The VBAC Link Meagan Heaton

Dr. Christina Pinnock is a Maternal Fetal Medicine Specialist/Perinatologist based in California and creator of the ZerotoFour Podcast. She is here to help us tackle topics like what constitutes a high-risk pregnancy, lupus, preeclampsia, HELLP syndrome, gestational diabetes, fibroids, and bicornuate uteruses and how they relate to VBAC. 

The overarching theme of this episode is that all pregnancies are individual experiences. If you are hoping to achieve a VBAC and you have pregnancy complications, find a provider whose goals align with yours. By ensuring that your comfort levels are a good match, you are on your way to a safe and empowering birth experience!

Dr. Pinnock’s Website and Podcast
Needed Website
How to VBAC: The Ultimate Prep Course for Parents
Full Transcript under Episode Details 

00:58 Review of the Week
03:13 Dr. Christina Pinnock
03:56 Importance of a VBAC-supportive provider
06:36 High-risk pregnancies
11:02 Lupus and TOLAC
14:31 Preeclampsia 
17:19 Varying ranges of preeclampsia
20:46 HELLP Syndrome 
26:36 Other High-risk situations 
27:54 Gestational Diabetes
35:00 Inductions with gestational diabetes
42:25 Fibroids 
46:33 Do fibroids tend to grow during pregnancy? 
51:20 Bicornuate Uterus

Meagan: Have you ever been told that you were high risk, so you’ll be unable to TOLAC? Or maybe you can totally TOLAC assuming nothing high-risk comes into play? What does high risk mean? We often get questions in our inbox asking if having your previous cesarean makes them high risk. Or questions about topics like preeclampsiaclampsia, gestational diabetes, bicornuate uterus, fibroids, and more. 

I am so excited to have board-certified OB/GYN Dr. Christina Pinnock on the show today. She is a high-risk pregnancy doctor passionate about educating women along their pregnancy journeys so they can be more informed and comfortable during their pregnancy. She is located in California and has a podcast of her own called “ZerotoFour” where she talks about topics that will help first-time moms prepare for, thrive, and recover from pregnancy as well as shares evidence-based information and answers everyday questions like we are going to discuss today. 

00:58 Review of the Week
Meagan: We do have a Review of the Week, so I'm going to jump into that and then we can dive in to get into these fantastic questions from Dr. Christina Pinnock. 

Today’s reviewer's name is Obsessed!!!! It says, “The best VBAC and birth podcast. I am grateful to have discovered Meagan and this podcast. I definitely believe listening to stories of these amazing women and their parent’s course helped me achieve my two VBACs. Thank you for all you do The VBAC Link.”

Oh, thank you so much Obsessed!!!!!  And as always if you wouldn’t mind, drop us a review leave us a comment and you never know, it may be read on the next podcast. 

03:13 Dr. Christina Pinnock
Meagan: Okay, Women of Strength. I am seriously so, so excited to have our guest here with us today! Dr. Christina, is it Pinnock? How do you say it?

 Dr. Pinnock: Yes that’s perfect.

Meagan: Ok, just wanted to make sure I was saying it correctly. Welcome to the show! You guys, she is amazing and has been so gracious to accept our invitation here to today to talk about high-risk pregnancy and what it means. Hopefully, we’ll talk a little bit about gestational diabetes because that's a big one when it comes to VBAC. And if we have time, so much more. So welcome to the show and thank you again for being here.

Dr. Pinnock: Thank you so much for having me, I'm excited to be here and chat with you and your audience about these great topics, so thank you.

03:56 Importance of a VBAC-supportive provider
Meagan: Yes! Okay well, this isn’t a question we had talked about, but I’m curious. Being in California, do you find it hard to find support for VBAC or do you find it easy? I mean, California is so big and you’re in Mountain View. So I don’t know exactly wher

Our friend, Kelsey, shares with us today what giving birth is like in Canada. From moving and traveling between provinces, Kelsey had experienced different models of care and when it came time to prepare for her VBAC, she was very proactive about choosing a birth environment where she felt safest. 

From a scary Cesarean under general anesthesia to an empowering unmedicated VBAC in a birth center, Kelsey’s journey is entertaining, beautiful, and powerful. We love hearing the unique details of her story including giving birth at the same time as her doula just in the next room over! 

