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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.
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Episode 297 Macy's Amazing HBA2C + What Does the Evidence Show for VBA2C?

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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.

Macy’s first birth was a scheduled C-section due to breech presentation that required follow-up exploratory surgery due to an unknown cause of internal bleeding. Unfortunately, her surgeon had accidentally nicked an ab muscle. Macy’s recovery was very difficult.

With her second, doctors were nervous about her chances of VBAC and would only let her try if she showed up in active labor before 39 weeks. Otherwise, she would go in for a scheduled C-section. Macy agreed and her birth ended in another Cesarean. Her birth was beautiful and her recovery was smooth, but it still wasn’t the empowering experience she hoped for.

Macy hit the ground running during her third pregnancy. When doctors were not supportive of a VBA2C, she knew home birth was her best option. She found a midwife who was willing to take Macy on as her first VBA2C client! We know you will absolutely love listening to this birth story.

Like Meagan said, “It is so beautiful. It is so peaceful. It sounds like one of those births where you close your eyes and you envision birth and how peaceful, beautiful, and calm it really can be.”

The VBAC Link Blog: VBA2C

Practice Bulletin - VBAC

Informed Pregnancy - code: vbaclink424

Needed Website

How to VBAC: The Ultimate Prep Course for Parents

Full Transcript under Episode Details

03:44 First C-section with internal bleeding and a follow-up exploratory surgery

09:04 Second pregnancy

11:37 Scheduled C-section and getting pregnant again shortly after

18:44 Finding a supportive home birth midwife

23:24 VBA2C prep during pregnancy

27:46 Labor begins

32:42 Breaking her own water and pushing for 17 minutes

36:47 ACOG’s statement on VBA2C

Meagan: Hello, hello Women of Strength. We are so excited to be sharing an HBA2C story and if you don’t know yet what HBAC means, that’s home birth after Cesarean and then HBA2C is home birth after two Cesareans. I feel like that’s kind of funny. It’s never really a term I used because I wasn’t at the hospital and I wasn’t at home, but I also kind of feel like I sort of had an HBAC. It was at a birth center. Maybe that’s a term, birth center birth after two Cesareans. I don’t know.

But obviously, VBAC after two Cesareans are near and dear to my own heart and today we have our friend Macy from California sharing her HBAC story and just before we started recording, we were talking about how one of her messages that she wants to give is that you can do this. Right, Macy? You’re just like, you can. People can do this.

Macy: For sure.

Meagan: Yes. Yes. I am excited to hear your story and then I wanted to also just talk a little bit at the end about some evidence on VBAC after two C-sections. So if you’re wondering more about VBA2C, make sure you stick to the very, very end even after the story because we’ll talk a little bit about that.

01:24

Meagan: We do have a Review of the Week and this is from Jenna. It is actually on our How to VBAC: Ultimate VBAC Prep Course. She says, “I just started but have already learned so much. After two C-sections and one where my doctor made me think it was very risky, I was terrified to try again. With this course, not only have I learned the truth about VBAC, but I am excited to attempt mine in August.” That’s coming up. I am so excited for Jenna. Thank you so much for the review and the support, of course, of taking the course. I am so excited that you are getting educated and definitely keep us posted.

03:44 First C-section with internal bleeding and a follow-up exploratory surgery

Meagan: Okay, cute Macy. Welcome to the show.

Macy: Thank you for having me.

Meagan: Absolutely. I’d love to turn the time over to you and share whatever message you feel is important for our beautiful Women of Strength listeners.

Macy: Okay, well like with all VBACs, my story begins of course with my first pregnancy. During my first pregnancy, I was pretty healthy. I didn’t love being pregnant, but I was excited that we were starting our family and I got to– I can’t remember– 34 weeks maybe, 35ish, and baby was still breech.

They offered me the ECV procedure, but they told me I would have to do it around 37-38 weeks and I was worried about it being so early before my due date that she would turn again. I was scared. They got me scared. They don’t really present the ECVs as something that should work.

Meagan: I know. I know.

Macy: My midwife with my third pregnancy was like, “I wish you would have done it,” but they talked me out of it so I decided not to do it. Come 40 weeks, she was still not flipped, but I wasn’t in labor so another thing is I wish I would have just waited to see because maybe she would have flipped in labor.

Meagan: Sometimes they do. I actually recently had a client last year in 2023 that did have that. She was scheduled for her version and then she went into spontaneous labor so she actually went in pretty early because she was like, “Oh my gosh. My baby’s breech. I was scheduled the next day for a version,” and they were like, “Baby’s head down.” So it definitely happens.

Macy: With my third one, she was sunny-side up. She was posterior, but I could feel her turning and getting into position. But anyway, I’ll get there. I’ll get there.

I had my C-section scheduled. My daughter, Alayna was born 10 days before Christmas in 2018. She was perfect. She was 6 pounds, 13 ounces. I was not great.

After my surgery, I came out. I was in the PACU and my blood pressure was dropping crazy low and my heart rate was spiking super high. I was ghost-white and they were like, “We don’t know what’s going on.”

Long, long, long story short, I was having crazy internal bleeding.

Meagan: I was going to say, were you hemorrhaging? Because that sounds like hemorrhaging.

Macy: I was hemorrhaging. I was bleeding internally, but it was from having surgery. It was not anything to do with baby or birth. It was just surgery. So what we discovered is they had accidentally nicked an ab muscle and it was bleeding.

24 hours after my daughter was born, I had to go back in for an exploratory surgery and I was put under anesthesia completely again. They had to cut back open my layers and start over. Thankfully, they didn’t have to cut into my uterus again, but they did open me back up and stop the bleeding, cauterize it and I mean, my recovery was just horrible.

Meagan: Not great, yeah.

Macy: I mean, thankfully I only had one baby so it was just her and my husband is amazing. I could not ask for a better partner, but it was just hard. It was hard to accept that, to grieve the birth I had dreamed of my whole life, but it never occurred to me that I couldn’t have a VBAC. My mom had me via C-section and my three subsequent siblings were all VBAC. So when someone said to me at 12 weeks, I recovered. I was back at the gym and someone from the gym was like, “Oh, so you have to have all your babies as C-sections now.”

I was like, “Wait, that’s a thing still? We’re still doing that?” I was like, “No. I’m going to have a VBAC.” I never even thought about it. I immediately was like, “Oh, so this is going to be a thing.” That’s when I found you guys and I started listening before I was even pregnant with my second one, but when I did get pregnant three years later with baby number two, I probably binge-listened to every single episode. I was like, “I’m doing this.”

09:04 Second pregnancy

Macy: I switched providers just because I didn’t have a great experience so I was like, my postpartum care, I didn’t care for my pediatrician so I just switched everything. But because I was with a new provider, I had a really difficult time locating my surgical notes. My new providers wanted to know if my first C-section was done with a single or double-layer closure.

Meagan: Oh, interesting. Okay.

Macy: Because of course, if it’s single, it’s going to increase my risk for a rupture. I at this point was already like, the risk of rupture is so low. I am not worried about it. Breech baby is a great candidate for VBAC.

Meagan: And the evidence on that is really not solid on which one really is best. There are some that show double may be better, but that doesn’t necessarily mean that your rupture rate skyrockets because you have a single layer. So they are focusing on something that didn’t have a ton of evidence.

