Putting VBAC Risks into Perspective

Your first baby was born via c-section and with this time you’re hoping to have a vaginal birth, or VBAC (vaginal birth after cesarean). You may have heard about some of the risks, but what does it all actually mean? Are VBACs more risky than having a repeat c-section? What factors should you consider before making this big decision for both you and your baby?

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Preggie Pals
Putting VBAC Risks into Perspective
Episode 141, April 25th,2016

[00:00:00]
Please be advised, this transcription was performed from a company independent of New Mommy Media, LLC. As such, translation was required which may alter the accuracy of the transcription.
STEPHANIE GLOVER:  You are expecting your second or third baby and you're considering having a vaginal birth after cesarean known as VBAC. But making sense of all the risks associated with both VBAC and repeat C-section can be overwhelming. Today we will breakdown how to interpret those risks and way your options.
This is Preggie Pals.
[Theme Music/Intro]

STEPHANIE GLOVER:  Welcome to Preggie Pals broadcasting from The Birth Education Center of San Diego. Preggie Pals is your online on the go support group for expecting parents and those hoping to become pregnant. I am your host Stephanie Glover.
Thanks to all our loyal listeners who have joined the Preggie Pals Club. Our members get special episodes, bonus content after each new show plus special giveaway and discounts. See our website for more information.
Another way for you to stay connected is by downloading our free Preggie Pals app available on the android, iTunes and Windows marketplace. You can also download our new network app so you can access all your favorite new mommy media shows on the go. So here is Sunny with more information about how you can get involved with our show.
SUNNY GAULT: All right, we are in the process of planning episodes for the coming year for 2016. We have done a lot of episodes for Preggie Pals and so we want to have your input on what topics you would like us to explore on the show. We are always looking for story ideas but thought I should put up a special call for it in this episode. So, if you have any story ideas, pregnancy related or topics that you think pregnant moms should know before they go into motherhood, those are the kind of topics we are exploring on Preggie Pals. You can go to our website on www.NewMommyMedia.com click on the contact link and there is a website form there.
We also have the ability for people to be able to leave voicemails through our website so you actually don't have to pick up a phone anymore, we are doing everything online. So again go to our website there is a little gray banner on the side that says send voice mail and you can just use the speaker and microphone on your computer and send it that way.
What else? Stephanie was talking about apps so we like to talk about different pregnancy apps on the show and so if there is one that you have on your phone, I know a lot of pregnant moms have several on their phones so if there is a couple that you like to share with us. We will check into it and perhaps we will review it on a future episode. So those are some ways you should get involved.
STEPHANIE GLOVER: Thank you Sunny
SUNNY GAULT: Sure
STEPHANIE GLOVER: So, let us get to know who we are talking to here on this episode. We will go around and introduce ourselves, I will start.
STEPHANIE GLOVER: So, again my name is Stephanie Glover, I am thirty-three years old. I host Preggie Pals and I am also a trained childbirth educator. No due date, I have two kiddos Gretchen is four and she was my C-section baby and Lydia is two and she is my VBAC.
SUNNY GAULT: I am Sunny and I am producing today's show and I am the proud mommy of four kids ages five and under so we had our boom boom boom. I have two boys and two girls and the girls are twins. So, that is how I did it boom boom boom. Everyone was like she was busy for like four years, we were busy but not as busy as you think. So, no VBAC's, my first baby was a virginal birth that was my only virginal birth and due to some complications I had to have C-sections after that.
STEPHANIE GLOVER: Jen, you are a mom, would you like to introduce yourself?
JEN KAMEL: Absolutely, I am Jen Kamel founder of VBAC Facts. I have two kiddos, my daughter who was born in 2004 so she is almost twelve now. I had a C-section with her for a single footling breech and then I had a VBAC with my son in 2007. He is eight years old now.
STEPHANIE GLOVER: Awesome
[Theme Music]
SUNNY GAULT: So before we get started today we have a headline that we want to share with you guys. You have heard of the Fitbit, Stephanie, Jen you have heard of the Fitbit?