The personalized care she was given during her VBAC is so endearing and heartwarming. As her husband mentioned, it should be the gold standard of care and we agree! 

The VBAC Link Blog: Assisted Delivery
Fetal Tachycardia in the Delivery Room
Is There Still a Place for Forceps in Modern Obstetrics?
Forceps Delivery Complications
Needed Website
How to VBAC: The Ultimate Prep Course for Parents
Full Transcript under Episode Details 

07:36 Review of the Week
09:27 Kelsey’s stories
11:47 Logistics of giving birth in Canada
14:38 A normal pregnancy
17:50 Arriving at the hospital
21:37 Stalling at 7 centimeters
26:22 Asynclitic and OP positioning
29:31 Kelsey’s Cesarean under general anesthesia
34:50 Second pregnancy and VBAC prep
41:07 Switching to midwives
46:14 Beginning of labor
51:07 Driving to the birth center
54:49 Pushing baby out in two pushes
1:00:24 Differences in care
1:02:11 Enterovirus
1:08:02 Risk factors for forceps and vacuum deliveries


Meagan: Hello, Women of Strength. We have our friend, Kelsey, from Canada. Is that correct? 

Kelsey: Yes. Yeah. 

Meagan: She’s sharing her story with you guys today. Something about her first story of her C-section that stood out to me was that she had a forceps attempt that didn’t work out. Sometimes that happens. I want to talk a little bit about forceps here in just a minute before we get into her story. Kelsey, I wanted to ask you that this is something that in our doula practice we will ask our clients. If it comes down to an assisted birth with forceps or a vacuum, what would you prefer? It’s a weird thing because you’re like, Well, I’m not planning on that, but a lot of people actually answer, “I would rather not do those and go straight to a C-section.” Some people are like, “I would rather do every last-ditch effort before I go to a C-section.” 

Did you ever think about that before? Had it ever been discussed before as their style? That’s another thing. Some providers are really vacuum-happy. Some are really forceps-happy. I know it’s a random question, but I was just wondering, had you ever thought of that before going into birth? 

Kelsey: So no. I didn’t think about whether I wanted a C-section or a forceps delivery. However, I was really staunchly against having a C-section. That was primarily nothing against it, it was just that I have a really huge fear of awake surgery so with my forceps attempt, the OB who was there because it wasn’t my provider. That’s not the way Canada works. The OB who was there who was called in said, “Are you sure you want to do forceps? You could tear.” 

I told her, “I would rather tear than have a C-section.” That was just a personal preference for me because I was so terrified of having a C-section. 

Meagan: Yeah. I think that is very common and very valid to be like, “No, I would rather try this.” 

Kelsey: Yeah. 

Meagan: So I did. I wanted to go over just a little bit. I mean, I have seen a couple of forceps and they are not happening as often these days, but there was an article that said, “Is there still a place for forceps delivery in modern obstetrics?” I’m trying to say obstetricians and obstetrics. We’re just going to stop. 

Kelsey: We know what you mean. 

Meagan: You know what I mean. There was an article and I was like, That’s a really good question, because I think a

The amazing Gina Conley from MamasteFit joins Meagan today to answer your questions all about perinatal fitness! Gina is a birth doula, perinatal fitness trainer, and founder of MamasteFit. ​​In partnership with her sister, Roxanne, who is a labor and delivery nurse and student-midwife, MamasteFit is a place for women to find education courses and fitness programs to be their strongest selves during each stage of motherhood. 

Gina shares her expertise on how exercise affects babies during pregnancy, labor, birth, and postpartum. She also touches on topics like when to start prenatal exercise, what to do if you didn’t exercise before pregnancy, how late into pregnancy you can exercise, weightlifting, and which movements to incorporate to create more space in the pelvis. 

Gina’s comprehensive prenatal fitness book, Training for Two, will be released in September 2024. It is a fantastic resource for all pregnant women!

