Episode 301 Janelle's Beautiful VBAC + Signs of PPD + What is Vaginal Cleansing?

Today’s episode is full of love. Meagan’s doula partner, Christin Carlson, joins as co-host today to hear their client, Janelle, share her beautiful VBAC story.Janelle’s first baby was determined to stay frank breech even after two ECV attempts. Her water broke on its own before her scheduled date. In prep for her surgery, Janelle unexpectedly experienced vaginal cleansing. Though the surgery went well, it was not the introduction to motherhood Janelle was hoping for. She was also hit hard with postpartum depression. Janelle shares how she found The VBAC Link and became obsessed with all things VBAC prep. Surrounded by the most loving and empowering team, they helped her stay steady when labor was most intense. Even though it was harder than she imagined it would be, Janelle was able to dig deep and achieve the unmedicated VBAC she desired. Vaginal Cleansing ArticlePostpartum Depression ArticleHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details 02:40 Janelle’s PPD experience07:25 Janelle’s stories12:06 Arriving at the hospital14:05 Janelle’s C-section17:00 VBAC preparation19:24 Appendicitis and second pregnancy24:22 Going into labor27:35 Laboring at the hospital30:30 Transition34:21 Achieving her VBAC38:47 The power of a supportive partner43:53 What is vaginal cleansing?50:26 Symptoms of postpartum depressionMeagan: Hello, everybody. You guys, today I have a very special episode to my heart because this is one of our own doula clients here in Utah and another even more special thing is that this is my partner, Kristen who ended up attending her birth, is co-hosting. Hello, Christin and Janelle. Janelle: Hello. Christin: Hi. Meagan: How are you guys today? Janelle: So good, so good. Meagan: Before we started recording, we started talking about time and how fast things are going. You guys, I mean I think you probably know if you are pregnant or have a newborn in your arms how fast time goes, but really, holy cow. We were with Janelle, we just talked about, 8 months ago from the time we are recording which is wild to think about. Janelle: So weird. So weird. It’s crazy. Christin: It seems like it was a couple of weeks ago. Janelle: Yeah, it’s not fair. Meagan: I know. How have things been? How have you been going with postpartum?Janelle: Things have been really good and I think that’s one of the things that pushed me to want a VBAC so badly is I was hoping for a better postpartum experience. I had pretty severe postpartum depression with my first baby and I felt like having the VBAC would be some sort of heavenly gateway into not having postpartum depression. In the beginning, that was true, but I ended up still having some of it. Things are good now, though. Meagan: Good. I actually love that you touched on that because I think that sometimes especially after a traumatic Cesarean or a traumatic experience that did lead to postpartum depression or anxiety or anything like that, that can be a big motivator for a different experience. I love that you talked about, “Well, it was a better experience, but I still had this a little bit. I’ve had to work through that.” I’m glad that you’re good now, but even sometimes when we have a different experience, we have similar things. So it’s important to recognize that. I love that you just pointed that out. Janelle: Yeah, for sure. Yeah. Meagan: Before we get going into the episode, do you have any tips on tackling that the second time around too? How were your feelings about things when you were starting to feel it and see it creep in? 02:40 Janelle’s PPD experienceJanelle: Well, with both experiences, it did creep in just like you said, but with my daughter, it felt really dark really fast. She was my first baby and then with my first son, the VBAC, it was kind of a little bit sneaky. I guess just having someone on your support team. For me, it was my husband and I just said, “Look, if you see any of these signs, please say something to me.” It wasn’t like we had a code word or anything. He was just really open in his dialogue with me and said, “Hey, I think something is up with you. You are not your normal self.” As soon as he said that, I was like, “Yeah. You’re right.” It was really hard to admit because you want to be this strong mom and you want to be there for everyone and be everything that everyone need, but sometimes that’s just not how life works. It’s literally a chemical imbalance in your body and in your brain. It has nothing to do with your circumstances. Just having someone on your team and on your side to say, “Hey, I love you. Let’s get help,” was absolutely integral to helping me get on the other side. Christin: I think it may have helped because you had been through it before so you were aware of the warning signs. That’s something I think that we don’t realize because I struggled with postpartum depression too but it didn’t happen until my third baby so I didn’t have any inclination that that was even something that I was going to deal with. I think it’s important. We do all of this work to prepare for our VBACs and to prepare for the arrival of a new baby, but sometimes I don’t think we educate ourselves on what those warning signs of postpartum depression are because they can be very sneaky. It’s not always deep, dark thoughts. Sometimes it’s postpartum rage or postpartum anxiety where just you are either extremely emotional or extremely angry all of the time. To have your husband looking out for you or someone on your support team who is keeping an eye out for those things and noticing a shift in the way that you’re behaving, I think, is super important. I think that’s great that you guys have had this conversation ahead of time. Meagan: Yeah, and we will talk a little bit more about some of those