Latest / The Birth Lounge Podcast / Ep. 476: Failure to Progress? What ACOG Actually Says About Stalled Labor + Avoiding Unnecessary C-Sections

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Ep. 476: Failure to Progress? What ACOG Actually Says About Stalled Labor + Avoiding Unnecessary C-Sections · The Birth Lounge Podcast

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I really do believe that in most cases it is a failure to wait and it is a failure to individualize care to make that person be able to have the pieces of their birth puzzle put together correctly.
So many times we're rushing these births, we are just throwing things at people's bodies that they don't actually need, or it's in a, a way or a system or an order that their body was not ready for certain things and we would've been better off making different decisions.
Yet we tell these women, "Failure to progress.
Your f- your body failed.
Your body didn't do it.
It couldn't get past this, this way."
Where in reality if we tried a couple of other things, some more individualized care, something that's safe and compassionate, chances are we mighta got, we mighta got some babies out of it.
Hello and welcome back to another episode of The Birth Lounge Podcast.
Hi.
Can I share something super exciting with you? Ah, I've got something new launching.
Well, it's actually not really like a full launch.
It is, um, more of, like, a facelift or an upgrade.
So I used to teach this class, and it was my best tips to avoiding failure to progress and a C-section and all my tips to, to tearing.
And I wanted to bring back a new and improved class.
That stuff is...
I've taught it for so long, and so I asked my audience over on Instagram, if you're not following me over there, what are you doing? I share all my favorite tips and, uh, things to help you have a better birth and also my life with Saggy Boy and Mr.
HeHe and Maximus, our dog, and just, um, letting you into my world.
But anyway, that's @tranquilitybyhehe over on Instagram.
But I asked my audience over there, which I love so deeply, um, "What do you guys want me to teach about? Like, if you got to pick my brain, what would you want to hear about?" And they said how to avoid a C-section.
Like, I really don't want a C-section, but I don't know how to not have one unless it's absolutely medically necessary, which of course, so grateful for C-sections, but we don't want them to happen every one in three women that walk in the hospital, and that's what we have currently.
And so over the last 10 years, I've really gathered a bunch of tips and tricks that will actually truly reduce your risk for a C-section up to 50%, and, um, I wanna share those with you.
So I have a free class that I'm hosting on August 19th.
We're gonna meet at 1:30 PM, and we're just gonna hang out, and I'm literally just going to brain dump all of my best tips of how to avoid an unnecessarean.
You get it? It's like an unnecessary cesarean, unnecessarean.
I love it.
Unnecessarean.
So, um, I'm gonna teach you how to not have one, and that way, when you get into the hospital, you don't have to be worried about the interventions that are coming your way.
You already know how to navigate those conversations.
It's totally free to join, so if you wanna hang out with me on August 19th at 1:30 PM, that is Eastern, I'm in Boston.
Um, and there'll be a replay if you can't make it live.
So, uh, yeah, go to thebirthlounge.com/freecall
Backslash free call and save your seat.
I cannot wait to hang out with all of you live.
It's genuinely so much fun every single time I do it.
That's why I decided to do it for the next few months, a live call every single month so we can help you understand the different things that impact your risk for having a C-section, and then how are you going to understand in the moment whether the C-section is an unnecessary one or is it medically indicated? These are all the questions that we're gonna ask and answer on our live call.
All right, you guys, I'll see you on August 19th.
Bye.
Have you ever heard about, failure to progress? Do you know what that is? Or some people call it stalled labor.
Um, a lot of times I hear it in the form of, My body just stopped dilating.
Like, I just got to this number dilation and, and my body just wouldn't go any further.
I just, I literally just never made any progress."
Sometimes it gets to the place where you push and you push and you push and you push for hours.
You push for a really long time.
If I was in the hospital, I certainly would have been diagnosed with failure to progress for pushing.
If you remember, I pushed for such a long time.
However, my personality, I would've been like, "No.
You can diagnose me with that if you want, but we're not gonna do anything about it.
You're certainly not giving me a C-section.
Like, I'm making progress, it's just slow."
Which a lot of people would argue that that's not failure to progress.
So which is it? Is it that you have to make some progress, or you have to make enough pro- progress? That really comes down to whether your doctor knows what the guidelines say or not And I think that this is a place where a lot of people actually end up with a C-section that they did not need is because they don't really understand what the guidelines say to failure to progress and also what led up to failure to progress.
Are there certain conversations and decisions that are made in the beginning of your labor or in active labor that actually come back and bite you in the butt? This is what we're gonna talk about in today's episode.