JEN KAMEL: Absolutely
SUNNY GAULT: Okay, so check out this headline, ‘Fitbit helps man discover wife’s pregnancy.’ So, this is what happens, this guy recently noticed that this device was showing his wife had logged ten hours in the fat burning zone and he thought that it was impossible due to her level of activity. Obviously, you would have to be doing it live. I mean ten hours of straight fat burning? I mean who would even be standing at that point, right?
Anyway she had a consistently high heart rate and again this is according to the device, so the guy thought that the device was defective and so he is on some sort of message board talking to other users and I am sure trying to get a hold of Fitbit to figure out why his wife’s device is broken and one of the users actually said to him 'has your wife recently experienced anything stressful or is she pregnant'? The guy they had just started to try to have a baby and he are like putting two and two together and I don't know how long it took, the article doesn't really go into that, but apparently that is how he found out that his wife is pregnant.
I am sure Fitbit are all over this and there are marketing people are going to be running with this story and you will probably see a lot online, you know Fitbit saying now you know we can announce your pregnancy for you.
I know Fitbit are very popular now, just a fun little headline for this morning.
STEPHANIE GLOVER: Did she know she was pregnant yet?
SUNNY GAULT: It doesn’t really say, this is all from his perspective. It doesn’t really say anything about his wife. I am assuming that she did and obviously if she did she didn’t tell but that is funny. So, if you have a Fitbit, you don't need to pee on a stick anymore, so you know how your heart rate is.
[Theme music]
STEPHANIE GLOVER: Today on Preggie Pals we are discussing the risks associated with VBAC and repeat C-sections and how to make sense of all the data. Joining us on the phone today is Jen Kamel founder of www.VBACFacts.com . Jen learned firsthand that more resources and information were needed for women seeking VBAC. She has made it her mission to collect him data and share it in any easy to understand terms for expecting moms.
Thank you so much for joining us today.
JEN KAMEL: My pleasure, thank you for having me.
STEPHANIE GLOVER: So, we have covered VBAC on a few previous Preggie Pals episodes but in this episode we really want to focus on the perception of risks and understanding what these statistics mean. To get started here can we talk about what sorts of risks we are looking at? VBAC moms often hear about the uterine rupture that tends to come up a lot when you are researching whether or not to have VBAC and what your risks are.
What is the statistical likelihood of a uterine rupture?
JEN KAMEL: Well it depends on a few different factors, first of all where the scar in your uterus is? Is it a low transverse or horizontal scar or is it a scar that is high up on the uterus? That is the first thing to look at, and you can confirm that via your medical records. You can also look at whether your VBAC labor is induced, augmented or spontaneous labor because that also has a big impact on your uterine rupture risk which is why many providers want women to go into labor spontaneously as opposed to being induced for a medical indication. Spontaneous labor is ideal.
STEPHANIE GLOVER: Okay, and when we are thinking about risks associated with VBAC how does this rate compare to other obstetrical complications that can occur in a pregnancy without a prior C-section? Often we talk about the risks following the surgery but how can we compare that?
JEN KAMEL: Yes, so the rate of uterine rupture varies depending on scar type, depending on induced, augmented or spontaneous but generally for a low transverse scar it is 0.4% which is about 1 in 240 to 1 in 100 which is a 1% statistic. That range is similar to the range of obstetrical complications that can occur in a first time mom who has never had uterine surgery.
So it is how we talk about this risks that really influences our perception of risk. When women are pregnant for the first time they are often not told why you have this risks for control lapse, do you have a risk of shoulder disclosure, they just go along their pregnancy and since these risks aren't continually brought up to them, like uterine rapture is frequently brought up to a VBAC mom, they are left with the perception that their pregnancy has an extremely low risk as opposed to women who are pregnant after a cesarean how uterine rapture is discussed in our general society and how people even who don't even have children are aware of these “risks of VBAC”.
There is this overall cloud of risks that seem to follow the mom but does it accurately reflect this gigantic additional risk? No it doesn’t because there isn’t this gigantic additional risk but the way we talk about this risk certainly influences our perception of what they really are.
STEPHANIE GLOVER: That is actually a great point and Sunny did you take your childbirth education classes with your first?
SUNNY GAULT: I did.
