Episode 290 Hayley's Unmedicated VBAC + Epidural and Prolapse Talk

Hayley joins the show today sharing her breech Cesarean and unmedicated hospital VBAC stories. Meagan and Hayley dive deep into the pros and cons of getting an epidural and why providers tell women so many different things when it comes to epidurals and VBAC!

While Hayley had the dreamiest birth she could have imagined and everything went according to plan, her postpartum experience with prolapse was not something she was prepared for. Hayley shares her symptoms, what she wished she knew, and what she has done since to recover and feel like herself again. 

Needed Website

How to VBAC: The Ultimate Prep Course for Parents

Full Transcript under Episode Details 

02:47 Just-in-case epidural

04:16 Dr. McGuire’s insight on epidurals

08:42 Using an epidural as a tool

10:44 Hayley’s first pregnancy and birth

12:00 Doing VBAC research before pregnancy

13:51 Hayley’s second pregnancy

18:15 Labor begins

20:16 Going to the hospital

24:20 Pushing

27:05 Hayley’s prolapse experience

32:01 Symptoms of uterine prolapse

35:29 Prolapse can happen

Meagan: Hello, hello Women of Strength. You guys, I am excited about today’s episode. I love talking about VBAC obviously, but specifically, we are going to talk a little bit about unmedicated versus medicated. Our friend, Hayley, from North Carolina has had a beautiful unmedicated hospital VBAC so I want to also talk about the opposite side of that and talk about medicated VBAC. 

We have so many people in our community that I see type, “I want a VBAC, but I don’t want to go unmedicated and my doctor says I have to. I can’t have an epidural” or the total flipside of that where, “I really want an unmedicated VBAC, but my doctor says I can’t go unmedicated. I have to have the epidural.” Did I just say that correctly, Hayley? 

Hayley: Yes, yeah. 

Meagan: It’s either one or the other. We’ve got providers telling people they can’t have an epidural or they have to have an epidural. So I wanted to just talk a little bit today before we get going on those two topics. 

First of all, let’s talk about unmedicated birth. Hayley and I are living proof today. We are on this episode that unmedicated VBAC is 100% possible, achievable, and safe. A lot of those providers come out and say that they can’t go unmedicated because they say it’s not safe. In the rare chance, we know that uterine rupture happens but it is rare. In the rare chance of a uterine rupture, that is where they say that is not okay. 

Or they will say things like, “But you wouldn’t want to be knocked out for your birth,” which is scary. I don’t want to be knocked out for my birth and I know people have. A lot of the time, it is not the most pleasant experience. Yeah. Okay, so let’s talk about that. 

Unmedicated vaginal birth is unmedicated vaginal birth. That’s what it is. I’m just laying it out there. Yes, we have a slight increase in uterine rupture. Yes. What happens if we have a uterine rupture and we are unmediated? 

A lot of the time, we are noticing that there are signs of uterine rupture. When we get an epidural and a spinal, we go back and have a C-section. Simple as that. 

Or if it is a true medical emergency, yes, there is that small risk of needing to be put under. Small risk and small risk equal risk of course, but it’s low. 

02:47 Just-in-case epidural

Meagan: What about if we have the just-in-case epidural? I seriously sometimes just want to sock someone who says “Just in case”. We don’t need to be placing an epidural just to have it ready to dose because guess what? In the event that it is a true emergency and we really do need to go in for an immediate Cesarean, it’s the same thing. We get knocked out. 

I know that these words are kind of big and harsh words. We get knocked out, but we get put under general anesthesia if we don’t have anything in our system. 

Now, let’s talk about an epidural. You actually have an epidural placed. It’s running. It’s dosed and we have a uterine rupture. Guess what? Women of Strength, more than likely, it still has to be dosed further because an epidural is not like a spinal. It’s just not. They have to dose it further. 

With my first Cesarean, I had an epidural. They had to come in, dose it to a deeper extreme so I wasn’t feeling my surgery and I had to wait. Right? We are still waiting. It’s the same thing. There is always a wait and it takes time. It takes about 15-20 minutes for any epidural to kick in deep enough. 

