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Episode 355 Alma's Precipitous VBAC After an Induced Labor for Gestational Diabetes Turned to a Cesarean

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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.

Alma’s first birth was an emergency Cesarean after an induction at 40 weeks due to gestational diabetes. Due to COVID-19 policies, Alma’s husband was not allowed into the OR. She did not expect the induction process to end the way that it did, and felt robbed of the positive birth experience she hoped to have.

Alma made sure to educate herself on all of her options for her second birth. She was very proactive about her health and did not have gestational diabetes the second time. She went into labor earlier than she expected at 38 weeks. She woke up in the middle of the night to her water breaking, and intense contractions began.

Within minutes, Alma knew she had to go to the hospital immediately. Alma felt pushy as they made the 45-minute drive. She was admitted to a room, and her beautiful baby was born just two pushes later!

Evidence Based BirthⓇ: Induction for Gestational Diabetes

The VBAC Link Blog: VBAC with Gestational Diabetes

Birth Ball Amazon Link

Needed Website

How to VBAC: The Ultimate Prep Course for Parents

Full Transcript under Episode Details

Meagan: Hello, hello. It is almost the end of November. It is crazy to think that the year is coming to an end. But guess what, you guys? We still have so many amazing stories coming your way. Today’s story is from our friend, Alma. I’m already messing it up. It looks like Alma, but you say it. Tell me how to say it correctly.

Alma: Alma, but any way you say it is fine.

Meagan: Perfect. I want to say it correctly though. She is sharing her stories today. Now, you are in New Jersey now, but you weren’t in New Jersey when you had your VBAC. Is that correct?

Alma: When I had the C-section, I was in New Jersey, so we just zigzagged a little bit.

Meagan: So she’s in New Jersey, but the VBAC wasn’t in New Jersey. I know a lot of people when they are listening are like, “Where was this VBAC?” We will talk a little bit more about that when we get into the story, but let’s give them a little teaser of what your episode is going to be.

Your first C-section, I feel like was the steps. It was the steps or the cascade, and then a little bit of what you went through. Tell us a little bit of a teaser before we get into the episode.

Alma: I had a lot of interventions in my first pregnancy and did end in an emergency C-section, then for my son, my second pregnancy, it was exactly the opposite. There wasn’t time for any intervention. He just flew out. My whole labor was 2 hours from the first contraction to when he was born. I almost delivered in the car. He was too fast, but it was exactly the experience that I wanted to have.

Meagan: Yes. Oh my gosh, so a precipitous labor after a lot of interventions, an induction, and all of these things. I’m so excited to get to this episode today, but we do have a Review of the Week. As usual, if you haven’t done so yet, please leave us a review. We absolutely love them.

Okay, this episode reviewer is Desiree Jacobsen. She actually just left this review this year in August of 2024. It says, “Thank you”. It says, “This podcast and parent’s course is amazing. I’m not a VBAC mom, but I have been listening since 2020. I binge-listen toward the end of pregnancy to remember everything I need to remember in the birth process through my previous births. This time around, I felt more prepared than ever before having plans in place just in case. We were able to have a quick birth for my fifth baby. I love the education, passion, love, and support this podcast gives. I recommend it to everyone I know, and I have learned so much from it. I am so grateful for this podcast. Thank you”.

Oh, I love that. I love that, love that, love that. That was actually sent to us via email. If you didn’t know, you can email your reviews at info@thevbaclink.com. Your reviews on the podcast and on Google are what truly help other Women of Strength find this platform and find the courage and the information that they need to choose the birth that they desire.

Okay, girl. Let’s get into this story. So first birth, lots of interventions. Let’s talk about it. One, what types of interventions, and two, why? What led up to needing those interventions or I don’t know if it’s “needing” or really medically needed? Tell us more.

Alma: Well, my first pregnancy was very normal and healthy up until I was diagnosed with gestational diabetes. That’s where things started to change a little bit. I just failed the test by just a point, so my blood sugar was elevated, but it wasn’t as bad as it could be. I wasn’t even on insulin. I was just on diet control.

Everything was going fine so I thought, but I would say a week before my due date, I was told that I needed to be induced because of the gestational diabetes. That was the first red flag of things going out of my control because I didn’t expect to be induced. Although I had gestational diabetes for a while already, I wasn’t told that this would probably be the case that I would be induced.

I agreed to the induction of course. I understand why it’s done, so I went along with it. I think my daughter just did not want to be born. On that day at least, we went in on my 40th week, and I was on Pitocin for hours, and it did nothing.

I tried some exercises. I tried a bunch of things. Nothing worked.

Eventually, the doctor suggested to manually break my water. That’s where I wish I had asked to do other things first. I wish I had rejected that choice, but I went along with it.

From that point, the labor went from 0 to 1000. I was in so much pain in a matter of minutes. Everything happened so fast, and I wasn’t ready for that. I asked for an epidural really fast. I got the epidural, and that’s also when things got worse because my blood pressure started to decrease.

I didn’t know that could happen actually. Later on, I scoured through every detail of what happened, and I tried to figure out exactly what went wrong. I realized that could happen with an epidural. When your blood pressure is affected, of course, the baby’s blood pressure is affected so my daughter started to have some fetal decelerations. It was very concerning.

They put me on my back to deliver to push her out. I wasn’t even 10 centimeters yet. They were going to stretch me, but her blood pressure just declined in a way that was really concerning. I was rushed to the OR and the C-section was done.

Everything happened so fast. I hesitate in using the word traumatic just because in the end, everybody was fine. I was fine. My daughter was fine. She was healthy, but it was very traumatic because nothing was in my control in that moment. I felt almost robbed of the experience that I expected to have.

That was my first birth.

Meagan: Well, and when things are rushed like that and you are left in a sense of– you said panic, but in a sense of urgent need to save something or save someone, it does. It sets all of your alarms off.

Alma: That’s exactly what happened.

Meagan: Everyone has trauma differently. They view trauma differently. Someone may see one things as traumatic, and someone would be like, “How is that traumatic?” It’s okay, I think, that you’re using that word because that is how you are perceiving this. Your feelings and your alarms that were going off in your body as everything was being rushed and all of these things left that traumatic feeling.

Alma: Yeah, definitely. In that moment, I felt like I couldn’t breathe. At this time too, there were a lot of COVID restrictions, so my husband wasn’t let into the OR. It was like, “What happpened to her?” He was more concerned than me probably. He thought both of us were going to die, my daughter and myself. It all just happened so quickly.

Thankfully, we were okay in the end, but I had no idea I would be coming back with a C-section scar. That requires more recovery. As a new parent, we were already new to everything. It was a lot to deal with, I think.

Meagan: Yeah, what you were saying, I’m sure your husband had a lot of trauma through that experience too. We know that COVID especially– I mean, birth in general comes with a lot of things especially the unexpected, but when you through COVID in with that, it’s a lot of ick. It’s a lot of icky feelings. It’s a lot of ick.

Alma: Yes.

