Episode 363 Aubrey's Induced VBAC with ICP (Cholestasis)
Aubrey shares her three birth stories that tell of resilience, healing, trust, and miracles. She has had a vaginal birth, a crash Cesarean, and a VBAC– all of which presented cholestasis. Aubrey’s first birth was a long but routine induction. Her second birth was a traumatic whirlwind including a complete placental abruption, general anesthesia, and her baby miraculously surviving 15 minutes without oxygen. Though her third pregnancy had many complications, the open and honest relationship Aubrey had with her provider is what ultimately led to her TOLAC and successful VBAC at 37 weeks and 6 days after another medically necessary induction. Aubrey is proof that no two births are the same, and miracles happen even when circumstances threaten to say otherwise. **Aubrey also wanted to mention that after her VBAC, she was readmitted to the hospital for postpartum preeclampsia. She had a headache every day, decided to eventually buy a blood pressure machine, and it was through the roof. She took herself to L&D, and they put her on magnesium. Aubrey had no idea it was even possible to get it postpartum and wanted to share!Managing Cholestasis SymptomsHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details Meagan: Hello, everybody. It is almost Christmas, and I am so excited to bring another story your way. This is a VBAC story from a mama who is from Louisiana. She had quite a few roadblocks within her pregnancies that could have easily stopped her from having a VBAC, but she really established a good relationship with her provider even though her provider wasn’t actually as gung-ho or excited about the VBAC specifically because she was nervous, together they communicated their feelings and understood where each other were, and came up with a plan to ultimately have a VBAC.I just respect that so much. It’s important to know. We talk about providers all of the time. Providers are so important, and they make such a big impact on our outcome, but this provider, even though she wasn’t really comfortable with VBAC, she truly believed in our guest, Aubrey, today. You’ll have to hear it from her own words. It’s awesome to hear how everything unfolded. We also have a topic today that maybe isn’t shared a ton. It’s called ICP or cholestasis that we are talking about. It is a liver condition that can occur during pregnancy and cause a range of symptoms. A lot of the times, it is baby being born that is the thing to end cholestasis. We are going to talk a little bit more about that, but I wanted to go over some of the symptoms. We’ve got dark urine, pale or light gray stools, and she’ll talk about this. That is definitely something that is not normal in pregnancy, so if you are seeing that, that is a reason to contact your provider. Nausea, she described some other symptoms there. Decreased appetite, pain in the abdomen, or jaundice. These are some things to look out for. Now, there is a website called icpcare.org. We’re going to make sure to attach that in the show notes, so if you have had cholestasis before or you want to learn more about cholestasis and how to manage the symptoms, and what types of things like healthy diet, they have so many amazing resources on their website. They even have recipes and different types of healthy fats and grains and legumes and things that we can focus on. We know that all of the time in pregnancy, really what we are putting into our body is so important. Definitely check out icpcare.org if you want to learn more about ICP and managing symptoms and resources and community support and all of the above. We do have a Review of the Week, so I want to get into that, and then turn the time over to Aubrey. This reviewer is reneekc89. The review title is, “A Turning Point”. It says, “When I was pregnant with my first, I was one of those ‘whatever happens is fine’ moms about birth. Then I had an unplanned Cesarean after a stalled induction. It wasn’t until I saw family members and friends so easily have vaginal births that I knew I had to try something different the second time around. I found this podcast through a local mom’s group and immediately binged every episode. I continue to listen every week even after my successful VBAC in October 2020.”It says, “Listening to what seemed like every possible outcome helped me release my fear that I might have had. I felt emotionally prepared for anything that might have come my way. I switched hospitals and advocated through my entire 25-hour labor in the hospital, and felt like every decision was a conversation between two adults rather than demands.” Oh, what a powerful thing right there, you guys. She says, “I advocated throughout my entire 25-hour labor in the hospital and felt like every decision was a conversation between two adults rather than demands.” That is how it should be. It says, “I have to thank this podcast for helping me gain that kind of confidence. Thank you also to the Facebook Community for always answering my questions.” Oh my gosh. Thank you, reneekc89, for that review. Just a reminder, you guys, if you have not found us on Facebook yet, check us out. You can find us at The VBAC Link Community. You have to answer a few questions to get in, and then you’ll get into this amazing community. We have the community on Instagram, and Facebook, and in this Facebook group. I believe so much that this Facebook community will empower you along the way. Like she said, you can ask questions, share pictures, and share concerns, and share triumphs and feel that love and support along the journey. I also wanted to throw out that we have a CBAC group, so if you are going for a TOLAC and it does end in a Cesarean, or you choose a Cesarean birth after a Cesarean, this group is here for you as well. You can find that at The CBAC Link Community on Facebook. Meagan: All right, Ms. Aubrey. Welcome to the show. Thank you so much for being here. I know you’ve probably been waiting. I feel like there are so many times when people are really excited to record their story, then I’m like, “Hey, you’re going to be aired this much further out.” You have two months to wait. You’re recording now, and then in two months, you’ll be airing on, but I’m so glad you are here to share your three stories. You had a C-section, then two VBACs, right? Aubrey: I had a vaginal birth, then a C-section, and then a vaginal birth. Meagan: That’s why I’m thinking two vaginal births. So vaginal birth, then Cesarean, then vaginal birth. You’ve got all sorts of different things added to your story. Aubrey: So many. Meagan: Cholestasis is one of them, right?Aubrey: Yes. Meagan: Okay. I’m excited to talk about that, because I think a lot of people think with cholestasis, there’s only one answer. We’re going to be talking about