STEPHANIE GLOVER: Do you remember them talking about cord prolapsed or any of these risks with your first?
SUNNY GAULT: I don't remember it but I didn’t know a lot going into that so if there was something that when I did my class I did like those cram it in a weekend classes and they could have said and I would have been like do I need to know that? Is that something that I need to know for the next two weeks ago and might have been a fleeting moment
STEPHANIE GLOVER: And it could have been because it was presented to be such a low rate because I don't recall learning too much about that yet I am a reader so I did read some pregnancy books front to back but never did I have a fear about those low percentage things.
I think Jen that is an interesting and important point that I think especially with first-time moms, I mean first-time moms I mean completely just did not read the C-section part.
SUNNY GAULT: Yes, because you don't think that it is going to happen to you.
JEN KAMEL: Exactly, and so you are like I don't need that and you are that person and you are like I should have read the chapter
STEPHANIE GLOVER: Oh the things that I didn’t know
JEN KAMEL: Exactly! Exactly!
STEPHANIE GLOVER: It is interesting too talking with different childbirth educators because I was working on my curriculum to teach students and I thought in the back of my mind, probably because I am a VBAC mom and we are presented with risks and how to combat them or to address them, I wanted to share about cord prolapse.
I remember talking with one of my mentors and she was like we usually don't even mention that, which is kind of interesting because I think now being a VBAC mom I just go a place and go let us just address everything so that you know as much as possible but then there is also that element of why introduce the fear if it is a low likelihood so it is kind of an interesting balance.
JEN KAMEL: I think it really depends on the personality that you have, some women feel more comfort not knowing all that information and other women like me find comfort understanding what the risks are and what would happen. I am the kind of person who likes a plan so if I know that if x y z happen, this is what we will do, this is how likely that will happen that gives me some comfort and then I can just shove it in the back of my mind. It is the great unknown that is scary for me. I think parents need to have a little heart to heart with themselves about what kind of person are you? Do you find comfort knowing what will happen if you were that statistic or do you find more comfort knowing I don't really want to know any of that?
STEPHANIE GLOVER: Sunny how are you on that?
SUNNY GAULT: I don't know that I am in one camp or the other, I feel like I am in the middle. I like the information but once I start to get scared with the information I back off.
JEN KAMEL: I think that is where understanding putting these risks into context comes into play because it can be easy to start freaking out about uterine rapture but then when you start to think well how likely is it to happen? Well, I was this first-time mom that has the same risk of these other complications occurring as uterine rapture after a C-section and yet was I fearful my entire pregnancy about these complications? No, did people bring them up to me constantly? No. Did my provider bring it up all the time? No
So, it goes back to thinking about how are these risks communicated because it makes a huge difference when your sister-in-law comes up to you and say “oh my gosh, my OB told me it was too dangerous to have a VBAC, yet her OB allowed her to have a virginal birth the first time”, you know allowed her to plan it because it is all about how those inherent risks are marketed to people. One way that we can inoculate ourselves from that marketing of risks in understanding what the statistics really are.
STEPHANIE GLOVER: I know there has been some confusion too in the VBAC community as well about entertaining those risks. Sometimes people will hear a statistic about like only 8% of births are VBAC and they will misread that as that is your likelihood of having one and they are not taking into account how many women are actually trying for one, and that how many of those women are trying for them are successful. This is very different statistics and a very encouraging one but if we don't understand the data then we are misled often.
JEN KAMEL: Any time you look at a percentage like that you have to understand what two numbers are included in the computation of the percentage. So, when you are looking at the total VBAC rate in America, we are looking at how many women had a VBAC divided by how many total women with a cesarean birth that year. That is a very different number than how many women had a VBAC divided by how many women planned a VBAC.
STEPHANIE GLOVER: Right, so Jen when you had your VBAC because I know you have done a lot of research to make VBAC Fact so composeable did you find that when you were in labor, were you thinking at all about your VBAC risks? I am just curious.
JEN KAMEL: you know I wasn't because your mind goes in a different place when you are on labor. You are not thinking about statistics, you are not thinking about spreadsheets and charts your brain goes to this other primal place where you are just surviving moment to moment and it is fascinating the transition that occurred when I was in labor. Loud noises were really distracting, bright lights were really distracting. So you just go to this different place and everyone had a different experience but I hear that a lot of other women had that same experience where they had all this information before they went into labor and you are just at the moment.