signs and symptoms. Like Christin was saying about how they can differ between rage, anxiety, depression, and the baby blues a little bit more at the end for sure because yeah, I think Christin just nailed it. We focus so heavily, and I think even more sometimes– I don’t want to say this as a fact, but sometimes I feel like more as a VBAC mom, we are so hyper-focused on the end result of a vaginal birth that sometimes I feel like we do forget a lot. That’s like everybody. I think they are so focused on getting baby here, but VBAC sometimes has to fight harder, search harder, read more, and emotionally work through things a little bit more so yeah, we can forget. Then that creeps in or like Janelle said, it was like boom and darkness came over. We want to know how to handle that so we will talk a little bit more about that in the end. 07:25 Janelle’s storiesMeagan: Okay, you guys. I wasn’t there, but in our practice, we have something that is like a live timeline that we have so whoever is at the birth can take notes of the timeline and we like to share that with our parents. We were all just sitting there watching it, checking in, and I just remember feeling this utter excitement inside of me for them as I was looking at the notes and following along with Christin’s updates. I’m excited to now be here with you both and hear it in a different way. I’m going to turn the time over to you. Janelle: Yes. I’m so excited. I was actually telling Meagan before we started that I was actually fangirling out. I don’t know exactly how I got started listening to The VBAC Link, but after I had my daughter, somehow I got onto it and I binged so hard on this podcast. It’s just really surreal to be recording with you. So thank you for allowing me to be here. Christin: You’ve come full circle. Meagan: Full circle. Janelle: I have. Meagan: I love that that happens with The VBAC Link. I love that it’s so often that it’s like, “I listened every day. You were in my ear and now here I am being in someone else’s ear. Janelle: Yeah, yep. So just to all the mamas out there who are preparing, you’ve got this. You can do this. With all VBACs, of course, there is a Cesarean that starts the story, right? We tried to get pregnant with my daughter for 14 months. We finally got pregnant and the pregnancy was super easy. I was going for a HypnoBirth unmedicated birth. I didn’t have a doula. I didn’t really have– I don’t know. You just don’t know what you don’t know and as a first-time mom, you think you know, but you don’t. You just don’t. Meagan: Or we have apps that tell us so we really think we know because the app said so. Janelle: Yes, but then you just don’t know until you’re in it. I gained 60ish pounds which was a lot, but I never had hypertension or a lot of issues with that. I never ended up with gestational diabetes which I was really grateful for and worried about, but in hindsight, it really wouldn’t have been a big deal. At my 36-week appointment, we found out my daughter was breech. Homegirl was freaking stuck. Let me just tell you, she has been stubborn ever since. We tried everything. We decided to do an ECV. We did it at 37 weeks and we just did that. I think a low dose of Fentanyl was the only medication. I was just trying to use my Hypnobirthing to breathe through it. The doctors told me that I was doing really well, but she was just stuck, and that one failed. We tried going to the chiropractor. We tried Spinning Babies. We tried basically everything that I could think of. We did not do acupuncture. That’s the only thing that we didn’t do and I never hired a doula. I could have done those things, but I didn’t. We tried a second ECV at my 38-week appointment. We did that one with a spinal block in the OR because they were like, “Well, sometimes on the second attempt, it can throw you into labor.” So I was like, Okay, well if that happens and we have any problems, they can just do a Cesarean right there. She was very, very stuck in my pelvis and the maternal-fetal medicine doctor actually tried to push her up vaginally and that was unsuccessful and very uncomfortable. Even though I was numb, it was still like, This is weird. I don’t know. I don’t like this. She just was stuck. She was frank breech, so I was like, Okay. We’re just going to go through with the Cesarean. I had 2 more weeks so two days later, I went out to dinner with a friend and then that night when I was sleeping, I got up to pee like you do a million times when you’re pregnant at the end and some water was leaking out as I was walking back from the bathroom and I was like, What the crap? I just peed. How is this happening?My water had broken and there was meconium. I knew that it was going to be a little bit of an issue with meconium just because my doctor told me something like they were just worried about meconium with a breech baby. I don’t know. I don’t know if that’s true or evidence-based or not. 12:06 Arriving at the hospitalJanelle: We drove to the hospital and we got there at 5:00. They had to do a COVID test and they cleaned me out. I don’t know if you’ve ever heard of that. Meagan: Like rectally? Janelle: No, like vaginally. They took some sort of– Meagan: They cleaned you out vaginally?Janelle: Yeah, I don’t know if it was because of the meconium, but they took some iodine-something and it felt like a membrane sweep. I never have had one of those, but if I could imagine what that was like, that’s what it felt like. Meagan: Christin, have you ever seen that? Christin: It’s funny that you say that because I had never seen it before until Janelle told me that she had it and I was like, That just sounds so odd, but I actually just saw it at a birth the other day. Meagan: What is it for? I actually don’t know what this is. Christin: I had never seen it previously and I thought it was just an