on out of the hospital, promoting the physiological birth experience and trusting the body versus the hospital where they are trying to focus on keeping you alive, you’re going to have completely different levels of care.

Those levels of care sometimes do more harm than good which is why out of hospital, when you’re going for a birth after Cesarean out of hospital, your chance of having a C-section is significantly lower. I say significantly in the literal way by the study but also in the way we all think of it. 39% decrease in Cesarean is a huge deal. How are we thinking about birth? How are we addressing it in-hospital and how are we addressing it out-of-hospital?

Not everyone is eligible for out-of-hospital birth and it’s unfortunate that not everyone has those options, but for women with healthy pregnancies without complications, it is a reasonable option and it’s worth looking into even if you just rule it out. There is my home birth soapbox.

36:52 Lower Cesarean rates = lower infant/maternal mortality rates

Julie: What are we talking about? Cesarean Awareness Month, yeah.

Meagan: My home birth soapbox. Home birth can be an amazing option. It can obviously reduce the chances of things like interventions and even Cesareans that are unnecessary and pushing those things on people. Typically, I feel like my clients who are in home births really do feel this sense of– I don’t know if awareness is right. Connection, maybe. They are more connected with their labor, their birth, and their team.

I’m not saying people in the hospital aren’t connected with their team or their labor or anything.

Julie: It’s so different.

Meagan: It’s different. It is. It’s very different and until you’ve experienced or if you’ve experienced it, you know what we are talking about. There is something different and it’s very unique.

Julie: One more thing, sorry, and then I promise I will close it off.

Meagan: No, you’re just fine.

Julie: I really like in here– I think it’s worth pointing out because I’m sure there are going to be a lot of people cringing about what I just said about how the goal is to keep the thing from killing you. It’s pretty well-known now. The United States has one of the highest infant and maternal mortality rates in the developed world. The highest in the developed world. Okay? But we have also the highest number of C-sections. One of the highest numbers of C-sections. Okay?

I love one of these Cesarean Awareness Month graphics from ICAN states that most places that successfully reduce maternal mortality have a lower Cesarean delivery rate. I’m not just spurting out garbage, you guys. There is information and there is information and statistics and evidence to support that higher Cesarean rates do not equal safer births. Higher intervention rates do not equal safety for mom and baby. It’s all over the place and I really love it since 2020 especially how there has been more information and more research coming out supporting the safety of home birth and home birth after Cesarean. It’s just wild how much the medical system– or not the medical system as much as the people who do these reviews and systemic reviews are getting on board with showing the safety there. I’m not just talking about my anecdotal views as a birth worker. I’m talking about actual evidence for these things.

I’m going to read that again. “Most places that successfully reduce maternal mortality have lower Cesarean delivery rates.” It’s science. It’s just science.

Meagan: It’s science.

Julie: It’s science. Okay, now I’m done.

Meagan: Okay, it was back in November 2023 and it says, “Infant mortality in the United States provisional data from 2022 period linked/infant death file.” Now, this is going to be a lot but I’m going to have Paige, our amazing transcriber–

Julie: Love Paige.

Meagan: –and poster of our podcast put this in the show notes for you guys. If you want to go there and read a little bit about where things have gone, it breaks it down between the methods, the gestational age, the maternal race, infant sex, state of residence, maternal age, leading causes of death, and more. It’s got a lot of studies and things like that and a lot of stats that could maybe be scary actually to find out, but also nice to know the information. We’ll have that in the show notes.

40:38 A message to the CBAC community

Meagan: Then next on the goal of ICAN’s mission is to help advocate for VBAC. I think this is one of the areas that a lot of the times our amazing CBAC community struggles with. I do not mean this in any– I don’t mean to say this rudely, but a lot of moms who have had Cesarean birth after Cesarean dislike April because of this. I feel like I see it every year. It’s a very tender topic and very hard. I mean, I’m going to always– for some reason, the radical acceptance episode that we did relates to so many things, but a lot of the time, we have unprocessed trauma, unprocessed guilt– guilt is a really big one. There is a lot to unpack and a lot of the time, that is not all processed or unpacked, and then April comes around and we’re like, “Ugh. Everybody is advocating for VBAC when I wanted a VBAC too but I didn’t have a VBAC. I didn’t have that option or I didn’t feel like I had that option” or whatever.