Macy: Right. I was like, “There is just not enough research to justify all of these C-sections.” But because they didn’t understand what had gone wrong and why I had to have a second surgery even though I told them a million times it wasn’t anything to do with my uterus. It wasn’t a me problem. It was a doctor's problem. They were just like, “We just don’t feel comfortable with TOLAC.” And you know, it’s always TOLAC. It’s never just a VBAC.

Meagan: I know.

Macy: But they didn’t want to do anything. They didn’t want to offer ultrasounds. They just were not willing to take a chance even though it was a really good chance.

So basically, they were like, “The only way you are having this second baby VBAC is if you come to the hospital and you are in labor and it’s time to push.”

I mean, that’s kind of scary to someone who doesn’t know. I mean, now that I’ve done it I’m like, “That’s what I should have done,” and that’s what I tell my friends. You don’t go to the doctor until your contractions are two minutes apart because they try to scare women out of their VBAC.

11:37 Scheduled C-section and getting pregnant again shortly after

Macy: So I just didn’t really stand up for myself. I just agreed like, “Okay, I guess.” I told myself, “If I go into labor before my scheduled C-section at 39 weeks, then that’s the way God wants it and I will have my VBAC.” Obviously, that never happened and 39 weeks is pretty early now knowing especially when due dates are just guess dates.

Meagan: Very important note that you just gave there.

Macy: Yeah. I had my baby at 39 weeks. She was perfect. I mean, my recovery was– she was another 6 pounds, 15 ounces so they were almost the same size. That was Reagan. Recovery was a lot better but still, I had a 3-year-old at home.

Going from one to two was pretty good for me. I have a big family. That was great. But it was still not the empowering birth that I wanted. I did feel– I don’t want to say I didn’t feel empowered because C-section is badass. It’s hard.

Meagan: Yeah. Mhmm, yeah.

Macy: It’s not the easy way out ever. There is no easy way out of birth. I do want to preface that and say if that’s what ends up happening and you only have two kids and you only have two C-sections, that’s okay too. I knew we weren’t done having kids. I wanted the birth I wanted.

I did not plan to get pregnant with such a short turnaround time. I was almost 8 months postpartum when we found out we were pregnant again. We were a little surprised. I mean, we are grown adults. It shouldn’t be that surprising.

Meagan: But still, it can be a little alarming when you weren’t mentally preparing for that.

Macy: I had just finished breastfeeding. I was just starting to track and all of these things so I was like, “Oh no.” But that was kind of when my work really started for me because I was like, “Okay. We are doing this again and I’m going to do this the way I want. This is going to be how I want it to go. This is my story and this is going to be an essential component of who I am as a woman and as a mother going forward for the rest of my life. I need this to go the way I want it to go.” I wanted it to go the way God wanted it to go of course, but I was like, “I’m going to take more control.”

Meagan: Can I add something to that? Sorry to interrupt, but there are so many times that I hear people, I read on social media that people are getting after moms and parents who are like, “I want this birth. This is what I want. This is what I feel I need,” or what you are saying. “I want it to go a certain way.” They are like, “Why do you have to focus on what you want? It’s not what you want. It’s what’s best for the baby.” They are railing on these people.

I want to stop and say that what you said is okay. I feel like maybe a little passionate about that too because so many people were naysayers to me. “It does not matter what you want. It’s what’s best for the baby.” It’s like, well guess what? That’s also maybe what’s best for my baby.

Macy: Right.

Meagan: It’s okay to say, Women of Strength, “I want this birth. This is what I want.” And you deserve that. You deserve to go after what you want.

Macy: It is hard and being a mom is hard.

Meagan: Yes.

Macy: You can start out in a way that you feel empowered. It is life-changing. It really is.

Meagan: It is. So sorry for interrupting, but I just wanted to give a little tidbit that it’s okay for people to want what they want. I wanted a white vehicle. I was going to find a white vehicle. It’s okay to get what you want and to put forth energy and to say that out loud, “I want this VBAC. I’m going to get this. I want it.”

Macy: You spend almost 10 months thinking about this and praying about it whereas you talk to– I mean, it wasn’t as important to anyone else in my life except for me. That was okay. Especially the doctors and the providers, I’m just another person to them and yes, there are some really great providers out there and they do care, but they are at their job. They are doing their job. Well, my job is to be a mother. That’s my job, so doing what serves me well was birthing my baby the way–

Meagan: Having a VBAC.

Macy: Having a VBAC. So I really hit the ground running. There were a few girls in my town who had recently had homebirths. They weren’t VBACs, but they were VBACs so I reached out to them– shoutout to my girls Megan and Emily. They were so helpful because they were real people. I reached out to you guys and I just wanted to know, “Hey, what is the research on really close pregnancies?” because I wasn’t going to hit the 18 months.

Meagan: The 18 months. Your babies were going to be 17 months apart, right?

Macy: 17 months. So that was even annoying too because I was like, “I’m right there. Come on.” You guys were like, “Go join the Facebook Community group.” I was so glad that I did because I was just finding story after story after post after post. Not only were so many women having VBACs after two+ C-sections, but they were close together. Some were like, “Mine were 12 months apart.” I’m like, “Oh, I’m good to go then.”

It was so nice having that community. I was even able to join a community within the community of everyone who was due at the same time as me so when we got close, we had a group message and everyone was like, “Is it happening today? Is it happening today?” It was so nice not to be alone in that.

I also had to find a midwife because I knew my providers were not going to be supportive of VBAC after two. I actually had a hard time finding a midwife which was also annoying because I was met with some medwives who were just really going to stick to that 18 months.

18:44 Finding a supportive home birth midwife

Then I happened to just find a woman who was like, “I’ve never done this before. You are my first VBAC after two,” but she was a midwife who was very knowledgeable. She had done lots of home births. She had done VBACs, but not after two.

She was like, “If we don’t start accepting these patients, how are we ever going to change the status quo? How are we ever going to make a change?”

Meagan: Boom.

Macy: Right.

Meagan: It’s so true though.

Macy: I was like, “Okay. Statistic me, please. I would love to be a statistic for the positive.” The only thing was I was like, “I can’t be one for a hospital birth, but it’s fine.”

Meagan: That’s okay. That’s okay.

Macy: So I found Sarah. I started my visits with her. I had to travel an hour to my visits. It wasn’t the worst thing ever.

Meagan: That’s a commitment though. That’s a commitment.

Macy: Towards the end, she came to me a lot more which was so nice. So nice.

Meagan: That’s really nice.

Macy: Then we did a couple of phone calls, but we also texted all of the time and would FaceTime. It was just so personal. I also received co-care with another third local provider. I did that because my midwife wanted to have me get ultrasounds to check my uterus. She wanted to check for previa and we wanted to check for– what’s the other one? I’m blanking.

Meagan: Accreta?

Macy: Yes, so she just wanted to be aware.

Meagan: Placental issues and make sure the placenta is out of the way and all is doing okay. You’re actually clear to have a VBAC.

Macy: Yeah.

Meagan: Which is very responsible of her.

Macy: I received my co-care. I would go in there. I don’t know. I almost had a chip on my shoulder because I was like, “I don’t really need you guys,” kind of. I didn’t leave those appointments feeling like I wanted to cry like I did with my second pregnancy because I knew that I had something better planned. So it wasn’t as upsetting, but they were pretty rough on me.

