TRANSCRIPT EPISODE 20 – All About Pregnancy & Birth With Dr. Nicole C. Rankins

Transcript episode #20: 2 Successful vbacs with kim gatling

Transcript

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00:00                                   One of my very best friends is joining me on the podcast today to talk about her two successful VBACs.

00:09                                   Welcome to the All About Pregnancy and Birth podcast. I'm your host Dr. Nicole Calloway Rankins, a board certified Ob Gyn physician, certified integrative health coach and creator of The Birth Preparation Course, an online childbirth education class that will leave you feeling knowledgeable, prepared, confident and empowered going into your birth. Quick note, this podcast is for educational purposes only and it's not a substitute for medical advice. See the full disclaimer at www.ncrcoaching.com/disclaimer.

00:46                                   Welcome to another episode of the podcast. I am so glad you are here today. I have one of my best friends on, Kimberly Bullit Gatling. Kim and I grew up together. We have known each other almost literally our entire lives, our mothers met when we were babies. So we grew up together in the same neighborhood, went to the same elementary school, Middle School, high school, and have remained friends ever since. And I asked Kim to come on to talk about her experience with having not just one, but two successful VBACs. And VBAC is vaginal birth after cesarean. Now Kim is a wife, a mom of course, to three boys. They are seven, eight and 15 and she's an intellectual property attorney at Fox Rothschild in Greensboro, North Carolina. And in addition to practicing law, Kim is very civically engaged in her community. I'm so proud of all the work that she does. She serves on numerous nonprofit boards, including the United Way of Greater Greensboro and the Cone Health Foundation. Now, Kim does not have a lot of spare time, but when she does have some time to herself, she enjoys sleeping, of course, and also swimming. She's actually active in getting African American families involved in swimming. I'm going off on a little bit of a tangent here, but there's a history of African American kids not learning how to swim at the same rates as other racial and ethnic groups, and there's a long history behind that. It dates back to segregation and the civil rights era. When black families didn't have access to the public pools in order to learn how to swim and that's kinda filtered down to the generations.

02:28                                   But anyway, she and her family are very active swimmers and her son is a competitive swimmer. Well, as I said, I invited Kim on today to talk about vaginal birth after cesarean and I'm not going to go into all of the risk and benefits of VBAC, but I do want to say that VBAC or vaginal birth after cesarean is safe for the vast majority of women who have had one or even two prior low transverse cesarean sections and low transverse refers to the scar on the the incision that was made on the uterus. And for women that have had one or two prior c-sections, low transverse c sections, it is safe for you to attempt a VBAC, and an attempt a VBAC, we actually talk about that as a TOLAC, trial of labor after cesarean. A TOLAC and if you're successful with your TOLAC then that's a VBAC or a vaginal birth after cesarean. Now, a lot of doctors do feel uncomfortable, I'll say with two prior low transverse cesarean sections and TOLAC. However ACOG does support it and ACOG is the American College of Obstetricians and Gynecologists. They set standards of care based on evidence and ACOG does say it's safe if you've had two prior c-sections to attempt TOLAC, but I'll be honest, there are some doctors who are not as comfortable with that. So I am a strong supporter of all women who are appropriate candidates to attempt a VBAC or have a TOLAC.

03:55                                   They should be able to, and part of my support in that is having women come on and share their birth stories of successful VBACs. So that's why I asked Kim to come on today. Now before we get into Kim's story, I do want to mention really quickly that there is a bonus lesson on a VBAC in The Birth Preparation Course. The Birth Preparation Course is my signature online childbirth education class, something. Of course, you know, I'm super proud of it. It's eight hours of content, covers everything from getting in the right mindset for your birth to labor and delivery to possible things that may happen to the postpartum period. It's an outstanding childbirth education course online along with some support through a Facebook group where I'm there, I have a Doula who runs the group and one of the bonus lessons in The Birth Preparation Course is VBAC and I talk about the risks, the benefits and detail, some factors that are associated with successful VBAC as well as some factors that decrease your chances of success.

04:56                                   And I also go over some specific clinical scenarios that sometimes make doctors uncomfortable with VBAC and I talk about what the recommendations are for management based on evidence. So I encourage you to enroll in The Birth Preparation Course in general because it's amazing childbirth education. However, if you happen to be someone who's thinking about VBAC, then I got you covered in the course as well. Okay. Without further ado, let's get into my conversation with my bestie Kim about her two successful VBACS.

05:32                                   Nicole: So hey Kim, thank you so much for being on the podcast. I am so excited to have one of my day one best friends on the show.

05:43                                   Kim: I am happy to be here.

05:44                                   Nicole: Yeah. So I asked you to come on to share your experience with having not one but two successful VBACS and I thought we would start off just by having you tell us about you or maybe your work and your family.