Link to Gina's Book: Training for Two
MamasteFit Website
How to VBAC: The Ultimate Prep Course for Parents
Full Transcript under Episode Details 

01:00 Review of the Week
03:59 Is it bad to exercise during pregnancy? 
09:00 How will exercise affect my baby’s development? 
13:40 Better pregnancies, better birth outcomes
16:23 What do I do if I wasn’t active before pregnancy?
19:30 Movements to incorporate
20:59 Three pelvic levels 
23:19 The mid-pelvis and outlet
25:56 Being told that your pelvis is too small
30:36 How late in pregnancy is okay to work out?
32:31 When is it too late to start exercising during pregnancy?
34:43 Postpartum fitness
39:20 Weightlifting and pregnancy
45:51 Training for Two

Meagan: Hello, everyone. Welcome to the show. We are going to be talking about prenatal fitness today with the one and only Gina Conley. Gina is the founder of MamasteFit, a prenatal fitness training company based out in North Carolina. Gina is a fitness trainer specializing in pre and post-natal fitness and a birth doula. She combines her expertise in both to prepare her clients for a strong pregnancy and birth. 

Fitness in general is one of my all-time favorite things to do and talk about. I do notice a difference when I’m not moving my body, but when it comes to pregnancy, there are a lot of questions surrounding fitness. Is it safe? When is it okay to start? Is it really okay to start later on? How to start? And so much more. 

I can’t wait to dive in on all of the amazing information that Gina is going to share after the Review of the Week. 

01:00 Review of the Week
Meagan: Just a reminder, if you have not left a review, I would love for you to do so. You can leave a review on Apple Podcasts, Google, Spotify, Facebook, or wherever you listen to your podcasts. 

Today’s review is by Janae Rachelle. It says, “The Best There Is.” It says, “I am so happy I found this podcast. After having two prior C-sections, I was convinced I would have to have another C-section for my birth this November. I feel empowered and educated and hopeful I can do this. Thank you for all of the true facts and the safe space where we can all talk about our birth trauma and space where we don’t sound ‘crazy’ for wanting to do something God created our bodies to do.”

Thank you, Janae Rachelle, for leaving that review. You are right. This is that space. This is the space where we do talk about all of the crazy things, where we talk about the trauma, where we talk about the things where in the outside world if we were to discuss them, people would and sometimes do look at us like we may be crazy. But Women of Strength, if you are wanting to pursue a VBAC, if you are wanting to learn about the evidence about VBAC, this is definitely the place. 

All of these stories here are going to share so much information, guidance, facts, and all of the things, and definitely leave you feeling inspired. 

03:59 Is it bad to exercise during pregnancy? 
Meagan: Okay, it’s been so fun. We’ve actually ha

Aisha’s first baby was a scheduled Cesarean for a breech presentation during the height of the COVID-19 pandemic. Though she was symptom-free, Aisha tested positive for COVID and was not able to be with her husband or her baby right after birth. Her surgery was routine and uneventful, but the isolation left her devastated.
 
Aisha moved and was living in Oregon during her second pregnancy. She deeply desired a home birth and found a midwife to support her who also happened to be trained in vaginal breech delivery. Aisha went into labor sooner than expected but handled it beautifully. When it was time to push, surprisingly, feet started coming out first! Her team stayed calm and ultimately brought her baby earthside safely. Aisha is so proud of what she accomplished!

Evidence-Based Birth Article
The VBAC Link Blog: ECV Explained
The VBAC Link Blog: How to Turn a Breech Baby
The VBAC Link Podcast: Chelsey's 2VBA2C Breech Babies
Needed Website
How to VBAC: The Ultimate Prep Course for Parents
Full Transcript under Episode Details 

03:31 Review of the Week
06:10 Aisha’s first birth
11:16 A COVID-positive Cesarean
14:38 Third pregnancy
20:02 Planning for a home birth
22:51 Breech workshop with Dr. Stu
24:57 Labor begins
31:25 Pushing out an unexpectedly breech baby
35:29 Reviving baby
40:53 Vaginal breech birth is possible
49:39 Adding to the supportive provider list

Meagan: Hey, hey everybody. Guess what? We have a breech VBAC, actually, it’s a breech HBAC coming your way today. We have our friend, Aisha, with us and she is going to be sharing her amazing journeys. We know that when it comes to breech, it is difficult to find support. It is difficult to find the evidence in that and this is one of the number one reasons for Cesareans in the first place. If you have gone through our podcast, we have over 300 episodes at this point, you will probably hear quite a bit that, “Oh, my baby was breech. We tried an ECV and it didn’t work so I had a C-section,” or “My provider didn’t even offer that and I had a C-section.” 