STEPHANIE GLOVER: I loved to ask that question because I think it comes up in forums where people say I am fearful going into labor, will my labor be full of worry that something bad is going to happen? I had the exact same experience you did where I researched and researched and then I hit labor and I sort of surrendered. There was no fear it was just very primal. I was just a breathing woman like any other breathing women which I thought was pretty awesome and encouraging I think.
JEN KAMEL: Yes, and you know you can't control everything, so there comes a point when you just have to say you know what? What will be, will be? I put forward this plan of my provider and etcetera and so now I am just going to and what will be will be. There is only so much that you as a birthing woman can control and you should kind of let it go.
STEPHANIE GLOVER: Now a lot of women going for VBAC are told that to safely deliver a VBAC, the hospital must have a 24/7 anesthesia in the event of an emergency C-section. If we take a look at the hospitals all over the country maybe some of them are rural or just smaller or are shorter on staff, so can you talk to me about the risks of not having these requirements? Are there any options for women who are at a smaller hospital?
JEN KAMEL: I think it is important to look at ACOG says, The American College of Obstetricians and Gynecologists and they actually do not say a hospital has to have a 24/7 anesthesia in order to offer VBAC. I think it is really important to get that information out there because a lot of people say ACOG say we have to do this and that is not the case.
ACOG actually said in Memo Guideline published in 2010 that even if a hospital has a VBAC ban or restricted VBAC policy, they still cannot force women to have a C-section. They say in hospitals with limited resources they should have a discussion with the patient about well what other resources are there? Maybe they have an anesthesiologist on call, maybe it is their policy that they are fifteen minutes away when they have a woman laboring.
But for the hospital and for the patient to have a discussion about what are the risks and benefits of giving birth at the hospital, what are the limitations of services at that hospital and for the patient to decide whether they want to accept that increased level of risk or if they want to have a repeat C-section at that hospital or if they want to transfer to another hospital which in the case of rural women might be hundreds of miles away.
The other thing we have to consider in this discussion is insurance commutation. It is not as if women have their pick of any hospital they want to go to, it is trying to find a hospital that “allows VBAC” and also takes your insurance. The other thing to consider is that any hospital that offers labor and deliveries has protocols in place to manage obstetrical emergencies. So, if you have a cord prolapse, if you have a shoulder disclosure, those hospitals have policies in place. Those same policies are applied to uterine rapture, no special response is needed.
In hospitals that don't have 24/7 anesthesia, they have a procedure in place. It is not like they don't know what they are doing if there is a uterine rapture.
STEPHANIE GLOVER: Right, that is what I was thinking of. A first-time mom wouldn’t really necessarily be faced with that because she would be laboring women and if they have labor and delivery then those procedures will be in place.
JEN KAMEL: I recently wrote an article on the subject on the website, you can go to www.VBACFActs.com/247, it talks all about this idea that hospitals have to have 24/7 anesthesia in order to offer VBAC. It puts women in a real tough spot when they are told you can't labor here because we don't have 24/7 anesthesia, well we don't have a NICU or we don't have insert other qualifications here. The reality is any hospital that offers labor and delivery should be able to respond to uterine rapture or any other obstetrical complication.
STEPHANIE GLOVER: Awesome, when we come back we are going to go over the risks associated with repeat C-sections and setting a gestation limit on when VBAC patients must go into labor.
We will be right back
[Theme music]
STEPHANIE GLOVER: Welcome back, today we are talking with Jen Kamel founder of www.VBCAFacts.com about perceived and actual risks of VBAC's. So, let us move on to cesareans. An argument often made by health care providers and well-meaning friends and family alike is that it is safer to deliver via C-section if you have already had a C-section.
While C-section is important and often lifesaving in certain circumstances, can you shed some light on risks of repeat C-sections?