05:58                                   Kim: Sure. So I am 44 years old and like you've mentioned, I've known you pretty much for all of those 40 years.

06:06                                   Nicole: Yes. We have literally all known each other pretty much our entire lives since we were babies.

06:11                                   Kim: Exactly. And growing up in Hampton, Virginia and being besties since infancy. Now I am a practicing intellectual property attorney in Greensboro, North Carolina. I've been married for almost 20 years and I have three funds ages 15, 8 and 7. And my last two are 18 months apart as some people call twins the hard way, which of course I have to add that the youngest son is my surprise baby that has me wrapped around his finger. And even though we won't be talking about infertility today, you know, Dr. Rankins, that he's my surprise baby because my first two kids were conceived with infertility treatments and I had been told I could not get pregnant on my own. And then voila, the baby boy with was conceived with no drugs or treatment, even while I was still exclusively breastfeeding my second child. So he broke all the odds and he was my sweet surprise.

07:12                                   Nicole: Okay. See, I almost feel like I'm going to have to have kind of you come back on the show to tell your infertility story.

07:19                                   Kim: That's quite a journey.

07:23                                   Nicole: And I will also give a shout out to my bestie. She's also very active in the community. I'm just really proud of her and super happy to be one of her best friends and watching all the wonderful things that she does to, to help folks in the Greensboro community and beyond.

07:40                                   Kim: Thank you.

07:40                                   Nicole: Yeah. So you had a c section for your first baby was breech. And y'all, forgive me if I throw in the kids' names, I'm just so used to like, you know, we're so used to talking to each other, but her first baby was breech. So walk us through when you were pregnant with the second, what was your thought process about having a repeat csection versus a VBAC? Tell us all about that.

08:06                                   Kim: Sure. So with the first one, he had been breech, actually frank breech with his bottom down in his feet in his face the entire pregnancy and he never moved. So I knew we were going to have a scheduled c section with him. And when I got pregnant with the second one, I asked my doctor if she would be supportive of me trying to VBAC if the baby's head was down. And she was always very supportive of it, never discouraged it in the least bit. So that was just our plan from day one that if the baby was positioned correctly that we would try to do a VBAC.

08:42                                   Nicole: Okay. So you really felt like that was what you wanted to do from the get go? It wasn't really like much of a, do I want to do this, do I not want to do this? You were pretty clear that you wanted to go for a VBAC.

08:53                                   Kim: I was. And my c section was very seamless. I had a very easy recovery apart from the fact that it's major surgery, but I knew that having a VBAC, the recovery time would be less and that would be easier. And of course by the time I had my second child, I still needed to be parenting the first one. So I thought if the VBAC will make it easier for me to bounce back and get into the swing of things and I definitely want to try that.

09:21                                   Nicole: That makes a lot of sense. Yeah. You're thinking about the whole like big picture and not just like for this pregnancy, but taking care of another kid and all that stuff kind of went into your thought process.

09:31                                   Kim: Right.

09:32                                   Nicole: Yeah. So what do you recall your doctor telling you about? I know it's been a little bit, but what do you recall her telling you about risk and benefits are? What was her, what was she telling you about VBAC versus a repeat cesarean?

09:45                                   Kim: You know, it was nine years ago now, which is hard to believe, but the second when I was pregnant with the second child, and so I only remember that she was fully supportive and I'm sure she reminded me of all the risks of it, the bad, you know, what I call the medical legalease. And I'm sure that she did that. But I think based on my medical history and what she was seeing, and there wasn't anything that gave her any pause with me trying to have a VBAC. So I only remember that she was 100% down for it. Didn't question me at all about the choice. I will say I remember that I asked her about it. I don't recall that it was specifically volunteered to me for me to consider that when I got pregnant with the second one, I said, I'd like to try VBAC if you're okay with it. And then she said, absolutely.

10:37                                   Nicole: Got It. Got It. Well that's good to know that she was really supportive because unfortunately some women find themselves in circumstances where their doctor is not entirely supportive of them having a VBAC. So that's great that you had the support there from your doctor. Now speaking of support. What about, was there any decision or a discussion between you and Danny between you and your husband about VBAC versus cesarean?

11:02                                   Kim: I don't recall that. He probably did not even know enough to understand the difference. I mean, he had been there through the c section. He knew what that was like, but he certainly didn't give me any push back. I didn't get push back at all from anyone on the medical staff or family wise. So I was in a great position that everybody was on board with me trying it.

11:24                                   Nicole: That's really awesome. Really, really awesome. And you were in Greensboro at the time?

11:28                                   Kim: I was, yeah. Yeah.