Meagan: So everything was good. Baby was good. You were good. Overall, it was a less-ideal situation, but where did that leave you after you had the baby and you were starting to recover? Where was your mind?

Alma: I think I had to process a lot of what happened. I think I went into the first pregnancy very naive. It’s important to be educated, and I really appreciate this podcast for that reason to encourage us to be educated. It’s not that we are doctors. At least, many of us are not medical professionals, but we need to be aware of our bodies and just what the process looks like, and even some terminology. I was totally clueless on everything. I think that what I tried to do in between both pregnancies was just learn. What’s going on in my body? What can I say no to in terms of interventions?

You don’t have to agree to everything. I never want to argue with a doctor of course, but if I really feel like that’s not the best choice, I can always ask for another choice. I can consider other options.

Meagan: Yes.

Alma: I just didn’t know I could do that the first time. I definitely tried to educate myself as much as possible, and I think that contributed a lot to how the second delivery went.

Meagan: Yeah. I just wanted to thank you so much for pointing that out and seeing that because if I were to guess, we all didn’t know that. We may have heard that you can always say no, but I don’t if we realized how much we really could say no to or ask for another opinion. Maybe we knew it, but didn’t really feel like we could.

It can be hard. It can be hard to say no, but I love that you are like, “I want a different option. I’m going to say no to this right now. Give me another option.” It’s always okay.

Alma: Definitely, definitely. Wanting to wait if the time allows, “Can we try this later?” There’s a conversation that needs to happen. It doesn’t have to be one thing that is suggested.

Meagan: This way or no.

Alma: For sure.

Meagan: Where did your education start stemming from? Where did you start when you were like, “Okay, I want to do something different next time”?

Alma: The podcast. The VBAC Link. I listened to a bunch of podcasts. There is All Things Pregnancy with Dr. Nicole Renkins, and of course, The VBAC Link Podcast.

Meagan: We’ve had her. We love her.

Alma: That’s just what I did all the time before I went to bed. I’d listen to an episode driving. I’d listen to an episode. It was very helpful. I felt like I could digest information better that way as opposed to reading, so that was a very helpful tool.

I also tried to find professionals around me who could speak to my specific situations. I had a doula, and of course, I had my providers as well. They were all so helpful with helping me navigate some of the things that might have gone wrong the first time, and how I could prevent them going forward.

Meagan: When they talked about some of the things that maybe went wrong the first time– I don’t want to say wrong. They went south.

Alma: Yes.

Meagan: I don’t know why people say that. I love south. I love the south. What were the kinds of things that stood out to them?

Alma: Well, I think the first thing was the induction in the first place. I completely understand the risk with gestational diabetes, but I think there could have been more conversations with that in my specific case. Seeing as I did not have diabetes that was really out of control, it was very well controlled with my diet, and there could have been room to say, “Maybe we can go a couple days past my due date.” I wouldn’t recommend that for everyone. I think it depends on your case, but I could have tried to have that dialogue, and maybe we didn’t need to have an induction.

I also could have considered different methods of induction, and I think that was the first thing because I felt like that was the first domino piece. If I didn’t have the induction, it might not have led to a C-section in the first place.

Another point was also the breaking of the water. Those things, I could have just said, “Let’s wait.” I was already there for the induction, so I could have just asked for a little more time.

But the big point for me too was the epidural. That was, I think, the immediate reason for the fetal distress.

Meagan: The response.

Alma: The response, yeah. Understanding how I could avoid that. I was told that now with the second epidural, I may not have the same reactions because I’ve had it before. Also, if you get flushed with some IV fluids–

Meagan: Yeah, I was going to say if you hydrate and not even just intravenously, but literally drinking water before. If you know that you’re going to want to get an epidural, or it’s heading that direction, start hydrating. The more you can hydrate, the better.

Alma: So I learned those things, then also, I tried to prepare myself for not even having an epidural, although that wasn’t my goal, because I experienced the pains before. Even though I had the C-section, I went through some labor pains. I was accepting the fact that I might just need the epidural, but I considered that as well. How can I overcome this pain without any kind of medication?

Those were things I was trying to consider about how we could do it differently so it doesn’t result in the same thing.

Meagan: Okay, I love those tips. So now, you’re pregnant, and we have baby number two. Tell us this journey.

Alma: Yes. I guess from the time of conception, it was about 18 months apart from the C-section. My pregnancy went perfectly fine. There were no issues. The difference being I had a toddler, so I was more active, of course. I was on my feet. I took at least 10,000 steps a day. I didn’t sit much just because of my daughter. I think that definitely helped in preparing my body.

I was really focused on how I can work on my pelvic floor and was just preparing for what it would take to push a baby out.

I also did a lot of exercises that I found online. I never did a class or anything, but these were just Instagram videos where you could see the top three videos for strengthening your pelvic floor and things like that that were just free and available. I had an exercise ball that was a lifesaver. I highly recommend that exercise ball for anybody who is pregnant, especially in the third trimester. You can sit on it. You can lean on it. You can squeeze it between your knees. All of those things provide relief, but they also strengthen your muscles down there.

I did the Miles Circuit. All of those things were super helpful, and I did it daily to prepare my body.

I guess going into the actual labor, I’ll start by saying that first of all, I didn’t have very supportive providers. I learned from this podcast that that’s very important. I do 100% agree that it’s half the battle if you have someone who is on your side and wants to help you make intelligent decisions. I would say my providers were not completely unsupportive, but there were a lot of policies from the hospital side that I think restricted them from encouraging a VBAC. There were a lot of if’s, and’s, and but’s. There were so many stipulations for when or if I could have a VBAC.

Meagan: Can I ask which ones stood out where you were like, “These for sure are alarms”?

Alma: The biggest one was that I would have to deliver before 40 weeks. I felt statistically that doesn’t happen. People usually birth after their due dates, so I felt like I was already set up for, this is not going to happen probably. I felt really discouraged by that.

Also, I guess the due date was a big thing, but also if I were to have gestational diabetes again, then the whole conversation on the doctor’s side was just completely mute. I would just need to go for the induction if I had gestational diabetes. Statistically, you do have it with each subsequent pregnancy according to what I have known.

I was also expecting, okay. I’m most likely going to have gestational diabetes. I’m most likely not going to give birth before 40 weeks. It seemed like I was most likely going to have to agree to a C-section.

Those things were not encouraging, but I did feel like the doctors were trying to help me find some safe loopholes. One of them being that they had to– I don’t know if this is law, but they had to schedule me for the C-section even though I didn’t want one. But they explained to me that I could go in and say to them that I didn’t want a C-section. I could ask for more time. I could ask to be induced, and hopefully, the induction wouldn’t lead to a C-section although it could. I guess they were trying to explain to me that there are some routes you could take, but given the fact that you had a previous C-section, we do have to just assume that you’re going to have another one.

I felt really alone on that journey of trying to do something that I felt like I could do, especially given that the reason for the first C-section was an emergency. I was dilated. It wasn’t a failure to progress. I felt like my body was perfectly primed to do it, but because of time, we had to go for the C-section.

