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Episode 358 Labor & Delivery Nurse Kerri’s Positive CBAC

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Inhoud geleverd door Meagan Heaton. Alle podcastinhoud, inclusief afleveringen, afbeeldingen en podcastbeschrijvingen, wordt rechtstreeks geüpload en geleverd door Meagan Heaton of hun podcastplatformpartner. Als u denkt dat iemand uw auteursrechtelijk beschermde werk zonder uw toestemming gebruikt, kunt u het hier beschreven proces https://nl.player.fm/legal volgen.

“Whatever happens, I just want it to be peaceful, and I want to be present.”

Kerri is a labor and delivery nurse born and raised in Kentucky. The only thing on her first birth plan was not to have a C-section, yet it became her reality. We know many of you can relate.

She had a medically necessary induction at 36 weeks due to preeclampsia. Kerri describes her experience with getting magnesium, aka a “flu in a bag”, seeing double and going in for a C-section. Her surgery was straightforward, but Kerri felt very out of it and disconnected.

Kerri was very intentional about her plans for a VBAC. Her birth team was on board and supported her requests. Throughout her pregnancy, Kerri’s greatest desire was to feel present for the moment of birth no matter the outcome.

When labor stalled and baby had a hard time engaging, Kerri felt peaceful about requesting a second C-section. With things happening on her terms, Kerri’s birth was the peaceful and healing experience she hoped it would be.

Evidence Based BirthⓇ - The Evidence on VBAC

Evidence Based Birth - COVID Resources

Needed Website

How to VBAC: The Ultimate Prep Course for Parents

Full Transcript under Episode Details

Meagan: Hello, Women of Strength. We have a CBAC story coming your way today. If you did not know what CBAC means, that is Cesarean Birth After Cesarean. This is a topic that a lot of people avoid. I don’t know, tell me, Kerri, who is sharing her story today. Do you feel like CBAC stories are sometimes avoided when you are preparing for a VBAC?

Kerri: I think so. I know I avoided that as I prepared for my own attempted VBAC.

Meagan: Yeah.

Kerri: Yeah. I think that CBAC is something that we try to avoid because we all hope for that VBAC.

Meagan: Yeah. We overlook it and it actually breaks my heart. I encourage everyone to listen, especially if they are wanting to VBAC, every VBAC story, but as well as every CBAC story for a lot of reasons. One, understanding maybe what led to another CBAC and two, the healing and the fact that it can be a peaceful experience. It’s not the end. There are so many things to CBAC, I think, that are missed.

It’s the same thing with uterine rupture stories or things like that. I’m not wanting that, so I don’t want to listen to that. Now, I don’t want to shame anyone if they skip over a CBAC story, but I really encourage everybody to listen to all of these stories because they are empowering. They are uplifting, and they are going to help you grow in ways that you may not even know.

Before we get into cute Kerri’s episode, I wanted to share a review. This was actually left a little bit ago too, actually. It was in 2022. No, 2021. It says, “Going for my VBAC after two C-section in 2022”. It says, “Thank you so much for this valuable resource. I have been listening to your podcast since early in my second pregnancy. I found out I was expecting again 9 months after my CBAC, and I was immediately and depressed that I would be going through all of that all over again very soon. I am now 14 weeks, and I’m drawing strength every day from the stories you share. Thank you, thank you, thank you. I have hope this time that it will be different.”

Now, that’s another good note to have. Even if you do have a CBAC, that doesn’t mean that’s the end. That also may mean you find healing in that, and you want future CBACs, right? You want to schedule that CBAC. I love that note about healing and strength. That’s what all of these episodes are doing.

Okay, Kerri. I am so happy that you are here. You are in Kentucky.

Kerri: Yes.

Meagan: Okay, were you in Kentucky for both of your births? Are you from Kentucky?

Kerri: I have lived in the same small town my whole life. I live just outside of Lexington. It’s a little bit bigger than it used to be, but it’s still a small town to me.

Meagan: Okay.

Kerri: I have lived in Lexington my whole life. I gave birth at the same hospital where I was born.

Meagan: Yeah, me too. I would say I’m boring. I’m boring. I haven’t been anywhere, but I don’t think it’s boring, actually. I love Utah. I’ve been born and raised here. I actually gave birth at the same hospital for my C-sections and with the same provider who gave birth to me.

Kerri: Oh, that’s so funny. That’s wild.

Meagan: Kind of crazy, huh. Well, thank you so much for being here today and sharing your beautiful stories. I’d love to turn the time over to you.

Kerri: Yeah. I’m so excited to share. I’ve listened to this podcast quite a bit since my first C-section, so I’m really excited to be on today.

Meagan: Well, thank you for being here.

Kerri: My first pregnancy was already a surprise pregnancy. Me and my husband had just gotten married, and a month and a half later found out we were pregnant. It was already quite a bit of a surprise being pregnant. You know, pregnancy went well. The first trimester went well.

Around 28 weeks, I had gotten COVID. This was November of ‘21. COVID was still fresh. I had gotten COVID, and I made it through that. I thought everything was going well, but from that point on, I just was feeling more and more sick. I had been a nurse for a while, but I was a new nurse to labor and delivery. I was working night shifts, so I just really attributed the way I felt to working nights. I’m just pregnant. I’m working the night shifts. This is probably what’s wrong with me.

Around 35 weeks, I just started feeling miserable. I had an appointment with a provider who wasn’t my provider, but he was a provider I had worked with. At that appointment, my blood pressure was elevated. He said, “Let’s just get a preeclampsia panel, and do a 24-hour urine just to be safe and see what’s going on.”

I did that, and I turned in my 24-hour urine. I went to work that night. That shift was miserable. I don’t know how I made it through that shift, but I did. I got off that morning, and the provider called me that morning. He was like, “You have preeclampsia. You cannot work anymore. You’re on light duty at home, and you’re being induced at 37 weeks.”

That was already quite a bit of a shock. I had been around birth just enough as a labor and delivery nurse. I had just already in my head pictured this beautiful birth experience that you see on Instagram, and I’m like, “This is already not happening for me.”

He tells me that. I’m home for a few days, and I’m just feeling more miserable as I’m home. After that phone call a few days later, I checked my blood pressure, and it’s severe at home. It’s over 160/110. Being the nurse I am, they say nurses make the worst patients. I was just like, “I’m going to ignore this for a little bit, and we’ll just see if this gets any better.”

I check it again later that afternoon, and it’s still super high. I called my husband, and we decided to go to the hospital. We get there, and my blood pressure was high, but it was not severe enough to do anything about it.

They were like, “Let’s just keep you overnight and see what you do.” Over the 24-hour period of being there for observation, my blood pressures just went up and up. I had some more severe, and they were like, “You know, it’s time to have a baby.” I was just shy of 36 weeks at this point.

They started a magnesium infusion to help with the preeclampsia.

Meagan: Blood pressure. Ugh, did it make you feel yucky?