I had expressed my interest in a VBAC after two and you have to see the series of providers within the office. I had only one who was a little bit younger which was interesting, but he was the only one who was like, “Yeah. I really support this and the birth you want to have. I’m going to give you a referral to UC San Francisco and when we get to the end, I want you to start care there and plan to have your birth there.”

He was the only one who was like, “I support the birth you want to have.” Everyone else was pretty awful. They told me, “If you TOLAC and your uterus ruptures, you will die and your baby will die.”

I was like, I will never forget getting in my car and texting my midwife and being like, “Can you believe that he just said this to me?” I was just like, “Are you God? Do you know?” How could you say that to someone? “You will die.” Because that’s not the case at all.

That was interesting but I knew. Like I said, I knew I had a backup plan in the back of my mind. It was just eye-opening for me more than anything. It wasn’t upsetting.

Meagan: Someone that doesn’t necessarily know the evidence of that, it can be terrifying.

Macy: Yeah. Yes, totally. And you know what? It’s frustrating because a lot of people just trust their providers. I’m a very skeptical person. I’m very conspiratorial, so I’m always researching things and looking into things, but people who are not prone to that are just going to trust what the doctor says because they went to school and they are smarter than them. It’s so unfortunate that it’s causing a high C-section rate for no reason.

23:24 VBA2C prep during pregnancy

Macy: That was a bummer but anyway, throughout my pregnancy, I did all of the things. I did my VBAC Link course. I loved it. It was great to have that. I did a Lamaze class which was really fun. It was funny because we were the only parents in there with other kids. One other lady was a VBAC, but the rest were all first-time parents. They were like, “What are you doing here?” I’m like, “This is new for me.” Again, shoutout to Modesto Birth and Beyond. They are fantastic. They have a great set of doulas. I’m now on a friendly basis with them. They were great to have and they were really supportive of my whole journey.

Let’s see what else. I did a Hypnobirthing class. I read Ina May’s Guide to Childbirth. I mean, I walked and I stayed in shape. I kept doing CrossFit. I did CrossFit for all three of my pregnancies so I kept on. I ate healthy. I drank lots of water. I did all of the things. But I knew that when it came down to it, my mind was going to either make or break me.

Fast forward to 41 weeks and I was getting very, very anxious.

Meagan: Were you getting anxious because you were getting ready to have a baby type thing or were people giving you some grief that you were over 40 weeks?

Macy: By the time I was 40-41 weeks, the grief and the doubt and the naysayers that I got were kind of gone. Most of the people in my life were supportive. I always got that question of, “What if this happens?” I live 5 minutes from the hospital, so I was not too worried about it. I was more anxious of, I was ready to meet this baby. I was the biggest I’d ever been. Third baby, only 17 months apart. My belly was huge. It was hot. I was swelling. I was ready to be done, but I also had never labored before.

I had no clue what my body was going to do. Was I just going to go into spontaneous labor at 40 weeks? At 39? I had no idea. So every day that passes, I’m sure you remember that too, every day was a whole week where you wake up in the morning and I would just cry, “I can’t believe I’m still pregnant.”

Meagan: I remember going to bed and I was like, “Tonight could be the night,” and then I’d wake up and I was like, “It wasn’t the night,” then that night, I’d be like, “Maybe tonight,” and it just kept happening.

Macy: So annoying. I had so much prodromal labor. I had contractions. I could time them and I was like, “Oh, they are 20 minutes apart. They are for sure going to get closer,” then I’d go to sleep, wake up, and be like, “Okay. Here we go again.”

Let’s see. So on a Monday, I did acupuncture. Then on a Wednesday morning, I was 41 weeks and I went and got a massage. I got some acupressure. You never know if these are the things that really get things going, but sometimes they do. I got a massage and she gave me some moxibustion so I did that. You light it and do it around– my mom was like, “This is so hokey.” I’m like, “If it works, who cares?” I was trying everything.

But I didn’t want to be induced and I hadn’t had my membranes swept yet. That was going to be the first intervention that my midwife and I agreed on because she was like, “Legally in California, you can’t go past 42 weeks and have a home birth.” I was like, “Okay. I’ve got one week. One week and this baby will be here.”

27:46 Labor begins

Macy: That Wednesday morning, I went and got my massage and by 2:00 in the afternoon, I was like, “Okay. Things are starting to pick up.” I started having pretty intense contractions. I was having to– I could still talk. I was still taking care of my two little girls, but I was starting to feel really uncomfortable. My mom went home, then she came back. My husband gets off work at 3:30 and it was 2:30. I was feeding my youngest one a snack and he was like, “Do you want me to come home early?” I was like, “No, I can totally make it until you get home.”

I had a contraction where I leaned over my kitchen counter, and then I was like, “Okay. Maybe just come home now.” He came home. I just didn’t feel it. I was starting to feel irritated by my kids and I was like, “I just want to go in my room and watch a show on my laptop. I just want to be alone.” I didn’t necessarily want them to leave yet, but I wanted to be alone and I wanted to know that they were taken care of.

He came home and he was taking care of them. He was like, “Do you think this is it? Let’s call my mom.” I was like, “Yeah. I think this is happening and I think it’s going to be soon.” I just didn’t know how long I was going to labor. It was a mystery.

My mother-in-law came and picked up my little two daughters. That was kind of sad watching them leave knowing the next time I saw them, we were going to be a different family– a better family, but a different family.

Yeah. I just labored at home. It was so nice not having to go anywhere. I took a shower. I had some snacks. I wasn’t super hungry, but I definitely started drinking my electrolytes and started preparing to be hydrated.

Meagan: Smart.

Macy: I was like, “I’m preparing to run a marathon so I need to gear up.” I didn’t nap. I’ve never been a great napper, but I laid around and watched some shows, then I didn’t text my midwife right away because I had been bugging her so much with all of my prodromal labor that I was like, “I’m not going to text her until it’s really happening.” But by 6:00 or 7:00 PM, i texted her and was like, “Just so you know, my contractions are about 10 minutes apart.”

As they got closer, she was like, “Okay. I’m going to come now.”

Once the sun started setting, it was getting a little bit more intense. We set up my birth space at home. I set up my pool. Well, I didn’t. My husband set up the pool and we laid out all of the sheets on the couch and hung my birth affirmations. Actually, they had been hanging. My birth affirmations had been hanging for a couple of weeks so I started having them memorized, but we turned on the twinkle lights and I started listening to the Christian HypnoBirthing app which was fantastic.

I just had such a peaceful labor. I don’t know how else to describe it. My mom came in and then my sister-in-law came over then my other sister-in-law came over. They just talked around me. I could hear them, but I was just in my space. I labored and my water never broke for a very long time. I got in the pool at one point and then I got back out because my husband was like, “I think that being in the pool is slowing down your contractions a little bit. I want you to get out and walk.”

I got out and started walking down the hall then I got really sick with a contraction. I happened to already be laboring backwards on the toilet and I was like, “Oh my gosh. I’m going to throw up.” I jumped back off the toilet so I could throw up in it then my midwife was like, “Okay. You’re in transition now. You’ve got to be.”

I hadn’t had any checks at all this whole time either too so I had no clue what I was even dilated at. I was just completely trying to trust my body and just know that when it was time, it would be time. It really was. My body just did what it knew to do.

32:42 Breaking her own water and pushing for 17 minutes

Macy: Like I said earlier, I felt her move into position. I got back in the water and I felt so relaxed in the water. I was drifting off in between contractions.