11:30                                   Nicole: So what research did you do to prepare for your VBAC?

11:34                                   Kim: You know, I am a doctor's worst patient because I stay on Google, so I probably just did a lot of Google searching on VBAC. And it's funny because the first one was a plan to theory and when I took the birthing class I zoned out on everything relative to labor and delivery because I knew that wouldn't apply to me. I only really listened on the c section portion, so I really was a little out the loop in preparing for the VBAC because I did not go back and take a refresher course. So any information that I got probably came off in the Internet.

12:13                                   Nicole: Right, right. Did you ever take any like questions and things back to your doctor or were you just kinda deep in Google and looking up stuff yourself?

12:23                                   Kim: I was probably deep in Google, but I have to say I'm also, I was crazy about researching anything relative to the health of the baby or the pregnancy, but when it came to delivery either way c section or VBAC, I just kind of had the thought the baby will get here some kind of way. It never really concerned me to the point that I was scared or had a ton of questions about it. And plus you have to remember Nicole, I had you, I was just texting you.

12:57                                   Nicole: Oh yeah, that is true. That is true. So, but it sounds like you took more of a kind of like even though you were doing your research, you had kind of a laid back approach. Like if it happens, great. If I have to have a, if I end up with another c section then I'll be okay with that too.

13:13                                   Kim: I absolutely thought that way. And again, my experience with my c section had been very good. So I had no trepidation about having to go back into a c section if that was medically required. So yeah, I was just kind of, you know, whatever happens, happens and it'll be fine. So long as the baby's okay.

13:32                                   Nicole: Right, right. That does probably help a lot that your first c-section, I remember your recovery from your first c section being pretty easy. So that probably helped a lot to make you feel at ease that if it came to that, then it would be okay.

13:44                                   Kim: Right. Yeah.

13:45                                   Nicole: So go ahead and tell us now about what your birth experience was like for that first feedback.

13:52                                   Kim: Sure. So the first feedback was with my middle son. He's the only child that has a summer birthday. He was born in early August and I was 35 weeks pregnant and went to work that morning feeling perfectly normal, ready to start my work day, probably got to work about 8:00 AM. And an hour later my assistant walked into my office to say good morning like she did every day. And we would sit and chat in the morning and she walked into the office and said, good morning. And I was facing my computer and I turned around and say hi to her and to start talking. And I said, "Ah!" and she looked at me and said, what's wrong? And I said, oh my gosh, I think my water just broke. And literally as I turned my chair to speak to her, I felt a gush of water. So, of course I immediately started panicking. For one, I had never experienced my water breaking, right?

14:47                                   Kim: Cause I had the plan c section with the first one. And more importantly, I was only 35 weeks pregnant. So it was not supposed to be happening that early. But my assistant, who's over 25 years older than I am, a grandmother, mother to three adults sons, completely went into mother mode, came and calmed me down, got Danny on the line, told him what was going on. He came and picked me up from work and then we went straight to the doctor's office because it was on a weekday morning. And so when I got to the doctor's office, my OB said, okay, you know, let's just confirm that his head is still down and then you're going to the hospital to have this baby. Because as you know, the risk of infection goes up with, the water having broken. And so she decided we were far enough along that we would go ahead and deliver the baby. So they did an ultrasound in the office confirmed that his head wasn't back down. So my doctor said, yep, we're doing it the back, let's go.

15:49                                   Kim: And so I went to the hospital and...

15:53                                   Nicole: And let me, let me before you talk about going to the hospital, how was that for you? Because I know you are a super planner, so with that, for you that things kind of came out of nowhere.

16:03                                   Kim: Oh, it was crazy because again, I was at work, like I was planning to have my normal work day. And so it was funny when I went to the doctor and they did the ultrasound and said, okay, head down, we're ready to go. My doctor said go to the hospital and my doctor's office is literally across the street from the hospital. And I said, oh no, I have to go home, I have to get my bag. And at the time I didn't work on my laptop at work. So my laptop was at home and I said, I have to go get my laptop. I am not going to the hospital without my laptop. So she said, you have one hour to go home and get your things and to report back to that hospital. So of course I went home and I was taking my time because I wasn't in labor. I wasn't feeling any contractions. I'm getting everything together for my oldest son, knowing I'm getting ready to go into the hospital for a few days. And apparently I took too long because the hospital called me on my cell phone and said you were supposed to be here like an hour ago, where are you?

17:04                                   Nicole: Right.

17:09                                   Kim: We made it in and again, I wasn't in labor so they had to induce me. So they hooked me up to the pitocin and that took several hours to kick in. So for most of the time I was just up on my computer working like nothing was going on. And then the labor finally started to intensify and I started getting some hard contractions and I will say I had never been opposed to getting an epidural or any other type of medication. But I had decided that I was going to wait as long as I could to see if I could do it without medication, but labor was no joke. So by the time they got really bad, I said, okay, I want an epidural. And literally over an hour went by and I was in really, really hard labor, but some emergency had happened at the hospital and there was no one available to give me the epidural.