Kerri: Oh, yes. Magnesium is awful. I feel for anybody who has to be on that. It was awful. We call it flu in a bag, and it truly is that.

Meagan: Flu in a bag. Okay. I’ve never heard of that, but I can understand that based off of the way I’ve seen my clients feel.

Kerri: Yeah, that’s exactly how you feel. Flu in a bag. It just makes you feel yucky.

We started that, and we started the induction process. We started with the Foley bulb. We put that in. That was in until the next morning, and it comes out. When it came out, I think I was 3 centimeters, but not very effaced. It was just an artificial 3, a Foley bulb 3. They were like, “You know, your cervix isn’t very favorable. Let’s do some Cytotec.”

We did a few doses of Cytotec. They rechecked me after that. It was still not very favorable. I think this was the evening at that point. They were like, “Let’s just take a break, let you have a meal, and we’ll try this again.”

We do that, and then we start Pitocin. We did that all night. The next morning, my provider checks me. I’m finally a 4. I was ecstatic. I was like, “Oh, I’ve made some change.”

I was really excited. They checked me. I was 4. They break my water, and they’re like, “Let’s just see what happens.” I had gotten an epidural at that point because I was already pretty miserable from being on magnesium and all of these induction agents. I was like, “I really need some rest.” I was already epiduralized.

The nurse who was taking care of me at the time was a really good friend of mine. She was like, “Let’s do everything that we can to try to have this baby vaginally.” She did Spinning Babies. We did all of the positions that we could. They checked me again later and I was a 5. I was ecstatic, like, okay. We’re doing something there.

A few hours later, I’m starting to feel pretty miserable, more miserable than I had felt before. I look over at the computer, and I’m seeing double. I call out to my friend. I’m like, “I don’t know if this is normal, but I’m seeing two of everything.” She was like, “No, it’s not.”

She calls my provider. He said, “Let’s draw a magnesium level. Let’s see what’s going on.” So they did. My magnesium level was high. They decided, “Let’s just recheck you. We’ll see you if you made change. If not, we’ll have to have a section.”

They checked me. I was still a 5 at that point. They decided with everything that was going on, it was probably in the best interest of the situation to have a section. I agreed, but I was heartbroken.

My whole pregnancy, my only birth plan was don’t have a C-section, and at that moment, that was my reality.

Everybody who was with me that day, they were my coworkers. They witnessed me have a full-blown panic attack over it, but everybody made it through that with me. They loved on me, then we finally went back to the C-section.

I’m pretty out of it from the magnesium at this point and just having labored so long. They started the section. I felt like I could feel more than what I probably should have been able to feel. I let them know, and once they got the baby out, they gave me ketamine just to help with my pain.

I was knocked out for 12 hours, so I don’t remember my baby’s birth at all.

Meagan: That’s hard.

Kerri: Yeah. It was really hard. I feel like the moment I actually realized I had a baby was the next morning. There’s a video where I’m like, “Oh my goodness.”

Meagan: Yeah. Yeah. Were you feeling any better by then?

Kerri: I was still under magnesium, but I was feeling better.

Meagan: Good.

Kerri: The protocol, at least at the hospital that I work at in, is magnesium 24 hours postpartum just to make sure you still don’t–

Meagan: Yes, that is how it is here too, then they’ll recheck things and if blood pressures are still elevated or anything like that, and if levels are elevated, then they’ll remain, and if not, then they’ll take you off.

Kerri: Yeah, we did that for 24 hours. Once that was off, I finally got to go up to the mother/baby unit. I started to feel more normal at that point, but just that whole experience, I felt like I was just not even a part of. I was just there having the baby, but I didn’t feel like I was actually there having a baby.

Meagan: Yeah. Yeah. Did that carry onto the postpartum and future as stuff to process for you, or did it feel okay?

Kerri: That was very hard for me because I worked with birth every day. I got to see these beautiful moments of people having their baby, and I didn’t feel like I had gotten that. I don’t remember my baby being born. You know, it’s different. I had pictures, but nothing quite as good as remembering that. That was very hard, and it really affected me for a long time.

You know, it still does. I would have loved to have been present in that moment. That just wasn’t the reality for me.

Meagan: Yeah. Have you done things to work through that, or anything to suggest for someone who maybe have experienced that or have been put under anesthesia where they just couldn’t remember or be present in their birth?

Kerri: For me, my faith is something that is very important to me. Praying and talking with God about it has really been helpful for me. It was still a beautiful moment. I’ve come to terms with that.

Meagan: Good. Good.

Okay, so baby number two. Oh, I was going to ask you, with being preterm, did they do a special scar or anything, or were they able to do a regular low transverse?

Kerri: Just a regular low transverse incision.

Meagan: Awesome. Awesome.

Kerri: Yeah. So baby number two, we knew we wanted another one, and honestly, as soon as we were in that hospital room, I remember I told my husband that I never wanted to have a C-section again. When we started thinking about number two, we were going to start working towards having a VBAC.

When she was around 20 months, I found out I was pregnant. Prior to the pregnancy, I had done a ton of research on what is the best way to get a VBAC, and what is the best way to prevent preeclampsia which is silly because we know preeclampsia can’t necessarily be prevented.

Meagan: Yeah, there are things we can do to try to reduce the chances, but there’s nothing that we know for sure, concrete that this is what you can do to make sure you don’t get it.

Kerri: Yeah. My provider did have me start taking low-dose aspirin early on in the pregnancy, and I didn’t get it again, but you know, I did all of this research like, what can I do? Looking back now, I think I put too much pressure on myself to try and prevent it.

I found out I was pregnant when she was 20 months old, and we were so excited. We were just thrilled. We just couldn’t even describe that. I was so excited to start doing what I could in the pregnancy to get my VBAC. That’s all I could think about was my VBAC.

I remember praying to God. I just prayed that this pregnancy I could have my successful VBAC. Then as the pregnancy got closer to delivery, in my head, I’m like, “I could have another C-section. I need to start thinking about this.”

So then I shifted my mindset. I was like, “You know, if I have to have another C-section, it’s okay. All we want is a peaceful delivery.” So that’s what I kept telling myself every day in my prayers. I was like, “Whatever happens, I just want it to be peaceful, and I want to be present.”

Meagan: Yeah, I bet that was a really big deal for you.

Kerri: Yes. I just kept saying that every day. That’s what we’re going to do. Peaceful delivery. Present delivery. I kept telling my coworkers because they were rooting for me. We were going to make this a better experience.

My provider the whole pregnancy was great. She was very VBAC-supportive. I did a lot of research prior to the pregnancy about who I wanted to see, and I worked with these providers. It was a hard choice to make. I work with great providers, but I feel very confident in the provider I picked. She took such great care of me, and I’ll forever be grateful for her.

Towards the end of the pregnancy, me and her had a chat about what are we going to do to get our best attempt at having a VBAC? I ultimately decided that I wanted to be an induced VBAC. Not necessarily that I wanted to be induced, but I needed the peace of mind. I already had a lot of anxiety just because of the last pregnancy, and I just needed an experience where I could at least expect something.