Meagan: Oh, that’s awesome.

Macy: It was so calm and I just kept telling myself, “Breathe her down with every contraction,” and just all of the things I had been practicing, I was finally able to put into use.

That was really cool, then I had a couple of urges where I was like, “I feel like I can start pushing soon.” I was like, “Do you want to check me now?” As soon as she stuck her finger, I was like, “Oh, no. No. Get your finger out. It’s time. She’s coming.”

She was like, “Yeah. She’s ready. She’s right there, but your waters haven’t broken yet.” I was like, “Can I break them myself?” She was like, “Yeah,” so I reached in. I gave it a pinch-twist and in the water, I broke it.

Meagan: Oh my gosh, that’s so cool.

Macy: I felt the padding around her head, then I just felt her head. I felt her hair. I started pushing when it was time to push and I pushed for 17 minutes. It was perfect. Like I said, I felt her move and get into position. She came out and she was 9 pounds, 12 ounces so she was 3 pounds–

Meagan: I was going to say 6lb,15oz, right, was your second and close to your first?

Macy: 3 pounds heavier than my other two. She came out. She did perfectly. Her heart rate was perfect the whole time. She came out mad, screaming mad. She was so cozy in there. She did not want to come out. She came out but hearing her cry within 20 seconds was so reassuring. She was safe. I didn’t need anybody. I just needed to trust my body and to trust the Lord. My midwife was like, “That was one of the most perfect births I have ever attended.” She was beaming with joy and she was so excited for me. She was just so happy because she was like, “I’ve never done this after two.” She was like, “You changed everything I thought I knew about home birth, about after two C-sections.” She even now has another client which is great who is a VBA2C. I cannot wait for this podcast to come out so I can share it with my midwife and she can share it with her new client. Hopefully, they have a really great birth too.

All in all, it was just everything I dreamed of. I was so thankful and I just remember laying there with her on my chest. I was watching the video last night trying to get in the mindset and remind myself and get there. On the video, I can hear myself go, “I’m so freaking proud of myself.”

Meagan: You should be!

Macy: I was beaming with joy. I was like, “That was so hard but so worth it.” So it was great. It was a great experience. I could not be more happy with her birth. She’s a great baby. She’s so happy. She was a little hard at first for 10 weeks which was different for me, but after that 10-week hump, she was a really good baby. Her name is Lucille.

Meagan: Cute.

Macy: We call her Lucy which means “light” and she is the light of our lives. She is the best and I can’t even believe we had a family without her for a minute there. But that’s my story.

36:47 ACOG’s statement on VBA2C

Meagan: Oh my gosh. It is so beautiful. It is so peaceful. It sounds like one of those births where you really do. You close your eyes and you just envision birth and how peaceful and beautiful and calm it really can be. To me, you just described the birth that you physically did with one that I would imagine.

Macy: Yes. It’s how it felt. My sisters-in-law and my other girlfriend who was there taking pictures just kept saying, “You did so good.” I was just like, “I don’t know what that means.” But everyone was proud of how it all went. I think that’s so super revolutionary. I hope my story touches other people’s lives.

Meagan: It totally will. I’m so happy that you found your midwife and that your midwife was willing to take you on because a lot of the time, providers can be nervous if they have never done it before.

Macy: Which I get.

Meagan: Oh yeah. For sure, for sure. I’m just so glad that she was willing. That’s one of the things that gets me sometimes with so many people who just are not, we have to respect them and what they are comfortable with. But really, the evidence does show that VBAC after two Cesareans is reasonable. The overall risk and rate of rupture is approximately 1.4% so it’s still very low. It’s still very, very low.

I mean, ACOG themselves, the American College of Obstetricians and Gynecologists, they suggest it. They say it’s a completely reasonable option so for so many people to be cut off after one is heartbreaking because there are so many people who could have a vaginal birth all over the world but aren’t given the option. We have a high Cesarean rate. We have so many.

There are so many people. Just actually weirdly enough at the gym, a man who is the darndest cutest thing ever, his name is Robin and he will always say hi to me and check in on me and how I’m doing. He knows that I cycle and one of the things he asked the other day was, “How’s that doula thing coming?” I said, “It’s really great.” He said, “I never asked you. What made you want to become a doula?” I just told him my story and he said, “Oh, so you had two C-sections?” His eyes were wide. He said, “But you said you have three kids.” I said, “Yeah.” He goes, “But you only had two C-sections?” I said, “Yeah.” I said, “With my first two girls.” He was like, “Wait.” He literally was stumped there for a minute.

Macy: Yeah, people don’t know.

Meagan: He said, “You had a normal birth after two C-sections?” I said, “Yes.” I said, “Robin, I had a vaginal birth after two Cesareans.” He looked at me because I said the word vaginal. I said, “That’s what it is.” He said, “I didn’t even know that was a thing.” People just don’t. They just don’t know that and then there are still so many providers all over the world who aren’t supporting it.

In the ACOG Practice Bulletin, it says that VBA2C, vaginal birth after two Cesarean, is reasonable to consider for women with two previous low-transverse Cesarean deliveries to be candidates for TOLAC. We mentioned the word TOLAC earlier, a trial of labor after Cesarean. A lot of providers use that. It is a medical turn. We call it VBAC. They call it TOLAC. It’s not a VBAC to them until the baby has passed through the vagina.

It says that they are candidates for TOLAC and “to counsel them based on the combination of other factors that affect their probability of achieving a VBAC.”

Meagan: Now, just a couple of things to share before we drop off on this episode, if you had a Cesarean before or two Cesareans, it is not necessarily a reason for you to have a third. If you have gestational diabetes, that doesn’t mean that you can’t VBAC either. I’m trying to talk up these other factors, right? If we have preeclampsia, that doesn’t always necessarily mean that we have to schedule a Cesarean. We’ve shared stories in the past. We’ve even had things like babies with medical conditions where still even their provider said, “Just because your baby has this doesn’t mean you can’t have a VBAC.” That doesn’t always necessarily mean you can’t either.

If you have a big baby, here we are. A nine-pound baby, right? A nice, squishy little baby. Big baby doesn’t mean you can’t either. A diagnosis of a small pelvis shouldn’t be considered– these factors really are more extreme I feel like so if your provider is giving you some of these, “Oh, well you could have a VBAC after two Cesareans but because your baby didn’t come down the last two times, it’s just probably not going to happen.”

You can’t see it. Macy rolls her eyes with me.

Macy: The baby is going to come out. It has to come out.

Meagan: Baby is going to come out. Believe in yourself. Do the research. We do have a VBAC after two Cesarean blog. We’ll make sure to link it here and kind of spin back to what you said about how you were like, “Let me be a statistic. Let me a statistic to your midwife.” VBA3C– we don’t have a lot of stats on VBA3C and I think a lot of it is because we are not doing them. We are not allowing them yet we have so many VBA3C moms in our community who share or on our podcast who show that it still is possible.

I feel like there needs to be more risk assessment there and studies need to be done there. So know that even if you’ve had three Cesareans, that still doesn’t mean that you are eliminated from the chance to go for what you want, fight for what you want, and have that experience not only that you want but that you deserve.

Macy: For sure.

Meagan: Yes. Thank you so much for sharing your story and I cannot wait for this to be published for you to send this to your midwife so she can send it on to the next Woman of Strength.

Macy: Thank you so much for having me. I have loved being here and talking with you. I hope there are so many lives touched and changed by sharing my story.