18:09                                   Nicole: And yeah, this is something that I have, I try to tell, some women don't realize an epidural is considered elective and not, you know, if there are other emergencies in the hospital, you may have to wait.

18:20                                   Kim: Oh yeah. And I waited over an hour. That was probably the hardest, well it was. It was the hardest hour of the entire delivery between when I asked her the epidural. And when I finally got it, I got probably zoned out during that hour trying to manage it. But then they finally came in the anesthesiologist and she administered the epidural. And once she got it in, you know, they laid me back down. And very quickly I could feel one side of my body going numb. And I mentioned to the nurse, I said, I'm only numb on one side. I still feel everything on the other side. And so she said, okay, that's normal. Let's turn you on your side. And so they turned me on my side and literally as soon as I got on my side, I said, I feel like I need to push. And the nurse was like, ummm, I don't know about that, you know, let me check you, roll me back.

19:15                                   Nicole: Right. Do you remember how dilated you were before you got the epidural?

19:18                                   Kim: I do not.

19:19                                   Nicole: Okay. Okay.

19:21                                   Kim: I do not remember that. It wasn't a whole lot though. In fact, they thought that because I was tensing up so much during the contractions because I wasn't really relaxing. They felt like I was, I guess stunting the dilation or I'm not using the right term. They kept saying, you need to relax, you need to relax. So when she turned me back over, cause I said I need to push, she was like, oh my gosh, you're right, the baby's about to come. And so she immediately called in my OB as well as the neonatologist, which I later understood was normal practice. I guess if the baby's a certain number of weeks premature that they have the neonatologist in the delivery room and two pushes, less than five minutes and he was out.

20:10                                   Nicole: Oh, nice. Nice. So you did not have a a long time to push at all?

20:15                                   Kim: No, I think the epidural was in less than 10 minutes and my husband kind of cracked a joke. He was like, do we still have to pay?

20:21                                   Nicole: Yeah, I was gonna say, that doesn't even really give it time to kick in. And you feel like you felt things or you just kinda in the zone.

20:30                                   Kim: I was in the zone. I mean it was definitely better than that hour when I didn't have any medication. But yeah, it was literally like 10 minutes after the anesthesiologist had left and it was ready to go.

20:42                                   Nicole: Okay. Yeah, that probably didn't have much time to kick in at all. And then it sounds like it was one sided on top of that. So how do you feel like the hospital staff was supportive of you during a VBAC?

20:57                                   Kim: I'm not sure if the hospital staff even knew that it was a VBAC. I mean, maybe they did if they had looked at my file, but I don't know that we talked about it at all. The nurse that I had from the afternoon into the evening who had been there during that really tough hour that I had was super nice. And then the shift changed. And so right before I had the baby, I got a new nurse. I didn't like her as much. She was kind of mean.

21:27                                   Nicole: Oh. Oh. Just, she just wasn't friendly.

21:30                                   Kim: She was not friendly. And in fact, the prior nurse who had been there with me the whole afternoon and evening wanted to stay with me a little bit longer and the new nurse was like, no, I got this.

21:41                                   Nicole: Oh dang. Oh, that always upsets me when people have like don't have a good nurse because it makes a huge difference. Your nurse is with you for so much of your labor. So it makes it a really big difference to have a good nurse.

21:52                                   Kim: But thankfully I had the nice nurse throughout pretty much most of the time or the last 30 minutes.

21:57                                   Nicole: Okay. Yeah. Okay. So from start to finish, when your water, like what time was it when your water broke and then when did you deliver?

22:06                                   Kim: So my water broke about 9:00 AM. I probably got to the hospital a little before lunchtime and I think he was born, oh, it's been a long time. Maybe seven o'clock that evening. Because like I said, for hours it was just nothing. I was the on that pitocin, I wasn't feeling anything. It was really only that one hour without the epidural that it was really bad.

22:30                                   Nicole: Okay, okay. Then things kind of kicked up and then voila, baby was here. Yeah. And then did he stay with you or did he have to go to the Nicu or how did that work?

22:38                                   Kim: So when he came out, the neonatologist, of course, was right there before the neonatologist even weighed him, he looked at him and he said, oh, he's just fine. And in fact, the neonatologist said he's about six pounds and then they put them on the scale and he was 5 pounds, 15 ounces.

22:54                                   Nicole: Okay.

