Ep 185: Erin’s Birth Story – Delivering a Big Baby Vaginally After a C-Section

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Erin and her newborn son, photo taken by Carly Montgomery of Capture.Life Photography LLC

Erin is sharing the amazing story of her successful VBAC. Despite her first birth ending in a cesarean after pushing for 2 hours, she was crystal clear that she wanted to try for a vaginal birth for her next pregnancy. In order to have the best chance of success she took it upon herself to get incredibly prepared, including childbirth education and making different choices in her pregnancy care.

You have to find a supportive provider and hospital if you want to try for a VBAC; actually for whatever you want for your birth. Many doctors would have discouraged Erin’s birth wishes but she sought out a team that was willing to try and make it work. Having agency and being listened to is so important for getting the birth you want and that’s just what happened for Erin. This is a great birth story and I know you’re going to love it as much as I did!

In this Episode, You’ll Learn About:

  • Why Erin’s first pregnancy ended with a cesarean - and whether it could have gone differently
  • Why she wanted to try for an unmedicated vaginal birth for her second baby
  • How she prepared for her VBAC
  • Why she opted for a midwife group and a doula for this time around
  • How her birthing team supported her wishes
  • How she and her family handled a fast moving labor
  • What made her VBAC recovery more difficult than her c-section

Links Mentioned in the Episode

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Dr. Nicole (00:00): So if you get to completely dilated, push for two hours, have a C-section, and get told that it was because the baby is too big for your next pregnancy, can you have a successful unmedicated vaginal birth of a bigger baby? Well, yes you can. And that is what Erin is going to share in her birth story today about her successful VBAC. Welcome to the All About Pregnancy & Birth podcast. I'm Dr. Nicole Calloway Rankins, a board certified OBGYN, who's been in practice for nearly 15 years. I've had the privilege of helping over 1000 babies into this world, and I'm here to help you be calm, confident, and empowered to have a beautiful pregnancy in birth. Quick note, this podcast is for educational purposes only and is not a substitute for medical advice. Check out the full disclaimer at drnicolerankins.com/disclaimer. Now, let's get to it.

(01:09): Hello there. Welcome to another episode of the podcast. This is episode number 185. As always, I'm so glad that you are spending some of your time with me today. In this birth story episode, we have Erin. Erin is a former middle school teacher, turned stay at home mom to two wonderful kiddos, Ellie and Ryan. Her husband she and her husband Dan, have been married for eight years. They spent four of those years living in Colorado, and they moved to Michigan in 2020 during the initial peak of the Covid Pandemic when she was three months pregnant. And she's gonna share some of that in the episode today. She loves running hiking, strength training, and she's excited to get back into rock climbing since her daughter is now taking classes. Erin is sharing her amazing story of her successful VBAC. Despite her first birth ending in a cesarean, after pushing for two hours, she was crystal clear that she wanted to try for a vaginal birth for her next pregnancy. And she's gonna share some of that thought process with us in the episode. And in order to have the best chance of success, she took it upon herself to get incredibly prepared, including having a great team that this time included a midwifery care team and a doula. You're gonna hear how things ended up going so fast that really her only option was an unmedicated VBAC because when she got to the hospital in an ambulance, by the way, she was completely dilated and pushed out her nine pound, six ounce baby shortly after arriving. I love a great birth story episode, and this one is no different. I love it, and you are going to love it too. As I mentioned, Erin took it upon herself to get incredibly educated, and I have a fantastic option for childbirth education for you as well.

(03:07): It's called the Birth Preparation Course. The Birth Preparation Course is my signature online childbirth education class that will get you calm, confident, and empowered to have the most beautiful birth. Childbirth education is so important, especially when you're giving birth in a system that you often can take a patriarchal approach to birth can take away women's power about what happens in their own bodies and can be racist. Good childbirth education prepares you not only for what to expect in your body and the process of labor and birth, but also gives you the tools that you know to advocate for yourself within that system. And yes, I know that system very well because I have been in it for a long time. I've been practicing now for nearly 20 years. So check out all of the details of the Birth Preparation Course so that you too can get calm, confident, and empowered for your birth. You can head to drnicolerankins.com/enroll to join us inside the course today. All right, let's get into this birth story episode with Erin. Thank you so much, Erin, for agreeing to come onto the podcast. I am so excited to hear about your successful. Yes,

Erin (04:17): Thank you so much for having me. I'm very excited to share my story as well.

Dr. Nicole (04:20): Yeah. So why don't you start off by telling us a bit about yourself and your family?

Erin (04:24): So my husband and I have been married for eight years now. We used to live in Colorado, and we actually just moved to Michigan two years ago when I was three months pregnant, and about eight months into the stay at home order with Covid and everything.

Dr. Nicole (04:37): Oh, fun times, but not really. Right.

Erin (04:40): And then we have two kids now. My daughter is four and a half years old, and my son is almost 17 months old.

Dr. Nicole (04:47): Okay. Okay. All right. And your first birth was a cesarean. Obviously we're gonna talk about the VBAC, but we need to know about the first birth a little bit so we can understand how you got to the successful. So your first birth was a cesarean. Why did you have a cesarean for that pregnancy?