This may not end in a successful VBAC, but I really want to try. We scheduled the induced VBAC, and she was like, “This might not work.” We had a lot of conversations about that. She was like, “Induced VBACs aren’t always successful,” which I appreciated her saying as a provider. I was like, “This is what I need just for my peace of mind.”

We scheduled an induction. Everything was going great. I went in at night. I had gotten a Foley bulb again. My cervix wasn’t favorable necessarily. I was 39 weeks on the dot. Maybe if I would have waited a little longer, I would have been more favorable. At that point, I wasn’t the most favorable, but I still wanted to go through with it. I had wrapped my head around that that day was going to be her birthday and we were going to go through with it.

We started with the Foley bulb, and it stayed in for what felt like forever. They put it in at midnight. It did not come out until 11:00 AM the next day. I was not expecting that because last time, the Foley bulb did not stay in that long. This time, I had made it to 39 weeks, and I was thinking that my cervix would do more, and it just didn’t.

My provider came in. She was able to get it out. She broke my water, and I was at a 4 at that point. It was ready to come out, but it didn’t on its own. I wasn’t expecting that. I was expecting a little bit more.

Meagan: That can happen. It can be in for up to 12 hours and not fall out. That can happen, but I’m sure after your previous experience, you’re like, “Wait. Why isn’t this out yet?”

Kerri: Yeah. We did that, and I decided she was going to break my water. Me and her and my nurse who was taking care of me was a really good friend. We were like, “Let’s just get an epidural because we know that there is a bit of a higher chance for uterine rupture for being an induced VBAC or TOLAC.”

Meagan: Were you feeling contractions at this point?

Kerri: I was. I was feeling contractions. That was something, I kept telling my husband, that I was really excited about. With the last experience, I was really out of it having been on magnesium and having gotten an epidural so early. I just didn’t even feel like I got to experience labor at all. Like I said, I didn’t feel like I was a part of that experience. I was really excited this time to be able to experience contractions.

While they were very, very painful, I was very grateful to have that experience.

I had asked for a few doses of fentanyl.

Meagan: Fentanyl?

Kerri: Fentanyl, yeah. We used to do [inaudible], but right now, we have fentanyl. I had asked for a few doses of fentanyl, but I really tried to tough it out because I was like, “I really want this experience.” The whole pregnancy, I had been prepping for how I was going to manage labor while I didn’t have an epidural. I had a friend who I worked with. She is also a doula, and she is going to school to be a midwife. She had talked me through a few different things that I could do. I had really prepared, and I was really excited to be able to experience some contractions.

Meagan: Yeah.

Kerri: But we had decided, “Let’s get an epidural just to be safe.” We got an epidural, and everything was smooth sailing. We got the epidural. We started some Pitocin. I had asked for peace of mind for me, an IUPC which is the intrauterine contraction monitor because I wanted to know what my uterus was doing. If I was going to be an induced VBAC and I’m going to have a higher risk of rupture, I wanted to know exactly what my uterus was doing, so I asked for one of those to be put in. They put one in. My contractions were adequate. We were moving along.

I’m just ecstatic at this point because I’m like, “I have never had adequate contractions. Last time, I made progress, but nothing like this.” I was very, very excited.

Throughout the course of the day, me and my friend who was taking care of me decided that we were going to do every Spinning Babies position that we could do. My epidural was just perfect enough. I was able to help move by myself and do all of these positions that I had planned on doing. It was great. I was so excited.

They checked me, and I was a 5. I was excited that I had made it a little bit farther than what I had thought I would because last time, I had stayed at a 5 forever. I was at a 5, and I was expecting to just keep making progress.

A few hours later, they checked me again, and I was still a 5. My provider is like, “Your pelvis feels very tight, and your baby’s head is not applied at all.” So then, I felt crushed in that moment. I had been planning on having this successful VBAC, and it doesn’t feel like it’s going to happen.

Prior to the induction, I had been living in the Miles Circuit and doing everything I could to get her the best engaged she could be. She wasn’t doing it.

She said, “We’ll give it a few more hours.”

Meagan: What were your MVUs at this point? Sorry, I just interrupted you.

Kerri: I think they were 200. They were adequate.

Meagan: Mhmm, cool.

Kerri: My contractions had been adequate for a while, and I wasn’t on very much Pit.

Meagan: Good.

Kerri: I was thinking that things were going great. She was like, “We can keep going if you want. I’m going to stay with you. I’m going to do your delivery regardless of the outcome.” We decided we were going to keep going. A few hours later, I get checked again. I’m still 5. Her head’s still not applied. My friend who was taking care of me was about to leave because her shift was over.

She was like, “We can call it right now, or we can give it another shot.” She said, “You’ll never get this experience again, so if you want to keep going, keep going, but if you don’t, it’s fine.”

Kerri: I decided, “I want to keep trying.” I kept trying. Then a few hours later, I was checked again. I was still a 5. Her head was still not engaged, so we decided that we were going to have another C-section. That was heartbreaking.

I remember in the moment feeling a little heartbroken, but also feeling at peace about it all in one.

Meagan: Yeah, which is important.

Kerri: Yeah. We go back for the section. I was nervous about having another section just because my first one was so traumatizing. I wasn’t sure how it was going to go. I was really nervous about anesthesia. Is it going to hurt this time? Am I going to be knocked out because I’m feeling too much?

The anesthesiologist who took care of me decided, “Let’s just give you a spinal.” My epidural had fallen out actually, so she said, “Let’s do a spina. Let’s make sure you are the most comfortable you can be.” They did that. They started the section. I couldn’t feel anything which I’m already thrilled for.

I remember just laying there, and I felt so present during the whole thing. My baby came out, and I remember being a part of that moment. There was a clear drape, so I was able to see what was going on. My provider– I feel like we had developed such a good bond. She did everything to make sure that it was a good experience for me and to make sure I was present.

Something that was important to me was that my baby would be with me a little bit longer while I was in the OR. I didn’t have my baby with me last time, so I really wanted that. I didn’t necessarily do skin-to-skin, but I got to hold her. She got to be with me the whole time, and it was perfect.

She got to be with me during recovery. That whole birthing experience was just the most beautiful thing.

Meagan: Good. So you have been able to walk away feeling positive about a birth experience.

Kerri: Yes. That’s not something I thought I would get with a C-section.

After my first, I had a lot of postpartum anxiety. I had very negative feelings towards C-sections. I didn’t enjoy seeing my scar. To me, that was just a reminder of what my body had done to me. I felt betrayed by my body, and for the longest time, I just was ashamed of the fact that I had a C-section.

After that experience with my second, I was very proud that I did have a C-section because reality hit me that this isn’t the most ideal way to give birth to a baby, but it happens, and thank God they are available, and I have two beautiful babies because of my C-sections, so I’m very, very thankful for them now.