that, but I’m going to turn the time over to you.Aubrey: Okay. I guess we’ll start with my first birth. Heads up if I cry at all during it because I just do that sometimes. Meagan: That is okay. That is okay. Aubrey: My first pregnancy was totally normal. I had no complications. I was big and miserable, but that was about it. I did have SPD, so my pelvis hurt really bad. I didn’t know enough about it to go to a chiropractor to fix it. That was really my only thing until right at 38 weeks, it was that night at about 11:00 at night. I started itching on my feet. I couldn’t scratch the itch. I got my husband’s socks, and I put gel ice packs inside of them and wore them. That helped, then the itching started in my hands. This had been going on for about 2 hours, so I got in a really cold bathtub. The itching had started to spread more. It wasn’t just my hands and my feet. It wasn’t a normal itch. It was coming from underneath my skin. It was like my blood was itching. Meagan: People have described it to me as an unreachable itch.Aubrey: It is. It’s the most miserable. Meagan: You touch the spot, but you can’t get to it.Aubrey: Yeah. It’s like when the inside of your ear itches. You’re like, ugh. It’s like that but all over. Nothing helps. I called the after-hours line at probably 4:00 in the morning. The doctor on call was like, “Pregnancy can be itchy. Take some Benadryl.” I was like, “I’ve already taken Benadryl. It’s not helping.” She was telling me to take some creams, and I knew something else was wrong. I spent the rest of the morning researching. I came to the conclusion that I was 99% sure that I had something called cholestasis, and that I was going to have to be induced.One thing that solidified that was that there were other symptoms that I didn’t know about. My stool was white. It was really weird. It just was white-colored. I had this really violent episode of vomiting beyond anything I had ever experienced in my life. That’s one of the things. It’s this uncontrollable exorcist-style vomiting. Meagan: I actually did not know that. Aubrey: Yeah. It was unnatural. I remember thinking, “That was so weird,” but it was a couple of days before that, and then the next day or so was when I had the weird white-colored stool, but again, I had never been pregnant, so I was like, “I guess this is just pregnancy,” then the itching. That’s when I put it all together, and I was like, “Well, I’ve got cholestasis.” My husband was working that weekend, so I got my best friend to bring me to the hospital. When we got there, I was scratching all over. I was saying, “I’m pretty sure I’ve got cholestasis.” They clearly didn’t believe me. They weren’t being ugly. They were like, “All right. Let’s see what’s really going on here.” They put me in triage, and the on-call doctor came in. She is a lovely person. I don’t mean anything bad, but she walked in. She said, “Okay, here’s why you don’t have cholestasis.” She starts listing off all of these reasons. One of them was that I wasn’t jaundiced. Later on, in my research, there’s only 30% of women who have elevated bilirubin levels when you have cholestasis. I wouldn’t have been jaundiced because my bilirubin wasn’t elevated. I said, “Okay. I understand all of that, but can you please just run the labs?” She was like, “Okay, if you want me to run them.” She brought the lady in there. They did the labs, and about 30 minutes later, she came back in, and she was like, “Okay. You were right, and I was wrong. You have cholestasis, and we are going to induce you right now.” I was like, “Okay.”Meagan: Oh my gosh.Aubrey: I called my husband and told him he needed to leave work. At about 5:00, I think– I guess it was about 5:00. They put misoprostol. Meagan: Mhmm, misoprostol, yeah. Cytotec. Aubrey: Yeah, they inserted that. After the first dose, they determined that my cervix was not tolerating it well. They decided to not continue it. They went straight to Pitocin. I didn’t know then that what they were doing was really, really fast, but they were upping it every 15 minutes 2 milliunits. Meagan: 15? Wow. That is really fast. Aubrey: It is. Now that I know. At the time, I was like, “Okay.” During my birth, I prepped. I read books, and I went to classes, and I did the Bradley method, and all of the things, but I didn’t prepare for induction because I had no idea that I would ever need that, so I knew a lot about birth, but I did not know anything about induction. I was like, “Okay, if you say we’re going to do that, we’ll do it.” I think I felt my first contraction. It wasn’t that long after the Pitocin, but it wasn’t that strong. I had contractions off and on for several hours, and the nurses would come in and say, “Oh, are you okay? That was a really strong one.” They didn’t feel that bad to me, so I was like, “Oh, I can do this.” That went on for a while, and I guess once I got going more, It just felt like I was always contracting. I didn’t know any different, again. I didn’t know any different. I just thought this was what it was. Sometimes, it would be more intense, but there was always a contraction. Even on the monitor, you could see that it never dipped down. She asked if she could break my water at 7:00 that morning. It was my doctor. I don’t know if she came to check on me or if she happened to be on rounds. She asked to break my waters. I told her I didn’t want her to right now. She came back later, and I was okay with her breaking it, so the floodgates opened. I had so much fluid. We did not realize how much fluid I had. That was that morning or maybe the mid-morning. That evening, I hadn’t slept in two days at that point because of the itching the night before, and then the contractions. I asked the nurse, “If I get an epidural, will I sleep?” She was like, “Probably so,” then I was like, “Then give it to me. I am so tired.” I did. I slept like a baby. The nurse, I wish I knew her name, but she was so sweet. She came in the night. She put a peanut ball in between my legs. I was only 4-5 centimeters at that point. She put a peanut ball in, and she would come in every 30 minutes. She would flip me from one side to another while I was sleeping. I woke up the next morning at 6:00 in the morning. I had been in labor at that point for 39 hours. I got the epidural at 30 hours. Meagan: Wow. Aubrey: Yeah. She came in the next morning, and the doctor was like, “Okay. You’re ready to push.” I was like, “I am?” The epidural was so strong. I couldn’t wiggle my toes. I had no idea. She came in, and set everything up. I pushed her out in 15 minutes. Meagan: Whoa. That’s awesome. Aubrey: 14 minutes actually. My doctor was like, “That’s the best I’ve ever seen a new mom push.” I was like, “Wow, yeah. Okay.” Meagan: Go me!Aubrey: Yeah. I didn’t have any reference. For me, I was like, “This is