I also had to have some conversations with myself accepting that if I do need to have another C-section, it’s not the end of the world. I guess what frustrated me about the first time was that I felt like I didn’t need to have it. C-sections save lives. They’re great tools when they’re needed, but I felt like I didn’t. Aside from the distress and all of that, I felt like I didn’t need it, so I wanted to really try for this vaginal birth.

I was just in between trying to accept what might happen, but still trying to hold on to what I believed I could do.

So, I guess fast forward to my 37th week, I had an appointment and I had to sign off that I would come in for a C-section, but my plan was to go in that day. This was on the 39th week. I would have the C-section. I could go in and say that I didn’t want to have it.

On the night of my 38th week, my husband just finished putting together the crib, and it was midnight. He put together the crib. We went to sleep, and at around 2:45, I wake up because I thought I peed on myself. Now, I think I realize that it was my water leaking. I got up, and at that point, I had maybe cramping, but it wasn’t really painful.

To make a long story short, 10 minutes later, I was having full-on contractions. They were super painful. I got out my phone to time it, and within two taps, the app was telling me to go to the hospital now. It was two taps. Everything was happening so fast.

Meagan: They were coming so close.

Alma: Yes. They were so close. I don’t remember how to count them. All I did was tap, and it was telling me to go. This was at 38 weeks, so I honestly didn’t have anything ready. I didn’t have my bags ready or nothing. Within a matter of minutes, I was just on the floor trying to remember the HypnoBirthing and everything, but it was all slipping because it happened so fast.

We get in the car, and I’m still in a whole lot of pain. At a certain point though, I got a grip. I was doing this Christian HypnoBirthing which really helped me. I finally grasped myself and was able to calm down, but the pain accelerated very, very fast.

At a certain point, though, I started to feel a lot of pressure. I was still driving, by the way. We had about a 45-minute journey to the hospital. I started to feel a pressure to push. I just couldn’t resist it, so I pushed. I hammered down really hard. It sounded like a fire hydrant was cracked open. My water busted open in the car. I’m sitting behind the driver’s seat on my knees, and my water just gushed open.

At that point, I really felt like he was coming out. I couldn’t hold back the desire to push because it also relieved the pain a little bit. It was more like a pressure as opposed to a pain. I just gave into that feeling, but I did feel like he was between my knees and was about to come out.

My husband made a few wrong turns, but eventually, we got to the hospital. I couldn’t even sit, actually. They put me in a wheelchair to go to the place where you would give birth. I couldn’t sit down. He was just about to come out, and when I got there, I was already beyond 10 centimeters at that point.

Later, the doctor told me when she came down to see me that she could already see the hair of my son’s head. He was already so close. Remember, the talk about the epidural? I wanted the epidural. I was asking the security guard, the person at the front desk– everybody I saw, I was asking for the epidural. I noticed that they didn’t respond to me on that. I overheard them telling my husband that it was way too late for the epidural. My son was already halfway out, and they couldn’t give me the epidural.

Once the doctor came, she told me to give a good push. I pushed one time. His head came out. The second time I pushed, he flew out. I had five nurses dive in to grab him.

Meagan: Oh my gosh.

Alma: He was born, and that was the whole thing. It was super duper fast, unmedicated, and yeah. The most touching part to me was that he came out, and they put him on my chest. That was all I wanted. When my daughter was born in the C-section, I had to beg them to let me see her. I didn’t see her until minutes later. I didn’t hold her until the next day, but this time, they put her right on my chest, and it was just so redemptive. It was everything that I really wanted to experience.

Meagan: Absolutely. It was probably a lot all at the same time, very shocking, but then to have that baby be placed on your chest, oh, what an amazing moment for you.

Alma: Yes, yes. It was.

Meagan: Oh my goodness. Super fast.

I was just going to say that was super fast.

Alma: It was. It was so fast. I think this is a thing with my kids. For my daughter, too, when they broke my water, everything went very fast. I don’t know. They are just really urgent, but my son was definitely in a rush. He came very, very fast.

Meagan: Did your doula even make it?

Alma: No, she didn’t. She did not. She couldn’t. It just happened too fast. She didn’t make it on time, but she was happy to hear everything went fine.

Meagan: Yes, of course. Of course. Oh my goodness. So after you had the baby, and you had him on your chest and everything, did all of the rest of everything go okay and smoothly?

Alma: Yeah. I was bleeding a lot, and that was a concern, but I thankfully recovered fine from that. I had a second-degree tear which I hear is not terrible for the first time doing that. So yeah. I recovered pretty quickly afterward.

In my experience, it really didn’t compare at all to the C-section recovery. I was in a lot of pain after my C-section, but this time, it was just maybe a week or two of taking some pain medication for the stitches and stuff, but overall, I was fine. Yeah. I was able to go home the next day actually, so that was also very good.

Meagan: The next day? That is awesome.

Alma: Yeah.

Meagan: How did your medical team feel about it? Did they say anything? Did they have any worries?

Alma: Everyone was just so shocked at how quickly everything took place. I think that was the main theme was just the speed, and also how determined my son was. With just two pushes, he just came out really fast. The concern of obviously dropping him because they all dove in to get him. I think that was the talk. This happened in the morning, so the whole rest of the day, they were just chatting about how quickly everything happened.

Meagan: Oh my goodness. I bet. I think sometimes those births are kind of a lot for medical staff where you come in and your baby is crowning, but I feel like those births are the type that they really do talk about for a really long time, and they were like, “Look at this.”

A lot of the times, here in Utah, anyway, they call them stop and drops where you show up at 10 centimeters. You just stopped in and dropped your baby. I feel like in a lot of ways, it shows people that labor can happen at home, and then you come and it can so beautifully happen without getting an IV, getting a heart trace, setting up fluids, doing this, having a cervical exam. There is just so much that doesn’t need to happen, and I love when medical staff can see that birth can just happen like that. It really, really can if we just leave it be.

Alma: Yeah. That’s exactly another point of how I felt before because I had gestational diabetes, and because I had a previous C-section, they did make it sound like I needed to be hooked up to every machine, and I could never give birth at home. I just felt almost like a robot connected to everything. That’s how it had to be, but yeah. This time, I wasn’t even in a hospital gown. It was just so organic how it happened. That was exactly what I wanted to experience, but I think it was a good experience for the nurses as well to see that it was okay. I was fine without the IV and the other stuff.

Meagan: Yeah, I love that.

You had listed some tips. One of them was doing pelvic floor exercises on the ball which we kind of talked about. I love the ball so much. If you guys are interested in a ball, I’m going to link a ball in the show notes because they are actually really inexpensive and can do a lot of really good things.

What other tips do you have for someone preparing for a VBAC?

Alma: The number one tip which I’ve heard constantly here is about being educated and understanding what your options are. Unfortunately, I think that most providers are not going to make it easy to have a VBAC just because of the risks that are associated with it. Of course, they may have your well-being in mind, but there are also a lot of hospital policies and protocols that they need to follow. They may not make it easy, but if you understand what your options are and what the research says, it opens the door for dialogue.