anomaly with your birth, Janelle, but I saw it the other day again. Janelle: Do they have a name for it? Meagan: I’m Googling it right now. Christin: They didn’t name it. They just used iodine swabs and just cleaned her out. Janelle: Was that also for meconium? Christin: Yeah. Janelle: Okay, interesting. Christin: Now that I think back on it, there was mec but I don’t think we knew there was mec until baby was born so I don’t know. Janelle: Oh, interesting. Okay. So yeah, that was the most unpleasant experience ever on top of mid-contraction, I was having the COVID swab up my nose so that was really great because this was early 2021. So yeah. Anyway, we waited for the ORand the nurse came in. I asked her, “Can you check me? I know I’m going back there for surgery, but I’m just curious. I’m having contractions. Can you just see if I’m dilating?” She’s like, “Yeah, you’re at a 4.” So I was like, "Oh, that’s kind of nice. My body’s actually doing the work here.” I was really excited about that. 14:05 Janelle’s C-sectionJanelle: Jumping to the surgery, I was so terrified. I don’t know what it was. You’re just going through so many emotions. You have to put so much trust in the nurses and the doctors and the anesthesiologists. You have to put so much trust that these people paid attention in med school that they know what they are doing, that they care about you, they care about your baby, and chances are they totally do and they did pay attention and they got good grades, but I just felt nervous as a first-time mom. They jostled me around and the anesthesiologist was really nice and he was just talking to me and telling me everything that was happening. When she was born, I knew it because I felt them yank her out. They had a clear drape, but I couldn’t see over it so I was really sad that I couldn’t see her. Because of the meconium, they had to take her and they cleaned her up and stuff. I was 16 minutes or something before I got to see her. In hindsight, it’s not that long, but it felt like forever. Then I got to see her sweet little face and oh gosh, it was just the most precious thing ever. My husband snuck a video of it. You’re not supposed to in the OR, but he snuck a video of it and it’s such a treasure for me to look back at the moment that I got to meet her because I didn’t get to be the first one to hold her. Yeah. Christin: I love that he did that though so you have the record of that memory. Janelle: Yeah. I never even asked him to. He just knew that I would want that. He’s the best. One thing I didn’t know about postpartum regardless of if you have a C-section or a vaginal birth, your nurses will push on your abdomen and it hurts like a mother trucker. Let me just tell you. Meagan: Crede-ing. Janelle: It’s what? Meagan: It’s called Crede-ing. They Crede and they are checking where the uterus is, if it’s clamping down, and making sure it’s not getting boggy and filling up. Janelle: Yep, and if you’re bleeding too much or not enough. It sucked. Then I had really bad postpartum depression. This one was not sneaky. This one was almost immediately. I felt like I bonded really well with my daughter, but there was just some darkness that was in my heart and I couldn’t figure out what it was. It took a while. I was actually maybe 6 or 8 weeks at my postpartum appointment and my doctor did the screening. She’s like, “Yeah, your score was really not good. Let’s get you some medication.” I was like, “Okay.” I was very reluctant, but I saw almost an immediate difference. I had it for a while, but it did help. 17:00 VBAC preparationJanelle: Anyway, so that was my daughter’s birth and ever since then, like I said, I was obsessed with The VBAC Link. I knew right away that I wanted a vaginal birth. Actually, come to think of it, right before we went back to surgery, I was talking to the doctors and I was like, “I really want to have another baby after this. Is there any way you guys could make sure that my scar looks really good and I could have more babies vaginally? That’s really important to me.” They were like, “Yeah. We will make sure you are taken care of.” I was very grateful for that. What I wanted out of this birth, I don’t know if what I told Christin is still what I have on my birth plan that I wrote down, but what I really wanted was a healthy mom, a healthy mindset, and a healthy baby obviously. Those are the minimum, right? Then I wanted baby out of my vagina. I wanted skin-to-skin. I wanted to be the first one to hold baby and I wanted to be fully present and fully included in all of the decisions. I don’t know if it was just, yeah. I don’t know exactly why that was so important to me at the moment, but it just felt like I didn’t want any of this robbed from me. I didn’t want any of the experience to be done to me. Do you know what I’m saying? I wanted as few interventions as possible. Those were what I really wanted out of this birth. Is that what you have, Christin?Christin: Yeah, pretty darn close to that. I also have skin-to-skin was super important. Janelle: Yes. Christin: And I think it’s worth noting that you wanted to catch and deliver your own baby. You said I wanted to be the first one to hold her– sorry, hold the baby boy– but you also told me that was super important to you. You actually wanted to deliver your child. Janelle: Yes, okay. With my son, my daughter was maybe 20 months old. It was the Sunday before Thanksgiving and I felt some pain in my side. We had been trying for 6 months and something was just wrong. I didn’t have a big appetite and it was Thanksgiving dinner at my mom’s house and I just didn’t feel good. Something intuitively was just wrong and I knew it. My husband was like, “Well, why don’t you just try taking an antacid?” I was like, “No. I know something is wrong.” 