taking so long, but apparently it was very quick.” Now I know it was pretty quick. Afterwards, my uterus would not contract back. My placenta wouldn’t come off. Now I know it’s because afterwards, she told me that my contractions never stopped. There was never a break between contractions, so my uterus was just completely exhausted. Meagan: Uterine atrophy, yeah. Aubrey: Yeah, so she had to manually go in there inside of me and start my uterus to contract again which was not pleasant, but she just basically had to shock it. Meagan: Stimulate it, yeah.Aubrey: Yeah. Eventually, it did, and my placenta just fell out. That was that. When they broke my water, I forgot to say, they did find meconium which is common in cholestasis. It was very light, and she wasn’t worried about it. It wasn’t an automatic C-section because of the meconium. It was really light. She did have to be suctioned, but other than that, she was perfectly fine. We didn’t know any of the genders for any of my babies, so it was fun to find out that she was a girl. That was birth number one, and that was in 2018.A year and a half or whatever it was, I got pregnant right before COVID became a big thing. I was pregnant all through the COVID scare. I was due in September, at the end of September. Again, it was non-complicated. I forgot about this. I had a subchorionic hemorrhage around 16 weeks which I didn’t know about. I didn’t have any bleeding or anything. They just found it on the ultrasound, and then by the next time I went, it was resolved. I was considered high-risk though the whole time because of the cholestasis, so I had frequent scans all the time. That was really the only thing that was weird. We had tested for cholestasis. There were a couple times because anyone who has had cholestasis knows that anytime you itch, you’re like, “It’s back.” There were several times I had her test me, and there were no elevated levels. Right before 39 weeks, I told her about some intense itching on my foot. I told her that this time was it. It was the itch. She was like, “Okay, well because of COVID, and we’re not sure what the hospital bed situation is going to be like, we’re going to go ahead and test your blood and find out if it’s present, but in the meantime, let’s go ahead and schedule your induction to make sure you have a place if we do have to induce, then you’re already there.” She wanted me to induce that day. I couldn’t because my husband was gone for the Army. I said, “I just need a few days for him to get back in town.” That was on a Thursday or Friday, and I was induced either Monday or Tuesday. It was on September 1, 2020. I went in for my induction. This time, I had not prepared at all. I was like, “Oh, it’s like riding a bike. I’ve done it once. I can do it again.” I want to say upfront that anything they did during the induction, I was totally a party to it. I agreed. I never said no. I never asked questions. I was uninformed or unprepared or whatever, but I never spoke up, so I don’t blame them for anything that happened because I could have spoken up, but I didn’t. They always asked me. They never told me, “This is what we’re doing.” They asked me my permission for everything. We got there. They did not do Cytotec because it hadn’t worked before. They went straight to Pitocin. Again, the same 2 milliunits every 15 minutes. Meagan: Is this just their way?Aubrey: I think it was. I don’t think it is anymore, because it was different when I went for my VBAC, but yeah. Meagan: Well, I wonder if that’s because you were a VBAC though. Aubrey: No, because one of the conversations I had with one of the nurses, I asked her if we could start slow. She was like, “Well, our policy is to go 2 milliunits every 30 minutes.” I was like, “I’d like to go slower than that.” I think they must have changed their policy. I don’t know. That’s what my hospital records say is that they were doing 2 milliunits every 15 minutes. I got those thanks to y’all. I was like, “Let me go see what that says.” Meagan: It’s nice to see what it says, yeah. Aubrey: Yeah, it is because in my situation especially with what happened to my son, it was so amazing to read what really happened and to know my son is where he is. I’ll get to that. Anyway, so she came in around 7:00 in the morning. My doctor was on shift. She asked if she could break my waters. I was like, “Sure, go ahead.” She broke my water. So far, it had been a pretty uneventful induction, nothing to write home about. I didn’t have an epidural. I didn’t feel like I needed one. I was going to try to do it without one if I could, but that might have been at 8:00 or 9:00 in the morning. I don’t know. It was in the morning. Around lunchtime, they started saying that the baby was wiggly and that they couldn’t really get a reading of his heart. He had been wiggly before, and so they were like, “Is it okay if we insert an IUPC?” I had that with my daughter. It doesn’t harm the baby. It didn’t hurt me. I didn’t mind them putting it in, which is for those of y’all who don’t know, it is a–Meagan: Intrauterine pressure catheter. You’ve got it. Aubrey: It measures the contractions from the inside so you can see how effective they are and all that. I was like, “Fine, yeah.” My nurse, whose name is Becca, she’s lovely, inserted the catheter into my uterus, and the tube that comes out is clear, and it filled with dark red blood. I knew something was wrong. I said, “That shouldn’t be red like that.” She said, “It’s okay. Sometimes we have a little bleeding.” I said, “Not like that. That’s red.” She was trying to calm me down. Meagan: Yeah, and sometimes they can knick the cervix and it can cause bleeding, but you were like, “No. Something’s not right.” Aubrey: Yeah. I just knew something was wrong, but before that, I had no symptoms. I had no clue that anything was wrong. I didn’t feel bad. I didn’t feel any pain. Nothing. I was like, “You need to take it out. Please take it out. Please take it out.” She called my doctor who was in her clinic down the hospital, and she said, “It’s okay to take it out if she’s not comfortable with it.” When she took it out, blood just came shooting out of me. It was gushing. Meagan: Really?Aubrey: I know it was blood mixed with fluid, so that’s why it was so much, but it looked like it was pure blood. It was so dark. I mean, I was like, “Okay, I need the doctor.” Becca was so sweet. She said, “Okay, just give me one minute. I’m going to go outside and get the doctor.” She was so calm. I was freaking out. She went out there. My doctor was in my hospital room within a couple of minutes. I think she was across the hospital in her office. She was there within a couple of minutes. She had an ultrasound machine. There wasn’t a lot of time for talking about what was going on. She just got the ultrasound