JEN KAMEL: Well I think it is important to acknowledge that there are risks and benefits with both VBAC and repeat C-sections. What is safer is really in the eyes of the beholder, for one woman she might look at the risks and benefits and say you know what, I really want a VBAC. Another woman might look at those exact same risks and benefits and say she wants a C-section. I think it is important for particularly for friends and families, well-meaning especially, to acknowledge that just because they would make a particular choice that doesn’t mean that is the right choice for their family member.
There is no right way to birth. Everyone gets the right to decide or should get the right to decide which risks and benefits are tolerable to them because they will be the ones ultimately at risk for those complications.
So when we look at repeat C-section there is a variety of different risks that can occur and do increase with each subsequent C-section. Unfortunately many women especially pregnant after one C-section are never informed of these risks. Things like placental abnormalities which who know what that really means, right? When a lay person hears that they are just like whatever.
But placental abnormalities are actually extremely serious. One of which is called placental accreta which is when the placenta abnormally attaches to the uterine wall and the risk of that occurring increases with each C-section and requires a far more complex response that uterine rapture. Any hospital can't respond to a placenta accreta because you need an ample blood bank and you need a variety of some specialties.
How the risk of accreta is communicated to women versus how the risk of the uterine rapture is communicated to risk women is quite different.
STEPHANIE GLOVER: Sunny since you have had repeat C-sections were you aware of these risks, did you talk to them with your health provider?
SUNNY GAULT: It never came up, can you believe that? Although in doing Preggie Pals obviously I knew more than I think most people did. My concern though it ended up being not very important because I had twins but I knew after my virginal birth after that birth that every subsequent delivery was going to be a C-section because of my complications. That was very hard for me to wrap my brain around because I just had this amazing virginal birth and I didn’t realize there were issues until after the birth.
It was just a beautiful experience and I felt like I was wasn't being able to give my children the same gift that I just gave my son, you know my unborn children that I didn’t even know I was going to have. It was very emotional overall for me and my biggest concern was that I didn’t know how many children I wanted to have and I had heard that the more C-sections you have the more complications you could have. You would probably get to a point when they say okay, we have cut you up enough we don't think you should have any more babies. Before I got pregnant with my first son we struggled with infertility and I didn’t want anyone telling me I could not have as many babies as I wanted.
Overall it really worked out for me because I have four kids total and babies three and four came in a package so I only had to have two C-sections but I definitely would have been nervous going to the second C-section just by the information I had from doing Preggie Pals. If I had to go through a third C-section I would have been really concerned.
JEN KAMEL: I recently shared on Facebook the story of a woman who wanted a VBAC, was talking to her doctor and her doctor did not quote do VBAC and he told her that she can have up to eight C-sections.
SUNNY GAULT: Oh my goodness!
JEN KAMEL: So, that goes back to the marketing of risks. I mean he is clearly saying even one VBAC, a VBAC after one C-section is too much of a risk, but eight C-sections you can totally do it.
SUNNY GAULT: That doesn’t make sense.
JEN KAMEL: So, that is such a loaded statements and especially when that woman goes down and she posted it online maybe to unknowing other moms or she says it to her friends and family and then, of course, her mom might say to the neighbor and the neighbor might tell their aunt and say 'gosh can you believe how dangerous VBAC is? Look you can have up to eight C-sections and there is no big deal.'
This is one of the ways that misinformation can just travel throughout a community and really reinforces this notion that once a C-section always a C-section, and that VBACs are dangerous and C-sections are relatively risk-free. I mean if you can have eight and it is no big deal, and there is no mention of hysterectomy, no mention of accreta no mention of ICU admission or operative time all of these things increase significantly with each subsequent C-section.
Again it goes back to this conversation when we talk with other people about risks and benefits, what information is stressed, what information is just completely left out of the conversation.
STEPHANIE GLOVER: Right, I have had several friends after just one C-section with complications such as their bladder was nicked or they had such scar tissue, I had a friend who opted for a repeat C-section on her second because she wanted a tubal ligation since they were done having kids and the doctors told her we can't, there is too much scar tissue, hubby is going to do something if you guys want a more permanent solution. She was shocked and was like I didn’t know, I didn’t even know that there would be a scar tissue.
SUNNY GAULT: Oh that is horrible, and then she had a C-section and couldn't even get the tubal ligation, then probably she would have gone for virginal birth.