22:56                                   Kim: No, no, he never went to the Nicu. He, you know, did the normal thing in the nursery and stayed with me and he was just fine. He went home in two days with me and did great.

23:06                                   Nicole: Awesome. Yeah, very often for folks listening, it's the case that babies that come a little bit early, they just got done early, and very often a 35 weeker will go home. That's different than if you were induced at 35 weeks for some reason, then kind of like your water breaking or going into labor at 35 weeks. So I know you were glad to have that experience where you didn't have to worry about having a baby in the hospital.

23:33                                   Kim: Yeah, yeah, for sure. Okay.

23:35                                   Nicole: So then fast forward just a few months later, and I'm trying not to laugh, but I distinctly remember when you told you were pregnant and you were like, oh my God. Oh goodness. So tell us about baby number three, the surprise baby, and VBAC number two. What was that pregnancy like for you?

24:05                                   Kim: So total shock. I literally found out I was pregnant and then decided I was going to stop breastfeeding number two because he was only nine months old. And I said mentally I cannot fathom still breastfeeding a child knowing I'm pregnant. So I cut him off.

24:26                                   Nicole: Did you just cut him off right away or...

24:28                                   Kim: I literally cut him off cold turkey.

24:31                                   Nicole: Okay. Did that hurt? Cause it can be hard to just sorta quit breastfeeding cold turkey.

24:35                                   Kim: No because he was nine months.

24:37                                   Nicole: Oh, so he was eating some solids then?

24:40                                   Kim: Yeah, he was eating food. And it was just a mental thing for me because as you know, it took me weeks to like accept it. Oh my gosh, I am pregnant again.

24:51                                   Nicole: And how old were you at the time?

24:53                                   Kim: I was, let's see how old I was 35 when I had the second one. So I guess I was 36 or 37 when I got pregnant with the third.

25:06                                   Nicole: So we're not even going to add the whole like, and we can even, I don't know. Did your doctor talk to you about advanced maternal age? You're very healthy and everything but advanced maternal age or any of that stuff? Didn't any of that kind of come into play in your mind?

25:18                                   Kim: Well, since I had been 35 with the second one, they had already done some of that genetic testing that they do when you're 35 with the second one, but it's funny, even in that short nine months, the protocols still had changed a little bit and they did even more testing when I was pregnant with the third one. But I was healthy and, and didn't have any concerns. The only thing differently the doctor did with the third was that because they could never explain or we never knew why my water broke at 35 weeks with the second one, she had me to take progesterone shots during my third pregnancy. I guess that was maybe during my third trimester. I gave myself a shot every week just to make sure that the baby would stay in and he did stay in until 39 weeks.

26:05                                   Nicole: Okay. Yeah. That's something called mekaena. It's a, or there's a generic for it now, progesterone shot, for the listeners. And it does help prevent when somebody has a preterm delivery the first time and helps prevent it the second time and it's a weekly injection. Well, why were they or how was that, how was it hard to do those injections and how did that make you feel?

26:26                                   Kim: Well, because I had gone through all that infertility treatment with the first and second child, I was used to shots, so that didn't scare me. But the progesterone shot, unlike the infertility shots was intra muscular. So I had to have my husband give it to me because he would give it like somewhere on the buttocks area, like in that muscle. So he got trained by the doctor on how to do it and we just had a day every week we'd pull out the shot and he'd do it. So it didn't bother me. I was used to having shots.

26:58                                   Nicole: Okay. Okay. And why am I blanking if, did you do IVF with the first one?

27:06                                   Kim: Not with the first one. With the first one, I did Clomid, several rounds of Clomid to get pregnant with him. And then if you remember Nicole, I had two miscarriages in between the first and the second and both of those pregnancies came from Clomid and then the Clomid stopped working. And so we did IUI with the second one, intra uterine insemination, and then we finally did IVF and that worked with the second child.

27:36                                   Nicole: Okay. So you, I mean you can see like Kim's just offering a wealth of experiences about the journeys that we go through with pregnancy and birth. So these things are just not uncommon. You're not alone if you're experiencing infertility or if you're experiencing miscarriage. It's way more common than we, than we realize or that we talk about. So, okay. So that pregnancy was good with baby number three. You feel like you kind of sailed through that and you had the same doctor for all three.

28:09                                   Kim: I did.

28:09                                   Nicole: Okay. All right. And so describe what your labor was like for the third one.

28:14                                   Kim: So the third one was interesting because the last doctor appointment I had before he was born, I was approaching 39 weeks and it was funny, my husband first pregnancy came to every single doctor appointment, second pregnancy came to some, third pregnancy probably came to like the first appointment and for whatever reason came to this last appointment that I did not know would be my last with the third. And I was dilated four centimeters. And the last thing the doctor said was, hey listen, once this thing gets going, I need you to go straight to the hospital because I don't think it's going to take very long for this baby to come out. So that had Danny on complete pins and needles because he was so worried about having a baby at home or in the car. So it was Super Bowl Sunday and we had some friends over to watch the game.