machine, looked for a second, pushed it up against the wall, and my doctor has the most wonderful bedside manner with the way she talks even when she is stressed out. She said, “Okay, Aubrey, we’re going to have to go back to surgery now. Brandon, I need you to tell your wife goodbye.” As she’s telling him that, they’re pulling my jewelry off. The other nurse handed me a consent form for a C-section. They were prepping me as we were talking. Then they ran me down the hall. It felt like Grey’s Anatomy. They pushed this poor woman up against the wall. I remember her head hitting the wall. It was that fast. We were running down the hall. We got into the OR, and I just remember them prepping my body and prepping the room. They were getting the instruments lined up. There was no time for anything. I didn’t have an epidural, so they didn’t have time to call an anesthesiologist to my knowledge. They started putting the lidocaine where my incision was or was going to be. I started hyperventilating. The nurses threw a bedsheet over my head. They popped up under there with me. They were like, “I’m so sorry, but this is the best we can do. We don’t have time to put a sheet up. We’re going to have to stay under here. We’ll stay here with you.”Meagan: Oh my lanta. Aubrey: Yeah, it was really scary. I remember right before they threw the sheet, I could still see the door swinging. That’s how fast everything happened. They eventually, she was like, “You have to calm your breaths down because the baby needs the oxygen.” Little did I know that it really didn’t matter how much breath I took. He wasn’t getting anything. Eventually, they put me out with gas. Meagan: Did they put you under general?Aubrey: I had to be gassed out. I was hyperventilating. They were like, “We need you to be still.” At the time, they were literally about to cut me before they threw the sheet over. I remember the very last thing that my doctor said to her nurse was, “There’s no fetal heartbeat. There are no fetal tones.” I knew at that point that he was dead. Meagan: That’s the last thing you heard. Aubrey: Yeah. I woke up. I don’t know how much longer it was. It was pretty quickly after surgery because I don’t think they anticipated me waking up so early. I was in a hallway. I wasn’t in a recovery room. Because I wasn’t out all the way, I don’t know, but I woke up, and two of the nurses, because there were like 18 people in the room with me when everything happened. The nurses’ backs were to me. I said, “Is my baby alive?” One of them said, “Oh, she’s awake.” They turned around. One of them said, “They’re doing everything they can.” I passed back out. Then I woke back up in the recovery room. My doctor was waiting for me. It was COVID, so my husband wasn’t anywhere near any of this. Meagan: Yeah, I was wondering. You said his name was Brandon, right? They were like, “Bye, Brandon. We have to take her.”Aubrey: Then he was just left alone in the labor and delivery room freaking out. Meagan: No one talked to him?Aubrey: He told me later that my doctor had come in after the surgery to tell him everything that happened. Immediately afterward, she came in there to tell him. She is the best doctor in the whole world. Meagan: But he had to wait. Aubrey: Yeah, he had to wait. There wasn’t any time for anybody to tell him anything. Meagan: How scary for him. Aubrey: Because come to find out, my placenta had spontaneously 100% completely detached from my body in a matter of a couple of hours. If anybody has ever had a placental abruption, it starts slow. It comes off a little bit at a time. Mine came off in a couple of hours. It was completely detached. We didn’t know why at the time. It was very unexpected. She was there. I woke up, and I said, “Is my baby alive?” She said, “Do you want to know what you had?” I said, “Is the baby alive?” She said, “He’s alive, and he’s a boy.” Then she told me what happened. He was dead when he was born. He was dead for 15 minutes. Meagan: Wow. Aubrey: Yeah, 15 minutes. He had no blood flow or oxygen flow to his brain. A lot of his blood had been drained out of him because my placenta had pulled it out of him because it was detached so quickly I guess. He was not completely exsanguinated, but he lost a lot of blood and he had no heartbeat. According to my hospital records, they tried compressions. They tried the electrode things. They tried an epinephrine shot, and they tried an epinephrine drip, and nothing started his heart, and then after 15 minutes, his heart just spontaneously started by itself. Meagan: Wow. Aubrey: Yeah. That’s why it was so cool reading back my hospital records to see. My doctor and everyone involved was like, “We can’t believe this. I cannot believe he is alive. I cannot believe you are alive,” but reading it and seeing how amazing it really was was really cool. She told me that the surgery had happened in just a few minutes, and that because of how quickly she had to perform that surgery, that my recovery was going to be really intense, and that most people who have a C-section would not be in as much pain as I’m going to be in because they literally had to rip my body open to get him out, but she said, “Your incision is fine.” Luckily, she’s a really skilled surgeon. She did all of that perfectly. She said, “I don’t expect any trouble with you healing or anything with your scar.” He was put on a cooling blanket and intubated and given maybe six blood transfusions. If anybody from the hospital is listening, I’m sorry if I get the numbers wrong. But it was a lot. There were six little stickers missing from his transfusion bracelet. He couldn’t eat. We couldn’t pick him up. We couldn’t touch him. I couldn’t see him for the first 24 hours because I couldn’t move, so the nurses had taken pictures of him and brought them to me so I could see what he looked like. They didn’t show me the really scary ones until later because there were some at the very beginning that were very scary-looking. My doctor came in the next day to check on me. It was her day off. She just came in to check in on me to tell me how grateful she was that I was there. I know it traumatized her too because she said she had never opened up someone and seen their placenta floating inside of their body. My nurse, Becca, came to see me. She was also pretty traumatized. But anyway, it was a lot. Once he was in the hospital, they put him on the cooling blanket and all that. He had to be on the cooling blanket for 72 hours, and then they were going to be able to test him to see how significant the brain damage was because we knew that he would have some. I mean, after 5 minutes, you start to have brain damage, and then we knew having been out for 15 minutes that we were looking at something pretty significant based on science. That was the thing that I