When you open that conversation, I think you will find that doctors will probably give you more options than what they may have initially suggested. I always spent time talking with the doctors about, “So what if this happens? How about this? How about that?” I feel like that did wiggle in some room for me to not do things just following the protocol.

Meagan: Yeah.

Alma: That’s really important.

Meagan: It’s so interesting how if you show up showing that you’re educated, there’s this different sense of– I don’t want to say respect, but I do want to say respect because I feel like these providers are like, “Oh. They get it. They understand. I can’t just say whatever. This needs to be an educated discussion.” It should always be like that, but I also think a lot of the times, providers don’t have time to really sit down and talk about the evidence, or their evidence is flawed because of personal experience. When you come in and you’re like, “Hey, what about this?” and they’re like, “Oh, she knows stuff,” it just really gives you some wiggle room. It gives the providers respect just a little bit more because they realize how important this is that we are educating ourselves. We are learning. We know the options, and we’re not just going to be like, “Okay, cool.” I love that tip.

That, and finding the supportive provider. In the beginning, you had said that the hospital policies may have trumped these providers’ stance. I think not only just finding your supportive provider, but really understanding the hospital policy. You can call, and you can talk to the head nurse. You can talk to the board and the directors of the hospital. You can say, “Hey, I need to know the hospital policies surrounding VBAC.”

Alma: Yeah. You know, I believe it was on this podcast where someone mentioned that the best way to know how a provider feels about a VBAC is just to ask them very straight, “What do you think about VBACs?” Their expression will say it all. You don’t have to have a preamble about it. Just ask directly, and I think that helps. I definitely did that. It wasn’t favorable in my case, but I definitely think looking into the hospital C-section rates is really important too. How often do they have C-sections? How often do they have VBACs? If they have that information available, that’s also really helpful.

In my case, I found out too late that it wasn’t the highest, but it was pretty high. Also, from this podcast, I learned that it’s never too late to switch providers if you want to. I didn’t take that route. I stuck with who I was with, but I guess I was just trying to be adamant with what I wanted to do as much as possible.

Meagan: Absolutely. Do you have any tips on how to possibly find the hospital’s Cesarean rate? It used to be out there on cesareanrates.org. It used to be out there, and you could look up your hospital. You could look up your state. You could look up your provider, even. That’s gone down a little bit and changed a little bit, but do you have any advice if someone is wanting to know their hospital’s Cesarean rate?

Alma: In my case, I just searched the hospital name and the Cesarean rate. This was a pretty big hospital. This was in Florida. It was a hospital with a very big network, so that information was readily available on their website. You do need to dig around, but it was on their website. If you are dealing with a big hospital with many departments and so on, they may have that information on their website easily with a Google search.

You could also talk to people who work at the hospital as well. If it’s not online, I think that information is quantified normally. They might not quantify how many VBACs they have, but definitely the C-section rate is information that they are following and tracking.

Meagan: Yeah. I feel like it’s always fair to ask your provider, “What’s your Cesarean rate?” A lot of the time, they will say, “I don’t know.” They know. They know. That’s something that they need to be able to give you. It’s okay to ask that. “What percentage of your deliveries end in a Cesarean?”

Alma: Yeah. Being direct is really the easiest way to know clearly where they stand.

Meagan: Yeah, absolutely.

I wanted to really quickly talk just slightly about gestational diabetes. There’s a lot when it comes to gestational diabetes. We know, just like you had experienced, that most providers suggest an induction. They just do.

According to the American Pregnancy Association, gestational diabetes occurs in 2-5% of pregnancies which is decent. For those who are at a higher risk in their pregnancy, it may be even higher up to 9%, but a lot of them are controlled like yours were through diet or even through insulin and things like exercise. A lot of people are controlling them.

Evidence Based BirthⓇ, which I want to make sure that this is linked in our show notes and our blog so if you want to go read more about gestational diabetes or you had gestational diabetes with your last pregnancy and you may have it again, definitely go check it out. They talked about how there is actually very little data in how often people are actually induced because of the diagnosis of gestational diabetes.

But in one of the retrospective studies, they found that out of 330,000 births from 2001-2007, they saw– okay, let’s see. It says, “The people in the study came from six health insurance plans, many different hospitals and regions, and represented a large and diverse population. Health insurance plans datas were linked to birth certificate data in order to improve accuracy compared to using birth certificates alone.”

Going down a little bit further, they said, “Overall, 30% of labors were induced. When they looked at the reasons for induction, 59% of labors were induced for an accepted medical reason and 41% were considered to be elective.” Those are pretty big numbers to me.

Alma: Yeah. Yes. Yeah, those are big.

Meagan: Yeah, those are really big numbers. It goes on. It talks about, does gestational diabetes always mean induction? What’s the evidence for randomized controlled trials? They go way into it because Rebecca Dekker is amazing, and their team is incredible. We will also have our blog linked because I believe this is a really important topic to know more about especially if you’ve had it so you can make the right decision. And how you said, you were like, “I was in a controlled state. Everything was controlled through my diet, and I could have likely gone further,” but you didn’t. You weren’t really encouraged to go further. It was like, “Let’s induce.”

Alma: Yeah, it literally was just like that. There was no conversation about it.

Meagan: Yeah. No conversation about it. I think that’s where we’re going wrong a lot in the medical system. A lot of the time, there is no conversation. Even though we have the power to start that conversation, sometimes it’s really difficult when we’re being told, “Your provider thinks this. Your baby is in danger. You’re in danger if you don’t do these things.” It’s like, “Okay. Okay. I’ll do those things,” but we need to have those conversations. I think that again, having the education and knowing the evidence behind it, and the risks and the benefits and all of those things, it will help you have that conversation if and when the time is needed.

So, thank you so much for chatting with us today and sharing your stories and giving us advice, and leaning into more conversations for gestational diabetes. I think it’s something that is happening. A lot of people are getting it. There are things we can do even before pregnancy like really increasing our protein and things. But sometimes, it just happens. It just happens.

Alma: I will say just to be clear, the second pregnancy, I did not have gestational diabetes.

Meagan: Okay.

Alma: That was also something. That was my biggest concern. The two points I mentioned were that the conditions were that I couldn’t have gestational diabetes, and I needed to deliver before 40 weeks. But this goes along with education. I did my best to improve my diet even pre-pregnancy to avoid that diagnosis. It was actually a miracle that my blood test came back really well. I almost thought this was the wrong test because it wasn’t elevated at all. I was really, really thankful that through some dietary changes and lifestyle changes, I didn’t have gestational diabetes at all.

Then the second point about giving birth before 40 weeks, it was a spontaneous labor at 38 weeks which also was so supernatural. I really thank God. Everything happened really perfectly. Yeah. That was really a blessing.

Meagan: Yes. Oh, thank you so much for everything. You are amazing.

Alma: Oh, thank you.

Meagan: We just love you.

Alma: Thank you so much. I had a great time sharing the story, and I hope it encourages other women as well.