STEPHANIE GLOVER: I don't think she would have gone. I think she did want the C-section regardless so that worked for her that is what she felt was right for her, but we just don't realize some of these other complications or infections. I have known so many women who have had infections afterward and it is just things that I didn't know, I kind of skipped the C-section part. I didn’t have a complicated C-section but I wouldn't have really even thought.
SUNNY GAULT: I mean just recovering from the scar and being able to move if you are breastfeeding your baby, there is a lot that is involved. I know from after having my virginal birth I didn’t have a lot of the complications that I had from having a C-section. I just felt that I was more active after the virginal birth faster and stuff like that. There are definitely a lot of complications after a cesarean.
STEPHANIE GLOVER: It is a major surgery but I think because it is so common people think it is not a big deal and thank goodness that it isn't often for many. Many women heal from it and it is fine. It’s a great option, and glad we have it but there are other stories and maybe they don't tell.
SUNNY GAULT: But eight C-sections, that is a lot.
STEPHANIE GLOVER: You can imagine the scar tissue on that one. So, Jen another thing that comes up, when women are trying for a VBAC and they have a “supportive care provider” and there are different schools of thought on this, they are given a time limit in gestation and they say oh my care provider is supportive of my VBAC but he wants me to deliver by 38 or 39 weeks, and when we were talking about spontaneous labor being preferred to lower risks of uterine rapture etcetera, can you speak on that a little bit because there are risks associated with having a baby come in an earlier gestation. Could you maybe shed some light on that?
JEN KAMEL: Absolutely, and you know much has been said it is best to wait until 39-40 weeks because you have lower complications, you have lower NICU admissions and you also have a lot of brain development and other stuff like that going on during those last weeks and that is pretty important. The other thing to keep in mind is when do women typically go into labor? The bulk of women doesn't go into labor before 39 weeks. In fact, the bulk of women goes into labor after 39 weeks.
We should also look at what ACOG says. I mean ACOG says that post-term pregnancy by definition refers to a pregnancy that has extended to or beyond 42 weeks. When we look at ACOG VBAC guidelines, they are very clear that going beyond 40 weeks alone should not preclude VBAC. Even if a woman goes to 42 weeks that is not just an expiration date, ACOG doesn’t stand behind the practice that says you can have a VBAC as long as you go into labor by 39 or 40 weeks. That is not just in line with national guidelines.
STEPHANIE GLOVER: I think it is important to acknowledge too that some women are very aware of when they have conceived, but some women just don't know. Pregnancy could be a surprise, you know they are just trying or maybe just a little confused when they ovulated or whatever. I think one of the risks to it is if you are put in a time line and you start augmenting or inducing someone who is 38 weeks and they really could be 36 weeks. We are just ignoring that then the baby could need to be in a NICU or have other health complications just because we have picked a calendar day and we are not really looking at the big picture, I have seen that happen a lot.
That happens to a planned C-section too, people get into a rush and say I might as well take the baby at 38 weeks, why be uncomfortable till 40 weeks? You could be off on the dates and your baby could have some issues there
JEN KAMEL: Another thing to look at is that ACOG talks about what is a term pregnancy? In 2013, they redefined that to mean a term pregnancy is not until 39 or 40 weeks and six days. Anything before that is considered early term. 37 weeks to 38 weeks and six days is considered early term. So really there should be no medically elective induction or C-sections conducted before 38 weeks and six days. This is because the baby is not just ready yet.
STEPHANIE GLOVER: Sunny, I am just curious for your repeat C-sections what gestation did they schedule your C-sections at?
SUNNY GAULT: I fought with them on this, I had MoDi twins so they were sharing a placenta. With MoDi twins they really don't want you to go past 38 weeks and my first baby was nine and a half pound or something like that, so I knew my body could hold big babies and my second baby was over seven pounds so in being pregnant with the twins I thought well I think I can carry these as long as they will let me carry them. I talked to my perinatologist and I wanted to push it all the way to 38 weeks and she gave me the look of okay we will try that. So, we set it the C-section date right at 38 weeks.