29:09                                   Kim: And throughout the entire game I was having what I thought were Braxton Hicks contractions. And so I would pull my shirt up and we were laughing because my stomach would ball up and the baby would be all lopsided. On one side, just not even thinking that it might be real labor. So the game ended, we cleaned up, I went to bed about midnight and I said to Danny, I feel like if I just pushed hard enough, this baby would fall right on out. And we just laughed about it and went to sleep three hours later at 3:00 AM my water broke in my sleep and it woke me up and so I woke Danny up and I said, I think my water broke, but I'm really not completely sure. So again, because he's so nervous, all he's thinking about is the Doctor said this is going to go quick, right? He is like up and fully dressed, car running, ready to go and I'm still in the room and I'm on my iPad googling, what's the difference between urine and amniotic fluid?

30:12                                   Kim: I was just trying to make sure I hadn't just peed in the bed. I was 9 months pregnant. That might not be unusual. I had been up late, we had friends over and he was like, Kim, if you don't get in this car and let's go!

30:27                                   Nicole: And then who was watching the kids? Like did you have to arrange childcare or where's your mom there? Or what?

30:33                                   Kim: Thankfully I had called my mom in, and it's funny, she wasn't supposed to come until that day, Sunday, the day of the Superbowl. But when we had gone to the doctor the prior week and the doctor said this is going to go quickly, I said, you know what mom, why don't you go ahead and come on Friday? Don't wait until Sunday. So she had already been at the house and of course we woke her up and told her that we were leaving to go to the hospital.

30:55                                   Nicole: Right.

30:56                                   Kim: So let's see, my water broke at three I of course I had to go log onto the computer and email work and tell them I wasn't going to be in today. And I was getting a major side eye still from Danny because car is running right in the driveway, right, ready to go. And so we got to the hospital about four, and when they took me into triage, the triage nurse said, you know, how far along are you? 39 weeks. When was the last time you went to the doctor? Oh, just last week. A few days ago. Were you dilated any? I said yes. She said I was dilated four. And she was like, okay, well you're not going to triage. We're sending you straight to a room.

31:35                                   Kim: And they did. They got me in the room. I got settled. They called my OB. And had to wake her up obviously in the middle of the night. And so this time, unlike the last time I said I want an epidural and my contractions were not even bad, but I was not waiting. So the anesthesiologist came in and administered the epidural and then my doctor said that she was going to lie down and to take a nap and that she would get called when it was time for me to deliver. So then it was literally a repeat of the first VBAC where I got back down after having the epidural. I told the nurse I was feeling the medication on one side but not feeling it on the other. And then the nurse told me to get on my side, which I did. And as soon as I got on my side I said, I feel like I need the push. And the nurse was like, wow, that's kind of early. Are you sure? Yes, I feel like I need to push. So they rolled me back over and the nurse was like, yeah it's time, so my doctor not even made it all the way down the hallway where she was going to take her down. The called her back in and one push and the baby was born.

32:48                                   Nicole: Oh my goodness. This is like the amazing, like the way women's bodies work, you just cannot predict how labor is going to go. So just before the epidural, you weren't even like hurting that much? Or was it like just starting to kick up?

33:04                                   Kim: I don't recall any painful contractions at all with the third one. I mean I probably felt then, but remember I had apparently been in labor all through the Superbowl and didn't think I was in labor. I may have been feeling the contractions, but they weren't what I would call painful. And because I was preempted this time and said I'm getting this epidural before these contractions get back. It just never got bad at all.

33:30                                   Nicole: And then you can get the epidural, which again, probably didn't have much time to kick in. And then one push and baby's here.

33:39                                   Nicole: Right. Wow. Two wasted epidurals. So very smooth pregnancy delivery. Did you tear after either one?

33:50                                   Kim: You know, I did tear after one of them, although I can't remember which one it was. I want to say it was the first VBAC that I tore. But um, and I think I had some stitches, but I literally had no pain or soreness after either the back. So I can't even tell you for sure which one it was because I never felt anything.

34:12                                   Nicole: Gotcha. So then how did your recovery compare from your vaginal birth versus your cesarean?

34:18                                   Kim: So with my cesarean, I do recall being sore and I recall taking a little Ibuprofen after I got home. But you know, it was fine. It's still a major surgery but I was sore for a couple of weeks. With the VBACs, it's literally like nothing. I mean both times after it was over and they let me get up, I was just walking around like nothing even happened.