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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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.

Macy’s first birth was a scheduled C-section due to breech presentation that required follow-up exploratory surgery due to an unknown cause of internal bleeding. Unfortunately, her surgeon had accidentally nicked an ab muscle. Macy’s recovery was very difficult.

With her second, doctors were nervous about her chances of VBAC and would only let her try if she showed up in active labor before 39 weeks. Otherwise, she would go in for a scheduled C-section. Macy agreed and her birth ended in another Cesarean. Her birth was beautiful and her recovery was smooth, but it still wasn’t the empowering experience she hoped for.

Macy hit the ground running during her third pregnancy. When doctors were not supportive of a VBA2C, she knew home birth was her best option. She found a midwife who was willing to take Macy on as her first VBA2C client! We know you will absolutely love listening to this birth story.

Like Meagan said, “It is so beautiful. It is so peaceful. It sounds like one of those births where you close your eyes and you envision birth and how peaceful, beautiful, and calm it really can be.”

The VBAC Link Blog: VBA2C

Practice Bulletin - VBAC

Informed Pregnancy - code: vbaclink424

Needed Website

How to VBAC: The Ultimate Prep Course for Parents

Full Transcript under Episode Details

03:44 First C-section with internal bleeding and a follow-up exploratory surgery

09:04 Second pregnancy

11:37 Scheduled C-section and getting pregnant again shortly after

18:44 Finding a supportive home birth midwife

23:24 VBA2C prep during pregnancy

27:46 Labor begins

32:42 Breaking her own water and pushing for 17 minutes

36:47 ACOG’s statement on VBA2C

Meagan: Hello, hello Women of Strength. We are so excited to be sharing an HBA2C story and if you don’t know yet what HBAC means, that’s home birth after Cesarean and then HBA2C is home birth after two Cesareans. I feel like that’s kind of funny. It’s never really a term I used because I wasn’t at the hospital and I wasn’t at home, but I also kind of feel like I sort of had an HBAC. It was at a birth center. Maybe that’s a term, birth center birth after two Cesareans. I don’t know.

But obviously, VBAC after two Cesareans are near and dear to my own heart and today we have our friend Macy from California sharing her HBAC story and just before we started recording, we were talking about how one of her messages that she wants to give is that you can do this. Right, Macy? You’re just like, you can. People can do this.

Macy: For sure.

Meagan: Yes. Yes. I am excited to hear your story and then I wanted to also just talk a little bit at the end about some evidence on VBAC after two C-sections. So if you’re wondering more about VBA2C, make sure you stick to the very, very end even after the story because we’ll talk a little bit about that.

01:24

Meagan: We do have a Review of the Week and this is from Jenna. It is actually on our How to VBAC: Ultimate VBAC Prep Course. She says, “I just started but have already learned so much. After two C-sections and one where my doctor made me think it was very risky, I was terrified to try again. With this course, not only have I learned the truth about VBAC, but I am excited to attempt mine in August.” That’s coming up. I am so excited for Jenna. Thank you so much for the review and the support, of course, of taking the course. I am so excited that you are getting educated and definitely keep us posted.

03:44 First C-section with internal bleeding and a follow-up exploratory surgery

Meagan: Okay, cute Macy. Welcome to the show.

Macy: Thank you for having me.

Meagan: Absolutely. I’d love to turn the time over to you and share whatever message you feel is important for our beautiful Women of Strength listeners.

Macy: Okay, well like with all VBACs, my story begins of course with my first pregnancy. During my first pregnancy, I was pretty healthy. I didn’t love being pregnant, but I was excited that we were starting our family and I got to– I can’t remember– 34 weeks maybe, 35ish, and baby was still breech.

They offered me the ECV procedure, but they told me I would have to do it around 37-38 weeks and I was worried about it being so early before my due date that she would turn again. I was scared. They got me scared. They don’t really present the ECVs as something that should work.

Meagan: I know. I know.

Macy: My midwife with my third pregnancy was like, “I wish you would have done it,” but they talked me out of it so I decided not to do it. Come 40 weeks, she was still not flipped, but I wasn’t in labor so another thing is I wish I would have just waited to see because maybe she would have flipped in labor.

Meagan: Sometimes they do. I actually recently had a client last year in 2023 that did have that. She was scheduled for her version and then she went into spontaneous labor so she actually went in pretty early because she was like, “Oh my gosh. My baby’s breech. I was scheduled the next day for a version,” and they were like, “Baby’s head down.” So it definitely happens.

Macy: With my third one, she was sunny-side up. She was posterior, but I could feel her turning and getting into position. But anyway, I’ll get there. I’ll get there.

I had my C-section scheduled. My daughter, Alayna was born 10 days before Christmas in 2018. She was perfect. She was 6 pounds, 13 ounces. I was not great.

After my surgery, I came out. I was in the PACU and my blood pressure was dropping crazy low and my heart rate was spiking super high. I was ghost-white and they were like, “We don’t know what’s going on.”

Long, long, long story short, I was having crazy internal bleeding.

Meagan: I was going to say, were you hemorrhaging? Because that sounds like hemorrhaging.

Macy: I was hemorrhaging. I was bleeding internally, but it was from having surgery. It was not anything to do with baby or birth. It was just surgery. So what we discovered is they had accidentally nicked an ab muscle and it was bleeding.

24 hours after my daughter was born, I had to go back in for an exploratory surgery and I was put under anesthesia completely again. They had to cut back open my layers and start over. Thankfully, they didn’t have to cut into my uterus again, but they did open me back up and stop the bleeding, cauterize it and I mean, my recovery was just horrible.

Meagan: Not great, yeah.

Macy: I mean, thankfully I only had one baby so it was just her and my husband is amazing. I could not ask for a better partner, but it was just hard. It was hard to accept that, to grieve the birth I had dreamed of my whole life, but it never occurred to me that I couldn’t have a VBAC. My mom had me via C-section and my three subsequent siblings were all VBAC. So when someone said to me at 12 weeks, I recovered. I was back at the gym and someone from the gym was like, “Oh, so you have to have all your babies as C-sections now.”

I was like, “Wait, that’s a thing still? We’re still doing that?” I was like, “No. I’m going to have a VBAC.” I never even thought about it. I immediately was like, “Oh, so this is going to be a thing.” That’s when I found you guys and I started listening before I was even pregnant with my second one, but when I did get pregnant three years later with baby number two, I probably binge-listened to every single episode. I was like, “I’m doing this.”

09:04 Second pregnancy

Macy: I switched providers just because I didn’t have a great experience so I was like, my postpartum care, I didn’t care for my pediatrician so I just switched everything. But because I was with a new provider, I had a really difficult time locating my surgical notes. My new providers wanted to know if my first C-section was done with a single or double-layer closure.

Meagan: Oh, interesting. Okay.

Macy: Because of course, if it’s single, it’s going to increase my risk for a rupture. I at this point was already like, the risk of rupture is so low. I am not worried about it. Breech baby is a great candidate for VBAC.

Meagan: And the evidence on that is really not solid on which one really is best. There are some that show double may be better, but that doesn’t necessarily mean that your rupture rate skyrockets because you have a single layer. So they are focusing on something that didn’t have a ton of evidence.