There are so many things. “My body couldn’t do it. I tried but it didn’t work” or “I couldn’t find the support despite looking for provider after provider.” I mean, there are tons of reasons why people have CBACs. I mean, I am a CBAC mom myself. I don’t know if anybody knows that, but I am. I’ve had two Cesareans and I did want a VBAC. I was going for a VBAC and I ended in a Cesarean.

Now, I didn’t want that Cesarean at all, not even close. That was not what I wanted. But I had it and I tried to make the best of it. It was a healing experience. I am grateful for that Cesarean which a lot of people don’t understand how I could possibly be grateful for the birth that I didn’t desire, but that’s something that I truly am.

Julie: You had to work for it though. You didn’t just get to be grateful. You had to work for that.

Meagan: Really, truly work, and let me tell ya. I was still working pregnant with my third. Really, I was reading my op reports. I was so frustrated. I was bawling. I was like, “Why? Why did this happen? This was not what I wanted. Why didn’t anyone tell me?” There were so many things so I get kind of wanting to feel angry about your unprocessed birth or your undesired outcome. I will promise you that in time– it might take years– it can come. It can. This healing can come and you can see Cesarean Awareness Month as a positive thing but also be an active participant in knowing that not only is it to help promote vaginal birth after Cesarean and lower the Cesarean rate, it’s also to make Cesarean birth better.

Julie: And safer.

Meagan: And not have traumatic Cesareans as often and to support the CBAC as well. So I don’t know. I feel like I’m talking in circles. I don’t know how to say it, maybe, but my message to you is if you are struggling with Cesarean Awareness Month and if you are hating to see all of the posts and all of the things saying, “Yes, I got my VBAC” and “Yes, vaginal birth is better” or whatever. We see those all in the month of April. It’s mid-April and again, we are recording this in February. I mean, I guarantee you that we’ve seen at least a dozen of these types of posts at this point when this is aired. Try your hardest to step back and also find self-healing within yourself so these months don’t trigger you.

April doesn’t have to be a triggering month. It can be an empowering, motivational month to stand up and be like, “Hey. I didn’t want that C-section either. It’s not what I desired, but here I am and I am here to help people know their options for Cesarean and have a better outcome and reduce the Cesarean rate,” because yeah. I didn’t want it either. Okay. I don’t really know. I maybe am just off-base, but I just feel so passionately about our CBAC community too and I know. I see them. I see them struggle through April. If you are listening, I don’t want you to struggle. I want you to hear a different message when you see Cesarean Awareness Month.

Julie: I agree. I agree because it’s hard. There is space for all of us here. There is space for all of us. Do you know what? Maybe, in April if you are really triggered with all of the Cesarean Awareness Month things, maybe the best thing you can do for your mental health is mute everything before they are talking about C-sections and VBACs and everything. Maybe you leave the group. Maybe you unfollow the page and then come back when it’s a healthier time for you. Maybe that’s the thing that you can do to love yourself the most if you’re not in the space to confront your triggers head-on. Maybe that’s the best thing for you and that’s okay. It’s okay to create space for yourself to grieve and heal and mourn that loss no matter what form that takes.

But when you’re in a more healthy spot, we absolutely want you to come back here and rally for us more. Rally with us, not for us. Rally with us more to improve access to better care options for our pregnant people to make Cesareans safer, to allow other support people in the OR, to increase evidence-based practices in hospitals, and things like that. It’s just more than just about reducing the overall Cesarean rate. It’s about so much more than that. We love you here. I mean, there is space for you here and we have all been there. We’ve all been there. Some of us are still in that journey and that’s okay. We’re all in all different spots of our journey and yeah. There’s space for you and we love you. But if you also have to take a step back for a little while, we still love you and we honor that journey and we honor that part of you.

Meagan: Mhmm, absolutely. Okay. We will leave this here and we will let you know right now. We love you. Just like she said, we honor your journey. We support you. Let’s rally together. This month, let’s build each other up and let’s spread the information, and let’s talk about our stories, and let’s talk about how someone else can have a better experience based on learning. Download the toolkit. Check out the links right here in the show notes and Happy Cesarean Awareness Month.

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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