I'm so excited to be diving into failure to progress, mainly so that I can help you avoid failure to progress.
Not only am I gonna help you avoid it physically, like I'm gonna teach you some things that you can do with your body to avoid failure to progress, but also if you start to have the conversation about failure to progress, you're gonna know exactly what to ask to make sure that you're not getting a C-section or interventions based falsely on something that is not actually guidelines.
And if you do meet the guidelines, you'll know exactly the questions to ask to get you there.
So excited.
So let's start right there.
Let's start at what do the guidelines say? Again, this is so important because we hear a lot of birth stories where people say You know I got a C-section.
It was because my body just, like, stopped dilating.
But then when you ask further questions, it's like, "Oh, your body didn't stop dilating.
You were just dilating, like, really, really slow."
What was that about? Was that a fear? Were you scared of someone in the room? Was someone in the room not jiving with you energetically? Were you afraid to actually have your baby, push your baby out? Was there some fear around the birth process, around your baby, around becoming a mom? Was there someone in the room that was bringing an energy that just didn't help you relax? Like, what was that about? Was it the position of your baby? We don't know.
What we do know, though, is that in order to be diagnosed with failure to progress, you have to meet a couple of criteria.
Number one, you have to be six centimeters or more.
Number two, your waters have to be released.
So your bag of waters cannot be intact.
So if you say, "I got a s- a C-section because I was four centimeters for three days after, you know, being induced for an elective induction, no medical reason, but I'm just four centimeters."
"Oh, was your water...
D- did your waters break?" "No, they never broke", you do not meet the criteria for having failure to progress.
You should be unhooked from that induction plan, assuming you and your baby are still healthy and doing well, and you should be sent home.
ACOG has that recommendation that for inductions that are...
They call them failed inductions.
I call them inductions your body didn't even want.
Your body's like, "Do not...
Don't help me.
I don't need the help.
I don't need the help.
I don't need it, thank you very much."
Sometimes we go in for inductions, and they literally just do not take, and you're like, "This is so crazy."
And you and your baby are great.
The induction just doesn't work, and your body is literally like, "No thank you for the help.
I have a plan.
I don't need your support right now.
I'll reach out if I do.
I have your number.
Thank you."
And it's nice because, honestly, again, you and your baby are good.
The induction didn't take.
You should go home and be pregnant for a little bit longer.
Again, ACOG says that.
So six centimeters, your waters have to be broken, and then if you do not have Pitocin going, we're looking for four hours with no cervical change.
If you do have Pitocin, six hours of no cervical change.
I would argue that even that is a little bit, a little bit fast because here's the thing.
Are you being upright? Are you changing positions? Are you optimizing your baby's position? If not, that is the first thing I would start to do Get those hips moving, get your lower back mobile, help your pelvis open up.
Your body's gonna...
Your pelvis region, not your whole body, but your, your whole pelvis region is gonna expand up to 30% in labor and we want you to be taking advantage of all of that space.
'Cause your baby is gonna come down and they really do only have, like, millimeters.
For them, it's plenty of room.
Remember, your body and your baby will work together to get your baby out.
But if you can do something to, like, give it a little mm, a little go-go juice, why would you not? And that is upright, changing positions, making sure that you are really optimizing your body's position to help your baby optimize their position.
That is the first thing I would literally do to avoid a C-section.
I'm not even kidding.
If you ever reach a point where you're like, "My labor is kind of stuck," or it's, it's not, like, it doesn't have the same energy behind it, get going.
Move.
Get up.
Start doing the, the cha-cha slide.
Get your hips moving.
Ask for a birth ball.
Walk the halls.
If you're still at home, go take a nap.
What if you are tired? You can get in different positions in the Miles Circuit.
Get your hips in different positions, but nap, because when you get to that hospital, you ain't napping, honey.
There's people coming in your room every 20 minutes, 30 minutes, every...
Oh my gosh, all the time.
All the time.
It's a revolving door of people.
Even, even when you have really respectful providers and you've asked them, like, clump it all together, well, the later you get in labor, the more often they have to come in and check in on your baby.
And you want it.
It's warranted.
That's fine.
You want it.
Same thing happens at home birth.
It's just not as disruptive.
It's also people that you really know and you love and you've grown to trust them, and they've been in your home so many times, 'cause that's where all your prenatals are, and their prenatals are an hour, two hours long.
These people are...
They're, like, part of your story.
