Episode 374 ​​Julia's HBAC with Labor Beginning at Almost 43 Weeks + The Evidence on Postdates

第374集朱莉娅的HBAC,劳动从近43周开始

The VBAC Link

育儿

2025-01-29

40 分钟

单集简介 ...

Julia knew something was off during her first pregnancy and birth experience. She knew she didn’t feel right about consenting to a Cesarean, but it wasn’t until she started diving into research that she realized how much her care lacked informed consent. She discovered options that should have been offered to her that never were. Julia’s research led her to choosing the midwifery model of care in a home birth setting. She felt in control of her experience and free to birth the way she felt she needed to.  Meagan and Julia discuss stats on uterine rupture, stillbirth, continuous fetal monitoring, induction, due dates, and how our birthing culture can highly influence what we think is safe versus what scientific evidence actually tells us.  Evidence-Based Birth: The Evidence on Due Dates The Business of Being Born Needed Website How to VBAC: The Ultimate Prep Course for Parents Full Transcript under Episode Details  Meagan: Hello. Women of Strength I am so excited for today's guest. Our friend, Julia, is from Texas. She is a wife and a stay-at-home mother living in, it Spring, Texas, Julia? Julia: Spring, Texas. Meagan: Close to Houston, yes, with her two sons. And she has had a Cesarean and then an HBAC. We get a lot of questions in our inbox every day, but a really common question is dates. "Hey, I'm 40 weeks. My doctor is telling me I had to have my baby by tomorrow or even approaching 39 weeks."  People are being told they have to have their babies or really bad things will happen. And Julia's story is proof that you don't have to have a baby by 40 weeks or 41 weeks, would you say? Almost 42 weeks is what you were. So we are excited to hear this story. And I know if you are one that goes past your due date and you're getting that pressure, you're definitely gonna wanna listen.  Julia: Thank you so much for having me, Meagan, I'm really, really happy to be here. Meagan: I'm so happy that you are here. I would just love to have you share your stories. Julia: Okay, so my firstborn, he came during the height of the COVID pandemic. It was August 2020. I just saw my OB who I had been seeing for regular gynecology visits. And from the very first appointment, it just, I just kind of got an off feeling. She had seen a small subchorionic hematoma on my ultrasound at my very first appointment at eight weeks. And she just told me, "Don't Google this. It's going to scare you." She basically just said, "Just enjoy being pregnant now because when you come back next week, you may not be."  So as a first-time mom, it was obviously pretty upsetting and caused a lot of anxiety. When I went back for my next appointment, she just kind of shrugged it off after she saw the ultrasound. She just said, "It cleared up on its own." There really wasn't any explanation of how it resolved. But that being said, that start to my prenatal care kind of set the tone for the rest of that pregnancy and birth. From then on there was just a lot of fear-mongering going on, and a lot of problems were brought up that really never turned out to be an issue.  Around 20 weeks at the anatomy scan, they saw that my son was in the bottom 10th percentile. She had said that she classified that as IUGR, intrauterine growth restriction. We had a lot of extra testing done. Everything was normal. I felt confident and very comfortable just waiting it out. And that really wasn't what she wanted. Actually, starting around 35 weeks, she had started talking about delivering early. I was pressured at each appointment by my OB and the nurses to stay that day and deliver solely because of his size, even though everything was looking great on the monitors. Keep in mind, you know, during COVID, I wasn't able to have my husband or anyone with me during these appointments.  And so just being asked that question each time I came in as a first-time mom by myself was just really hard and made me second guess a lot of things and second guess my intuition. I had explained that, "I think he's just a small baby. He needs more time to grow." She basically just said at my 38-week appointment if I didn't deliver that day, it would not be her fault if my baby died and that she or the hospital was-- Meagan: What?!  Julie: Right? Meagan: She said that she or the hospital, if I walk out that day, they're not liable if something happens because I'm going against her recommendations. I was even seeing a high-risk doctor as well at that point. And even he was saying, "Everything's looking fine. There's no problem with waiting if you want to." The reason she wanted to schedule the C-section because he was breech.  I knew that I wasn't even going to have the opportunity to go into spontaneous labor. There were really no alternatives presented at the time. I knew nothing about out-of-hospital birth or about midwives. She offered an ECV, but she said she didn't recommend it because of his size. She didn't really explain why.  