19:24 Appendicitis and second pregnancyJanelle: We went to the ER and I had appendicitis and I was pregnant. So that was really fun to find out all at the same time. Because I was 3 weeks, 4 days pregnant, I had not even missed my period. I hadn’t taken a test, they said that nothing in the surgery would change because baby was still so small. I was like, Okay. Well, that’s good. I was really nervous for the surgery and that there were going to be complications afterward, but everything was fine. As soon as I started to heal from surgery, I got so nauseous. I was so sick the whole pregnancy until maybe 25 weeks. That’s when it finally started to wean off. Like I said, I lived in VBAC mode. I binged the podcast on the daily. I went on walks. I would listen to it while I was cleaning, driving, naptime, all of the things. I also was very into the Evidence-Based Birth Podcast because I was very curious about water birth and home birth and all of the statistics. My husband actually pulled me aside while I was in crazy VBAC mode as we call it. He was like, “Janelle, I’m just worried if you end up having a C-section, where are you going to be at mentally? Are you going to be okay with this if that ends up being your path?” I was like, “You know what? I really do need to prepare for that too,” because things really can go in any direction with birth. As soon as he said that to me and I started to prepare that way, I just became like, Okay. Whatever happens happens. This is okay. I did have the same VBAC-crazed mindset but I was also okay with things happening. I don’t know if that makes sense. Meagan: Yeah, it totally makes sense. I think a lot of the time as we are preparing for that, it is important to note that things can go and still prepare for the other but prepare, prepare, prepare, and then do all of those things while you are preparing so if it doesn’t happen, then you don’t have to look back and be like, But what if this and what if that? Then you are confident in the way you prepared, but then you know, Well, it could go this way. It’s not what I’m going to plan for, but it could go that way and I’m going to be more content because I’m doing everything within my control. Janelle: Yes. At 20 weeks, my insurance changed and I had to find a new provider. That was a whirlwind. I actually found my midwife through The VBAC Link list of providers. Her name is Kira Waters and she is the best. I love her so much. The first thing that I said to her when I interviewed her was, “How do you feel about VBACs?” She said, “I love VBACs!” I was like, “Oh my gosh, okay. Say no more.” Yeah, after we met Kira, then we were on the search for a doula. I came across you guys. I met with Christin and the stars were just aligning like, this is going to work out. This is going to be perfect. I don’t know how to explain it. It wasn’t like an instant connection, but it was this deep trust that I instantly had in her if that makes sense. Meagan: Mhmm, yeah. Janelle: It was almost like I’d known her for a long time, but not like a high-school friend. She’s my long-lost aunt, I guess. She’s full of wisdom. Christin: I’ll take it. Meagan: Well, and there is something about a doula. Don’t you think? Fun fact, Christin and I actually had the same doula, but there was something about our doula– her name is Robin. She is amazing. I didn’t even know her that well. I mean, I knew her through the birth community and stuff but I didn’t know every detail about her, but there was this weird sense of confidence where I was like, It’s going to be fine. Then her partner, Angie, was also somebody who I was like, I know she has to be in my corner. I just knew that those two people had to be on my team and yeah. It wasn’t like I instantly knew them and felt the connection of being childbirth friends, but I was so deeply connected right away and still am to this day to them. Janelle: Mhmm, yep. It’s interesting. I’m kind of a private person and I didn’t want my mother-in-law or my mom in the birth room, but as soon as I met Christin, I’m like, “Yep. Come to the birth.”24:22 Going into laborJanelle: Let’s see, I think it was my 34th or 36th appointment and I met with the OB because if you are with the midwife, they want you to meet with the OB. He did the VBAC calculator. I think it said 47%. It was 47 or 50% chance. It was a pretty moderate chance of success. He was really nice, but I just was like, Eh, I don’t really want him to deliver my baby. Let’s see. I had gained a similar amount of weight, but again, no hypertension. Everything was pretty much the same to this point other than baby was head down at this time. I was 37 weeks and I went out to dinner with a friend. Fun fact, it was the same restaurant and the same order. That night, I went into labor. Christin: You’re onto something. Janelle: It was Zupas. Meagan: I was going to say, what was it? Zupas? Janelle: It was Zupas. Christin: Now we have to get your order too. Meagan: What was your order? Janelle: I want to say it was the pulled pork sandwich. Maybe one of the soups, like the cheesy soup, the Wisconsin…Meagan: The Wisconsin Cauliflower? Janelle: That one, and then the pulled pork sandwich. That’s what I ordered both times. So if you want to go into labor…I don’t know if that’s even tried and true, but it was so interesting. Christin: I’m pretty sure it’s not evidence-based. Janelle: No, but for me. Christin: For you it is. Meagan: You’ve got some good stats. Janelle: Yeah. So I went into labor that night and my husband, I didn’t say this before but when I went into labor with my daughter he was like, “No!” because it was so early and he’s a gamer so he was up that night playing games on the computer and he was just really tired. The same reaction was had from him this time too. He was like, “No!” Christin: It was early in the morning. Janelle: He was like, “Dang it!” I wanted