Meagan: It will, for sure.

Alma: Great.

Closing

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Alma’s first birth was an emergency Cesarean after an induction at 40 weeks due to gestational diabetes. Due to COVID-19 policies, Alma’s husband was not allowed into the OR. She did not expect the induction process to end the way that it did, and felt robbed of the positive birth experience she hoped to have.

Alma made sure to educate herself on all of her options for her second birth. She was very proactive about her health and did not have gestational diabetes the second time. She went into labor earlier than she expected at 38 weeks. She woke up in the middle of the night to her water breaking, and intense contractions began.

Within minutes, Alma knew she had to go to the hospital immediately. Alma felt pushy as they made the 45-minute drive. She was admitted to a room, and her beautiful baby was born just two pushes later!

Evidence Based BirthⓇ: Induction for Gestational Diabetes

The VBAC Link Blog: VBAC with Gestational Diabetes

Birth Ball Amazon Link

Needed Website

How to VBAC: The Ultimate Prep Course for Parents

Full Transcript under Episode Details

Meagan: Hello, hello. It is almost the end of November. It is crazy to think that the year is coming to an end. But guess what, you guys? We still have so many amazing stories coming your way. Today’s story is from our friend, Alma. I’m already messing it up. It looks like Alma, but you say it. Tell me how to say it correctly.

Alma: Alma, but any way you say it is fine.

Meagan: Perfect. I want to say it correctly though. She is sharing her stories today. Now, you are in New Jersey now, but you weren’t in New Jersey when you had your VBAC. Is that correct?

Alma: When I had the C-section, I was in New Jersey, so we just zigzagged a little bit.

Meagan: So she’s in New Jersey, but the VBAC wasn’t in New Jersey. I know a lot of people when they are listening are like, “Where was this VBAC?” We will talk a little bit more about that when we get into the story, but let’s give them a little teaser of what your episode is going to be.

Your first C-section, I feel like was the steps. It was the steps or the cascade, and then a little bit of what you went through. Tell us a little bit of a teaser before we get into the episode.

Alma: I had a lot of interventions in my first pregnancy and did end in an emergency C-section, then for my son, my second pregnancy, it was exactly the opposite. There wasn’t time for any intervention. He just flew out. My whole labor was 2 hours from the first contraction to when he was born. I almost delivered in the car. He was too fast, but it was exactly the experience that I wanted to have.

Meagan: Yes. Oh my gosh, so a precipitous labor after a lot of interventions, an induction, and all of these things. I’m so excited to get to this episode today, but we do have a Review of the Week. As usual, if you haven’t done so yet, please leave us a review. We absolutely love them.

Okay, this episode reviewer is Desiree Jacobsen. She actually just left this review this year in August of 2024. It says, “Thank you”. It says, “This podcast and parent’s course is amazing. I’m not a VBAC mom, but I have been listening since 2020. I binge-listen toward the end of pregnancy to remember everything I need to remember in the birth process through my previous births. This time around, I felt more prepared than ever before having plans in place just in case. We were able to have a quick birth for my fifth baby. I love the education, passion, love, and support this podcast gives. I recommend it to everyone I know, and I have learned so much from it. I am so grateful for this podcast. Thank you”.

Oh, I love that. I love that, love that, love that. That was actually sent to us via email. If you didn’t know, you can email your reviews at info@thevbaclink.com. Your reviews on the podcast and on Google are what truly help other Women of Strength find this platform and find the courage and the information that they need to choose the birth that they desire.

Okay, girl. Let’s get into this story. So first birth, lots of interventions. Let’s talk about it. One, what types of interventions, and two, why? What led up to needing those interventions or I don’t know if it’s “needing” or really medically needed? Tell us more.

Alma: Well, my first pregnancy was very normal and healthy up until I was diagnosed with gestational diabetes. That’s where things started to change a little bit. I just failed the test by just a point, so my blood sugar was elevated, but it wasn’t as bad as it could be. I wasn’t even on insulin. I was just on diet control.

Everything was going fine so I thought, but I would say a week before my due date, I was told that I needed to be induced because of the gestational diabetes. That was the first red flag of things going out of my control because I didn’t expect to be induced. Although I had gestational diabetes for a while already, I wasn’t told that this would probably be the case that I would be induced.

I agreed to the induction of course. I understand why it’s done, so I went along with it. I think my daughter just did not want to be born. On that day at least, we went in on my 40th week, and I was on Pitocin for hours, and it did nothing.

I tried some exercises. I tried a bunch of things. Nothing worked.

Eventually, the doctor suggested to manually break my water. That’s where I wish I had asked to do other things first. I wish I had rejected that choice, but I went along with it.

From that point, the labor went from 0 to 1000. I was in so much pain in a matter of minutes. Everything happened so fast, and I wasn’t ready for that. I asked for an epidural really fast. I got the epidural, and that’s also when things got worse because my blood pressure started to decrease.

I didn’t know that could happen actually. Later on, I scoured through every detail of what happened, and I tried to figure out exactly what went wrong. I realized that could happen with an epidural. When your blood pressure is affected, of course, the baby’s blood pressure is affected so my daughter started to have some fetal decelerations. It was very concerning.

They put me on my back to deliver to push her out. I wasn’t even 10 centimeters yet. They were going to stretch me, but her blood pressure just declined in a way that was really concerning. I was rushed to the OR and the C-section was done.

Everything happened so fast. I hesitate in using the word traumatic just because in the end, everybody was fine. I was fine. My daughter was fine. She was healthy, but it was very traumatic because nothing was in my control in that moment. I felt almost robbed of the experience that I expected to have.

That was my first birth.

Meagan: Well, and when things are rushed like that and you are left in a sense of– you said panic, but in a sense of urgent need to save something or save someone, it does. It sets all of your alarms off.

Alma: That’s exactly what happened.

Meagan: Everyone has trauma differently. They view trauma differently. Someone may see one things as traumatic, and someone would be like, “How is that traumatic?” It’s okay, I think, that you’re using that word because that is how you are perceiving this. Your feelings and your alarms that were going off in your body as everything was being rushed and all of these things left that traumatic feeling.

Alma: Yeah, definitely. In that moment, I felt like I couldn’t breathe. At this time too, there were a lot of COVID restrictions, so my husband wasn’t let into the OR. It was like, “What happpened to her?” He was more concerned than me probably. He thought both of us were going to die, my daughter and myself. It all just happened so quickly.

Thankfully, we were okay in the end, but I had no idea I would be coming back with a C-section scar. That requires more recovery. As a new parent, we were already new to everything. It was a lot to deal with, I think.

Meagan: Yeah, what you were saying, I’m sure your husband had a lot of trauma through that experience too. We know that COVID especially– I mean, birth in general comes with a lot of things especially the unexpected, but when you through COVID in with that, it’s a lot of ick. It’s a lot of icky feelings. It’s a lot of ick.

Alma: Yes.

Meagan: So everything was good. Baby was good. You were good. Overall, it was a less-ideal situation, but where did that leave you after you had the baby and you were starting to recover? Where was your mind?