They're not, like, on call, they're they delivered my baby part of my story.
They're like, "Oh my gosh," and, "At this prenatal," and, "Remember when we discovered that? That was so funny."
They, they're, like, part of your pregnancy.
That's the difference between home births.
It's not as disruptive, but they're still coming in that same frequency It's just you're not gonna get any sleep.
So if you're at home, get in the Miles Circuit positions, open up your hips and rest.
If you're already in the hospital, get up and get moving.
You can also do those Miles Circuit positions in the hospital bed, just not with as much freedom 'cause the hospital bed is only so big.
But yeah, that kinda hit number one and two, upright, move, change, get your baby in the right position by utilizing your body in the optimal position, and then laboring at home.
I mean, obviously we know that ACOG recommends laboring at home.
You should stay at home as long as possible, and that's gonna be depending on your plan of pain relief and when you wanna arrive and exactly how much you want the hospital, you know, providers to be involved.
Some people prefer to labor all the way through until, you know, they're eight or nine centimeters, get in the car, go, and their, their hospital staff is just there really for the delivery.
And then you have people who they don't want that at all and maybe they want an epidural really as soon as labor starts.
You're gonna head to the hospital much sooner than someone who has a different plan than that.
And neither one are wrong or right.
It's really based on what you want.
And the thing is too, you should not be making that decision based on what other people want really, really nobody but you.
You have to feel safe in your decisions.
You have to feel secure and confident in those decisions and if you do not, then it is going to impact your labor.
It really, really is.
So labor at home.
We also know laboring at home reduces your risk of C-section, of infection, of getting to the hospital too early and it stalling your labor.
Of people who have a desire for unmedicated birth, getting to the hospital too early actually increases your risk of having an epidural.
Did you know that? I mean, it makes sense because if when you get to the hospital, your clock starts, hypothetically, that clock, you know, quote-unquote, then obviously at the end of that clock, well into that clock, they are gonna be starting to push, you know, "Maybe you should get an epidural and relax.
Maybe you should get Pitocin."
Well, if you get the Pitocin, then maybe you need the epidural because it's so intense, you know? So just think about it.
Labor at home, that is really...
That, that will help you avoid failure to progress so, so much 'cause you're just doing it.
You're rocking it in your own space.
Assuming that you and your baby are good and you know the signs of when to go to the hospital, things that come to my mind are if you're feeling pushy or grunty, if you see a lot of bleeding, if your waters break and it's dark and there's stuff in, in your water, that's called meconium.
Like, know those things.
You need a comprehensive childbirth education to learn something like that.
That's what I teach in the Birth Lounge.
So you can join the Birth Lounge.
Um, I'll teach you literally everything from how do you cope with being at home in that early labor, depending on whatever your goals are.
So the other good thing about the Birth Lounge is it's really tailored to you.
You get to consume it in whatever way that you want because I w- I want your birth planning to be as individualized as your pregnancy and as your birth goals are for this pregnancy.
So if you've already had babies and you're like, "Well, it didn't go the way I wanted it," or, "Well, I had these plans, but I didn't really know how to do it", I'm gonna teach you how to do that in the Birth Lounge.
So Anywho, join The Birth Lounge, learn those things.
If, if you're good to labor at home and you're safe, you and your baby are still just rocking out, I think you should stay at home as long as you can.
That goes into having a realistic expectation, which is what I wrote down for number four.
You should know that first-time moms are in labor for 24 to 36 hours on average.
On both ends of the spectrum, so you could have what's called a prodromal labor.
It's several days.
I didn't have prodromal labor but I did have a three-day labor.
I was prepared for that.
Did I want it? No, for sure not.
But we did it, and I was prepared for it, and I never once thought something was wrong based on the timing alone.
I mean, uh, nothing was ever wrong in my labor, so I never once thought something was wrong.
But specifically, I never looked at the clock and thought, "Oh, gosh, something might be wrong," or like, "Oh, shit, I've been in labor for a long time.
I wonder if anything's wrong."
I didn't ever think that.
I was like, "This is just taking a long time, but is my baby good? Yep.
Am I good? Cool.
Then we're just taking a long time, and that's, like, totally fine."
On the opposite end of the spectrum of the prodromal labors is something called precipitous labor, and it is where your birth is just a few hours long, literally three, four, five, six hours long.
Not long at all.
Very fast, rapid births.
It's very, very intense.
Your labor starts, and then literally you have a baby before you can even process that you're in labor.
For some people, it works really well.
For some people, it's very traumatizing.