to labor at home as long as I could so let’s see. I think we texted you pretty close to that time. Was it at 4:00 or 5:00? Christin: I got a text at 3:06 AM that you thought your water broke. Janelle: Yeah. So I labored at home in the tub for a while. My husband made me the best peanut butter and jelly sandwich that I ever had in my entire life. I ate a peach. I just hung out in the tub. When I would listen to the podcast before bed, I would listen in the tub and hang out and relax. It was a safe space for me that I was very used to. I hung out there for a long time. It really wasn’t that long, but when you’re in labor, it feels like a long time. I had my mom come over so she was with our daughter. Once my contractions were 4-5 minutes apart, we were like, Okay. Our hospital is 30-45 minutes away. We should probably head in just to be safe. 27:35 Laboring at the hospitalJanelle: I got admitted around 6:00. Is that what you have, Christin? Christin: Yeah. It was around 6:00, a little bit before 6:00. Janelle: I agreed to be checked at that time. I didn’t want a lot of checks because I didn’t want to introduce bacteria by having my water being broken, but I was curious about where I was at. They said I was at a 4. I told the nurse beforehand, I was like, “I don’t want to know,” but she let it slip. She was like, “Oh, you didn’t want to know, huh?” I was like, “No, but that’s okay.” Meagan: Isn’t that where you were with the first one?Janelle: Yeah, kinda. I was like, Okay, well at least I got this far before. She said I was 50% effaced and -2 station. At this point, my husband and I were kind of clueless because we only had one meeting with Christin. We hadn’t gone over counterpressures. We hadn’t gone over how he was going to be actively supporting me in birth so we were just like, Okay, now what?Christin: I think we had your second prenatal scheduled for the day after you went into labor. Your baby just decided to beat us to the punch. Janelle: He was so excited. He just wanted to be a part of it. We were really clueless and I started feeling the contractions really intensely. I was not as prepared as I thought I was for contractions. I was second-guessing all of my life decisions because I again even wanted to be unmedicated. I even signed a consent form for the epidural at this point. I was like, Okay, just call it. I’m done.Christin: Christin joined us I think an hour after I got there around 7:00. The second that she stepped in the room, the energy just shifted. I don’t know how to explain it. She just brought so much excitement like, I’ve got this. I got you. It’s all right. It’s going to be okay.I know she wasn’t intending to be my savior, but she kind of was in that moment for energy’s sake. I don’t think I could have done it if she hadn’t walked in with the confidence and the joy that she had, just the excitement for birth, the passion to be there, and it just made such a huge difference in our experience and I just love you so much, Christin. Thank you. Christin: You’re going to make me cry. Meagan: She’s all emotional. Janelle: We’re all just crying here. It’s fine. Christin: It’s really the best job in the world. It’s the best job. Janelle: It’s really a sacred space. Like I said, I didn’t have my mom or my mother-in-law there. I just wanted it to be very intimate and Christin was so good at honoring how intimate it was. 30:30 TransitionJanelle: Let’s see. Let me jump back to the story. Around 10:00, I got a new nurse. This nurse was awesome. Her name was Alisha and she was at St. Mark’s. If you ever get Alisha at St. Mark’s, she is a godsend. She was great. There were multiple times where Christin, Alisha, my midwife Kira, and my husband were all taking turns doing counterpressures on me. They all synced up and were so harmonious. Okay, so at 10:00, I was still 4 centimeters, 100% effaced. I labored in the tub at this point for a while. It really wasn’t that long, but in the moment, it felt like a long time. I loved and hated the tub because I didn’t have anything to brace myself on. Michael, my husband, couldn’t give me any counterpressure in the tub, but the relief afterward in the water was so amazing. I really loved that and then Christin was like, “I’m going to leave you two alone and have a little moment.” I think you had even brought these little tea light, like the electric tea lights. You had set those up in the bathroom and the lights were dimmed. It was such a special, sacred moment with Michael and I. He just was like, “I really get why you hired her. I love her. She is amazing.” I was like, “Yep. This is why.” He was like, “Yeah, we don’t ever want to do birth without her.’ Christin: Have more babies. I’ll be there. Janelle: Yes. Undecided. But we do, absolutely. Christin: Fair enough. Fair enough. Janelle: That was at 10:00. I was at a 4. Then I got in the bath. At 11:15, I was out of the bath by then. I had a cervical check and I was at a 7. I jumped a lot in that time. I was doing a lot of work. I was 100% effaced and I was at 0 station. I was moving all over in positions. We did the throne position. There was one where I was on hands and knees on the birthbed, but I didn’t have the birth ball. At 11:40ish, I was feeling really pushy and I got so emotional. Christin will remember this. I sobbed. It was ugly crying for a good half hour. This is now what we know is transition, but it was rough. I was having Charlie horses and oh, it was just rough. I just was crying a lot. I don’t know exactly what was happening, but I just was preparing, I guess, and releasing emotion for the baby to come out. Around 12:30, I was pushing here and there, and around 12:45ish, I started really pushing. Again, at this point, I was in the lithotomy position which is sitting upright how you picture in movies and stuff how people have babies. I was