34:42                                   Nicole: Right. So definitely easier, I mean your cesarean was easier, but your vaginal births recoveries were even easier.

34:50                                   Kim: Yes. And with the last one, because he was born at like five in the morning on a Monday. I decided I was not staying in the hospital for two nights. So we left on Tuesday the day after he was born and got home and settled with the new baby and I got in my car and drove to the daycare to pick up the second one. And when I got to daycare they were like, uh, did you have a baby yesterday? Cause I was by myself. Yeah I did yesterday.

35:22                                   Nicole: The things women do, sometimes you just kind of get going cause you know you got stuff to do.

35:29                                   Kim: That's right. Yup. Yup, Yup. Yup.

35:31                                   Nicole: So I want to wrap things up by asking you to share your, to the listeners. Are there any resources that you found useful in particular and if you didn't find any that's fine but were there any resources, resources that you found useful as you prepared for pregnancy or for your VBACs in particular?

35:51                                   Kim: Well, again, that handy Internet probably was useful and a lot of ways, um, but I'm also one that probably did not get fearful of the random 1% chance of bad things that could happen. So, I got a lot of good information that way. Obviously talking to my doctor, having friends like you Nicole that I could bounce things off of. It's funny, I was thinking, I don't know, I don't think I have any personal friends that had VBACs. So I didn't really have a close friend to go talk to about it because all of my friends that had c-sections elected to do c-sections the second time.

36:33                                   Nicole: Okay.

36:33                                   Kim: Yeah. So I was kind of the first person in my circle to go and do a VBAC.

36:39                                   Nicole: Interesting. So then what would you tell women who are thinking about a VBAC versus a repeat cesarean?

36:48                                   Kim: I would definitely say for one, don't stress either way. Like I'm a high believer in the baby will get here, do what's most comfortable for you. It's not a competition regarding which way you have a baby, nobody even cares how the baby got here once the baby's here. But having said that, if there's no medical reason suggesting otherwise, the VBAC is so much easier and the recovery time is so much less. I think any woman that has a successful VBAC appreciate to doing that versus having another cesarean.

37:25                                   Nicole: Okay. And had you, did you connect with any other, I mean have you since connected with other women who made the decision to have the VBAC and they said something similar?

37:34                                   Kim: I don't think I have. Maybe people will connect with me as a part of this podcast. I can pass on some wisdom. Now remember too, I was so advanced in age when I had my younger two, that most of my friends were already done with kids. Most of my friends have kids that are around the age of my oldest and I brought up the backside with my younger two.

37:57                                   Nicole: Yeah. Yeah. It's a group of us y'all. It's five of us. Wait, what am I counting right? Five of us. And we have kids ranging in age from 20 something all the way down to what, two? So the five of us have quite a range of experiences of birth. So anyway, the last thing I would ask is what is that you, I don't even know how you can boil this down to one piece of advice. Because you were a busy working woman, you had to go through, you know, infertility treatment to have a baby, you had miscarriage, you had cesarean section, you had VBAC. So if you could pick one piece of advice or a couple pieces of advices you would tell other women as they get ready for birth, what would you tell them? What would you want them to know?

38:52                                   Kim: The biggest thing is to not stress out. So many things we worry about during pregnancy and with regards to the delivery, at the end of the day, if you have a healthy baby, none of that ever matters. I think women put so much pressure on themselves and have these really strict birthing plans. In my opinion, you just need to be flexible and go with the flow and just want to get to the end result of having a healthy baby. And no matter what happens in the steps leading up to that, at the end of the day nobody cares and it won't matter at all.

39:32                                   Nicole: That is excellent advice for sure to be flexible and go with the flow of birth because birth is unpredictable and none of us can really plan exactly how things will go. So being flexible is key for sure.

39:44                                   Kim: And one other thing I would add for professional women, you know, having the c section the first time and knowing I would have to have the c section was nice because we knew exactly the date I could prepare all of my work projects. You know, I knew what my last day of work would be and that definitely aligns with us type A professional women. And then like with the second one, totally out the blue at 35 weeks and here I am having a baby. But again all the things that I thought would have mattered in terms of trying to plan and make sure I had managed everything accordingly with work, it didn't matter and it all worked out just fine. I think we all still have to let go of that, wanting to have some level of exactness with planning for our delivery and just let it happen however the way God intends for it to happen and all the other stuff that we care about will work itself out that we think we care about so much will work itself out.

40:45                                   Nicole: That is an absolute perfect place to end. So Kim, where can women connect with you if they want to connect with you on social media or anything like that? Are you on social media?

40:54                                   Kim: I am on Facebook and Twitter and Instagram. My handle is easy. It's Kim Gatling for Facebook and for Twitter and for Instagram it's KimBullGat. And you can Google me and find me and get all my work info and email me as well.