In my head, I was just like I have to make it to that date and kept saying the day to my head and then one of my babies broke her water at about 35 weeks, but you know what, they were ready to come out. They didn’t even need NICU or anything. That helped me because again I didn’t want to have a C-section if I didn’t have to so it forced me into the whole C-section thing because of my first labor and delivery experience. It made me feel so much better that they picked their day and I was okay with that. I just felt better about the whole thing. I wanted to push it to 38 weeks but I made it to 35 weeks.
STEPHANIE GLOVER: Jen I am curious what were the gestation of your two kiddos?
JEN KAMEL: I actually went into spontaneous labor with both of my kids in my 38th week of pregnancy. I was one of those lucky ladies that went kind of early and wasn't super uncomfortable in 41 weeks, I went nice and early.
STEPHANIE GLOVER: I was uncomfortable because I had two late summer babies,
SUNNY GAULT: I had a late summer baby too with my first one.
STEPHANIE GLOVER: Well my first one was and then we said we are not doing this again and we got pregnant at the exact same time again.
SUNNY GAULT: You should have abstained during that time
STEPHANIE GLOVER: We are total in late November early December turns out, but I was actually blessed as well that I never had to be faced with the going over, in each situation I think I was 39 weeks 4 days with my first and 38 weeks 5 days with my second with my VBAC, so that worked out well
JEN KAMEL: And then you are relieved of everyone asking are you still pregnant? You circumvent that whole bit
STEPHANIE GLOVER: I love it when women post their profile picture; I keep calling them still pregnant
SUNNY GAULT: That is really smart, like don't ask me you will see a baby in my profile picture when they are here
STEPHANIE GLOVER: This wraps up our episode of Preggie Pals for today, thank you so much, Jen, for joining us
JEN KAMEL: Thank you for having me
STEPHANIE GLOVER: It was so informative. Well for more information about our show as well as information about our panelists and experts visit the episode page on our website. This conversation continues for members of the Preggie Pals Club. After the show, we will be talking about understanding the risks of home birth after cesarean also known as an HBAC.
[Theme Music]
SUNNY GAULT: One of the segments we have here on Preggie Pals is called “pregnancy brain blunders”. Everyone who has been pregnant knows that you get that pregnancy brain and it is just like you can't think straight. So, we thought we will make a segment out of this where you guys can share with us your funny moments and so I actually have a bunch here but I am only going to read one of them today.
This has to do with labor and delivery and sometimes you are not just thinking clearly as we talked about today, there is a lot going through your head when you are trying to push out a baby.
Carrie from Massachusetts wrote in and she said;
“During labor my husband said ‘nice deep breaths’, and I loudly replied thank you, they are nice breasts.”
When I was reading this I was like he was completely embarrassed like why did she do this? Well, there is nothing to be embarrassed about it is just so funny. That would be me because I would be like could somebody give me a compliment please, like you know your legs are spread wide open, you are trying to push out this baby and he is like nice deep breaths, I would do that first and totally hear something, thank you for the compliments, they are nice, my milk is coming in
STEPHANIE GLOVER: I am kind of the opposite I think that if I thought someone was complimenting my breasts while still pushing I would probably would have darted like the evil eye
SUNNY GAULT: Well if it there was someone other than you husband. Thank you, Carrie, for sending this in. If you have a funny “pregnancy brain blunder” you can email us through the website and we will read it on a future show.
STEPHANIE GLOVER: That wraps up our show for today. We appreciate that you listening to Preggie Pals.
Don’t forget to check out our sister show:
• Newbies for newly postpartum moms
• Parent Savers for moms and dads with infants and toddlers and
• Twin Talks for parents with multiples.
• Boob Group for Moms who Breastfeed

This is Preggie Pals, your pregnancy your life
[Disclaimer]
This has been a New Mommy Media production. The information and material contained in this episode are presented for educational purposes only. Statements and opinions expressed in this episode are not necessarily those of New Mommy Media and should not be considered facts. While such information and materials are believed to be accurate, it is not intended to replace or substitute for professional, medical advice or care and should not be used for diagnosing or treating health care problem or disease or prescribing any medications. If you have questions or concerns regarding your physical or mental health or the health of your baby, please seek assistance from a qualified health care provider.
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