This is one of the number-one leading reasons for a C-section and it doesn’t always have to be that way. Aisha is living proof of that. Welcome to the show, love. How are you today? I’m so excited for you to be here. 

Aisha: Yeah, thanks. I’m so excited to be here. It’s like a dream come true. It’s wild. 

Meagan: It was so fun. Before we started recording, she said that not long after she had her baby, she was like, I’ve got to get my submission into The VBAC Link. 

Aisha: It was bathtime earlier this week when I saw the email and I was freaking out like, Oh my gosh. It was cool because my daughter is going to be a year old soon, so it was fun to think about her birth and I almost felt guilt because I was like, Oh my gosh, I haven’t listened to The VBAC Link in a minute, but how much this podcast blessed me and strengthened me to go on to have a VBAC, specifically a breech VBAC which was not planned for. It was wild and I’m just really grateful for my provider. 

Meagan: Yeah, absolutely. I cannot wait to dive into this story. 

03:31 Review of the Week
Meagan: We do have a Review of the Week and then we will turn the time over to our friend, Aisha. This is from larrr23 and it was left in March of 2023 so just over a year ago on Apple Podcasts. It says, “Hi, Meagan. I love your podcast so much. I always end up crying at the end of them. So happy for these moms who get this VBAC. Thank you for creating this podcast. It is so inspiring to hear these stories. I’m 38 weeks pregnant and hope and dream I get my VBAC here soon as well. Keep doing what you are doing here. You are helping so many women achieve their dream birth and knowing that they are not alone. Thank you for that.” 

Well, larrr23, if you are still listening with us, let us know how your birth went. I hope that you had an amazing birth no matter how it ended. Thank you so much for that sweet review.

Kristen joins us today to share her tough C-section and two beautiful VBAC stories! After a 41-week elective induction that turned into a C-section and a 2.5-week NICU stay due to meconium and heart decelerations, Kristen was very nervous about giving birth again. She found The VBAC Link Podcast and found hope. Through her VBAC research, she gained the determination and confidence she needed to try again. 

When she was showing symptoms of preeclampsia, Kristen accepted the reality of a medically necessary induction. She was nervous but knew things would be different. She labored well and had moments of discouragement, but she used the tools available and achieved her VBAC. 

Kristen also had some preeclampsia symptoms but was able to avoid induction, labored almost completely at home, and caught her baby in a wheelchair at the hospital waiting for the elevator!

How to VBAC: The Ultimate Prep Course for Parents
Full Transcript under Episode Details 

01:11 Review of the Week
04:23 Kristen’s first pregnancy
06:20 Agreeing to induction
08:27 Emergency C-section and NICU stay
12:55 Gaining confidence to VBAC and getting pregnant again
17:28 39-week induction
21:18 Feeling discouraged
27:15 Getting the epidural and pushing for less than an hour
30:58 Third pregnancy
34:41 Forced to find a new provider at 36 weeks
40:45 Labor begins
46:11 Rushing to the hospital
48:06 Delivering her own baby in a wheelchair
51:27 Preeclampsia article and calibrating your blood pressure cuff

Meagan: Hey everybody, welcome to the show. We have our friend, Kristen with us today. Hello, Kristen. 

Kristen: Hi. 

Meagan: We have her and her little baby as well so you can hear those little cute coos in the background. You can just smile. I love when we have little babies on the podcast or kids. The other day, we had a little toddler. It was so fun. It makes my heart so happy. How old is your little baby now? 

Kristen: She is over a month. Just over a month. 

Meagan: Just little little. This is a VBAC baby. 

Kristen: Yes, she is. 

Meagan: We were just talking before we got recording. Kristen had a C-section and then a VBAC and with that VBAC, she had preeclampsia. We are going to talk a little bit more of what that looked like, but that has definitely been one of the themes that our listeners have been asking about. Is VBAC possible with lab-positive preeclampsia? The answer is yes. It is. We will talk a little bit more about that and then she has a surprise. 

01:11 Review of the Week
Meagan: We are going to read a review and then we are going to dive into her stories. 

This review was left in March 2023 by mcgrace and it says, “Must-listen For Every Mom”. It says, “This podcast is a must-listen not just for a mom preparing for a VBAC, but for anyone who gives birth and has given birth or plans to give birth in the U.S. Meagan wonderfully walks through personal stories while prepping for helping for helpful advocacy tips and a solid dose of empowerment in each episode. If you want to hear people discussing their plan to VBAC, if you are curious about what giving birth in the U.S. is like, and if you are wanting to have tips on how to mentally, emotionally, and physically prepare yourself for the best birth, this is the podcast to listen to.”