screaming this baby out. I was the loudest person on that floor of the hospital for sure. Meagan: I think there’s something to it. I think sometimes roaring your baby out is what people need. Christin: Absolutely. Janelle: I was absolutely a screamer. Christin: It’s funny because I don’t remember you being loud. Janelle: Oh my gosh, really? Christin: Yeah, I don’t remember it. Janelle: Oh, praise be. That’s great because I remember at one point– Christin: There’s a good chance you weren’t as loud as you thought you were. That happens a lot of the time. You think you are very loud and you probably aren’t. But I mean, there’s nothing wrong with that. A lot of women roar their babies out and it’s very powerful and very primal and natural to do so. Janelle: Mhmm, yeah. 34:21 Achieving her VBACJanelle: I remember at one point, there was a nurse that came in. I could tell she was one of the baby nurses because she had the baby cart and stuff. I was in mid-push and I remember saying, “Get the f- out!” I’m pretty sure that everyone in the room thought I was talking about the baby, but I was talking about the nurse. I was like, “Get out!” Meagan: Like, “I don’t want you here.” Janelle: I was like, “I don’t want anyone in here seeing this. It’s ugly.” Meagan: Oh my gosh, that’s funny. Janelle: Anyway, so I finally pushed the baby out at 1:30 so I was pushing for an hour. The moment that I got to push him out, I was very emotional and my midwife handed him to me and helped me finish. She delivered the first part of him and I had a little bit of a cervical lip so she was like, “You’ve got to really push him out,” or maybe it was the shoulder. Was it the shoulder that was stuck? I feel like I’m butchering this last part right now. Christin: No, you didn’t have an official shoulder dystocia. He just needed a little extra strength to get the rest of his body out. Janelle: Okay, yeah. That’s where we were at. She was like, “You really need to push here.” I just remember like you said, roaring him out. She helped me pull him to my chest and having that warm, gooey, slimy baby was just everything that I could have hoped for. I would not change that for the world. That oxytocin hit that you get from smelling that baby that comes out of you is just unreal. I was so happy that I got to be the first one to hold him and see him. I just am really, really grateful that I had the support that I did because I don’t feel like I could have done it without my husband, without Kira our midwife, without that nurse Alisha. Okay, like I said, I am butchering this best part because I forgot to say so many things that I wrote down. Okay, let me back up a little bit. So right around the time that I was crowning, I just felt like my skin was crawling and oxygen was not enough for me. I couldn’t get comfortable. I couldn’t get on top of my breathing. I was asking for an epidural. I had already signed the consent form, but my nurse Alisha was like, “Oh, the anesthesiologist is busy and by the time he comes, it’s going to be too late so sorry.” Sneaky little nurse because she knew what I wanted. I actually asked for a local anesthetic. I was asking for lidocaine or something. I was like, “What do you use to stitch people up? Use that on me because I am struggling here.” My contractions were, Kira told me they were three little ones and then one really, really big one then I would have a 5-minute break. That’s how my contractions were up until the end. Like I said, I couldn’t get on top of my breath. I remember looking at Christin and my husband. I just couldn’t figure it out. There was this moment inside of me that even though I had them there, I had to dig so deep in my own body and in my own soul. I even said a prayer to God and I was like, I have got to have some help here. I cannot push this baby out alone. Can you please send some angels or something to be with me because I can’t do it?I got a little bit of a longer break in between contractions and I finally had Christin and Michael help me to get on top of my breathing and that’s when I was able to push the baby out. Meagan: It’s crazy how breath really is so impactful but then we are always told to hold it, so you’ve got to find the breath and find the strength and regrasp. Sometimes, that means taking a step back and rebreathing and finding that regrounding. Christin: Yeah. Janelle: It’s so hard in the moment. Like I said, you think you know but you don’t know until you’re there. 38:47 The power of a supportive partnerJanelle: But I do have to say that the second I pulled him out and he was warm and gooey and on my chest, they were trying to arouse him a little bit because he was a little bit slower to take his first couple of breaths, I was just screaming, “I did it! I did it! I did it!” a million times. My husband just said, “I’m so proud of you. I’m so proud of you.” I actually wanted to say what he told his family. He said, “Today I saw what Janelle was made of and she freaking did it. I’m so proud of her.” The way that he said that about me unprovoked was really sweet. Yeah. So there it is. There’s my story. It’s choppy. Meagan: No, listen. I love that. I love that. And would you have anything to add, Christin, to that?Christin: I would just say that Janelle went into this whole thing very prepared. She had educated herself and she was very prepared for whatever came at her. She did her work ahead of time. She found a fantastic provider and she knew what she was doing. She knew everything that she needed to know about a VBAC, but at the same time, she was very welcoming to let birth just unfold how it was going to unfold. There was a time. We talked about this a little bit earlier. You got to the hospital. You had been laboring really well at home and contractions had been coming very quickly. You were progressing really well