Alma: I think I had to process a lot of what happened. I think I went into the first pregnancy very naive. It’s important to be educated, and I really appreciate this podcast for that reason to encourage us to be educated. It’s not that we are doctors. At least, many of us are not medical professionals, but we need to be aware of our bodies and just what the process looks like, and even some terminology. I was totally clueless on everything. I think that what I tried to do in between both pregnancies was just learn. What’s going on in my body? What can I say no to in terms of interventions?

You don’t have to agree to everything. I never want to argue with a doctor of course, but if I really feel like that’s not the best choice, I can always ask for another choice. I can consider other options.

Meagan: Yes.

Alma: I just didn’t know I could do that the first time. I definitely tried to educate myself as much as possible, and I think that contributed a lot to how the second delivery went.

Meagan: Yeah. I just wanted to thank you so much for pointing that out and seeing that because if I were to guess, we all didn’t know that. We may have heard that you can always say no, but I don’t if we realized how much we really could say no to or ask for another opinion. Maybe we knew it, but didn’t really feel like we could.

It can be hard. It can be hard to say no, but I love that you are like, “I want a different option. I’m going to say no to this right now. Give me another option.” It’s always okay.

Alma: Definitely, definitely. Wanting to wait if the time allows, “Can we try this later?” There’s a conversation that needs to happen. It doesn’t have to be one thing that is suggested.

Meagan: This way or no.

Alma: For sure.

Meagan: Where did your education start stemming from? Where did you start when you were like, “Okay, I want to do something different next time”?

Alma: The podcast. The VBAC Link. I listened to a bunch of podcasts. There is All Things Pregnancy with Dr. Nicole Renkins, and of course, The VBAC Link Podcast.

Meagan: We’ve had her. We love her.

Alma: That’s just what I did all the time before I went to bed. I’d listen to an episode driving. I’d listen to an episode. It was very helpful. I felt like I could digest information better that way as opposed to reading, so that was a very helpful tool.

I also tried to find professionals around me who could speak to my specific situations. I had a doula, and of course, I had my providers as well. They were all so helpful with helping me navigate some of the things that might have gone wrong the first time, and how I could prevent them going forward.

Meagan: When they talked about some of the things that maybe went wrong the first time– I don’t want to say wrong. They went south.

Alma: Yes.

Meagan: I don’t know why people say that. I love south. I love the south. What were the kinds of things that stood out to them?

Alma: Well, I think the first thing was the induction in the first place. I completely understand the risk with gestational diabetes, but I think there could have been more conversations with that in my specific case. Seeing as I did not have diabetes that was really out of control, it was very well controlled with my diet, and there could have been room to say, “Maybe we can go a couple days past my due date.” I wouldn’t recommend that for everyone. I think it depends on your case, but I could have tried to have that dialogue, and maybe we didn’t need to have an induction.

I also could have considered different methods of induction, and I think that was the first thing because I felt like that was the first domino piece. If I didn’t have the induction, it might not have led to a C-section in the first place.

Another point was also the breaking of the water. Those things, I could have just said, “Let’s wait.” I was already there for the induction, so I could have just asked for a little more time.

But the big point for me too was the epidural. That was, I think, the immediate reason for the fetal distress.

Meagan: The response.

Alma: The response, yeah. Understanding how I could avoid that. I was told that now with the second epidural, I may not have the same reactions because I’ve had it before. Also, if you get flushed with some IV fluids–

Meagan: Yeah, I was going to say if you hydrate and not even just intravenously, but literally drinking water before. If you know that you’re going to want to get an epidural, or it’s heading that direction, start hydrating. The more you can hydrate, the better.

Alma: So I learned those things, then also, I tried to prepare myself for not even having an epidural, although that wasn’t my goal, because I experienced the pains before. Even though I had the C-section, I went through some labor pains. I was accepting the fact that I might just need the epidural, but I considered that as well. How can I overcome this pain without any kind of medication?

Those were things I was trying to consider about how we could do it differently so it doesn’t result in the same thing.

Meagan: Okay, I love those tips. So now, you’re pregnant, and we have baby number two. Tell us this journey.

Alma: Yes. I guess from the time of conception, it was about 18 months apart from the C-section. My pregnancy went perfectly fine. There were no issues. The difference being I had a toddler, so I was more active, of course. I was on my feet. I took at least 10,000 steps a day. I didn’t sit much just because of my daughter. I think that definitely helped in preparing my body.

I was really focused on how I can work on my pelvic floor and was just preparing for what it would take to push a baby out.

I also did a lot of exercises that I found online. I never did a class or anything, but these were just Instagram videos where you could see the top three videos for strengthening your pelvic floor and things like that that were just free and available. I had an exercise ball that was a lifesaver. I highly recommend that exercise ball for anybody who is pregnant, especially in the third trimester. You can sit on it. You can lean on it. You can squeeze it between your knees. All of those things provide relief, but they also strengthen your muscles down there.

I did the Miles Circuit. All of those things were super helpful, and I did it daily to prepare my body.

I guess going into the actual labor, I’ll start by saying that first of all, I didn’t have very supportive providers. I learned from this podcast that that’s very important. I do 100% agree that it’s half the battle if you have someone who is on your side and wants to help you make intelligent decisions. I would say my providers were not completely unsupportive, but there were a lot of policies from the hospital side that I think restricted them from encouraging a VBAC. There were a lot of if’s, and’s, and but’s. There were so many stipulations for when or if I could have a VBAC.

Meagan: Can I ask which ones stood out where you were like, “These for sure are alarms”?

Alma: The biggest one was that I would have to deliver before 40 weeks. I felt statistically that doesn’t happen. People usually birth after their due dates, so I felt like I was already set up for, this is not going to happen probably. I felt really discouraged by that.

Also, I guess the due date was a big thing, but also if I were to have gestational diabetes again, then the whole conversation on the doctor’s side was just completely mute. I would just need to go for the induction if I had gestational diabetes. Statistically, you do have it with each subsequent pregnancy according to what I have known.

I was also expecting, okay. I’m most likely going to have gestational diabetes. I’m most likely not going to give birth before 40 weeks. It seemed like I was most likely going to have to agree to a C-section.

Those things were not encouraging, but I did feel like the doctors were trying to help me find some safe loopholes. One of them being that they had to– I don’t know if this is law, but they had to schedule me for the C-section even though I didn’t want one. But they explained to me that I could go in and say to them that I didn’t want a C-section. I could ask for more time. I could ask to be induced, and hopefully, the induction wouldn’t lead to a C-section although it could. I guess they were trying to explain to me that there are some routes you could take, but given the fact that you had a previous C-section, we do have to just assume that you’re going to have another one.

I felt really alone on that journey of trying to do something that I felt like I could do, especially given that the reason for the first C-section was an emergency. I was dilated. It wasn’t a failure to progress. I felt like my body was perfectly primed to do it, but because of time, we had to go for the C-section.