think was different about me then than now. My background was in physiological psychology. That’s what I studied in grad school. My immediate thought was, “I know what science says. I know the probability is of my baby,” and that’s what I was looking at. What do we need to do to take care of this baby with significant brain damage?We waited, and on the second day, the day before I was released from the hospital, I had a really cool encounter that was just the way that God changed everything for me which came into my VBAC later because of the faith that it gave me, but I had dragged myself to the shower that morning. It was so painful. My husband was still asleep on the couch. I got in the shower, and the water was cold. That made it even worse pain because it was cold. I was in the shower, but I couldn’t get up because I was frozen in pain. I was like, “Why is this water in the hospital cold? It shouldn’t be cold.” I sat in there for about 15 minutes. The water stayed cold, and it never warmed up. Finally, I said, “God? If you can’t save my baby, can I at least have some hot water?” The water turned hot. I just started laughing and crying at the same time. I just knew that my baby was okay. I don’t know how I knew. I just knew that even if he wasn’t going to be perfect, whatever was wrong with him was okay. It helped me to get through the next few days because it was hard to see him just laying there. Finally, when they were able to do his tests after 72 hours, we had to go to a different hospital. He had to go in a little ambulance and go over there. We had one of the best pediatric neurologists in the area, Dr. Holman. She’s not known for her bedside manner, but she’s an incredible, incredible doctor. I say that in a way that she’s very to the point. She doesn’t sugarcoat anything. My sister, who is a nurse, warned me, “I’m just telling you that she’s the best of the best, but she’s not–” Meagan: She’s blunt. Aubrey: She’ll give it to you straight. That’s what we were expecting. They did his little scans, and when she came back she said, “I don’t have a medical explanation, but your baby is perfect. There’s not a single spot on his brain. The cooling blanket does incredible things, but I should see something, and I don’t see anything.” Meagan: Wow. Aubrey: She said, “Your baby’s going to be perfectly fine.” She told us that he’s probably going to have some issues from being in the NICU and being still. He would have to have physical therapy to help his muscles and all of that, but as far as his functioning as a human being, he was perfectly fine, and nothing was wrong with him. Meagan: Yay. What a miracle. Aubrey: Yeah. That’s what she said. She said, “Your baby is a miracle, and I don’t get to say that with what I do very much.” Meagan: That’s awesome. Aubrey: Yeah. So that was his birth, and after that, that day, my husband left and went back to the Army. I recovered from that. I recovered from that pretty much alone which was almost as traumatic as what happened in the hospital because I was in so much pain, and I had a 1.5-year-old and a new baby who screamed all the time which was one of the things they warned me about after the NICU. They said, “He’s going to cry a lot. We don’t know why, but coolant babies just scream a lot.” He did. For hours and hours and hours, he would scream. It felt like torture in a way because it was like I couldn’t do anything. He would scream and scream and scream. My friend, Ashley, and my sister were the only way I made it through that. I would call my sister, Kelly, and be like, “I need to come over,” at 3:00 in the morning. She was like, “Come on.” She would hold him while he screamed so I could go in the back and sleep because I was so sleep-deprived and in so much pain. Then my friend, Ashley, would come over and help me clean. She helped me with my daughter. They helped me through that part. My husband was gone for the first 6 months of Amos’ life. About 2 years later, I got pregnant again. I was really scared of having to have another C-section. I was on a pregnancy app, and I asked, “Has anyone ever had a vaginal birth after they’ve had a Cesarean?” Somebody on there was like, “Oh, you should try this thing called a VBAC. There is a place called The VBAC Link.” I was like, “Okay.” I had no idea. I had never heard of The VBAC Link or the term “VBAC”. I found The VBAC Link, and like everybody else, I became obsessed. I listened to every episode, read every article, and every post. By the time it came time for my first appointment with my doctor, I knew that I was going to at least give it my best try. When I told my husband that I wanted to have a VBAC, he was not okay with that. He was really freaked out because, I mean, everybody involved was traumatized. He was. The nurses, the doctors, everybody. He was just like, “Are you sure that’s safe?” I was like, “Yes, actually. I am sure that’s what is safest.” I got on The VBAC Link, and I was like, “How do I make my husband understand?” They were like, “Enroll in the course and show him the course.” Meagan: Yes. Take the course with him. Aubrey: We did. By the end of it, he was like, “Okay. If that’s what you want to do, we will do it.” That’s what we planned for. I was really hoping that I didn’t get cholestasis for the third time. There’s not really anything you can do to prevent it, but I was just really hoping that somehow it wouldn’t show up. About, I guess, 20 weeks, I was told that I had complete placenta previa, so that was super fun. My maternal-fetal medicine doctor explained it, and this is for everybody who gets diagnosed with that. It made my brain so much more calm. He told me that your uterus is a muscle. It’s juicy, and it has all of these blood vessels. Your cervix is a connective tissue. It doesn’t have all of that. Naturally, your placenta is going to gravitate toward where it can get the most nutrients. It almost always resolves itself because it’s not going to get what it needs off of your connective tissue. I just banked on what he said, and by 28 weeks, it had gone so far up that it wasn’t a concern at all. Around 24 weeks, I started seeing a chiropractor for severe SPD. My pelvis was on fire. It was grinding, and all of the things. It was worse than with my daughter. I didn’t have it at all with my first son, but man, it was back with a vengeance with my third pregnancy. The chiropractic care helped so much. If anybody is in the Natchez, Mississippi area, my chiropractor moved to Natchez, Mississippi after she helped me. But anyway, that’s where she is if you’re near there and you need a good Webster-certified chiropractor, she’s amazing. Her name is Dr. Ashley Edwards. She helped me. Then she helped me with positioning and stuff. She’s really good. That was 24 weeks. I started that. Early on in