Erin (05:04): So my goal with my first birth was also to have an unmedicated vaginal birth. Clearly, it did not go as I had hoped. I think essentially it was a kind of cascade of interventions that led to the cesarean. In the end, my water broke about seven o'clock in the morning, and my doctor at the time was an OB, and she wanted me to come to the hospital right away. I was having zero contractions, no signs of labor starting right away. So we got to the hospital, they gave me five hours for labor to start on its own and I was sitting on the birthing ball, walking the halls, nothing starting moving at that point. So they started me on Pitocin, and after nine hours on Pitocin, I finally said, I need an epidural. The Pitocin induced contractions at that point had gotten really, really intense, almost no break in between them just really unmanageable.

(06:04): Sure. And they decided to see how far dilated I was before the epidural. I was two centimeters. Okay. So when they said that, yeah, I said, yes, definitely epidural. At this point. As soon as I got the epidural, my daughter's heart rate dropped. They did an internal fetal monitor, took me off the Pitocin for a little bit to labor down. And then I think about 14 hours after my water had broke, I started pushing. I pushed for two hours. My OB was with me for about the last 30 minutes, but all my pushing was on my back, same position. And after the two hours, my doctor had said essentially that she was confident I was pushing strong in the right direction, but baby wasn't moving down at all. So her recommendation was a C-section. Okay. And at that point, my husband and I were exhausted. I put a lot of trust and faith in my doctor. So we said, okay, let's, let's just go in and do that. And after 22 hours 22 hours after my water broke, she was pulled out via cesarean, which was a struggle. My doctor said she couldn't even hold a pen for two days afterwards because it was that tough to get her out. I had lodged her down in my pelvis.

Dr. Nicole (07:21): Okay. And how much did she weigh?

Erin (07:23): She was eight pounds, 14 ounces.

Dr. Nicole (07:25): Okay. So it's a pretty solid size. So some people might have that experience the first time and decide the next time that they may not wanna go through that again to get all the way to pushing and then have a C-section. How did you come to the decision that you wanted to go for a VBAC?

Erin (07:44): So part of it, I really just wanted to experience what natural labor was like since I was Pitocin induced and the cesarean in the first round, I didn't get to experience any part of natural labor, short of my water breaking. Sure. So that was definitely part of it. I also, I did a lot of research ahead of time too, and I personally felt for myself and the baby that a VBAC was really what I wanted to go for. I would say it wasn't until a couple months into my pregnancy, one of my closest friends at the time, her first son, was at birth center this time, her second pregnancy ended up her son was breach, so she couldn't go to the birth center and ended up finding a doctor who was willing to do a vaginal breach birth essentially after she went into labor. So the amount of advocating she did for herself really made me feel, I can advocate for myself too, and I feel like my body can do this, so I'm, I'm gonna go for it.

Dr. Nicole (08:44): Okay. Okay. Side note, did she have a successful vaginal breach birth?

Erin (08:48): She did, yes.

Dr. Nicole (08:49): All right. Love it. Love it. Love it. Yep. So did your wish to have VBAC influence your choice of your doctor at all?

Erin (08:57): All? It definitely did. Okay. So the OB that I went with for my first pregnancy I wasn't able to stay with them anyway because we moved to Michigan. But when I first was asking her at my initial appointments about my wish for a VBAC, her responses, I didn't very confident that they were actually going to be fully supportive. It was essentially, we'll evaluate you late in pregnancy, and if it looks like you'll, you have a high chance of a successful VBAC we'll let you do it. Otherwise they'd really push for a repeat c-section. Okay. So I had friends who had really good experiences with midwives, and that's what I decided to switch to when we moved to Michigan. Okay. I felt like I'm really glad there are OBs like you out there, and I think there are more OBs like you that you can find, but it doesn't seem to be as easy to find an OB who's really supportive as it is to find a midwife who can't do those interventions anyway.

Dr. Nicole (10:01): Right. Gotcha. Gotcha, gotcha. So this was a midwife practice that delivered in a hospital?

Erin (10:06): Yes. That was definitely, since I had the C-section previously, I definitely wanted a midwife group that birth, a midwife group that birthed in a hospital, and also worked with an OB group. So if there was any reason or need to switch over to an OB it would be a smooth transition during labor at the hospital.

Dr. Nicole (10:27): Okay. Awesome. So with the midwives, when you said, Hey, I wanna have a VBAC, and you told them what happened with your first labor and birth, how were they supportive? What was the feedback that you got?

Erin (10:44): They were amazing. They were very supportive, and it was a big group of midwives. So I saw different ones for most of my appointments. But each of them was very, they seemed excited that that's what I wanted to do, and that I wanted to go unmedicated. They also told me the nurses at the hospital, they're excited about those births too, to work with the women who are going unmedicated and might need that extra help to get them through the labor and pushing.

Dr. Nicole (11:10): So you didn't feel like you got any pushback of like, oh, you should probably get an epidural because you've had a previous C-section. Did you get anything like that?

Erin (11:21): No. They were very supportive of my wishes and everything I brought up. I explained my previous birth to them and how I was given five hours for labor to start, and I had to go to the hospital right away after my water broke. And they said, oh, no, we would give you 12 hours. And at that point we would recommend Pitocin. But it's still a recommendation, not, Hey, we need to do this because we have to get the baby out. Right.

Dr. Nicole (11:47): Okay. I'm just like, sigh, because I wish we would all do that because that's how we should all really practice. But I'm glad you found a group and a practice that was much more supportive. Did you meet any of the physicians at all, or you just stuck with the midwives?