I also had to have some conversations with myself accepting that if I do need to have another C-section, it’s not the end of the world. I guess what frustrated me about the first time was that I felt like I didn’t need to have it. C-sections save lives. They’re great tools when they’re needed, but I felt like I didn’t. Aside from the distress and all of that, I felt like I didn’t need it, so I wanted to really try for this vaginal birth.

I was just in between trying to accept what might happen, but still trying to hold on to what I believed I could do.

So, I guess fast forward to my 37th week, I had an appointment and I had to sign off that I would come in for a C-section, but my plan was to go in that day. This was on the 39th week. I would have the C-section. I could go in and say that I didn’t want to have it.

On the night of my 38th week, my husband just finished putting together the crib, and it was midnight. He put together the crib. We went to sleep, and at around 2:45, I wake up because I thought I peed on myself. Now, I think I realize that it was my water leaking. I got up, and at that point, I had maybe cramping, but it wasn’t really painful.

To make a long story short, 10 minutes later, I was having full-on contractions. They were super painful. I got out my phone to time it, and within two taps, the app was telling me to go to the hospital now. It was two taps. Everything was happening so fast.

Meagan: They were coming so close.

Alma: Yes. They were so close. I don’t remember how to count them. All I did was tap, and it was telling me to go. This was at 38 weeks, so I honestly didn’t have anything ready. I didn’t have my bags ready or nothing. Within a matter of minutes, I was just on the floor trying to remember the HypnoBirthing and everything, but it was all slipping because it happened so fast.

We get in the car, and I’m still in a whole lot of pain. At a certain point though, I got a grip. I was doing this Christian HypnoBirthing which really helped me. I finally grasped myself and was able to calm down, but the pain accelerated very, very fast.

At a certain point, though, I started to feel a lot of pressure. I was still driving, by the way. We had about a 45-minute journey to the hospital. I started to feel a pressure to push. I just couldn’t resist it, so I pushed. I hammered down really hard. It sounded like a fire hydrant was cracked open. My water busted open in the car. I’m sitting behind the driver’s seat on my knees, and my water just gushed open.

At that point, I really felt like he was coming out. I couldn’t hold back the desire to push because it also relieved the pain a little bit. It was more like a pressure as opposed to a pain. I just gave into that feeling, but I did feel like he was between my knees and was about to come out.

My husband made a few wrong turns, but eventually, we got to the hospital. I couldn’t even sit, actually. They put me in a wheelchair to go to the place where you would give birth. I couldn’t sit down. He was just about to come out, and when I got there, I was already beyond 10 centimeters at that point.

Later, the doctor told me when she came down to see me that she could already see the hair of my son’s head. He was already so close. Remember, the talk about the epidural? I wanted the epidural. I was asking the security guard, the person at the front desk– everybody I saw, I was asking for the epidural. I noticed that they didn’t respond to me on that. I overheard them telling my husband that it was way too late for the epidural. My son was already halfway out, and they couldn’t give me the epidural.

Once the doctor came, she told me to give a good push. I pushed one time. His head came out. The second time I pushed, he flew out. I had five nurses dive in to grab him.

Meagan: Oh my gosh.

Alma: He was born, and that was the whole thing. It was super duper fast, unmedicated, and yeah. The most touching part to me was that he came out, and they put him on my chest. That was all I wanted. When my daughter was born in the C-section, I had to beg them to let me see her. I didn’t see her until minutes later. I didn’t hold her until the next day, but this time, they put her right on my chest, and it was just so redemptive. It was everything that I really wanted to experience.

Meagan: Absolutely. It was probably a lot all at the same time, very shocking, but then to have that baby be placed on your chest, oh, what an amazing moment for you.

Alma: Yes, yes. It was.

Meagan: Oh my goodness. Super fast.

I was just going to say that was super fast.

Alma: It was. It was so fast. I think this is a thing with my kids. For my daughter, too, when they broke my water, everything went very fast. I don’t know. They are just really urgent, but my son was definitely in a rush. He came very, very fast.

Meagan: Did your doula even make it?

Alma: No, she didn’t. She did not. She couldn’t. It just happened too fast. She didn’t make it on time, but she was happy to hear everything went fine.

Meagan: Yes, of course. Of course. Oh my goodness. So after you had the baby, and you had him on your chest and everything, did all of the rest of everything go okay and smoothly?

Alma: Yeah. I was bleeding a lot, and that was a concern, but I thankfully recovered fine from that. I had a second-degree tear which I hear is not terrible for the first time doing that. So yeah. I recovered pretty quickly afterward.

In my experience, it really didn’t compare at all to the C-section recovery. I was in a lot of pain after my C-section, but this time, it was just maybe a week or two of taking some pain medication for the stitches and stuff, but overall, I was fine. Yeah. I was able to go home the next day actually, so that was also very good.

Meagan: The next day? That is awesome.

Alma: Yeah.

Meagan: How did your medical team feel about it? Did they say anything? Did they have any worries?

Alma: Everyone was just so shocked at how quickly everything took place. I think that was the main theme was just the speed, and also how determined my son was. With just two pushes, he just came out really fast. The concern of obviously dropping him because they all dove in to get him. I think that was the talk. This happened in the morning, so the whole rest of the day, they were just chatting about how quickly everything happened.

Meagan: Oh my goodness. I bet. I think sometimes those births are kind of a lot for medical staff where you come in and your baby is crowning, but I feel like those births are the type that they really do talk about for a really long time, and they were like, “Look at this.”

A lot of the times, here in Utah, anyway, they call them stop and drops where you show up at 10 centimeters. You just stopped in and dropped your baby. I feel like in a lot of ways, it shows people that labor can happen at home, and then you come and it can so beautifully happen without getting an IV, getting a heart trace, setting up fluids, doing this, having a cervical exam. There is just so much that doesn’t need to happen, and I love when medical staff can see that birth can just happen like that. It really, really can if we just leave it be.

Alma: Yeah. That’s exactly another point of how I felt before because I had gestational diabetes, and because I had a previous C-section, they did make it sound like I needed to be hooked up to every machine, and I could never give birth at home. I just felt almost like a robot connected to everything. That’s how it had to be, but yeah. This time, I wasn’t even in a hospital gown. It was just so organic how it happened. That was exactly what I wanted to experience, but I think it was a good experience for the nurses as well to see that it was okay. I was fine without the IV and the other stuff.

Meagan: Yeah, I love that.

You had listed some tips. One of them was doing pelvic floor exercises on the ball which we kind of talked about. I love the ball so much. If you guys are interested in a ball, I’m going to link a ball in the show notes because they are actually really inexpensive and can do a lot of really good things.

What other tips do you have for someone preparing for a VBAC?

Alma: The number one tip which I’ve heard constantly here is about being educated and understanding what your options are. Unfortunately, I think that most providers are not going to make it easy to have a VBAC just because of the risks that are associated with it. Of course, they may have your well-being in mind, but there are also a lot of hospital policies and protocols that they need to follow. They may not make it easy, but if you understand what your options are and what the research says, it opens the door for dialogue.