Same thing for pro-prodromal labor, like sometimes people have a lot of trauma, and sometimes people are like, "I mean, it was, it was horrible and brutal, but, uh, didn't love it, but I don't have trauma."
You know? So just have a realistic expectation.
Just know that if someone comes to you and they're like, "You're low-risk.
You and your baby are looking great.
Everything's rocking and rolling, but you've been in labor for 16 hours," you can be like, "Okay?" Question mark.
"Is there a point to telling me that?" Like, that is so beyond normal.
Like, 16 hours? Yeah, duh, I'm in labor.
Even at 24 hours, I'm like, "Yep, that's totally normal."
30, 36.
First-time moms can be in labor for a day and a half, for sure.
For sure.
Sometimes your baby has to really work to get out.
Sometimes you have to really work to get your baby out.
But yeah, for sure.
Just know what is normal and know your thresholds of what and where you will call the line, um, so that you can either go into the hospital and get pain relief or ask for a C-section or ask for Pitocin or ask for options.
Yeah.
I teach you all of that in the Birth Lounge, though.
So we go through these scenarios so that you kind of understand what your different options are, and that's how I teach your childbirth ed 'cause I want you to know, like, if I'm in this situation, what should I do? Um, and I think it's really, really powerful to have already thought that out if you find yourself in those situations, so that's what we do in the Birth Lounge.
Okay.
So we've talked about, like, laboring upright and changing positions.
We've talked about being at home for as long as you can, having a realistic expectation of your timeline.
The other two that are super important, but I think don't need a lot of explanation, is make sure that you're resting in between contractions.
You probably won't be able to, like, take a full-on nap.
You know? We're not falling asleep for two and a half hours.
But what you can do is just close your eyes, relax your whole body.
And I did used to think this was a bunch of mumbo jumbo, but now I know that you can literally go deeply so, like, snoring asleep in labor, even in between contractions.
And then when your contraction starts again, you just kind of wake up, and that's what it is.
Um, if you remember from my birth story, my contractions during pushing never got closer together than six minutes, and so I was actually taking, like, these three, four, five-minute little mini naps, um, in between contractions.
And yeah, you can.
It's not great sleep.
I'm not gonna sell it as amazing sleep with, you know, a Sleep Number mattress and pillow.
But It was something.
It's enough to get you through.
Sleep Number, that's not sponsored by the way.
I don't even know anything about their pillows, mattresses.
Don't own them Not gonna try and tell you that it's good sleep, but I will say try and rest in between your contractions.
It's easier in early labor, so take advantage of that time.
And then obviously eating and drinking.
Eat what you want, drink what you want, as long as you're low risk.
That should be the default.
We know that's what the data says.
The risk is aspiration, so talk to your doctor and your anesthesiologist about what that specific risk is and if you're comfortable with that.
But the recommendations to not eat and drink in labor are absolutely bogus.
Your uterus is a muscle.
You need energy to be able to labor.
Could you imagine if I didn't l- and if I didn't eat for three days? LOL, that'd be crazy, you guys.
That would be insane.
Um, I didn't eat a lot, but I ate.
You know, I t- I talk all about that in the episodes where I tell my birth story, so go back and listen to that, but you can't not eat when you're in labor.
That's insane.
Okay, here's my last one, and remember at the beginning when I said that some of the decisions you make earlier in labor can come back and bite you in the butt, uh, later in labor? This is one of those, and that is amniotomy.
That is the artificial rupturing of your membranes.
Now, ACOG is very clear, and they say they do not recommend this routinely, and it should only be used in circumstances where it's absolutely necessary.
And so for the most part, we should not be rupturing people's membranes.
There are a couple of caveats here, though.
Obviously, there are times when you need to do that.
So I'm thinking if we needed to place a fetal scalp electrode on your baby's head, that is the one that actually screws into your baby's head, and it gives us a very direct insight into how they are doing, their wellbeing in the womb.
It does require us to break the waters, 'cause we've gotta get through that amniotic sac to screw this little electrode into their head, right? Like, we have to get to them.
We can't preserve the waters.
There's no way for us to get through the bag of waters without rupturing it.
Just is what it is.
The other caveat is that, if you're being induced, then there is that data that says that starting Pitocin and breaking your waters around that four-centimeter mark can actually help improve outcomes as far as, like, speeding up your labor, right? Without compromising you or your baby's outcomes, I think is kind of what the data says.
And so you've got that, too.