04:16 Dr. McGuire’s insight on epidurals

Meagan: Dr. McGuire wrote for Yale Medicine. She talks about this epidural and is it safe and how are they different. She talks about how they truly are different than they were back in the day because they are dosing them lighter. We know that. We have seen that, but we still have some pretty serious risks as well with epidurals even though again, they are smaller. There are blood clots, spinal infections, spinal headaches, them not working, and things like that, and blood pressure. 

I’m going to say as a doula, I’ve attended over 350 births. As a doula, I will say a large portion of any client, not just VBAC, who receives an epidural has a blood pressure dip. Even when they have a large amount of fluid because a lot of the time they will cram fluids in to try to help this, but there is some sort of blood pressure dip and baby seems to struggle when that happens. 

Then it’s the cascade– rolling over, move, move, move, move. Baby doesn’t recover or mom’s blood pressure doesn’t recover and we are off to an OR. 

One of the biggest questions that I think is a really hot debate in the medical world is does an epidural raise your chances of a Cesarean? Most people out there are going to say, “No, it doesn’t.” The studies are pretty low, though. I think in one study there were 2,000 people or something like that and they showed it didn’t. 

But I mean, from a doula’s standpoint, I know I don’t see as many births as these OBs, but I definitely see it seems to do that– the blood pressure drop thing. So is it safe? Yes. Do you have to go unmedicated if you have a VBAC? No. Do you have to get an epidural if you have an epidural? No. Do what is best for you. 

What she says is, “Those studies we know that have a higher concentration of epidural medicine was associated with an increased risk of Cesarean, though lower concentration we now use actually promotes normal, spontaneous vaginal delivery without assistance.” When she says assistance, a lot of the time when we have epidurals, we have vacuum or forceps assistance because we have lack of mobility. 

That’s what she was saying here. I want to make sure to provide the link and some other links on our blog for epidurals so you can decide what is best for you. But for now, we are going to get into a story of an unmedicated, vaginal birth. 

08:42 Using an epidural as a tool

Meagan: Okay, Ms. Hayley. Welcome to the show. 

Hayley: Thank you for having me. It’s really crazy to be on here sharing so thank you. 

Meagan: I talk about how it’s crazy to be full-circle where you are listening. You are preparing. All of the people in your ear are motivating and then here you are today sharing your story motivating others in your same space x, y, z months ago. 

Hayley: Yeah. It’s crazy. It really is a full-circle moment like you mentioned. 

Meagan: Yeah. Well, I am so honored that you are here. I would love to turn the time over to you. 

Hayley: Sure. So yeah, I also love what you were saying really quickly on the epidural versus not. Full transparency, when I went into this, I definitely recognized that an epidural is a tool and I knew and wanted to prepare myself. If I am– obviously, birth is not pleasant. It’s not going to be a walk in the park. But I knew there was a difference between being in pain versus suffering. I really wanted to know that for myself. It if turned into that suffering, I wouldn’t have been opposed to helping my body to get my baby. 

Meagan: To the next point, yeah. 

Hayley: But there is a difference between being in pain and suffering. 

Meagan: As a doula, we talk about that a lot where we are like, okay. We are planning to go unmedicated. That is fantastic and then we talk about that pain versus suffering and that transition because when we are suffering, we start having things that come up later. We don’t think about it. We are suffering now, but postpartum depression, postpartum anxiety, and postpartum trauma. We have these things that are not worth it, so in the end, you have to do what’s best for you and keep you in that positive space and recognize pain versus suffering. 

Hayley: Yeah. Exactly, so I love that. 

10:44 Hayley’s first pregnancy and birth

Hayley: To start this whole story I guess, is back in April 2021, I had my daughter. She was breech. For me, I knew pretty early on that she was breech. She was so active. I knew that, “Oh, you are trying to flip in there.” I did all of the things. I did Spinning Babies and tried all of the things, but it was still COVID time so I just didn’t go to acupuncture. I feel like if it wasn’t COVID times still, I maybe would have tried more things. But with that being said, I felt like she was literally trying to turn because I’m like, “What are you doing? If you’re not flipping, then I’m n