Erin (12:03): I just stuck with the midwives. It was a really good group, so I just went in with the faith that if I had to get switched the OBs, they're also a good group that they work with.

Dr. Nicole (12:13): Okay. Okay. So then how was your prenatal care and your pregnancy in general?

Erin (12:19): In general, I would say it was pretty great with my first pregnancy and my second pregnancy. The first trimester was essentially filled with nausea, just to the point of nothing sounded good. I couldn't think of what I was going to eat. But as soon as I hit 13 weeks, both pregnancies switch just flipped and I felt fine. I had my energy. I was able to run till 36 weeks this pregnancy. Oh, wow. Okay. Strengths training. Everything felt really good. As far as prenatal care with the midwives, it was great. There were a couple issues that popped up with my pregnancy. At my 20 week ultrasound, they found a marginal cord insertion, and the big risk with that is low birth weight. So I had a couple extra ultrasounds during my pregnancy because of that to make sure that baby was growing appropriately. And actually at my repeat ultrasound, they said, oh, the cord insertion is normal now. Okay.

(13:23): I have a picture of my placenta after I gave birth. It is the most marginal cord insertion it could possibly be, not in the center of the placenta. It's all the way on the side.

Dr. Nicole (13:36): So that was, it actually hadn't gone away. It sounded Right.

Erin (13:40): Yeah. It had no impact on my pregnancy which was great.

Dr. Nicole (13:44): Okay. Well, that's good. That's good. That's good. And oh my God, I was gonna ask you something about prenatal care. Oh. What was the difference between the care you got from the midwives and the care you got from the OB? How did the prenatal care differ?

Erin (14:00): As far as the care went? It was relatively similar. I asked pretty similar questions both times around. The OB group that I worked with the first time also seemed very supportive of, an unmedicated birth in the hospital setting. I would say overall, the OB group didn't spend as much time getting to know me as a person, as the midwives may have. So overall, I felt a little bit more comfortable and at ease with the midwives. But otherwise, everything was pretty standard with the appointments the ultrasounds, everything went pretty smoothly for me.

Dr. Nicole (14:36): Okay. Okay. So what did you do to prepare for your birth?

Erin (14:41): Anything and everything. I used to be a middle school science teacher before having my daughter down, a stay at home mom. So I am very organized and to do my research and have things planned out. So my husband and I took an online birth course that was directed towards unmedicated hospital births. And then I got every book I could find out of the library on VBAC, natural birth, anything that I could find, read birth stories, one thing that made a huge difference for me. I also did daily meditations, which has also carried over into mom life. I think it really helps me take a much more calm approach and attitude towards everything.

Dr. Nicole (15:27): For sure. For sure. And then where did you find the daily meditations?

Erin (15:32): So I actually, I downloaded the Headspace app. They have a couple pregnancy courses, which were really great. And then there's also a book that he wrote as well that's geared towards pregnancy. Nice. So I read that book, which also helped shift the mental attitude, I would say. Okay.

Dr. Nicole (15:48): Yeah. So much of it is where you start in your mindset. So I'm really glad that you said that and mentioned that because it makes a huge difference. And as you said, it most certainly carries over into being a parent. Right? For sure. For sure. For sure. So what are some things that you wanted for your birth? I know you said you wanted unmedicated. Are there any other things that you wanted?

Erin (16:12): I definitely wanted the immediate skin to skin. I missed that with my daughter in the C-section. Right. She had low blood sugar at birth. I was told, I asked questions about C-section with my OB just in case I needed to have one. Sure. And I was told they do things like delayed cord clamping and immediate skin to skin, even if you have the C-section. Okay. But I didn't get that

Dr. Nicole (16:34): Just because, I mean, why not? Did they say what?

Erin (16:37): They didn't specifically say why? No I heard her cry when they pulled her out. But like I said, I know she had low blood sugar. I don't know if there were any other signs that they wanted to examine her right away. My only other thought I lost a lot of blood. They had actually called for a couple liters to be brought to the OR. Okay. They didn't have to give them to me but I was on that border. So I don't know if it was more that they needed to take care of me, and that's why they had to skip it. Okay. So that was definitely a big thing that I wanted.

Dr. Nicole (17:11): Did they at least show her to you? Or your husband could hold her, or partner could hold?

Erin (17:16): My husband got to go over when they were measuring her and weighing her, and then they had a TV screen that I could see her. Okay. But that was really it. After it was probably five or 10 minutes after they pulled her out, they brought her over onto my chest, which at that point it was really awkward because I'm still out on the table arm spread wide,

(17:36): There's this baby that I is slippery and trying to figure out how to hold onto her.

Dr. Nicole (17:41): Yeah. Yeah. It is really awkward. As a matter of fact, I was looking into, apparently there's a type of carrier that you can use in or for skin to skin where you can just put it on before you get started. And this is a side note, put it on before you get started for the C-section, they can just tuck the baby down in when the baby's born, so. Oh, that's amazing. Yeah. I think we need to look at some other options cuz it's so weird when your arms are out and all that kind of stuff.

Erin (18:10): It was very awkward. Yeah, great. Because you're meeting your baby for the first time, but it just, it's not the same

Dr. Nicole (18:16): Yeah, exactly. Exactly. So you wanted skin to skim, wanted unmedicated, delayed cord clamping. Any other things in particular that you wanted?