pregnancy, I had been coming from one doctor to the other in the same building, and I was really huffing it. My blood pressure was high. They let me sit for a minute and retest it, and it was fine. I didn’t think anything of it until later on in pregnancy when that happened again. My maternal-fetal medicine doctor freaked out. He was like, “You’ve had two high blood pressure readings. We need to test you for preeclampsia.” That was in my third trimester at some point. I’m probably skipping around. He kept pinching me to see, and asking me if the swelling was normal. I kept telling him, “That’s just my ankles. I just have big calves and ankles.” Every time, he would be like, “Is this swelling always like this?” I’m like, “That’s not swelling. It’s just what my ankles look like, but thank you.”Meagan: Oh my goodness. Aubrey: That was fun. I had to carry around my urine for 24 hours to the urine test. He said that I did have protein in my urine, but it didn’t meet the threshold of preeclampsia, so I was not preeclamptic, but they were going to watch me for it. Toward the end, I did get, “Your baby’s really big,” not from my OB, but from my maternal-fetal medicine. My OB– I guess I should rewind. I didn’t even talk about how we had that conversation. My OB from the very start was so amazing. When I first came in, she was like, “I’m so excited for you.” She was like, “Is it okay if I tell Becca (my nurse from before)?” I said, “Yeah, you can tell her.” She texted Becca and told her. Becca and I stayed in touch through everything. She texted me, and she was excited for me. But I told my doctor that I wanted to try for a VBAC, and she said, “I’m perfectly fine with that. I don’t see an issue.” She was like, “The only thing that could possibly present an issue is if your cholestasis comes back, and it’s early on. But for now, let’s plan for a vaginal birth, and that’s the goal. If something changes, then we’ll talk about it when it changes.”She’s a very great doctor because you can talk to her, and you can be open with her and be honest and never feel like she’s judging you for telling her how you feel. I can’t tell you how many times I cried just with her telling me all kinds of different things. She just listens and never judges. We went through most of the pregnancy with that as the goal until at the end, around 32 weeks, my itching came back. They tested me, and I had elevated bile acids, so I was considered to have cholestasis. They put me on ursodiol. I only itched for a few hours, but I knew what the itching was. It’s so different. I knew what it was. I never itched again the whole pregnancy. Even before I got on the medicine, before I had even picked up the prescription, the itching had stopped. I still took it. At that point, they were like, “Okay. We can’t let you go into labor naturally. We’re going to have to induce,” because that is an automatic induction. Then the whole thing with the preeclampsia came around a little bit after that, so my maternal-fetal medicine doctor was talking about, “We might need to do this at 35 or 36 weeks.” I was like, “I don’t think I’m comfortable with that.” My doctor was like, “We’ll see, but if you have preeclampsia, that changes everything.” My doctor, my OB doctor– I was talking to her about everything, and she was like, “The reality is that what you have could potentially be dangerous for baby. So every week from about 35 weeks on, we’re just going to have to determine if baby is safer in or if baby is safer out, then at that point, we can determine how we are going to deliver the baby because we don’t know what your body is going to be doing. We just have to see.” She said, “I’m not telling you that you can’t have a VBAC. I’m just telling you that we need to be open to the possibility that it could turn into a C-section if this doesn’t go the way we want.” She said, “I feel like as your doctor, I wouldn’t be doing you any service if I didn’t at least have this conversation with you because if it came to the point that we had to have a C-section, and we had never talked about it, then you would be like, where did this come from? I don’t want you to feel blindsighted.” I appreciated it. I did leave really discouraged from that conversation. I cried because I thought that secretly she was trying to bait and switch me. But I should know that my doctor really is great. Anyway, so we went through the next couple of weeks where she would tell me, “Baby is safer in, so baby gets to stay in.” I had scheduled a lunch with Becca. I had asked her if she would be at my new baby’s birth. She said she would be my labor and delivery nurse. We’d get to try it again. She was like, “I’m going to help you have a VBAC. You can totally do this.” We had lunch. I told her about the conversation that I had with my doctor. I said, “I just want the opportunity to try. If I get to try and something happens and it doesn’t work out, then I’ll be okay with that. I just want to try because I know my body can birth a baby.” I said, “I don’t have to have the epidural, but if that’s what makes her comfortable, I’m okay with that because I’ve had the epidural before. It’s not like I’m anti-epidural. I’ll have it if that makes her more comfortable.” I’ve realized that she is a person with trauma, and I knew that what I was asking her to do was scary for her because of what happened and because probably most people don’t know, but cholestasis comes with the risk of placental abruption. It does something to the vascular structure, so it’s not that it causes it, but it makes you more susceptible to placental abruption. I knew that she was worried about that. I knew that everything else that had popped up and popped up and popped up, she probably was like, “I don’t think I want to do this anymore.” I told Becca all that, and she said, “Have you ever told your doctor that?” I said, “No,” because she knows her. She works with her. She said, “I think if you have that conversation with her, and you tell her just like you told me that she would feel a lot differently about it.” The next appointment was the appointment where we were going to do my first cervical check. We needed to know what my body was doing, so if I had to induce, they knew. Meagan: Where you were at. Aubrey: Yeah. It was one that I wanted and that I needed, I think, in that situation. Before she checked me, I knew that this time if she checked me and it wasn’t doing anything that she was probably going to be leaning more toward C-section because I was going to have to be delivering within that week or a few days after based on everything that was going on. When I got in there, I said, “Before you check me, I want to tell you something.” I said, “I just want to tell you this so you don’t think that my response to whatever happens in the check is me begging