Meagan: Yes, good. Good.

Kerri: When my husband and I decide to have another one, I’m like, “This will be great because I think that for me, I’ll just have another repeat section, and it will be scheduled. It’s going to be great, and I’m excited about it.” But it’s just something to be able to look back and be able to think of this as such a positive experience as opposed to my first. I wasn’t proud of my birth story at all. It was something I carried with me for a long time, and now, I’m thankful that I can have a different perspective about it. Even about my first, my first birth was beautiful in its own way.

Meagan: Yeah. It’s hard because you don’t want to only think about those births as negative or traumatic. You want to pick out the positivity from it, but sometimes it is hard to see all of that, so it’s been so great to hear that you– one, it sounds like with your labor, it really was a lot of your choice along the way. You decided this was something you wanted. Your team went with you and then walked with you along the way. In the end, it was able to be something that was a lot more healing.

Even though it was still a Cesarean, it was a healing experience for you. You got to have your baby that whole time, and you got to grow through that experience. Like you said, you may choose to have a third C-section, and that’s okay. I think that’s one of the things I love about this podcast is that it’s not if you choose a C-section, you are shamed. That’s just not how it is.

Everyone needs to choose what is best for them and their individual circumstances. I love that you’ve been able to go from the furthest end of the extreme to coming back, and then possibly if you have another baby, it sounds like something that you are already looking forward to having an even different experience. I love that you’ve been able to have that and you can share these stories and you can hold onto these good feelings because it really is important.

Kerri: Yes. Even as a labor and delivery nurse, I feel more positive about taking care of women who have C-sections because for the longest time, every time I went into the OR, it brought up feelings from my own first C-section. It was hard to be the best nurse that I could be when I was dealing with my own feelings, so I’m thankful now that I have this perspective of, “This is beautiful in its own way.” Every birth is beautiful. You’re bringing your baby into the world. Who cares how it happens?

I think we get so wrapped up in God made our bodies to give birth a certain way, and that’s just not the reality for some people. I’m thankful we live in a society where C-sections are readily available and we can have them. They can be just as beautiful.

Meagan: Yeah. CBACs really can be. My second C-section was very, very healing. I think it was exactly what I needed to have healing from my first birth that I didn’t realize I didn’t heal from. I was really, really grateful that I had the experience. Again, it wasn’t the birth I desired, but it was such a better and healing experience for me. I was really, really grateful for those.

Okay, I have two things that I want to talk about. One is preeclampsia. Not even just preeclampsia, but COVID. I was just wondering, as a labor and delivery nurse, have you seen things like preeclampsia or placental issues or anything like that from people who have had COVID during pregnancy?

Rebecca Dekker has such an incredible blog, and I’m going to make sure to link it here. I have seen this weird connection with pre-e with a placenta or placental issues that have had COVID. I was just curious if you’ve seen anything like that.

Kerri: You know, I feel like that is something that we’ve seen more of. I will say I started working as a labor and delivery nurse in 2021, so I can’t speak for what nurses saw prior to this, but I do feel like I see a great deal of preeclampsia, especially during that COVID time. Women were having more complications. More women are getting more sick. I don’t know if there’s a correlation, but I will say that as far as pregnancy goes, it does seem like a lot of pregnancies are becoming more high-risk.

Meagan: Because of that? Because of COVID?

Kerri: I don’t know if it’s necessarily COVID or just the way we eat, the way we take care of ourselves, but I feel like during COVID, there were a higher number of combinations whether there’s a correlation or not.

Meagan: Yeah, that’s interesting. I just barely read the most recent update. I need to dive into that more, but I was wondering as a labor and delivery nurse if you had seen that.

You mentioned with your first that they had tested you, and your magnesium levels were too high. Are there things that can reduce magnesium levels? Obviously, maybe lowering the magnesium levels that are given, but are there things that can be done in that situation to lower their magnesium levels?

Kerri: If your magnesium level is high, we can give you the reversal drug which is calcium gluconate. We can give you that, but we are already inducing, you and it’s high, and you’re not making very much progress, at that point–

Meagan: The provider may not be wanting to do that.

Kerri: Yeah, delivery is the best option.

Meagan: Yeah, for preeclampsia, which we do know. I was just wondering if there was such a thing that could help.

Kerri: Yeah. Ideally, just do what you can to deliver. But you know, that’s something that people should talk to their provider about in that moment.

Meagan: Yeah. I agree. I agree.

Then last but not least, I just wanted to share a little bit more because I think a lot of people do question induction and VBAC. What are the risks? Sometimes, the risks seem astronomical, and sometimes they are not to some people. Everyone takes it differently. I wanted to share some evidence on that.

With the risk of induction, it does increase just like you had mentioned. It does increase the risk of uterine rupture when we are induced. It’s about a 1.1% if you have Pitocin and about a 2% if you have prostaglandins, and then of course, we know misoprostol. How do you say that?

Kerri: Misoprostol, but however you want.

Meagan: Yeah. I saw misoprostol, but I’ve heard people say MYsoprostol. It is about 6%. It definitely increases with certain things that you do. It’s about a 1.1%. Uterine rupture in general is just around 1%. It increases it ever so slightly, but it’s really important to take the right precautions. A Foley bulb is a fantastic way to start jumpstarting labor, but sometimes it does need to have a little bit of an opening, at least 1 centimeter.

Kerri: Where I work, we don’t do Cytotec for TOLACs.

Meagan: Most people shouldn’t..

Kerri: It’s a 1 to 1 assignment. Your nurse who is taking care of you wouldn’t have another patient.

Meagan: Interesting.

Kerri: They make sure that all hands are on you and make sure that your uterus is okay. When it came down to me when I was thinking about wanting to TOLAC and hopefully have a VBAC, I looked at the risk. I think it’s important. I listened to a podcast. I think it was by Jordan Lee Doulie. She had an OB on her podcast talking about VBAC. He said, “It’s important to remember that there is a risk whether you’re having a repeat section or you’re having a TOLAC.”

I really took that to heart. For me, the risk of uterine rupture is small enough that I want to try. I know that I’m going to be in a hospital. I know I’m going to be monitored, and if that’s something that’s happening, I know I’ll be taken care of quickly. I was okay taking the risk. I think that has to be such an individual choice. It does carry risk as well, so that’s why I needed to at least give it a shot.

I’m somebody that I fully support whoever wants to have a VBAC after two sections, but for me, that’s not something I want to do. But as with everything, you have to look at both sides of it and make your decision.

Meagan: Yeah. I think that’s what we talk about on this podcast. Learn the risks. Learn the facts. Learn what the evidence says, and then follow your heart. What feels right? I appreciate you so much for coming on and sharing your journey. I do love how much you were able to be a part of your birth that second, and then also your postpartum experience is so important.

Kerri: Oh yeah. I’m 11 weeks postpartum now, and I just have to say that my mental health this time is so much better, and my recovery post-C-section was so much better. I really have such positive things to say. It was such a good experience. I’m forever grateful for everybody who took care of me. I’m forever grateful for my provider. I just love her dearly and am just so thankful for her.