When you open that conversation, I think you will find that doctors will probably give you more options than what they may have initially suggested. I always spent time talking with the doctors about, “So what if this happens? How about this? How about that?” I feel like that did wiggle in some room for me to not do things just following the protocol.

Meagan: Yeah.

Alma: That’s really important.

Meagan: It’s so interesting how if you show up showing that you’re educated, there’s this different sense of– I don’t want to say respect, but I do want to say respect because I feel like these providers are like, “Oh. They get it. They understand. I can’t just say whatever. This needs to be an educated discussion.” It should always be like that, but I also think a lot of the times, providers don’t have time to really sit down and talk about the evidence, or their evidence is flawed because of personal experience. When you come in and you’re like, “Hey, what about this?” and they’re like, “Oh, she knows stuff,” it just really gives you some wiggle room. It gives the providers respect just a little bit more because they realize how important this is that we are educating ourselves. We are learning. We know the options, and we’re not just going to be like, “Okay, cool.” I love that tip.

That, and finding the supportive provider. In the beginning, you had said that the hospital policies may have trumped these providers’ stance. I think not only just finding your supportive provider, but really understanding the hospital policy. You can call, and you can talk to the head nurse. You can talk to the board and the directors of the hospital. You can say, “Hey, I need to know the hospital policies surrounding VBAC.”

Alma: Yeah. You know, I believe it was on this podcast where someone mentioned that the best way to know how a provider feels about a VBAC is just to ask them very straight, “What do you think about VBACs?” Their expression will say it all. You don’t have to have a preamble about it. Just ask directly, and I think that helps. I definitely did that. It wasn’t favorable in my case, but I definitely think looking into the hospital C-section rates is really important too. How often do they have C-sections? How often do they have VBACs? If they have that information available, that’s also really helpful.

In my case, I found out too late that it wasn’t the highest, but it was pretty high. Also, from this podcast, I learned that it’s never too late to switch providers if you want to. I didn’t take that route. I stuck with who I was with, but I guess I was just trying to be adamant with what I wanted to do as much as possible.

Meagan: Absolutely. Do you have any tips on how to possibly find the hospital’s Cesarean rate? It used to be out there on cesareanrates.org. It used to be out there, and you could look up your hospital. You could look up your state. You could look up your provider, even. That’s gone down a little bit and changed a little bit, but do you have any advice if someone is wanting to know their hospital’s Cesarean rate?

Alma: In my case, I just searched the hospital name and the Cesarean rate. This was a pretty big hospital. This was in Florida. It was a hospital with a very big network, so that information was readily available on their website. You do need to dig around, but it was on their website. If you are dealing with a big hospital with many departments and so on, they may have that information on their website easily with a Google search.

You could also talk to people who work at the hospital as well. If it’s not online, I think that information is quantified normally. They might not quantify how many VBACs they have, but definitely the C-section rate is information that they are following and tracking.

Meagan: Yeah. I feel like it’s always fair to ask your provider, “What’s your Cesarean rate?” A lot of the time, they will say, “I don’t know.” They know. They know. That’s something that they need to be able to give you. It’s okay to ask that. “What percentage of your deliveries end in a Cesarean?”

Alma: Yeah. Being direct is really the easiest way to know clearly where they stand.

Meagan: Yeah, absolutely.

I wanted to really quickly talk just slightly about gestational diabetes. There’s a lot when it comes to gestational diabetes. We know, just like you had experienced, that most providers suggest an induction. They just do.

According to the American Pregnancy Association, gestational diabetes occurs in 2-5% of pregnancies which is decent. For those who are at a higher risk in their pregnancy, it may be even higher up to 9%, but a lot of them are controlled like yours were through diet or even through insulin and things like exercise. A lot of people are controlling them.

Evidence Based BirthⓇ, which I want to make sure that this is linked in our show notes and our blog so if you want to go read more about gestational diabetes or you had gestational diabetes with your last pregnancy and you may have it again, definitely go check it out. They talked about how there is actually very little data in how often people are actually induced because of the diagnosis of gestational diabetes.

But in one of the retrospective studies, they found that out of 330,000 births from 2001-2007, they saw– okay, let’s see. It says, “The people in the study came from six health insurance plans, many different hospitals and regions, and represented a large and diverse population. Health insurance plans datas were linked to birth certificate data in order to improve accuracy compared to using birth certificates alone.”

Going down a little bit further, they said, “Overall, 30% of labors were induced. When they looked at the reasons for induction, 59% of labors were induced for an accepted medical reason and 41% were considered to be elective.” Those are pretty big numbers to me.

Alma: Yeah. Yes. Yeah, those are big.

Meagan: Yeah, those are really big numbers. It goes on. It talks about, does gestational diabetes always mean induction? What’s the evidence for randomized controlled trials? They go way into it because Rebecca Dekker is amazing, and their team is incredible. We will also have our blog linked because I believe this is a really important topic to know more about especially if you’ve had it so you can make the right decision. And how you said, you were like, “I was in a controlled state. Everything was controlled through my diet, and I could have likely gone further,” but you didn’t. You weren’t really encouraged to go further. It was like, “Let’s induce.”

Alma: Yeah, it literally was just like that. There was no conversation about it.

Meagan: Yeah. No conversation about it. I think that’s where we’re going wrong a lot in the medical system. A lot of the time, there is no conversation. Even though we have the power to start that conversation, sometimes it’s really difficult when we’re being told, “Your provider thinks this. Your baby is in danger. You’re in danger if you don’t do these things.” It’s like, “Okay. Okay. I’ll do those things,” but we need to have those conversations. I think that again, having the education and knowing the evidence behind it, and the risks and the benefits and all of those things, it will help you have that conversation if and when the time is needed.

So, thank you so much for chatting with us today and sharing your stories and giving us advice, and leaning into more conversations for gestational diabetes. I think it’s something that is happening. A lot of people are getting it. There are things we can do even before pregnancy like really increasing our protein and things. But sometimes, it just happens. It just happens.

Alma: I will say just to be clear, the second pregnancy, I did not have gestational diabetes.

Meagan: Okay.

Alma: That was also something. That was my biggest concern. The two points I mentioned were that the conditions were that I couldn’t have gestational diabetes, and I needed to deliver before 40 weeks. But this goes along with education. I did my best to improve my diet even pre-pregnancy to avoid that diagnosis. It was actually a miracle that my blood test came back really well. I almost thought this was the wrong test because it wasn’t elevated at all. I was really, really thankful that through some dietary changes and lifestyle changes, I didn’t have gestational diabetes at all.

Then the second point about giving birth before 40 weeks, it was a spontaneous labor at 38 weeks which also was so supernatural. I really thank God. Everything happened really perfectly. Yeah. That was really a blessing.

Meagan: Yes. Oh, thank you so much for everything. You are amazing.

Alma: Oh, thank you.

Meagan: We just love you.

Alma: Thank you so much. I had a great time sharing the story, and I hope it encourages other women as well.

Meagan: It will, for sure.

Alma: Great.

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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