or anything like that. I just want you to know that this is how I feel.” I told her everything I told Becca. I told her that I wanted to meet her halfway and do whatever made her comfortable as long as I got to try. She said, “Okay. Let’s just check you and see what’s going on.” She checked me, and she said, “You’re soft. You’re 1 centimeter dilated, and we can have a VBAC.” She said– hold on. Let me get myself together. She said, “I’m uncomfortable with this, but the reason that I’m okay with this is because I trust you. I trust you enough to know that when you tell me your body can do this, I believe you. I know that you trust me enough to know that if I tell you it’s time to call it, then you’ll believe me and we’ll call it.” She said, “The reason that we’re doing this is because we have a mutual trust and understanding. We can be honest with each other.”I just sobbed and sobbed and sobbed. I mean, I was just so excited. On the way home, I got into a wreck. I totaled my car. Meagan: Oh my gosh!Aubrey: Yeah. It wasn’t as bad because it was totaled because my airbag came out, but it was in very slow bumper-to-bumper traffic. I had to go back to the hospital. She was on-call, and she was like, “Why are you here?” I had to be monitored for that, but everything was okay. Saturday at midnight was my induction. I came in, and they started my IV. It took them a while because I have really weird veins and they are hard to stick. Eventually, they called in an anesthesiologist to use his machine to find my veins. If anybody has hard-to-stick veins, you can use an anesthesiologist, and it works like a charm. He got my vein, and we started fluids. About 30 minutes later, it was probably at 2:30 or so whenever the Pitocin was in. I had my first baby contraction. Rebecca– a different Rebecca, but her name was Rebecca– said, “Okay, here’s the schedule we’re going to go on.” I forgot to mention this too, but right before my induction, my husband surprised me with his VBAC certification doula course. He had gone through the doula course. Meagan: Oh my gosh!Aubrey: He went through The VBAC Link doula course. He was like, “Surprise! I can be your doula.” Meagan: That is amazing. Aubrey: It was cute. My husband, when she starts telling me the schedule of how we were going to do everything, was like, “Excuse me, I think we need to not be going every 30 minutes. We need to be going every 45 to an hour.” He was so well-educated about the whole thing. She did. She did it slow at first, then we did that through the night. I don’t remember if I slept or not, but Becca came on her shift at 7:00. She was like, “Okay. You’re doing good, but here’s the reasons why I think that we need to increase the interval. We were having contractions, but we need to get a pattern going.” She told me why. I agreed with her that I was okay with it as long as it didn’t go faster than 30 minutes. We did that, and that started to actually get a pattern which was really nice. She is a brilliant nurse, and she knows what she’s doing. She was like, “We’re going to get you moving. Come on. Get up. We’re getting out of bed.” She had me walking down the hall, and with the peanut ball, and sitting on the ball. My doctor came in around 9:00. She told me that she thought we needed to break my water. I was really nervous about that because in my research of what happened to my placenta, I had found that it was likely that I had a placental abruption due to the rapid decompression of my uterus. My doctor agreed that that’s probably what happened, but when they broke my water, because my vessels were already weak, the pressure suctioned it off. I was really worried about breaking my water. She was like– I’ve never seen her be so stern with me before because she’s always so calm and nice. She said, “Aubrey, I’m very uncomfortable right now. I do not want to see you have a rupture. I do not want to see your placenta detach. We need to be real about this.” She said, “You have a lot of fluid. If we do not let some of that fluid out, your baby is not going to drop. You have a lot of fluid.” I did. I guess I forgot to mention that. I wasn’t quite poly, but I was pretty close to having poly.Meagan: Borderline. Aubrey: Yeah. I told her that I was scared. She said, “You cannot make decisions based off of fear. You have to make decisions based off of what is happening and what is fact. The facts are that your baby is high. Your body is contracting. You have a pattern, but your baby is not dropping. There is a reason, and it’s likely because of the fluid level.” So, she said, “I can break your water in a way that is not aggressive. I will just cut a tiny little slit and let it come out on its own, then it will come out.” I agreed. I mean, when I step back and look at it, I was like, “She’s right. Scientifically, the baby is buoyant and is just floating there.” Come to find out, I definitely had poly. I had so much fluid. When it finally came out, Becca was like, “I don’t think I’ve ever seen that much fluid come out of somebody.” It was the exact thing that the baby needed. He came down, and immediately, I went from 4 centimeters to 6 in an hour. I could feel my body doing very differently. It was changing differently than it had before. I started to get nauseous and shaky. I knew that I was probably getting closer to go-time. I told Becca, “You might want to get the guy to come give the epidural now. I promised her I would get the epidural, and if we’re going to get it, we’re probably going to need to get it now.” She was like, “Yep. Let’s go ahead and get it put in.” She had him put it in really light though so I could still move my legs and wiggle my toes. I could even put pressure on my legs which was nice. That was maybe at 2:00 in the afternoon or 3:00. Oh no. I got the epidural at almost 5:00. I was way off on the time. It was almost at 5:00 that I got my epidural. I had been between a 6 and a 7 and about 70% effaced. After the epidural, they had to go to an emergency, her and my doctor. They came back afterward, and me and my husband were playing Scrabble. I started throwing up. I had the bag, and I was like, “I need to throw up.” Becca came in and she was like, “You’re throwing up? This is the best!” She was like, “It’s time. It’s time.” I was like, “How do you know?” She was like, “I’m telling you. I’m telling you.” She checked me, and then Dr. Barrios came in, and she was like, “Okay, Aubrey. We’re going to have this baby.” My husband caught the moment. He has a picture of me the second that she told me I was going to have my VBAC. It was just the least flattering picture I could possibly have, but it’s so cool because it’s a live picture, and I could see the wave of emotion washing over me. I could feel pretty much everything. I mean, I’m sure if I had no epidural