and then you got to the hospital and everything just stopped. That’s completely normal. We see that happen all the time in birth where just that chance in scenery and the commotion tends to slow things down a little bit, but that didn’t get to you. You just needed to get back into your groove. You got settled back into the hospital and you and Michael had some time together. I don’t think we should ever discount those special moments that you have with just your husband. When I step out to give you time in the bathroom, that’s not me necessarily trying to take a break myself, it’s to give you guys time to help that oxytocin get flowing, to get labor progressing again, and to protect that intimate space. You guys were a phenomenal team. It was incredible to watch the two of you together. Michael was so incredibly supportive. That moment where he leaned down and just said to you, “I’m so proud of you, Janelle,” it was so touching just to watch his love and his pride for you. It was incredible. Janelle: He really is the best. I’m so emotional just thinking about him because I just love him. Obviously, none of my family would be possible without him, but I couldn’t do mom life without him and I couldn’t do the birth without him. He really was everything. So get yourself somebody who loves you and who loves the ugly parts of you too. Christin: You know, I say this too. I don’t think– I mean, moms obviously are going through so much during labor, but I don’t think dads are ever given as much credit as they deserve because they are watching someone they love go through the hardest thing they’ve ever done. While there are things to help mitigate some of that, there is nothing they can do to fix it or take it away and it is emotionally taxing on them. Meagan: I agree. I was just about to say the same thing. As mothers, thinking about your child doing one of the hardest things in their entire life and how they feel. Now, you are not his child, but you are someone he loves probably more than anyone on this earth, and especially at that time, he was feeling those things too and he watched you. He watched you prepare and he even was questioning, “I see how much you want this. How will this affect you if it doesn’t go this way?” He was literally taking into consideration that far before the birth even happened thinking about you that deeply. It just is amazing. I think that’s one of my personal favorite things about being a doula. Of course, seeing babies being born is just incredible. It’s absolutely incredible, but seeing what Christin just described, these two people who love each other more than anything that just brought this human into this life, and seeing them bond and grow and take pride in on another during the support of their baby is just really one of the coolest parts about being a doula. Janelle: When my kids are a little bit older, I think that’s what I want to do, but we’ll see. Meagan: Yes. Listen, I think that’s how a lot of us start. We get inspired by our own births then we find the time in our life when the journey feels right and we take off. I encourage you to. I encourage you to become a doula. Yeah, it’s such an amazing journey. 43:53 What is vaginal cleansing?Meagan: I definitely want to touch on the postpartum stuff that we wanted to talk about, but I also found a little article thing on the vaginal cleansing. I just wanted to share. Janelle: Oh, okay. Meagan: It’s actually from cochrane.org. This was published in April 2020 4 years ago. We’ll make sure to have the link here in the show notes, but I was just curious more about what it was and in one of the articles, it said “vaginal toileting”. I’m like, What? That’s weird.Janelle: Odd. Meagan: Yes, toileting is a really strange vocabulary, but maybe in my head, I’m thinking that maybe they are getting rid of– I’m not going there. It’s called vaginal cleansing with antiseptic solution before Cesarean delivery to reduce infections after surgery. Janelle: Oh. Meagan: Kind of interesting. I’m not going to go through the whole thing because I really want to get to postpartum, but it says, “What evidence did we find? We searched for new evidence in July of 2019 and in this update, we have included 21 randomized controlled studies involving a total of 7,038 women” –which to men kind of sounds small– “undergoing a Cesarean section.” It goes down and it says, “Cleansing the vagina with antiseptic solution immediately before a Cesarean delivery probably reduces the incidence of post-Cesarean infection of the uterus. 20 trials of 6,918 women showed moderate-certainty evidence” –so they are moderately confident– “that the reduction was seen for both iodine-based solution and chlorhexidine-based solutions.” It says, “The risk of postoperative fever and post-operative wound infection was probably reduced by vaginal cleansing both moderately again.” It goes on even more talking about wound complications and infection of the uterus may be lower in women receiving pre-operative vaginal cleansing with solution. So that is interesting because one of the things for me and maybe I’m wrong, but I was under the impression that meconium was sterile. It’s poop, but the reason why they get so worried in the lungs is because it’s really thick and tarry poop. If you think about our lungs and tarry poop, right? That’s what my understanding was. It was more of that versus it was toxic to them but maybe I don’t know. Maybe I need to research my meconium evidence. Do you know, Christin?Christin: I don’t. Does that study say that they do it specifically related to meconium or just in prep for a C-section? Meagan: Just in prep for the C-section. When you guys were talking about the relation to meconium, it just made me think because I thought that meconium was okay. It doesn’t really talk about it here at all. It did