Meagan: Good. I’m so grateful for you. I’m so glad you had that support and that loving team. Thank you again for sharing.

Kerri: Yes. Thank you so much for having me on here.

Closing

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“Whatever happens, I just want it to be peaceful, and I want to be present.”

Kerri is a labor and delivery nurse born and raised in Kentucky. The only thing on her first birth plan was not to have a C-section, yet it became her reality. We know many of you can relate.

She had a medically necessary induction at 36 weeks due to preeclampsia. Kerri describes her experience with getting magnesium, aka a “flu in a bag”, seeing double and going in for a C-section. Her surgery was straightforward, but Kerri felt very out of it and disconnected.

Kerri was very intentional about her plans for a VBAC. Her birth team was on board and supported her requests. Throughout her pregnancy, Kerri’s greatest desire was to feel present for the moment of birth no matter the outcome.

When labor stalled and baby had a hard time engaging, Kerri felt peaceful about requesting a second C-section. With things happening on her terms, Kerri’s birth was the peaceful and healing experience she hoped it would be.

Evidence Based BirthⓇ - The Evidence on VBAC

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Full Transcript under Episode Details

Meagan: Hello, Women of Strength. We have a CBAC story coming your way today. If you did not know what CBAC means, that is Cesarean Birth After Cesarean. This is a topic that a lot of people avoid. I don’t know, tell me, Kerri, who is sharing her story today. Do you feel like CBAC stories are sometimes avoided when you are preparing for a VBAC?

Kerri: I think so. I know I avoided that as I prepared for my own attempted VBAC.

Meagan: Yeah.

Kerri: Yeah. I think that CBAC is something that we try to avoid because we all hope for that VBAC.

Meagan: Yeah. We overlook it and it actually breaks my heart. I encourage everyone to listen, especially if they are wanting to VBAC, every VBAC story, but as well as every CBAC story for a lot of reasons. One, understanding maybe what led to another CBAC and two, the healing and the fact that it can be a peaceful experience. It’s not the end. There are so many things to CBAC, I think, that are missed.

It’s the same thing with uterine rupture stories or things like that. I’m not wanting that, so I don’t want to listen to that. Now, I don’t want to shame anyone if they skip over a CBAC story, but I really encourage everybody to listen to all of these stories because they are empowering. They are uplifting, and they are going to help you grow in ways that you may not even know.

Before we get into cute Kerri’s episode, I wanted to share a review. This was actually left a little bit ago too, actually. It was in 2022. No, 2021. It says, “Going for my VBAC after two C-section in 2022”. It says, “Thank you so much for this valuable resource. I have been listening to your podcast since early in my second pregnancy. I found out I was expecting again 9 months after my CBAC, and I was immediately and depressed that I would be going through all of that all over again very soon. I am now 14 weeks, and I’m drawing strength every day from the stories you share. Thank you, thank you, thank you. I have hope this time that it will be different.”

Now, that’s another good note to have. Even if you do have a CBAC, that doesn’t mean that’s the end. That also may mean you find healing in that, and you want future CBACs, right? You want to schedule that CBAC. I love that note about healing and strength. That’s what all of these episodes are doing.

Okay, Kerri. I am so happy that you are here. You are in Kentucky.

Kerri: Yes.

Meagan: Okay, were you in Kentucky for both of your births? Are you from Kentucky?

Kerri: I have lived in the same small town my whole life. I live just outside of Lexington. It’s a little bit bigger than it used to be, but it’s still a small town to me.

Meagan: Okay.

Kerri: I have lived in Lexington my whole life. I gave birth at the same hospital where I was born.

Meagan: Yeah, me too. I would say I’m boring. I’m boring. I haven’t been anywhere, but I don’t think it’s boring, actually. I love Utah. I’ve been born and raised here. I actually gave birth at the same hospital for my C-sections and with the same provider who gave birth to me.

Kerri: Oh, that’s so funny. That’s wild.

Meagan: Kind of crazy, huh. Well, thank you so much for being here today and sharing your beautiful stories. I’d love to turn the time over to you.

Kerri: Yeah. I’m so excited to share. I’ve listened to this podcast quite a bit since my first C-section, so I’m really excited to be on today.

Meagan: Well, thank you for being here.

Kerri: My first pregnancy was already a surprise pregnancy. Me and my husband had just gotten married, and a month and a half later found out we were pregnant. It was already quite a bit of a surprise being pregnant. You know, pregnancy went well. The first trimester went well.

Around 28 weeks, I had gotten COVID. This was November of ‘21. COVID was still fresh. I had gotten COVID, and I made it through that. I thought everything was going well, but from that point on, I just was feeling more and more sick. I had been a nurse for a while, but I was a new nurse to labor and delivery. I was working night shifts, so I just really attributed the way I felt to working nights. I’m just pregnant. I’m working the night shifts. This is probably what’s wrong with me.

Around 35 weeks, I just started feeling miserable. I had an appointment with a provider who wasn’t my provider, but he was a provider I had worked with. At that appointment, my blood pressure was elevated. He said, “Let’s just get a preeclampsia panel, and do a 24-hour urine just to be safe and see what’s going on.”

I did that, and I turned in my 24-hour urine. I went to work that night. That shift was miserable. I don’t know how I made it through that shift, but I did. I got off that morning, and the provider called me that morning. He was like, “You have preeclampsia. You cannot work anymore. You’re on light duty at home, and you’re being induced at 37 weeks.”

That was already quite a bit of a shock. I had been around birth just enough as a labor and delivery nurse. I had just already in my head pictured this beautiful birth experience that you see on Instagram, and I’m like, “This is already not happening for me.”

He tells me that. I’m home for a few days, and I’m just feeling more miserable as I’m home. After that phone call a few days later, I checked my blood pressure, and it’s severe at home. It’s over 160/110. Being the nurse I am, they say nurses make the worst patients. I was just like, “I’m going to ignore this for a little bit, and we’ll just see if this gets any better.”

I check it again later that afternoon, and it’s still super high. I called my husband, and we decided to go to the hospital. We get there, and my blood pressure was high, but it was not severe enough to do anything about it.

They were like, “Let’s just keep you overnight and see what you do.” Over the 24-hour period of being there for observation, my blood pressures just went up and up. I had some more severe, and they were like, “You know, it’s time to have a baby.” I was just shy of 36 weeks at this point.

They started a magnesium infusion to help with the preeclampsia.

Meagan: Blood pressure. Ugh, did it make you feel yucky?

Kerri: Oh, yes. Magnesium is awful. I feel for anybody who has to be on that. It was awful. We call it flu in a bag, and it truly is that.

Meagan: Flu in a bag. Okay. I’ve never heard of that, but I can understand that based off of the way I’ve seen my clients feel.

Kerri: Yeah, that’s exactly how you feel. Flu in a bag. It just makes you feel yucky.