Erin (18:26): I definitely wanted to make sure I had a very, very supportive team with wanting the unmedicated VBAC, specifically. So my husband and I this time decided to hire a doula, and she was also a birth photographer. She was such a critical part of our team. My labor was so short that we didn't spend that much time with her at the hospital. But it still, just the preparation with her ahead of time and knowing that she was there to help me made such a big difference. And then I definitely wanted some freedom of movement and position changes too.

Dr. Nicole (18:58): Okay. Okay. And I, the answer to this is yes, but I'm sure the midwives are like, sure, you can move around. You can change positions. Midwives are gonna support things like that. For sure.

Erin (19:10): Yeah. Yep. They were very supportive of that.

Dr. Nicole (19:11): Yeah. Yeah. So at what point did you hire the doula?

Erin (19:18): Probably about midway through my pregnancy, I think is when we started to reach out. I wanted to make sure that I had one who would be available for my birth. There were a lot of different midwives in the, a lot of doulas in our area that we're already booked way past my due date,

Dr. Nicole (19:32): Oh, wow. Okay.

Erin (19:33): So the one that I found, she actually was a doula more and does family photography and things like that also, which has been great because we've had her got to see her a couple times since the birth too, to do family photos.

Dr. Nicole (19:49): Oh, that's nice. That's really, really nice. And how many times did you meet with her before the birth in person?

Erin (19:56): It was just one prenatal visit that we had. She also did maternity photos for us, so we had that bonus chance to get to know her a little bit more. Right. Otherwise, she was available via phone, text, email. So if I had questions, I could check in with her.

Dr. Nicole (20:13): Sure. Sure. And you felt like, see I, my unknowledgeable self, when I first heard about doulas, I always thought that, oh, they just show up at the birth. But it's so much more than that. They're actually available during your pregnancy to support you and help you. And it may not even necessarily be in person tons, like you said, but definitely available by text and email to add all those additional levels of support that people should have.

Erin (20:39): She became more like a friend versus, a doctor or midwife support.

Dr. Nicole (20:44): Right. Yeah. Yeah. So let's talk about what happened for, how did your labor and your birth go? So how did that go?

Erin (20:51): Oh, this, it was completely different from my first experience. So I

Dr. Nicole (20:56): See. I know the ending, so I'm like, I just can't wait to hear this story. So yeah. So tell us what happened. Yeah.

Erin (21:02): So I think about five days past my due date, which was also when I went into labor with my first daughter. I woke up, I think around midnight and just felt some cramping in my lower abdomen. So I was thinking, oh, I think early labor started. It's just a little bit of cramping. What I really, really wanted to sleep. So until about two o'clock, I just tossed and turned, couldn't really get comfortable, was still feeling some, what I'm calling cramps. Even though looking back, they were contractions. Okay. I was kind of fooling myself there. At two o'clock, I woke my husband up and said, Hey, I can't really get comfortable. I'm just having some cramping. I think it's just early labor. You can get some sleep because we probably have a long day ahead of us. So I'll just go downstairs and watch tv. He double checks, said, are you sure you don't want me to come downstairs with you? Are you sure you're okay? Right. Yeah. It's just early labor. Right. Don't worry about it. I'm fine. So I went downstairs, put the TV on. Probably within 10 or 15 minutes I had to go get the birthing ball because what I was still calling cramps, were getting a little more intense, but they felt just more intense period cramps to me. The Pitocin induced contractions felt much more like my entire uterus tightening and getting hard. Gotcha. Which is what I was waiting for.

(22:22): So I was using the birthing ball, still going through it on my own for about an hour. And in there I had downloaded a contraction timer app. And so I was using that and it was like four minutes and 30 seconds in between, and then three minutes, and then 3 45, and then 2 45. And then it says, time to go to the hospital. And I'm still thinking, no regular contractions.

Dr. Nicole (22:47): Right. Right.

Erin (22:49): And it should be coming every three minutes or every four minutes. So it's just early labor, the app's wrong.

Dr. Nicole (22:54): Right.

Erin (22:55): And then pretty soon after that, in the middle of a contraction, I felt a pop and my water broke. And that's when it really got intense really, really quickly. Okay. As soon as my water broke, I felt really intense rectal pressure, what still felt like a cramping sensation. My actual contractions were getting stronger then too. Okay. I went to the bathroom. My thought was, oh no, I'm gonna get the carpet all a mess. I had to go get myself cleaned up right away. And at that point, there was a little bit of blood, not enough that I really felt concerned, but in the back of my mind with having the previous thinking, okay, okay, I wanna analyze these sensations. Sure. Make sure there's no uterine rupture going on.

Dr. Nicole (23:41): Right, right.

Erin (23:42): And at that point, I was wishing that we had been at the hospital 30 minutes earlier.

(23:48): So yeah, I had to go upstairs, wake my husband up and say, right. Call the midwife. Call our doula. Right. Call my sister who lives four minutes away to stay with our daughter. So he calmly makes all the calls, grab suitcase to head out to the car. We made it as far as the car, and I had a really strong contraction, was leaning over the seat of the car and just thinking to myself, I don't think I can get in the car right now. Right. Oh my God. We were 30 minutes away from the hospital and I just couldn't envision sitting in the car for 30 minutes and making it. Right.