say that they did not observe any difference between groups of women with ruptured membranes and women with in-tact membranes which to me says– because in-tact membranes mean no meconium, right? Janelle: Right, no. Meagan: Yeah. They wouldn’t know or it wouldn’t be present, so it’s interesting. It’s interesting. Janelle: Yeah, interesting. Christin: It must have just been a coincidence with your C-section and meconium being present. Like I said, the one that I just saw– it might have been a week ago. Meagan: It ended in a Cesarean? Christin: Yeah, it was for a C-section, but I don’t think they knew that meconium was present at the time that they did the cleansing or the vaginal toileting I guess that we are calling it. Janelle: Vaginal toileting. That sounds so gross. Meagan: Vaginal toileting, I know. This article says vaginal cleansing specifically, but yeah. Janelle: I prefer that. Meagan: There was another article that talked about the effects of vaginal douching and another article that talked about the effects of vaginal toileting before a Cesarean. Janelle: I’m not a fan regardless. Meagan: Yeah. It’s so interesting. I honestly have never seen that. I mean, it was 4 years ago so maybe some places are catching up. I mean, I don’t know. Anyway, moderate. It may. It may not. It’s not complete. But anyway, there was that. I just had to throw that in because that was a big question. Janelle: Yes and touching on that, I think maybe it’s okay to decline that and I would have declined that had I known that was what was going to happen to me because it very much happened to me.Christin: Yeah. Absolutely. Meagan: Yeah and it wasn’t discussed. You still didn’t even know the reason right now. You were still processing. Those are the types of things that as those things are happening, you can stop and say, “Hey, whoa. What is the evidence on this?” You can ask about that. Or, “Hey, can you tell me the pros and cons here because I don’t know if I want this?” Then again, it’s ultimately up to you to choose if you want that. Now, if you’re not expecting a Cesarean and all of a sudden they are doing this, that might be a red flag to start asking questions because they may be mentally on the other side of the wall preparing you for a Cesarean that you are not aware of. Christin: Yeah, I think this is a good example of just in general how much they don’t let you know how much is actually voluntary. A lot of times, the way they phrase things is, “Okay, I’m doing this to prepare for this or I’m going to do this” without letting you know, “Hey, if you don’t want this, we don’t have to do this.” Janelle: Right. Christin: So I think that happens with a lot of things, especially as a first-time mom, you don’t know. You don’t know what is– Janelle: Protocol. Christin: What you have to consent to and what is protocol and even if it is protocol, you can still decline it. You don’t know a lot of that stuff. Meagan: Yeah. Yeah. Okay, so we’ll be quick and we’ll include this link in there. 50:26 Symptoms of postpartum depressionMeagan: This is from the Mayo Clinic. It talks about the different symptoms of postpartum depression. We talk about baby blues. I’m just going to talk about this really fast. I encourage everyone to go click on it. But baby blues symptoms may include things like mood swings, anxiety, sadness, irritability, feeling overwhelmed, reduced concentration, appetite problems, and even crying. No, postpartum depression symptoms they have listed as depressed mood or severe mood swings, crying too much, difficulty bonding with your baby, withdrawing from family and friends, overall tiredness, hopelessness, feeling worthless, restlessness, super anxiety, and stuff like that. Postpartum psychosis, getting confused and lost. A lot of the time, people with postpartum psychosis will be mid-thought and then they just stop and they literally have no idea what’s going on. They’re very confused. Having obsessive thoughts about your baby. Hallucinating kind of sometimes goes into that feeling very confused. Not sleeping or having too much energy. Almost feeling like you’re so exhausted but you are really, really, really high. Does that make sense on energy? Making attempts to harm yourself or your baby and then there is more. So when to see a doctor— if it goes past 2 weeks after your baby is born, you are noticing it getting worse. Your partner is noticing it getting worse. It is making it harder on you to physically take care of your baby or yourself and things like that. All good things to know and be aware of. Yes, like Janelle said, it is very hard to admit sometimes because we are in it, but get that supportive team. This is also a really great conversation to have prior to having a baby even if you have never had a baby before or never had any of these symptoms before to talk about it and create a plan for if these symptoms are coming in, what to do, what you want to do while you are in a different space. All right, I just ran really quickly through that because I know our time is up, but definitely check that out. Women of strength, know that it is okay to ask for help. It is okay. Janelle: Yes. I agree 100%. Christin: Absolutely. Meagan: Thank you guys so much for joining me today. It was such a pleasure. I loved seeing the emotion, the waterworks, the smiles, the uncontrolled laughter. It just was so much fun and I absolutely adore you both. Janelle: Aw, I love you. Thank you so much for having me. I love you, Christin. I love you, Meagan. Christin: Love you too. Meagan: Love you. Christin: Thank you so much, Megan. ClosingWould 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.Our Sponsors:* Check out Dr. Mom Butt Balm: drmombuttbalm.comSupport this podcast at — https://redcircle.com/the-vbac-link/donationsAdvertising Inquiries: https://redcircle.com/brands