We started that, and we started the induction process. We started with the Foley bulb. We put that in. That was in until the next morning, and it comes out. When it came out, I think I was 3 centimeters, but not very effaced. It was just an artificial 3, a Foley bulb 3. They were like, “You know, your cervix isn’t very favorable. Let’s do some Cytotec.”

We did a few doses of Cytotec. They rechecked me after that. It was still not very favorable. I think this was the evening at that point. They were like, “Let’s just take a break, let you have a meal, and we’ll try this again.”

We do that, and then we start Pitocin. We did that all night. The next morning, my provider checks me. I’m finally a 4. I was ecstatic. I was like, “Oh, I’ve made some change.”

I was really excited. They checked me. I was 4. They break my water, and they’re like, “Let’s just see what happens.” I had gotten an epidural at that point because I was already pretty miserable from being on magnesium and all of these induction agents. I was like, “I really need some rest.” I was already epiduralized.

The nurse who was taking care of me at the time was a really good friend of mine. She was like, “Let’s do everything that we can to try to have this baby vaginally.” She did Spinning Babies. We did all of the positions that we could. They checked me again later and I was a 5. I was ecstatic, like, okay. We’re doing something there.

A few hours later, I’m starting to feel pretty miserable, more miserable than I had felt before. I look over at the computer, and I’m seeing double. I call out to my friend. I’m like, “I don’t know if this is normal, but I’m seeing two of everything.” She was like, “No, it’s not.”

She calls my provider. He said, “Let’s draw a magnesium level. Let’s see what’s going on.” So they did. My magnesium level was high. They decided, “Let’s just recheck you. We’ll see you if you made change. If not, we’ll have to have a section.”

They checked me. I was still a 5 at that point. They decided with everything that was going on, it was probably in the best interest of the situation to have a section. I agreed, but I was heartbroken.

My whole pregnancy, my only birth plan was don’t have a C-section, and at that moment, that was my reality.

Everybody who was with me that day, they were my coworkers. They witnessed me have a full-blown panic attack over it, but everybody made it through that with me. They loved on me, then we finally went back to the C-section.

I’m pretty out of it from the magnesium at this point and just having labored so long. They started the section. I felt like I could feel more than what I probably should have been able to feel. I let them know, and once they got the baby out, they gave me ketamine just to help with my pain.

I was knocked out for 12 hours, so I don’t remember my baby’s birth at all.

Meagan: That’s hard.

Kerri: Yeah. It was really hard. I feel like the moment I actually realized I had a baby was the next morning. There’s a video where I’m like, “Oh my goodness.”

Meagan: Yeah. Yeah. Were you feeling any better by then?

Kerri: I was still under magnesium, but I was feeling better.

Meagan: Good.

Kerri: The protocol, at least at the hospital that I work at in, is magnesium 24 hours postpartum just to make sure you still don’t–

Meagan: Yes, that is how it is here too, then they’ll recheck things and if blood pressures are still elevated or anything like that, and if levels are elevated, then they’ll remain, and if not, then they’ll take you off.

Kerri: Yeah, we did that for 24 hours. Once that was off, I finally got to go up to the mother/baby unit. I started to feel more normal at that point, but just that whole experience, I felt like I was just not even a part of. I was just there having the baby, but I didn’t feel like I was actually there having a baby.

Meagan: Yeah. Yeah. Did that carry onto the postpartum and future as stuff to process for you, or did it feel okay?

Kerri: That was very hard for me because I worked with birth every day. I got to see these beautiful moments of people having their baby, and I didn’t feel like I had gotten that. I don’t remember my baby being born. You know, it’s different. I had pictures, but nothing quite as good as remembering that. That was very hard, and it really affected me for a long time.

You know, it still does. I would have loved to have been present in that moment. That just wasn’t the reality for me.

Meagan: Yeah. Have you done things to work through that, or anything to suggest for someone who maybe have experienced that or have been put under anesthesia where they just couldn’t remember or be present in their birth?

Kerri: For me, my faith is something that is very important to me. Praying and talking with God about it has really been helpful for me. It was still a beautiful moment. I’ve come to terms with that.

Meagan: Good. Good.

Okay, so baby number two. Oh, I was going to ask you, with being preterm, did they do a special scar or anything, or were they able to do a regular low transverse?

Kerri: Just a regular low transverse incision.

Meagan: Awesome. Awesome.

Kerri: Yeah. So baby number two, we knew we wanted another one, and honestly, as soon as we were in that hospital room, I remember I told my husband that I never wanted to have a C-section again. When we started thinking about number two, we were going to start working towards having a VBAC.

When she was around 20 months, I found out I was pregnant. Prior to the pregnancy, I had done a ton of research on what is the best way to get a VBAC, and what is the best way to prevent preeclampsia which is silly because we know preeclampsia can’t necessarily be prevented.

Meagan: Yeah, there are things we can do to try to reduce the chances, but there’s nothing that we know for sure, concrete that this is what you can do to make sure you don’t get it.

Kerri: Yeah. My provider did have me start taking low-dose aspirin early on in the pregnancy, and I didn’t get it again, but you know, I did all of this research like, what can I do? Looking back now, I think I put too much pressure on myself to try and prevent it.

I found out I was pregnant when she was 20 months old, and we were so excited. We were just thrilled. We just couldn’t even describe that. I was so excited to start doing what I could in the pregnancy to get my VBAC. That’s all I could think about was my VBAC.

I remember praying to God. I just prayed that this pregnancy I could have my successful VBAC. Then as the pregnancy got closer to delivery, in my head, I’m like, “I could have another C-section. I need to start thinking about this.”

So then I shifted my mindset. I was like, “You know, if I have to have another C-section, it’s okay. All we want is a peaceful delivery.” So that’s what I kept telling myself every day in my prayers. I was like, “Whatever happens, I just want it to be peaceful, and I want to be present.”

Meagan: Yeah, I bet that was a really big deal for you.

Kerri: Yes. I just kept saying that every day. That’s what we’re going to do. Peaceful delivery. Present delivery. I kept telling my coworkers because they were rooting for me. We were going to make this a better experience.

My provider the whole pregnancy was great. She was very VBAC-supportive. I did a lot of research prior to the pregnancy about who I wanted to see, and I worked with these providers. It was a hard choice to make. I work with great providers, but I feel very confident in the provider I picked. She took such great care of me, and I’ll forever be grateful for her.

Towards the end of the pregnancy, me and her had a chat about what are we going to do to get our best attempt at having a VBAC? I ultimately decided that I wanted to be an induced VBAC. Not necessarily that I wanted to be induced, but I needed the peace of mind. I already had a lot of anxiety just because of the last pregnancy, and I just needed an experience where I could at least expect something.

This may not end in a successful VBAC, but I really want to try. We scheduled the induced VBAC, and she was like, “This might not work.” We had a lot of conversations about that. She was like, “Induced VBACs aren’t always successful,” which I appreciated her saying as a provider. I was like, “This is what I need just for my peace of mind.”