whatsoever, and I think Becca said she turned it down, but I’m sure it was way more intense if I was doing it without completely. I could feel everything. I could feel the ring of fire. I could feel opening up. To me, it didn’t feel like I had to poop. It felt like I had a bowling ball just sitting there. They were still setting up while I was trying to push. They were like, “Wait. Let somebody get there, so we can catch it.” Right as they were finished setting up and getting dressed and everything, I was like, “Okay, we’re pushing now.” I pushed. I don’t remember how many times I pushed, but I felt the head come out. I said, “Is that what the head feels like?” She was like, “Yep. That was the head. We just need one more push and we can get the body.” I pushed. He was out in 4 minutes. Meagan: Wow. Aubrey: Yep. It was crazy. I had to go back and make sure I was not crazy. I looked at the timestamps of the pictures because I was like, “There was no way that it was that fast. It felt like an eternity.” It was 4 minutes. Everybody cried. My husband got a picture of the first time they put him on my chest. As soon as I pushed him out, it was like all of the trauma and everything from before just washed off of me. It was so amazing. Meagan: I bet it was so healing for you to see that you could have a different experience. Aubrey: It was. Meagan: Even though you had a different experience with your first, after having that experience the second time, I’m sure that weighed over you for sure.Aubrey: Yeah. I love the fact that both my doctor and my nurse from the time before were there and we all got to do it again. Meagan: Yeah. Yeah. I was going to say that. I bet this was really healing for your provider and your nurse, and not even just healing for your provider, but something that stepped up her experience to see that birth could go a different way after a very traumatic experience. Aubrey: Yeah. Yeah. I think so. I hope that. I would say she’s not, “Woo, I love VBACs.” She was not anti-VBAC at all, but I would like to think that it helped her see VBACs in a more positive and more probable light. Meagan: Mhmm, exactly. I think you probably did a lot for her that she may not have even known that you did. Aubrey: She did a lot for me. She’s the best. The sad thing is that I have different insurance now so if I got pregnant again, I can’t have her. But she’s incredible. She really is. My baby– we didn’t have a name picked out. One of the other nurses, Jordan, who helped me deliver my baby was like, “I know you don’t have a name picked out. You don’t have to use this if you don’t want to, but I was just thinking that y’all wanted a cute, short name that started with A, and Becca’s last name is Anders, and it would just be really cute.” So we named our son Anders.Meagan: Cute. Oh my gosh. That’s adorable. I bet Becca is so happy. Aubrey: Yeah. When she left the hospital that night, because she charted forever and she left at 11:00 that night, we still hadn’t picked out a name. Jordan came in after she had left. She suggested it, and we were like, “That’s it. That’s his name.” I sent her a picture of the announcement with his name on it. She said, “I had to pull my car over on the road. Don’t do that to me while I’m driving.” Meagan: Oh my gosh. That is so cool and so special.Aubrey: Yeah. There were so many times on The VBAC Link where I see people who are like, “I don’t know if I should do it. I’m scared.” Just do it. Just try. If you succeed, it changes you. It’s so, so powerful. Meagan: It really is. It’s hard to explain. It’s so hard to explain that feeling that you get after having a VBAC. It’s unreal. It really is unreal. We just had a client the other day who had to be induced due to some pretty severe preeclampsia, and she was a VBAC. The second she found out that she had preeclampsia and needed to be induced, I think a lot of her faith slipped and her belief that it was going to happen slipped. We too have a very raw, beautiful, live photo of the second she saw her baby and her hands reaching down to grab the baby. It tells the whole story within that and that one image tells her whole story. It’s incredible. It’s incredible. Aubrey: The picture that I submitted to y’all is a picture of right when they put him on my chest, and I mean, it was so surreal. Another thing that I think I didn’t really mention is that there was a point when– because I had so much going on. I had all of these different complications and week to week. We don’t know if you’re going to have a baby this week. It was so stressful. Eventually, I just had to say, “Okay, God. You healed my baby. You started his heart. You healed his brain. You can make my body do what it’s supposed to do. I can only do so much. I can eat the dates. I can drink the tea, but after a certain point, there’s nothing else I can do other than just walk it out and just trust that God’s going to walk me through that.” I had to keep reminding myself of that with every single step because it got really hard. There’s a community called “Labor Nurse Mama”, and I was a member of that community too. There’s a doula on there. Her name is Lamay Graham. I think she’s in Milwaukee. I’m going to tell you where she is, but she’s a doula, and she’s incredible. We would have these live chats and Zoom calls. They would talk to you.She would help remind me, “You can only do so much, Aubrey. You’re doing everything that you can. Stop putting it on you because your body is going to do what it’s going to do, and you’re not going to change that the more you stress yourself out. You have to just trust God.” She is one of the reasons I kept being able to come back to reality. It was because she would remind me, “You have to just remember. Stop trying to do it all yourself.” Meagan: Yeah. We have to trust, have faith, and do everything we can within our own power, but then understand that there are going to be other things, and you have to have faith in those things. The more educated we are and prepared we are, we can navigate through those things. Well, I am just so stinking happy for you. I can see the emotion. I can hear the emotion. I saw the pictures. If you guys are listening right now, go over to our Instagram or Facebook page, and check out this beautiful image of her just holding your baby. You’ve got Jordan in the background, your nurse Jordan. I mean, really, it’s so beautiful and I’m so happy for you. Congrats. Aubrey: Thanks. I’m sorry I was kind of all over the place. Meagan: No. Listen, that’s okay. That is totally okay. I’m just so happy you are here to share your stories. Aubrey: Thanks. I appreciate you. 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.Support this podcast at — https://redcircle.com/the-vbac-link/donationsAdvertising Inquiries: https://redcircle.com/brands