Dr. Nicole (24:22): And so about what time was this now?

Erin (24:24): Three o'clock, maybe a little after three.

Dr. Nicole (24:27): So, okay. So they contractions started around 12, and then by three o'clock, water had broken. And now you're trying to get into the car and things have ramped up.

Erin (24:37): I told my husband, I said, I really, really feel like I need to push now. And he said, this is too soon. I'm just gonna call 9 1 1. Okay. He took charge and said he didn't wanna be driving in the car and have to pull over and handle things himself. So I'm so glad that he was able to stay calm and make that decision himself. Otherwise, I would've stood in the car door for the next 30 minutes.

Dr. Nicole (25:02): I can't get in. Right. Yes.

Erin (25:04): So he called 9 1 1 right away and then moved me into the house. He got some towels to lay down on our dining room floor. I just got on hands and knees. The rectal pressure was the worst. Contractions, I would say were totally manageable. Not that bad. The rectal pressure was awful. Our birthing class had mentioned if a laboring woman says she feels like she has to go poop, she, it's probably time to start pushing. I was thinking, no, it feels like that's where the baby's coming out right now. Okay.

Dr. Nicole (25:35): It's trying to come out of my, it's just gonna blow my whole backside out for clean language. That. Right.

Erin (25:45): That is what it felt like. Yes.

(25:47): So I'm just on hands and knees. My sister gets there and go, takes the dog upstairs and makes sure that my daughter's okay. She slept through all of this. Of course, I was not being quiet by any means. I was letting all the sounds out. Pretty quickly the EMTs arrived. Then they checked me to make sure he wasn't crowning, and then the paramedics arrived. They got me on a stretcher to ride in the ambulance. So now I have this intense rectal pressure and I'm laying on my back on a stretcher, which made it a lot worse, but there was nothing I could do about it. Right. They ended up getting us to the hospital in 15 minutes. So at least it cut down the time a lot.

Dr. Nicole (26:31): Yes, a lot.

Erin (26:32): Yeah. They're middle of the night, no traffic. In the ambulance. They were able to get us there really quick, but then

Dr. Nicole (26:39): Okay. And I'm sure they had lights and sirens on at this.

Erin (26:42): Oh yeah. At this point, I was probably going through transition. So the strongest part of my labor was strapped to a stretcher in the ambulance. Oh,

Dr. Nicole (26:52): Okay.

Erin (26:53): Okay. The paramedics were really great. One of them was timing contractions, which were coming about every two minutes for the whole ambulance ride, and lasting about 30 seconds. And then the other one was up by me and checking to see if he was crowning in between every contraction. Telling me I was doing great. Being really supportive. Meanwhile, when we pull into the parking lot, I'm thinking to myself, the contractions aren't bad. I can handle the contraction, but I might have to ask for an epidural because of the rectal pressure. Just, it's the worst. Wow. It was that intense.

Dr. Nicole (27:30): It was just that bad.

Erin (27:31): Yeah. Okay. Contractions the whole time were really just intense period cramps. But the rectal pressure

Dr. Nicole (27:37): Was just so much.

Erin (27:38): Right. All right. When we got to the hospital, though, my doula was already there, which was amazing. That's good. I texted her at two to let her know that I thought it was early labor, just some cramping. So she had a heads up for the day. And then my husband called her at three and said, we're going to the hospital now. And then she gets another call. We called 9 1 1. I don't think we're making it to the hospital. Right. So she turned around to come towards our house, gets another call. We're in an ambulance to the hospital.

Dr. Nicole (28:08): Got it.

Erin (28:09): But she beat us there, which was amazing.

Dr. Nicole (28:12): That is impressive.

Erin (28:13): Getting there and seeing her face just totally calmed me. Okay. It's gonna be okay. Right. We got this. My team's here. Right.

Dr. Nicole (28:21): Okay. So then you get to the hospital, and then what happens once you get to the hospital?

Erin (28:26): Hospital? The midwife and a nurse greeted us at the entrance also. They debated, they could tell how far along I was, just with sounds and how close contractions were. Triage was the closest room. So they pulled in there, I was fully dilated, ready to push. They thought that I might deliver in the triage room, but decided after my next contraction, you know what, we're just gonna go for it. So they pushed me on the bed down to a labor and delivery room.

Dr. Nicole (28:59): Okay. Okay.

Erin (29:01): And this point, as soon as I got off the stretcher, I was like, I wanna be on hands and knees. That is the only position I wanna be in right now. Right. Relieve this pressure a little bit for me. Right. So I pushed, I think, only for about 15 minutes. Oh,

Dr. Nicole (29:15): Where was your husband? When did he get there?

Erin (29:17): He got to ride in the ambulance. Oh,

Dr. Nicole (29:19): Good. Okay. Which

Erin (29:19): Was great. Okay. We weren't really sure about that because of Covid restrictions at the time. I think technically he shouldn't have been allowed to. Got it, got it, got it. They're not gonna leave my husband when I'm so far along in labor not to be with me.

Dr. Nicole (29:35): Okay. Well, good, good,

Erin (29:37): Good. Yeah. He was up front listening to me the whole time. Not being able to come back and support me. But yeah, he did his best or he did all he could, I guess.

Dr. Nicole (29:46): Gotcha, gotcha. So you got to the triage and was it triage and labor and delivery? Did they at least get you up to wherever labor and delivery was? Or did you have to stop in the regular er?