So, you know, that would- that's arguably like is that absolutely necessary? Of course, it's not absolutely necessary, but is that a risk that you're willing to take in order to have a shorter labor with an induction? Maybe so, especially if it doesn't, you know, compromise you or your baby's safety.
That's really up to you.
You're the only person that can make that decision.
But you do have those scenarios.
Things like infection, if your amniotic sac is, like, coming up very low, um, and we wanna do some sort of a amnioinfusion, um, we wouldn't necessarily break your waters for that, but that is a risk that comes with that.
Every cervical check comes with breaking of the waters, um, if you decide to get a membrane sweep.
So just think about that when you're making your decisions.
If one of the risk is that your waters might accidentally be ruptured during that process, then think about if that's worth it for you.
And the risk is that will, A, the increased risk for infection, and so, you know, the longer your waters are open, the more risk you have that an infection's gonna find its way in there.
Obviously too, your baby coming down asynclitic, which means that their head doesn't come down in the exact way that we would hope that it would.
Yeah.
You know, amniotomy has its risk.
I do think that a lot of times it's presented as this very safe and benign thing, and there are actually a ton of risk with it, um, that may change what you have to do later.
If your baby comes down asynclitic and you're unable, with position changes and even maybe some manual, um, stimulation to them or actually moving them, then that's it.
I mean, there if they can't come out of your pelvis because of the way their head came down, then you have to have a C-section.
There's no other way around it.
I mean, we can't force a baby out that has come down in, in a way that is not comparable to your pelvis It doesn't work, right? And so we just wanna think about that.
If you're already GBS positive, and you know that once your water breaks, you have to receive antibiotics, we don't ever have to do anything.
Obviously, you don't have to, but you've decided to.
You've decided that you are okay getting antibiotics for being GBS positive, then you probably will consider maybe not breaking your waters because what if your waters don't break until literally minutes before your baby is born? Or maybe they never break at all, and you never need the antibiotics.
Or maybe you decide that if they break really close to labor, you're okay with that risk.
Not labor, but pushing your baby out, the time that your baby is born.
You know? It's all so individual, but I just don't think routine amniotomy should be part of routine care, and ACOG agrees with this, yet it is so often presented to people, and we never think about failure to progress.
You also have to think, too, and I'll get off my soapbox here and wrap this up, but with the waters breaking, you get this big, huge rush of oxytocin.
And so what if your body is saving that big dose of oxytocin for a time that it needs it, and actually, the time that your water breaks is very based on what your body needs at that time, and that's why it breaks differently for everybody 'cause everyone's body knows exactly the amount of oxytocin it's gonna get from that water breaking, and it may use it at a very specific time.
Just what if? I mean, I'm just, like, being a little philosopher over here, but let's just say that the body is smart, and she knows what she's doing.
Why would you take this tool from her? It'd be like someone coming in and plucking out something from your toolbox.
Nope, you just can't have it.
I've decided to use it here."
That's kinda how I feel when we break waters, and there's no medical reason.
I feel like we're just kind of robbing your body of being able to do it herself.
Like, she knows what she's doing.
It's a tool in her toolbox.
She literally built that tool.
Let her use it, unless there's a reason that we have to get to your baby or that you need your waters broken.
That is my personal opinion.
And also, amniotomy is not recommended by ACOG.
So, you know, just think, just keep that in mind.
Once your waters are done, we, we, the only option that we have is Pitocin.
And so if you want to avoid failure to progress, I really think that leaving your body to her own devices as much as possible is probably the best thing, and we get to avoid an asynclitic baby, for the most part, an iatrogenic one, at least.
Maybe not a naturally occurring one.
Sometimes babies, you have no interventions at all, and they just come down in a funky position.
I actually think that's what was the problem in my birth.
I think my son was coming down with his head, like, straight down In my birth pictures, you can kind of see it.
Instead of tilting his chin, which is called flexion, I think he just kind of came down.
That's called military style.
I don't know.
That's my hypothesis.
I guess we'll never know.
Sometimes we just don't ever get to know things.
But what we do know is the number one thing that is going to lead you to not failure to progress.
You can do all these other things, but if you don't feel safe in your environment giving birth, your body is not going to be safe enough to relax and get a baby out.
I can tell you that.
I can guarantee it.
I promise it with everything that I have, literally everything I have.
You have to feel safe.
So make sure if you don't feel safe at home that you're at the hospital.
Make sure if you don't feel safe at the hospital, then you're looking into home birth.