We scheduled an induction. Everything was going great. I went in at night. I had gotten a Foley bulb again. My cervix wasn’t favorable necessarily. I was 39 weeks on the dot. Maybe if I would have waited a little longer, I would have been more favorable. At that point, I wasn’t the most favorable, but I still wanted to go through with it. I had wrapped my head around that that day was going to be her birthday and we were going to go through with it.

We started with the Foley bulb, and it stayed in for what felt like forever. They put it in at midnight. It did not come out until 11:00 AM the next day. I was not expecting that because last time, the Foley bulb did not stay in that long. This time, I had made it to 39 weeks, and I was thinking that my cervix would do more, and it just didn’t.

My provider came in. She was able to get it out. She broke my water, and I was at a 4 at that point. It was ready to come out, but it didn’t on its own. I wasn’t expecting that. I was expecting a little bit more.

Meagan: That can happen. It can be in for up to 12 hours and not fall out. That can happen, but I’m sure after your previous experience, you’re like, “Wait. Why isn’t this out yet?”

Kerri: Yeah. We did that, and I decided she was going to break my water. Me and her and my nurse who was taking care of me was a really good friend. We were like, “Let’s just get an epidural because we know that there is a bit of a higher chance for uterine rupture for being an induced VBAC or TOLAC.”

Meagan: Were you feeling contractions at this point?

Kerri: I was. I was feeling contractions. That was something, I kept telling my husband, that I was really excited about. With the last experience, I was really out of it having been on magnesium and having gotten an epidural so early. I just didn’t even feel like I got to experience labor at all. Like I said, I didn’t feel like I was a part of that experience. I was really excited this time to be able to experience contractions.

While they were very, very painful, I was very grateful to have that experience.

I had asked for a few doses of fentanyl.

Meagan: Fentanyl?

Kerri: Fentanyl, yeah. We used to do [inaudible], but right now, we have fentanyl. I had asked for a few doses of fentanyl, but I really tried to tough it out because I was like, “I really want this experience.” The whole pregnancy, I had been prepping for how I was going to manage labor while I didn’t have an epidural. I had a friend who I worked with. She is also a doula, and she is going to school to be a midwife. She had talked me through a few different things that I could do. I had really prepared, and I was really excited to be able to experience some contractions.

Meagan: Yeah.

Kerri: But we had decided, “Let’s get an epidural just to be safe.” We got an epidural, and everything was smooth sailing. We got the epidural. We started some Pitocin. I had asked for peace of mind for me, an IUPC which is the intrauterine contraction monitor because I wanted to know what my uterus was doing. If I was going to be an induced VBAC and I’m going to have a higher risk of rupture, I wanted to know exactly what my uterus was doing, so I asked for one of those to be put in. They put one in. My contractions were adequate. We were moving along.

I’m just ecstatic at this point because I’m like, “I have never had adequate contractions. Last time, I made progress, but nothing like this.” I was very, very excited.

Throughout the course of the day, me and my friend who was taking care of me decided that we were going to do every Spinning Babies position that we could do. My epidural was just perfect enough. I was able to help move by myself and do all of these positions that I had planned on doing. It was great. I was so excited.

They checked me, and I was a 5. I was excited that I had made it a little bit farther than what I had thought I would because last time, I had stayed at a 5 forever. I was at a 5, and I was expecting to just keep making progress.

A few hours later, they checked me again, and I was still a 5. My provider is like, “Your pelvis feels very tight, and your baby’s head is not applied at all.” So then, I felt crushed in that moment. I had been planning on having this successful VBAC, and it doesn’t feel like it’s going to happen.

Prior to the induction, I had been living in the Miles Circuit and doing everything I could to get her the best engaged she could be. She wasn’t doing it.

She said, “We’ll give it a few more hours.”

Meagan: What were your MVUs at this point? Sorry, I just interrupted you.

Kerri: I think they were 200. They were adequate.

Meagan: Mhmm, cool.

Kerri: My contractions had been adequate for a while, and I wasn’t on very much Pit.

Meagan: Good.

Kerri: I was thinking that things were going great. She was like, “We can keep going if you want. I’m going to stay with you. I’m going to do your delivery regardless of the outcome.” We decided we were going to keep going. A few hours later, I get checked again. I’m still 5. Her head’s still not applied. My friend who was taking care of me was about to leave because her shift was over.

She was like, “We can call it right now, or we can give it another shot.” She said, “You’ll never get this experience again, so if you want to keep going, keep going, but if you don’t, it’s fine.”

Kerri: I decided, “I want to keep trying.” I kept trying. Then a few hours later, I was checked again. I was still a 5. Her head was still not engaged, so we decided that we were going to have another C-section. That was heartbreaking.

I remember in the moment feeling a little heartbroken, but also feeling at peace about it all in one.

Meagan: Yeah, which is important.

Kerri: Yeah. We go back for the section. I was nervous about having another section just because my first one was so traumatizing. I wasn’t sure how it was going to go. I was really nervous about anesthesia. Is it going to hurt this time? Am I going to be knocked out because I’m feeling too much?

The anesthesiologist who took care of me decided, “Let’s just give you a spinal.” My epidural had fallen out actually, so she said, “Let’s do a spina. Let’s make sure you are the most comfortable you can be.” They did that. They started the section. I couldn’t feel anything which I’m already thrilled for.

I remember just laying there, and I felt so present during the whole thing. My baby came out, and I remember being a part of that moment. There was a clear drape, so I was able to see what was going on. My provider– I feel like we had developed such a good bond. She did everything to make sure that it was a good experience for me and to make sure I was present.

Something that was important to me was that my baby would be with me a little bit longer while I was in the OR. I didn’t have my baby with me last time, so I really wanted that. I didn’t necessarily do skin-to-skin, but I got to hold her. She got to be with me the whole time, and it was perfect.

She got to be with me during recovery. That whole birthing experience was just the most beautiful thing.

Meagan: Good. So you have been able to walk away feeling positive about a birth experience.

Kerri: Yes. That’s not something I thought I would get with a C-section.

After my first, I had a lot of postpartum anxiety. I had very negative feelings towards C-sections. I didn’t enjoy seeing my scar. To me, that was just a reminder of what my body had done to me. I felt betrayed by my body, and for the longest time, I just was ashamed of the fact that I had a C-section.

After that experience with my second, I was very proud that I did have a C-section because reality hit me that this isn’t the most ideal way to give birth to a baby, but it happens, and thank God they are available, and I have two beautiful babies because of my C-sections, so I’m very, very thankful for them now.

Meagan: Yes, good. Good.

Kerri: When my husband and I decide to have another one, I’m like, “This will be great because I think that for me, I’ll just have another repeat section, and it will be scheduled. It’s going to be great, and I’m excited about it.” But it’s just something to be able to look back and be able to think of this as such a positive experience as opposed to my first. I wasn’t proud of my birth story at all. It was something I carried with me for a long time, and now, I’m thankful that I can have a different perspective about it. Even about my first, my first birth was beautiful in its own way.