Erin (30:00): The entrance for labor and delivery is through the regular er.

Dr. Nicole (30:04): Oh, that's nice. Okay.

Erin (30:05): Yeah. Okay. So there was a triage room there. Got it. And actually, this is something I had forgotten. My midwife, when she started to check me asked, have you been feeling any movement? And I'm thinking to myself, that was the last thing on my mind. I have no idea if I felt movement for the last three hours.

Dr. Nicole (30:23): Yes, yes. Cause it feels like I'm, my behind is about to blow out. I don't know.

Erin (30:30): They got the fetal monitor on. He was doing just fine. Which, okay. You made me feel relieved because Sure, sure. Like I said, I just was not thinking about, yeah. Is he moving? Is you okay? Yeah.

Dr. Nicole (30:39): And that's totally natural cuz it, it's gonna grab all your attention. That's just not something that you necessarily think about for sure. Right. For sure. Okay. So they whisked you to la to a labor and delivery room. And by then you were ready to push. And you said you only pushed for how long?

Erin (30:54): It was about 15 minutes.

Dr. Nicole (30:56): Okay.

Erin (30:56): All right. Yeah. Most of that was on my hands and knees. My doula was doing amazing double hip squeezes. One of the nurses that was with me, she was right up holding out of my hand, giving me reminders to breathe and relax in between contractions to kind of shift my sounds, to be deeper to really help with pushing him down and out. I was having a little bit of a struggle getting him that last little bit out. So my midwife had recommended doing a position change. So they rolled me onto my side and on the next contraction, I was able to push him right out with that.

Dr. Nicole (31:34): That did the trick. Okay. Yeah. Okay. All right. And did they do skin to skin right away?

Erin (31:42): They did immediate skin to skin. They did delayed cord clamping for about two minutes. He was making some kind of guttural sounds is how they described it. So after two minutes, they asked me if it was okay to cut the cord so they could go look at him. Sure. They were assuming that he just had some extra fluid left in his lungs because IED him out. Cause he went

Dr. Nicole (32:05): Through so fast. So fast. Yeah.

Erin (32:06): He didn't have a chance for the birth canal to help squeeze that out. Yeah. So my husband got to cut the cord this time, and that immediate skin to skin to cord clamping. Yeah. Was great.

Dr. Nicole (32:17): Love it. Love it, love it. So did you have to get any stitches or anything?

Erin (32:22): I did. I had a second degree perennial tear, which was also jagged. So my midwife wanted to call an OB down to help with that since it wasn't just a straight tear that she's used to stitching up. And then I had two second degree internal tears as well.

Dr. Nicole (32:39): Okay. Yeah. How was that part? Because I love an unmedicated birth is so fabulous. And then I always, my heart is like, oh, if people have tears and you have to get anesthesia to numb. So what was that like for you?

Erin (32:55): I would say there were enough other sensations going on at that point that getting the stitches done, I couldn't feel anything. The only annoying part of that, I would say is that I still had to be more restricted with how I was sitting and laying. Okay. I was ready to be sitting up and moving a little bit more, but I had to still be laying reclined, but Gotcha. Mostly on my back at that point.

Dr. Nicole (33:18): Gotcha, gotcha. Well, that's good that the repair itself wasn't that painful. Did it take a long time since you had a few?

Erin (33:27): It felt like it took a pretty long time. I don't know exactly, but I'd say at least 15 minutes is what it seemed like.

Dr. Nicole (33:33): Okay. That's actually not that atypical. And then second degree tear is very common after birth. So now, had they brought him back to you by that point? Was he with you or was he still Okay, good.

Erin (33:46): They only had to take him for a few minutes, essentially and then they brought him back over. So I was able to still hold him while they were stitching me up. And then I also let my husband hold him and do some skin to skin.

Dr. Nicole (33:57): Okay. Okay. Yeah. That's the best distraction.

Erin (34:00): Yep.

Dr. Nicole (34:01): Yeah. So then what was your recovery and everything?

Erin (34:09): It was actually a lot harder than I was expecting.

Dr. Nicole (34:12): Why is that?

Erin (34:13): In my mind, I was thinking I had a C-section previously, and I've gone through that recovery. So vaginal births will be easier. I had a very straightforward C-section recovery. I think the OB that I had who did it, she did a great job with the staples and the whole procedure. And I also think my body was prepared well. So it recovered pretty quickly. I think the extra nerves that you have down there made the healing from the tearing a lot harder than I expected it would be. Okay. Yeah. I would do a repeat v a any day. I'm so excited that I was able to do that. And I love that decision of mine. But it's definitely, it's not always easy, I would say. And then I also had some pretty nasty internal hemorrhoids from the amount of pushing. Got it. Or intensity of the pushing. Got it. And that probably took nine months to fully heal, I would say. Oh,

Dr. Nicole (35:18): Wow. Yeah. Okay. Yeah. That's a lot.

Erin (35:20): I ended up working with a nutritionist a few months postpartum because my stools weren't allowing my hemorroids to heal, essentially. Got it. It, so working with her definitely helped me get to a much better place as far as that goes.

Dr. Nicole (35:34): Okay.