I love that. Thank you so much and I agree. This is such a great place for everybody, anyone preparing for birth to listen. I think with crazy-high Cesarean rates, we’ve talked about this before. We have to talk about why they are happening and this podcast literally shares a lot of why Cesareans are happening. It is such a great podcast for anyone including first-time moms or even fifth-time moms who haven’t had a Cesarean. 

As always, if you wouldn’t mind leaving us a review, you can head over to Apple Podcasts or Google or Spotify or wherever you are listening and drop us a review. You can even email us at info@thevbaclink.com.

04:23 Kristen’s first pregnancy
Meagan: Okay

Emily’s first birth experience was a home birth turned hospital transfer which ended in a C-section and then a birth center VBAC ending in hospital transfer and another C-section with her second. She found herself feeling alone, frustrated, and surrounded by people who just didn't get it as she worked to process the trauma and grief of not one but two back-to-back traumatic births and C-sections. 

Throughout her journey, Emily took charge of what she could, learned about her options, and made the right decisions even when they were disappointing. Emily has been proactive about physical and emotional healing. She has been open to new perspectives. Emily is grateful to share her story and all that she has learned for other mamas who have found themselves in similar situations. And we are so grateful that we can feel of her strength! 

The VBAC Link Blog: How to Cope When You Don't Get Your VBAC
The VBAC Link Blog: Deciding on VBAC vs Repeat Cesarean
NPR Article
Spinning Babies: What to Do When...
Needed Website
How to VBAC: The Ultimate Prep Course for Parents
Full Transcript under Episode Details 

05:02 Review of the Week
09:10 Emily’s first pregnancy and labor
14:59 First C-section
17:47 Second pregnancy
21:16 Moving and switching providers
33:20 Pushing for 5 hours
35:45 Transferring
37:47 C-section
41:29 Tips for adhesions
44:20 Hospital births are beautiful
49:09 All about transferring


Meagan: Hello, everybody. It is Meagan and we have our friend, Emily, with us from Texas today. Hello, Emily. How are you?

Emily: I’m good. How are you?

Meagan: I am wonderful. I am so wonderful. I love recording these stories if you can’t tell. We are producing them a lot because I love recording. I love hearing these stories and sharing these stories. Your story is a CBAC story which I think is so important to share on The VBAC Link Podcast. As technically a CBAC mama myself because I don’t know if anybody knows who is listening, but I had a C-section then I wanted a VBAC and had a Cesarean and then I had a vaginal birth. So all over the place. 

CBAC is really special to my heart and I think that this is such an important topic to share on the podcast because we know that obviously, so many C-sections are happening, right? I also think it’s important to know that sometimes even when we are preparing for a VBAC, it might end in a Cesarean birth and even more important, I think it’s really important to know that Cesarean births can be healing and are a lot of the times healing. Would you agree with me, Emily? 

Emily: Yes. I mean, I loved hearing the healing stories. Mine was not and I think that’s what I yearned for to her is that I’m not alone and it’s okay to have a repeat C-section and I hate calling it a failed VBAC, but a repeat C-section that wasn’t wanted and wasn’t healing. I mean, my second birth was much more traumatic than my first. I mean, I hate saying traumatic because I have two beautiful, healthy babies, but I also want listeners to know that just because you have a healthy baby and you didn’t have serious complications you can’t feel what you felt about the trauma of it all. 

Meagan: Okay, and I love that you point that out too because just as much as Cesarean birth can be healing and can be amazing, it can also have a lot of that trauma. Trauma, I think, is a completely valid word to use. It can be used to be described as traumatic. It can be described as hurtful. I was angry. I was angry when I walked myself down for my second C-section. I didn’t want that. That was not what I wanted. It was not what I planned. 

Yeah. Also, going into that it doesn’t always happen the way we want to. It can go both ways so that’s why I think sharing CBAC stories on this podcast is so important because we have to learn both sides of things. We have to know that Cesarean birth can be healing and it can be exactly what someone needs and it can also be traumatic and not what someone needs. I