Meagan: Yeah. It’s hard because you don’t want to only think about those births as negative or traumatic. You want to pick out the positivity from it, but sometimes it is hard to see all of that, so it’s been so great to hear that you– one, it sounds like with your labor, it really was a lot of your choice along the way. You decided this was something you wanted. Your team went with you and then walked with you along the way. In the end, it was able to be something that was a lot more healing.

Even though it was still a Cesarean, it was a healing experience for you. You got to have your baby that whole time, and you got to grow through that experience. Like you said, you may choose to have a third C-section, and that’s okay. I think that’s one of the things I love about this podcast is that it’s not if you choose a C-section, you are shamed. That’s just not how it is.

Everyone needs to choose what is best for them and their individual circumstances. I love that you’ve been able to go from the furthest end of the extreme to coming back, and then possibly if you have another baby, it sounds like something that you are already looking forward to having an even different experience. I love that you’ve been able to have that and you can share these stories and you can hold onto these good feelings because it really is important.

Kerri: Yes. Even as a labor and delivery nurse, I feel more positive about taking care of women who have C-sections because for the longest time, every time I went into the OR, it brought up feelings from my own first C-section. It was hard to be the best nurse that I could be when I was dealing with my own feelings, so I’m thankful now that I have this perspective of, “This is beautiful in its own way.” Every birth is beautiful. You’re bringing your baby into the world. Who cares how it happens?

I think we get so wrapped up in God made our bodies to give birth a certain way, and that’s just not the reality for some people. I’m thankful we live in a society where C-sections are readily available and we can have them. They can be just as beautiful.

Meagan: Yeah. CBACs really can be. My second C-section was very, very healing. I think it was exactly what I needed to have healing from my first birth that I didn’t realize I didn’t heal from. I was really, really grateful that I had the experience. Again, it wasn’t the birth I desired, but it was such a better and healing experience for me. I was really, really grateful for those.

Okay, I have two things that I want to talk about. One is preeclampsia. Not even just preeclampsia, but COVID. I was just wondering, as a labor and delivery nurse, have you seen things like preeclampsia or placental issues or anything like that from people who have had COVID during pregnancy?

Rebecca Dekker has such an incredible blog, and I’m going to make sure to link it here. I have seen this weird connection with pre-e with a placenta or placental issues that have had COVID. I was just curious if you’ve seen anything like that.

Kerri: You know, I feel like that is something that we’ve seen more of. I will say I started working as a labor and delivery nurse in 2021, so I can’t speak for what nurses saw prior to this, but I do feel like I see a great deal of preeclampsia, especially during that COVID time. Women were having more complications. More women are getting more sick. I don’t know if there’s a correlation, but I will say that as far as pregnancy goes, it does seem like a lot of pregnancies are becoming more high-risk.

Meagan: Because of that? Because of COVID?

Kerri: I don’t know if it’s necessarily COVID or just the way we eat, the way we take care of ourselves, but I feel like during COVID, there were a higher number of combinations whether there’s a correlation or not.

Meagan: Yeah, that’s interesting. I just barely read the most recent update. I need to dive into that more, but I was wondering as a labor and delivery nurse if you had seen that.

You mentioned with your first that they had tested you, and your magnesium levels were too high. Are there things that can reduce magnesium levels? Obviously, maybe lowering the magnesium levels that are given, but are there things that can be done in that situation to lower their magnesium levels?

Kerri: If your magnesium level is high, we can give you the reversal drug which is calcium gluconate. We can give you that, but we are already inducing, you and it’s high, and you’re not making very much progress, at that point–

Meagan: The provider may not be wanting to do that.

Kerri: Yeah, delivery is the best option.

Meagan: Yeah, for preeclampsia, which we do know. I was just wondering if there was such a thing that could help.

Kerri: Yeah. Ideally, just do what you can to deliver. But you know, that’s something that people should talk to their provider about in that moment.

Meagan: Yeah. I agree. I agree.

Then last but not least, I just wanted to share a little bit more because I think a lot of people do question induction and VBAC. What are the risks? Sometimes, the risks seem astronomical, and sometimes they are not to some people. Everyone takes it differently. I wanted to share some evidence on that.

With the risk of induction, it does increase just like you had mentioned. It does increase the risk of uterine rupture when we are induced. It’s about a 1.1% if you have Pitocin and about a 2% if you have prostaglandins, and then of course, we know misoprostol. How do you say that?

Kerri: Misoprostol, but however you want.

Meagan: Yeah. I saw misoprostol, but I’ve heard people say MYsoprostol. It is about 6%. It definitely increases with certain things that you do. It’s about a 1.1%. Uterine rupture in general is just around 1%. It increases it ever so slightly, but it’s really important to take the right precautions. A Foley bulb is a fantastic way to start jumpstarting labor, but sometimes it does need to have a little bit of an opening, at least 1 centimeter.

Kerri: Where I work, we don’t do Cytotec for TOLACs.

Meagan: Most people shouldn’t..

Kerri: It’s a 1 to 1 assignment. Your nurse who is taking care of you wouldn’t have another patient.

Meagan: Interesting.

Kerri: They make sure that all hands are on you and make sure that your uterus is okay. When it came down to me when I was thinking about wanting to TOLAC and hopefully have a VBAC, I looked at the risk. I think it’s important. I listened to a podcast. I think it was by Jordan Lee Doulie. She had an OB on her podcast talking about VBAC. He said, “It’s important to remember that there is a risk whether you’re having a repeat section or you’re having a TOLAC.”

I really took that to heart. For me, the risk of uterine rupture is small enough that I want to try. I know that I’m going to be in a hospital. I know I’m going to be monitored, and if that’s something that’s happening, I know I’ll be taken care of quickly. I was okay taking the risk. I think that has to be such an individual choice. It does carry risk as well, so that’s why I needed to at least give it a shot.

I’m somebody that I fully support whoever wants to have a VBAC after two sections, but for me, that’s not something I want to do. But as with everything, you have to look at both sides of it and make your decision.

Meagan: Yeah. I think that’s what we talk about on this podcast. Learn the risks. Learn the facts. Learn what the evidence says, and then follow your heart. What feels right? I appreciate you so much for coming on and sharing your journey. I do love how much you were able to be a part of your birth that second, and then also your postpartum experience is so important.

Kerri: Oh yeah. I’m 11 weeks postpartum now, and I just have to say that my mental health this time is so much better, and my recovery post-C-section was so much better. I really have such positive things to say. It was such a good experience. I’m forever grateful for everybody who took care of me. I’m forever grateful for my provider. I just love her dearly and am just so thankful for her.

Meagan: Good. I’m so grateful for you. I’m so glad you had that support and that loving team. Thank you again for sharing.

Kerri: Yes. Thank you so much for having me on here.

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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