So I just kind of felt backed into a corner. I remember I had left the office that day at 38 weeks and called my husband immediately and explained what she had said. We felt like, "Okay, well, I guess, we obviously don't want our baby to die, so maybe we need to just stay."  I remember pushing my gut feeling aside the whole time. As they were prepping me, I just felt, This isn't right." I wanted to give my baby more time to grow and also to flip so that I wouldn't be backed into a C-section. Had I known then what I know now, I definitely would have opted for a home birth with my midwife who's trained in breach delivery. Just at the time with COVID, I didn't have the resources or the information, so we went through with the C-section that ended in a four-day hospital stay. I didn't sleep at all. Meagan, I'm not even kidding you. I did not sleep those four days. The nurses were really concerned about the baby's size, even though he was growing. He was actually back to his birth weight by the time we were discharged. But I'll never forget this one- Meagan: That's quick! Julie: Right? I know. And so there was so much fear-mongering, so much uncertainty by medical staff, despite how great my baby was doing. And I remember this nurse frantically coming into the room just a few hours after my C-section with this Medella hospital-grade pump. She was just like, "You need to start pumping now on top of breastfeeding because your baby's small. He's not going to grow." It just kind of left me feeling like, I feel confident in what I'm doing, but now all these medical professionals are telling me like, I'm in danger, my baby's in danger. It triggered a lot of feelings of postpartum anxiety. I really struggled that first year. And so it wasn't a very good experience. I just felt like my power had been taken away in the birthing process and felt defeated and like I didn't have a say for my first birth. Meagan: Yeah, I was just listening to an episode the other day, not on our podcast, on another podcast about that experience after baby is born and that postpartum within the hospital and how crazy it is that sleep is one of the best things we can get when it comes to energy, milk production, getting our babies fed and helping them grow, and doing all these things.  But then we're not allowed that time. And then on top of it, it's all the fear-mongering and the doubt when it's like we should be being built up like, "Oh my gosh, look how good you're doing. Look how good this baby's doing. Look how good you're doing. Let's keep doing this." Instead of making you doubt that what you're doing isn't good enough and not letting you sleep and doing all these things. It's just weird to me. It doesn't make sense. Julia: Right, and as a first-time mom, you're just like, okay, they know what's best, obviously. I'm going to listen to them and what do I know about birth? They're the doctors. But yeah, it was just really eye-opening, and I really knew I wanted a completely different experience the next time around. Meagan: Yeah, I don't blame you. I don't blame you for wanting a different experience. Julia: So after I had my C section, pretty soon after that, I started digging and doing a lot of research and realized I felt really cheated by the lack of informed consent. I had mentioned that my doctor just had said, "You need a C-section because he's breech." I had no idea that there were even midwives and out-of-hospital birth options where they delivered breech vaginally and not only that, but were highly trained and qualified to do so. I had no idea that in other parts of the world of similar economic status to the US that they were routinely delivering breech babies vaginally with better outcomes than we have here in the US hospitals.  So I really didn't feel like there was informed consent there. Even the fact that she didn't even want to try the ECV was upsetting to me. I just felt like I really wish I would have done more research at the time. But I just put all my energy into this next birth. I knew even before I got pregnant that I wanted a VBAC. Pretty early on in the process of my research, I became really fascinated with physiological birth and I knew that I really wanted to experience that. For someone who may not be familiar with that term, physiological birth is natural unmedicated childbirth with no intervention unless medically necessary. It sees birth as a safe biological function rather than a medical event or something that that's inherently dangerous which is how I felt I was treated my whole first pregnancy and birth.  I felt like a walking hazard, to be honest, when in reality I was an extremely healthy 25-year-old, first-time mom with a healthy baby with no issues. So the fact that I was gaslit into thinking there was a lot of danger was sad. So I knew that for my next birth I wanted to do a physiological birth and I knew that it would kind of be a fight to achieve in the hospital.  I did a lot of research, I watch
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