Macy: Right. I was like, “There is just not enough research to justify all of these C-sections.” But because they didn’t understand what had gone wrong and why I had to have a second surgery even though I told them a million times it wasn’t anything to do with my uterus. It wasn’t a me problem. It was a doctor's problem. They were just like, “We just don’t feel comfortable with TOLAC.” And you know, it’s always TOLAC. It’s never just a VBAC.

Meagan: I know.

Macy: But they didn’t want to do anything. They didn’t want to offer ultrasounds. They just were not willing to take a chance even though it was a really good chance.

So basically, they were like, “The only way you are having this second baby VBAC is if you come to the hospital and you are in labor and it’s time to push.”

I mean, that’s kind of scary to someone who doesn’t know. I mean, now that I’ve done it I’m like, “That’s what I should have done,” and that’s what I tell my friends. You don’t go to the doctor until your contractions are two minutes apart because they try to scare women out of their VBAC.

11:37 Scheduled C-section and getting pregnant again shortly after

Macy: So I just didn’t really stand up for myself. I just agreed like, “Okay, I guess.” I told myself, “If I go into labor before my scheduled C-section at 39 weeks, then that’s the way God wants it and I will have my VBAC.” Obviously, that never happened and 39 weeks is pretty early now knowing especially when due dates are just guess dates.

Meagan: Very important note that you just gave there.

Macy: Yeah. I had my baby at 39 weeks. She was perfect. I mean, my recovery was– she was another 6 pounds, 15 ounces so they were almost the same size. That was Reagan. Recovery was a lot better but still, I had a 3-year-old at home.

Going from one to two was pretty good for me. I have a big family. That was great. But it was still not the empowering birth that I wanted. I did feel– I don’t want to say I didn’t feel empowered because C-section is badass. It’s hard.

Meagan: Yeah. Mhmm, yeah.

Macy: It’s not the easy way out ever. There is no easy way out of birth. I do want to preface that and say if that’s what ends up happening and you only have two kids and you only have two C-sections, that’s okay too. I knew we weren’t done having kids. I wanted the birth I wanted.

I did not plan to get pregnant with such a short turnaround time. I was almost 8 months postpartum when we found out we were pregnant again. We were a little surprised. I mean, we are grown adults. It shouldn’t be that surprising.

Meagan: But still, it can be a little alarming when you weren’t mentally preparing for that.

Macy: I had just finished breastfeeding. I was just starting to track and all of these things so I was like, “Oh no.” But that was kind of when my work really started for me because I was like, “Okay. We are doing this again and I’m going to do this the way I want. This is going to be how I want it to go. This is my story and this is going to be an essential component of who I am as a woman and as a mother going forward for the rest of my life. I need this to go the way I want it to go.” I wanted it to go the way God wanted it to go of course, but I was like, “I’m going to take more control.”

Meagan: Can I add something to that? Sorry to interrupt, but there are so many times that I hear people, I read on social media that people are getting after moms and parents who are like, “I want this birth. This is what I want. This is what I feel I need,” or what you are saying. “I want it to go a certain way.” They are like, “Why do you have to focus on what you want? It’s not what you want. It’s what’s best for the baby.” They are railing on these people.

I want to stop and say that what you said is okay. I feel like maybe a little passionate about that too because so many people were naysayers to me. “It does not matter what you want. It’s what’s best for the baby.” It’s like, well guess what? That’s also maybe what’s best for my baby.

Macy: Right.

Meagan: It’s okay to say, Women of Strength, “I want this birth. This is what I want.” And you deserve that. You deserve to go after what you want.

Macy: It is hard and being a mom is hard.

Meagan: Yes.

Macy: You can start out in a way that you feel empowered. It is life-changing. It really is.

Meagan: It is. So sorry for interrupting, but I just wanted to give a little tidbit that it’s okay for people to want what they want. I wanted a white vehicle. I was going to find a white vehicle. It’s okay to get what you want and to put forth energy and to say that out loud, “I want this VBAC. I’m going to get this. I want it.”

Macy: You spend almost 10 months thinking about this and praying about it whereas you talk to– I mean, it wasn’t as important to anyone else in my life except for me. That was okay. Especially the doctors and the providers, I’m just another person to them and yes, there are some really great providers out there and they do care, but they are at their job. They are doing their job. Well, my job is to be a mother. That’s my job, so doing what serves me well was birthing my baby the way–

Meagan: Having a VBAC.

Macy: Having a VBAC. So I really hit the ground running. There were a few girls in my town who had recently had homebirths. They weren’t VBACs, but they were VBACs so I reached out to them– shoutout to my girls Megan and Emily. They were so helpful because they were real people. I reached out to you guys and I just wanted to know, “Hey, what is the research on really close pregnancies?” because I wasn’t going to hit the 18 months.

Meagan: The 18 months. Your babies were going to be 17 months apart, right?

Macy: 17 months. So that was even annoying too because I was like, “I’m right there. Come on.” You guys were like, “Go join the Facebook Community group.” I was so glad that I did because I was just finding story after story after post after post. Not only were so many women having VBACs after two+ C-sections, but they were close together. Some were like, “Mine were 12 months apart.” I’m like, “Oh, I’m good to go then.”

It was so nice having that community. I was even able to join a community within the community of everyone who was due at the same time as me so when we got close, we had a group message and everyone was like, “Is it happening today? Is it happening today?” It was so nice not to be alone in that.

I also had to find a midwife because I knew my providers were not going to be supportive of VBAC after two. I actually had a hard time finding a midwife which was also annoying because I was met with some medwives who were just really going to stick to that 18 months.

18:44 Finding a supportive home birth midwife

Then I happened to just find a woman who was like, “I’ve never done this before. You are my first VBAC after two,” but she was a midwife who was very knowledgeable. She had done lots of home births. She had done VBACs, but not after two.

She was like, “If we don’t start accepting these patients, how are we ever going to change the status quo? How are we ever going to make a change?”

Meagan: Boom.

Macy: Right.

Meagan: It’s so true though.

Macy: I was like, “Okay. Statistic me, please. I would love to be a statistic for the positive.” The only thing was I was like, “I can’t be one for a hospital birth, but it’s fine.”

Meagan: That’s okay. That’s okay.

Macy: So I found Sarah. I started my visits with her. I had to travel an hour to my visits. It wasn’t the worst thing ever.

Meagan: That’s a commitment though. That’s a commitment.

Macy: Towards the end, she came to me a lot more which was so nice. So nice.

Meagan: That’s really nice.

Macy: Then we did a couple of phone calls, but we also texted all of the time and would FaceTime. It was just so personal. I also received co-care with another third local provider. I did that because my midwife wanted to have me get ultrasounds to check my uterus. She wanted to check for previa and we wanted to check for– what’s the other one? I’m blanking.

Meagan: Accreta?

Macy: Yes, so she just wanted to be aware.

Meagan: Placental issues and make sure the placenta is out of the way and all is doing okay. You’re actually clear to have a VBAC.

Macy: Yeah.

Meagan: Which is very responsible of her.

Macy: I received my co-care. I would go in there. I don’t know. I almost had a chip on my shoulder because I was like, “I don’t really need you guys,” kind of. I didn’t leave those appointments feeling like I wanted to cry like I did with my second pregnancy because I knew that I had something better planned. So it wasn’t as upsetting, but they were pretty rough on me.

I had expressed my interest in a VBAC after two and you have to see the series of providers within the office. I had only one who was a little bit younger which was interesting, but he was the only one who was like, “Yeah. I really support this and the birth you want to have. I’m going to give you a referral to UC San Francisco and when we get to the end, I want you to start care there and plan to have your birth there.”