Erin (35:34): Gotcha. And then I also had an issue pop up postpartum, two weeks postpartum. I found a lump in my breast, which I was thinking, oh, I have a clogged milk duct. I'd never had one before. And I just made that assumption. So I was trying everything I could to unclog it. I didn't wanna get mastitis. And after a few days I went to go see a lactation consultant, and she checked it and recommended that I go see my midwife and get an ultrasound because it didn't feel like a clogged milk duct to her, so two weeks postpartum, I ended up having to get an ultrasound, a mammogram. And I also had to get a breast biopsy because the ultrasound and mammogram were not definitive. Ended up being a benign cyst. So it no big deal besides the fact that I'm extra stress. That's

Dr. Nicole (36:30): A lot of emotional

Erin (36:31): And then six months afterwards I got a repeat ultrasound and the cyst was essentially gone.

Dr. Nicole (36:37): Okay, okay. Yeah. That's stressful. But at the same time, you have to take it seriously cuz you certainly don't wanna miss anything. Right. Unfortunately knock on what, once in my career diagnosed someone with breast cancer pretty two weeks postpartum, essentially. Same sort of story. Unfortunately for her it was a cancer. And I've heard so many stories of women not having that taken seriously. And then things didn't go as anticipated. So I'm glad everything ended up being benign, but that it was taken seriously. Yeah. Right. Yeah. Yeah. And then how much did he weigh?

Erin (37:18): He was nine pounds, six ounces.

Dr. Nicole (37:20): Look at you pushing out a bigger baby. Right. But it was

Erin (37:26): Very empowering to hear that. Yes. What did the midwives, I think at my 38 week appointment was feeling around and asked how big my daughter was and if anyone had thought or made guesses to how big he was. And I said, no one said anything yet. She goes, well, I don't think he's gonna be bigger than eight pounds. I don't think he'll be bigger than your daughter. Looking back and thinking, is that actually how it felt or was she just making me feel good? It helped regardless. Yes. Thinking, oh, okay. I'm giving birth to an eight pound baby. Right. That'll be easy. That's fine.

Dr. Nicole (37:59): Right, right. Did he feel bigger or smaller? Do you remember?

Erin (38:04): No, I think just with the way that I've carried with both pregnancies, they kind of get twisted and curled up in there and it's not really easy to tell exactly how big they are. Gotcha. Just with my stomach size.

Dr. Nicole (38:19): Sure. Sure. Yeah. So did you breastfeed and did you have any issues there?

Erin (38:25): I did breastfeed and breastfeeding went great. I continued breastfeeding for 14 months. Oh

Dr. Nicole (38:32): Wow.

Erin (38:32): Okay. Would've continued longer and he would have also but I also in the past year, was diagnosed with small intestinal bacterial overgrowth. So I had kind of reached a point where I was ready to heal my own body a little bit more and I couldn't treat that while breastfeeding. Okay. So giving him till 14 months, I felt really happy with that. Yeah,

Dr. Nicole (38:55): Yeah, yeah. And then when did you see the midwives back postpartum? I know you said you had it for the breast mass, but would otherwise, did they schedule a six week checkup or did they have you, or were they gonna have you come in sooner than that?

Erin (39:10): A six week checkup is their standard. So I had the early one because of the breast lump and then the six week checkup where everything was great and I was cleared to exercise and do everything as normal again at that point. Gotcha,

Dr. Nicole (39:24): Gotcha. Now with the way that your body was healing differently or you felt like things were different, do you wish that you would've had a checkup sooner or someone to check in at all?

Erin (39:35): No, I did. The midwives were available via phone also. I think I called them at least once about the hemorrhoids too, to make sure that there weren't any issues there. Got it. So I felt comfortable just with the accessibility of being able to contact them. Not that I needed to come in to see them in person earlier. Okay.

Dr. Nicole (39:53): Okay. Okay. All right. So looking back, how do you feel about the overall experience?

Erin (39:59): It was amazing. I feel like it went as best as it could to be honest, since, so this labor was just less than five hours and my first was 22 hours. The fact that it went so fast, I had no choice but to have an unmedicated. Yeah.

Dr. Nicole (40:17): There was no time for an epidural cuz you showed up at the hospital, just the baby was gonna come out.

Erin (40:22): Yeah, he was ready. I was ready. We made it happen, which is very, very empowering, especially since he was bigger than my first and after my first, I was essentially told she was just too big to fit through my pelvis.

(40:38): Looking back, I feel like if I had been given a chance for labor to start on its own or more of a chance for that to happen, and if I had been allowed some position changes to open up my pelvis, more. I don't think it's that she was too big, it's just my body wasn't prepped in such a way that it was able to squeeze her through.

Dr. Nicole (41:00): Right, right. Yeah. Have to, especially when you have after an epidural, you have to move, still move people to try to help get the baby in a good position. And that doesn't maybe sound like that's what happened in the first instance, but this time things went very well. Amazing. I love that. I love that. So what is the one piece of advice that you would give other people as they get ready for their birth?

Erin (41:24): It's so hard to pick just one

Dr. Nicole (41:26): Oh, you can do a couple if you want. Yeah. Ok.

Erin (41:29): I've heard several women on your podcast mention education, which is definitely key. I totally agree with that. But to add something to that, yeah, I would definitely say really think about what you want your ideal birth experience to be, and then do what you need to get there. If that means that you switch providers in the middle of your pregnancy or you know, hire a doula or you start doing different techniques like meditation, visualization, incorporate what you can in your daily life to have that birth experience. I think every woman has the right to that amazing positive birth experience, and with the right supportive team, you can get that.