41:17                                   Nicole: All right, well thank you so much for being on the podcast and again, super excited to have one of my day one best friends on the show. I really appreciate the time cause I know you're super busy.

41:27                                   Kim: No problem. Thank you. I'm so proud of you.

41:29                                   Nicole: Oh thanks. Okay, I'll talk to you later. Love you to pieces.

41:32                                   Kim: Love you too.

41:32                                   Nicole: Okay, bye.

41:34                                   Nicole: Oh now, that was just so much fun talking to my friend. I'm really grateful that she came onto the podcast today. Now after each episode where I have a guest on, I give something called the Nicole's notes, which are just my top three or four takeaways from the episode and let me tell you what my notes are for today's episode.

41:51                                   Nicole: Number one. I just love how her doctor was so fully supportive of her having a VBAC, not just her doctor, but also the hospital was supportive of her having a VBAC and it was never really much of a question. Although she went over the risks and everything. Just from day one it was clear that she was on board. Her doctor even went so far as using pitocin. Some doctors aren't comfortable using pitocin in the setting of VBAC. I am and many doctors are, but some aren't because it does slightly increases the risk of something called uterine rupture, which is the catastrophic outcome that we worry about with with VBAC, but her doctor was really supportive of everything. And there are supportive doctors out there. That's why I'm saying this, I want you to know that there are supportive doctors who exist who will be there for you if you want a VBAC, you may have to look for them, but the supportive doctors are there.

42:49                                   Nicole: Number two, and this is perhaps the most important thing I can say to a woman, it is actually the most important thing for a woman who is considering TOLAC or wants a VBAC. You need to bring it up early. Kim says she brought it up really early in her prenatal care. Her doctor hadn't even brought it up yet and maybe her doctor was, you know, going to get to it later on. But Kim brought it up that I want to have a VBAC. I suggest that if you're thinking about it, you do the same thing. The first appointment is not too soon to bring it up. And the reason I say that is because there are some doctors who do not support TOLAC or VBAC, and there are hospitals that don't support VBAC. So you really need to know up front and early if your doctor and hospital are on board or not. Because if they're not, then you want to be able to have plenty of time to find options to support you. And I will say, I've seen it one or two times where a doctor doesn't even mention until towards the end of pregnancy that they don't support VBAC. And then it's like, well, we're scheduling your repeat c section. And it's like, whoa, wait a minute, I don't want a repeat c section. And you're finding out that your doctor doesn't support it or the hospital doesn't support it. You do not want to be in that situation. So if you're thinking about VBAC, then ask early.

44:13                                   Nicole: And then the last thing, and this is a recurring thing that I say and that I'll say over and over again on the podcast and that Kim mentioned as well, you need to be flexible with the process of birth. You need to be comfortable with going with the flow and understanding that you can't control everything. And that those things that you spend so much time worrying about, they typically end up being fine in the end. Well, in the end, birth is an unpredictable process and you need to be flexible with that. That's how you're most likely to be fulfilled and happy with the outcomes. When you can relax into it, be flexible, go with the flow, control what you can. That doesn't mean that you don't plan at all and you just kinda throw caution to the wind. Absolutely not. You control what you can, but you know that you're flexible and can go with the flow again in that process of of birth.

45:11                                   Nicole: So that's it for this episode. I would love to know what you've heard about VBAC. If you know anybody who's had a successful VBAC or or who had trouble with finding someone who was willing to support VBAC, I'd love to hear about it in the All About Pregnancy and Birth Podcast Community on Facebook. This is a closed group on Facebook. If you're not already a member, the link to join is in the show notes or you can search All About Pregnancy and Birth Podcast Community on Facebook. Also be sure to subscribe to the podcast in iTunes or wherever you listen to podcasts and if you feel so inclined I'd really appreciate you leaving an honest review in iTunes, it helps other women find the show. And I also give shout outs from time to time on the podcast from those reviews.

45:56                                   Nicole: Now next week on the podcast, I am taking a dip into the woo woo. I have Nicole Kieron on, she is an energy coach who helps moms. Now trust me, it's actually not as out there as it sounds and she gives some really great advice. So come on back next week. And until then, I wish you a healthy and happy pregnancy and birth.

46:21                                   Today's episode is brought to you by Women's Wellness Coaching by Dr. Nicole Calloway Rankins. Head to www.ncrcoaching.com to check out my free one hour mini course on how to make your birth plan as well as my comprehensive online childbirth education class, The Birth Preparation Course, with over eight hours of content and a private course community. The Birth Preparation Course will leave you knowledgeable, prepared, confident, and empowered going into your birth. Head to www.ncrcoaching.com to learn more.

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