He was the only one who was like, “I support the birth you want to have.” Everyone else was pretty awful. They told me, “If you TOLAC and your uterus ruptures, you will die and your baby will die.”

I was like, I will never forget getting in my car and texting my midwife and being like, “Can you believe that he just said this to me?” I was just like, “Are you God? Do you know?” How could you say that to someone? “You will die.” Because that’s not the case at all.

That was interesting but I knew. Like I said, I knew I had a backup plan in the back of my mind. It was just eye-opening for me more than anything. It wasn’t upsetting.

Meagan: Someone that doesn’t necessarily know the evidence of that, it can be terrifying.

Macy: Yeah. Yes, totally. And you know what? It’s frustrating because a lot of people just trust their providers. I’m a very skeptical person. I’m very conspiratorial, so I’m always researching things and looking into things, but people who are not prone to that are just going to trust what the doctor says because they went to school and they are smarter than them. It’s so unfortunate that it’s causing a high C-section rate for no reason.

23:24 VBA2C prep during pregnancy

Macy: That was a bummer but anyway, throughout my pregnancy, I did all of the things. I did my VBAC Link course. I loved it. It was great to have that. I did a Lamaze class which was really fun. It was funny because we were the only parents in there with other kids. One other lady was a VBAC, but the rest were all first-time parents. They were like, “What are you doing here?” I’m like, “This is new for me.” Again, shoutout to Modesto Birth and Beyond. They are fantastic. They have a great set of doulas. I’m now on a friendly basis with them. They were great to have and they were really supportive of my whole journey.

Let’s see what else. I did a Hypnobirthing class. I read Ina May’s Guide to Childbirth. I mean, I walked and I stayed in shape. I kept doing CrossFit. I did CrossFit for all three of my pregnancies so I kept on. I ate healthy. I drank lots of water. I did all of the things. But I knew that when it came down to it, my mind was going to either make or break me.

Fast forward to 41 weeks and I was getting very, very anxious.

Meagan: Were you getting anxious because you were getting ready to have a baby type thing or were people giving you some grief that you were over 40 weeks?

Macy: By the time I was 40-41 weeks, the grief and the doubt and the naysayers that I got were kind of gone. Most of the people in my life were supportive. I always got that question of, “What if this happens?” I live 5 minutes from the hospital, so I was not too worried about it. I was more anxious of, I was ready to meet this baby. I was the biggest I’d ever been. Third baby, only 17 months apart. My belly was huge. It was hot. I was swelling. I was ready to be done, but I also had never labored before.

I had no clue what my body was going to do. Was I just going to go into spontaneous labor at 40 weeks? At 39? I had no idea. So every day that passes, I’m sure you remember that too, every day was a whole week where you wake up in the morning and I would just cry, “I can’t believe I’m still pregnant.”

Meagan: I remember going to bed and I was like, “Tonight could be the night,” and then I’d wake up and I was like, “It wasn’t the night,” then that night, I’d be like, “Maybe tonight,” and it just kept happening.

Macy: So annoying. I had so much prodromal labor. I had contractions. I could time them and I was like, “Oh, they are 20 minutes apart. They are for sure going to get closer,” then I’d go to sleep, wake up, and be like, “Okay. Here we go again.”

Let’s see. So on a Monday, I did acupuncture. Then on a Wednesday morning, I was 41 weeks and I went and got a massage. I got some acupressure. You never know if these are the things that really get things going, but sometimes they do. I got a massage and she gave me some moxibustion so I did that. You light it and do it around– my mom was like, “This is so hokey.” I’m like, “If it works, who cares?” I was trying everything.

But I didn’t want to be induced and I hadn’t had my membranes swept yet. That was going to be the first intervention that my midwife and I agreed on because she was like, “Legally in California, you can’t go past 42 weeks and have a home birth.” I was like, “Okay. I’ve got one week. One week and this baby will be here.”

27:46 Labor begins

Macy: That Wednesday morning, I went and got my massage and by 2:00 in the afternoon, I was like, “Okay. Things are starting to pick up.” I started having pretty intense contractions. I was having to– I could still talk. I was still taking care of my two little girls, but I was starting to feel really uncomfortable. My mom went home, then she came back. My husband gets off work at 3:30 and it was 2:30. I was feeding my youngest one a snack and he was like, “Do you want me to come home early?” I was like, “No, I can totally make it until you get home.”

I had a contraction where I leaned over my kitchen counter, and then I was like, “Okay. Maybe just come home now.” He came home. I just didn’t feel it. I was starting to feel irritated by my kids and I was like, “I just want to go in my room and watch a show on my laptop. I just want to be alone.” I didn’t necessarily want them to leave yet, but I wanted to be alone and I wanted to know that they were taken care of.

He came home and he was taking care of them. He was like, “Do you think this is it? Let’s call my mom.” I was like, “Yeah. I think this is happening and I think it’s going to be soon.” I just didn’t know how long I was going to labor. It was a mystery.

My mother-in-law came and picked up my little two daughters. That was kind of sad watching them leave knowing the next time I saw them, we were going to be a different family– a better family, but a different family.

Yeah. I just labored at home. It was so nice not having to go anywhere. I took a shower. I had some snacks. I wasn’t super hungry, but I definitely started drinking my electrolytes and started preparing to be hydrated.

Meagan: Smart.

Macy: I was like, “I’m preparing to run a marathon so I need to gear up.” I didn’t nap. I’ve never been a great napper, but I laid around and watched some shows, then I didn’t text my midwife right away because I had been bugging her so much with all of my prodromal labor that I was like, “I’m not going to text her until it’s really happening.” But by 6:00 or 7:00 PM, i texted her and was like, “Just so you know, my contractions are about 10 minutes apart.”

As they got closer, she was like, “Okay. I’m going to come now.”

Once the sun started setting, it was getting a little bit more intense. We set up my birth space at home. I set up my pool. Well, I didn’t. My husband set up the pool and we laid out all of the sheets on the couch and hung my birth affirmations. Actually, they had been hanging. My birth affirmations had been hanging for a couple of weeks so I started having them memorized, but we turned on the twinkle lights and I started listening to the Christian HypnoBirthing app which was fantastic.

I just had such a peaceful labor. I don’t know how else to describe it. My mom came in and then my sister-in-law came over then my other sister-in-law came over. They just talked around me. I could hear them, but I was just in my space. I labored and my water never broke for a very long time. I got in the pool at one point and then I got back out because my husband was like, “I think that being in the pool is slowing down your contractions a little bit. I want you to get out and walk.”

I got out and started walking down the hall then I got really sick with a contraction. I happened to already be laboring backwards on the toilet and I was like, “Oh my gosh. I’m going to throw up.” I jumped back off the toilet so I could throw up in it then my midwife was like, “Okay. You’re in transition now. You’ve got to be.”

I hadn’t had any checks at all this whole time either too so I had no clue what I was even dilated at. I was just completely trying to trust my body and just know that when it was time, it would be time. It really was. My body just did what it knew to do.

32:42 Breaking her own water and pushing for 17 minutes

Macy: Like I said earlier, I felt her move into position. I got back in the water and I felt so relaxed in the water. I was drifting off in between contractions.

Meagan: Oh, that’s awesome.