Dr. Nicole (42:12): I love that. Love it, love it, love it. So where can women connect with you? You can say nowhere, if you're not on social media or anything.

Erin (42:19): I'm not super active on Instagram, but I'll get on there and check some messages. If anyone wants to connect with me on there, it's at ereka 19. Okay.

Dr. Nicole (42:29): All right. And we will put that in the show notes. Well, thank you so much, Erin, for agreeing to come on to the podcast. There are so many. After our interviews, of course I do my Doctor Nicole's Notes and I have 'em all in my head right now. I record them later after the interview, but I'm excited to, there's just so many great things about this story and things that people can learn, so I appreciate you coming on. Yeah,

Erin (42:52): Thank you.

Dr. Nicole (43:00): Wasn't that a great episode? I'm so glad. Things turned out well for Erin and she had her beautiful, successful unmedicated. Now, when I have a guest on the episode, I do something called Dr. Nicole's Notes where I talk about my top takeaways from the conversation. Here are my Doctor Nicole's Notes from my conversation with Erin. The first one I wanna mention is the importance of meditation and visualization. Those are tools that can just be so helpful and helping you have the birth that you want. There's something about seeing things in your mind as far as visualization goes that helps you to manifest it in your life. And manifest just means to make a real, like I've always had like a woo woo. What do you mean manifest? Are we doing, I don't know, crystals or whatever? Not if there's anything wrong with that, but manifest has sort of a negative connotation, but really all it means is to make real.

(44:00): And when you visualize it, it can help you see the things that you need to make something a reality in your life. It doesn't guarantee anything of course, but it's a tool that elite business folks use, athletes use all the time. Similarly, meditation is great to help you get in that appropriate calm mind space that you need to control your anxieties, help control your fears about birth. And meditation is just a great tool for your overall health to reduce stress and anxiety, not just in pregnancy, but outside of pregnancy. I believe in these tools and they're so important that actually inside of the Birth Preparation Course, I start with some of these tools and talking about these things in the very first module of the course before we even get into anything about labor and birth, because your mindset is so important. So you can check out all of the details of the Birth Preparation Course at drnicolerankins.com/enroll.

(44:58): I also have a handy meditation jumpstart guy that you can grab on my website. You can head to drnicolerankins.com/meditate and grab that free guy. Go. All right. The remainder of my comments are gonna focus on VBAC specifically, and that's vaginal birth after cesarean. Many doctors would have told Erin that because she got to completely dilate it and the baby didn't fit that it wasn't worth a shot in order to try for this pregnancy. Listen, let me tell you, we do not know if a baby will fit until we try. Okay? We just don't know. And that's in any pregnancy. Also, you can never be told like my pelvis is too small or your pelvis is too small to have a vaginal birth. Uhuh clinical estimates of the size of the pelvis are inaccurate in terms of predicting the course of labor or the outcome of labor.

(45:53): So no one can tell you whether or not your baby will fit until you try. One of the most humbling experiences that I had with the VBAC, a patient who had a delivery by C-section at 35 weeks, and this was after a failed vacuum birth, so not a big baby at 35 weeks, and then came back and she was like 37, 38 weeks. Bigger baby, of course, couple weeks bigger and had a completely fast vaginal birth. We just don't know until we try. And every pregnancy is different. You will see VBAC calculators out there that give you a percentage chance of success for VBAC. Those are trash because I have so often seen that people put in the numbers in the calculator, they have a low chance of success and go on to successfully have a VBAC or the flip side where the numbers may be high and they don't have a successful VBAC.

(46:49): So those calculators really aren't helpful. I think they just messed up people's mind space for the most part, especially if the results aren't something that are encouraging. And then the final thing I wanna say about VBAC is that you most certainly have to find a supportive doctor, midwife, and hospital for VBAC. This is crucial, crucial, crucial. And of course you need that for any birth, but you definitely need to find it for VBAC. And you don't wanna find someone who is just a tolerant of VBAC and says things like, oh, if you go into labor, or if by 39 weeks you've had a vaginal birth, that's fine. You know, don't want to find someone who's just tolerant of it and seems like, okay, well if it happens, it happens. You really want to find someone who is supportive of feedback and that can make all the difference.

(47:50): A couple of resources. VBAC Link is one. VBAC Facts is another one that you can look for if you are trying for a VBAC. All right, so there you have it. Share this podcast with the friend. Sharing is caring and helps me to reach and serve more pregnant folks. Helps me to fulfill my passion and purpose of helping people have the most beautiful pregnancy and birth experience. So appreciate if you share the podcast. Also subscribe to the podcast. Where are you listening to me right now? Whether that's Apple Podcast, Spotify, Google, or all of the dozens of other podcast players that are out there. Also, leave me a review, an Apple podcast. I'd love to hear what you think of the show, helps other women to find the show. And speaking of hearing what you think, shoot me a DM on Instagram. Let me know what you think about the podcast. I'm on Instagram at Dr. Nicole Rankins. I love to hear the impact that the podcast has had on people. So feel free to reach out to me and DM and shoot me a message on the gram. So that's it for this episode. Do come on back next week and remember that you deserve a beautiful pregnancy and birth.