Macy: It was so calm and I just kept telling myself, “Breathe her down with every contraction,” and just all of the things I had been practicing, I was finally able to put into use.

That was really cool, then I had a couple of urges where I was like, “I feel like I can start pushing soon.” I was like, “Do you want to check me now?” As soon as she stuck her finger, I was like, “Oh, no. No. Get your finger out. It’s time. She’s coming.”

She was like, “Yeah. She’s ready. She’s right there, but your waters haven’t broken yet.” I was like, “Can I break them myself?” She was like, “Yeah,” so I reached in. I gave it a pinch-twist and in the water, I broke it.

Meagan: Oh my gosh, that’s so cool.

Macy: I felt the padding around her head, then I just felt her head. I felt her hair. I started pushing when it was time to push and I pushed for 17 minutes. It was perfect. Like I said, I felt her move and get into position. She came out and she was 9 pounds, 12 ounces so she was 3 pounds–

Meagan: I was going to say 6lb,15oz, right, was your second and close to your first?

Macy: 3 pounds heavier than my other two. She came out. She did perfectly. Her heart rate was perfect the whole time. She came out mad, screaming mad. She was so cozy in there. She did not want to come out. She came out but hearing her cry within 20 seconds was so reassuring. She was safe. I didn’t need anybody. I just needed to trust my body and to trust the Lord. My midwife was like, “That was one of the most perfect births I have ever attended.” She was beaming with joy and she was so excited for me. She was just so happy because she was like, “I’ve never done this after two.” She was like, “You changed everything I thought I knew about home birth, about after two C-sections.” She even now has another client which is great who is a VBA2C. I cannot wait for this podcast to come out so I can share it with my midwife and she can share it with her new client. Hopefully, they have a really great birth too.

All in all, it was just everything I dreamed of. I was so thankful and I just remember laying there with her on my chest. I was watching the video last night trying to get in the mindset and remind myself and get there. On the video, I can hear myself go, “I’m so freaking proud of myself.”

Meagan: You should be!

Macy: I was beaming with joy. I was like, “That was so hard but so worth it.” So it was great. It was a great experience. I could not be more happy with her birth. She’s a great baby. She’s so happy. She was a little hard at first for 10 weeks which was different for me, but after that 10-week hump, she was a really good baby. Her name is Lucille.

Meagan: Cute.

Macy: We call her Lucy which means “light” and she is the light of our lives. She is the best and I can’t even believe we had a family without her for a minute there. But that’s my story.

36:47 ACOG’s statement on VBA2C

Meagan: Oh my gosh. It is so beautiful. It is so peaceful. It sounds like one of those births where you really do. You close your eyes and you just envision birth and how peaceful and beautiful and calm it really can be. To me, you just described the birth that you physically did with one that I would imagine.

Macy: Yes. It’s how it felt. My sisters-in-law and my other girlfriend who was there taking pictures just kept saying, “You did so good.” I was just like, “I don’t know what that means.” But everyone was proud of how it all went. I think that’s so super revolutionary. I hope my story touches other people’s lives.

Meagan: It totally will. I’m so happy that you found your midwife and that your midwife was willing to take you on because a lot of the time, providers can be nervous if they have never done it before.

Macy: Which I get.

Meagan: Oh yeah. For sure, for sure. I’m just so glad that she was willing. That’s one of the things that gets me sometimes with so many people who just are not, we have to respect them and what they are comfortable with. But really, the evidence does show that VBAC after two Cesareans is reasonable. The overall risk and rate of rupture is approximately 1.4% so it’s still very low. It’s still very, very low.

I mean, ACOG themselves, the American College of Obstetricians and Gynecologists, they suggest it. They say it’s a completely reasonable option so for so many people to be cut off after one is heartbreaking because there are so many people who could have a vaginal birth all over the world but aren’t given the option. We have a high Cesarean rate. We have so many.

There are so many people. Just actually weirdly enough at the gym, a man who is the darndest cutest thing ever, his name is Robin and he will always say hi to me and check in on me and how I’m doing. He knows that I cycle and one of the things he asked the other day was, “How’s that doula thing coming?” I said, “It’s really great.” He said, “I never asked you. What made you want to become a doula?” I just told him my story and he said, “Oh, so you had two C-sections?” His eyes were wide. He said, “But you said you have three kids.” I said, “Yeah.” He goes, “But you only had two C-sections?” I said, “Yeah.” I said, “With my first two girls.” He was like, “Wait.” He literally was stumped there for a minute.

Macy: Yeah, people don’t know.

Meagan: He said, “You had a normal birth after two C-sections?” I said, “Yes.” I said, “Robin, I had a vaginal birth after two Cesareans.” He looked at me because I said the word vaginal. I said, “That’s what it is.” He said, “I didn’t even know that was a thing.” People just don’t. They just don’t know that and then there are still so many providers all over the world who aren’t supporting it.

In the ACOG Practice Bulletin, it says that VBA2C, vaginal birth after two Cesarean, is reasonable to consider for women with two previous low-transverse Cesarean deliveries to be candidates for TOLAC. We mentioned the word TOLAC earlier, a trial of labor after Cesarean. A lot of providers use that. It is a medical turn. We call it VBAC. They call it TOLAC. It’s not a VBAC to them until the baby has passed through the vagina.

It says that they are candidates for TOLAC and “to counsel them based on the combination of other factors that affect their probability of achieving a VBAC.”

Meagan: Now, just a couple of things to share before we drop off on this episode, if you had a Cesarean before or two Cesareans, it is not necessarily a reason for you to have a third. If you have gestational diabetes, that doesn’t mean that you can’t VBAC either. I’m trying to talk up these other factors, right? If we have preeclampsia, that doesn’t always necessarily mean that we have to schedule a Cesarean. We’ve shared stories in the past. We’ve even had things like babies with medical conditions where still even their provider said, “Just because your baby has this doesn’t mean you can’t have a VBAC.” That doesn’t always necessarily mean you can’t either.

If you have a big baby, here we are. A nine-pound baby, right? A nice, squishy little baby. Big baby doesn’t mean you can’t either. A diagnosis of a small pelvis shouldn’t be considered– these factors really are more extreme I feel like so if your provider is giving you some of these, “Oh, well you could have a VBAC after two Cesareans but because your baby didn’t come down the last two times, it’s just probably not going to happen.”

You can’t see it. Macy rolls her eyes with me.

Macy: The baby is going to come out. It has to come out.

Meagan: Baby is going to come out. Believe in yourself. Do the research. We do have a VBAC after two Cesarean blog. We’ll make sure to link it here and kind of spin back to what you said about how you were like, “Let me be a statistic. Let me a statistic to your midwife.” VBA3C– we don’t have a lot of stats on VBA3C and I think a lot of it is because we are not doing them. We are not allowing them yet we have so many VBA3C moms in our community who share or on our podcast who show that it still is possible.

I feel like there needs to be more risk assessment there and studies need to be done there. So know that even if you’ve had three Cesareans, that still doesn’t mean that you are eliminated from the chance to go for what you want, fight for what you want, and have that experience not only that you want but that you deserve.

Macy: For sure.

Meagan: Yes. Thank you so much for sharing your story and I cannot wait for this to be published for you to send this to your midwife so she can send it on to the next Woman of Strength.

Macy: Thank you so much for having me. I have loved being here and talking with you. I hope there are so many lives touched and changed by sharing my story.

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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