If you don't like the doctors or you don't like the care or the policies or the facilities and you have the option, I know America's a healthcare desert in certain places, so I get it may not always be an option, but if you have the option to change providers or change facilities or go to a different place, then do that.
This is the time to make decisions that make you feel the most comfortable and the most safe because it will literally determine how well your body works in labor.
If your body is stressed or your mind is stressed or there is energy that is not jiving with you, it's going to impact your labor.
The best way we can counterbalance this is making sure that you feel safe at the place you're birthing, with the things that are being done to your baby and your body, and with the people that are surrounding you.
I promise you, that is the magic sauce.
When you do that and you make sure that you feel safe and you're the one who's making the decisions for your birth Plus you do all the other things, you birth upright, you're changing positions, you're being mindful of your body, you labor at home.
You know how long labor's gonna be.
You're not gonna freak out and make decisions based solely on the time that you've been in labor.
You're gonna eat, you're gonna drink, you're gonna rest.
You're gonna really consider whether amniotomy is right for you or not And you partner that with being safe, boom, done.
The other thing I'll leave you with is, you know, if you have the option to look into C-section rates of your doctor or the hospital, if you don't know about leapfrog.org,
we'll link it in the sh- notes, but you can actually look up hospital rates.
Now, the hospitals have to opt in and participate with that...
It doesn't work.
It kind of sucks because if you don't have a great rate, why would you do that? So not all hospitals are saying, and it's like, to report certain stats, you have to have the staff to be able to do that, to gather those numbers, to be part of this program and keep things updated.
So yeah, maybe your hospital's on there, maybe it's not.
A larger, a lot of larger city hospitals are, a lot of major hospitals are, so go ahead and look.
But you can also ask your doctor, and you know how I feel about that.
If you ask your doctor their C-section rate and they say they don't know, that is, I would run for the hills.
You don't know how many people you're cutting open and giving a major surgery.
Scary.
Okay? I don't want you touching me.
That tells me you're not following up with these people.
This is, you're not using them appropriately.
Like, how many people? You should know.
Not an exact number.
I'm not looking for your doctor to say, "317 people."
I'm looking to say like, "Oh, roughly this many of my patients, X number a month, or 10 to 20% of my patients."
Right? In the US, we have a 33 and rising C-section rate, so I would say automatically, if they're under that, then great.
If they say 50% and you don't want a C-section, I would probably find a provider that has a lower C-section rate The other thing you don't really want is someone who says like, "I have like a 1% C-section rate."
Okay, well, you are working in a hospital.
You see a lot of births.
You probably should have more than a 1% C-section rate.
What the World Health Organization says is that our nation should have a 10 to 15% C-section rate.
So I would say that is kind of what you want to shoot for, 20 even maybe.
You know, let's, we can meet, we can meet our nation's stats in the middle.
They're at 33.
The World Health Organization says get down to 10 or 15.
If 20 feels comfortable for you, that's one in five.
If you are okay being one in five women that walk into the hospital to get a C- you know, to have a baby and you get a C-section, then that is an okay risk.
Your hospital and your doctor are going to have two different stats.
So don't forget, your hospital is going to be all the stats of all the doctors, and your doctor's going to have their individual C-section stat.
I would really press them on that, you guys.
I would not let them get away with saying, "I don't know," or, "That's a hard number to calculate."
It shouldn't be.
That shouldn't be a hard number to calculate.
Just take five minutes to think about all the births that you've attended over the last 30 days, and tell me roughly how many C-sections you did out of how many shifts you attended.
Like, we can do a little simple math.
Get out some pen and paper and say like, "All right, let's think about it."
Because that's important for you to know.
If you don't want a C-section and you're low risk and you have no reason to have a C-section and you continue to have no reason to have a C-section and you see a doctor that has an 85% C-section rate, chances are you're going to end up with a C-section.
85% of their patients do.
That's crazy.
You're not immune to that.
You got to find your good match.
You got to find a doctor that looks at you and goes, "Oh, yeah, low risk, no reason.
Cool.
We're not going to section this woman.
I know how to get her a vaginal delivery.
85% of my patients have a vaginal delivery."
However, if you are someone who is having twins that should not be birthed vaginally.
There, those do exist and you need a C-section and you are wanting a very good surgeon, you should ask for that.
You should go in and say, "I am looking for probably your OBGYN that is the best surgeon when it comes to C-sections."
I'm thinking the incision, the recovery, the healing of my site, the scar tissue, the way that they close me up.
These are all things we talk in the Birth Lounge about, um, when it comes to, like, really preparing deeply for your conversations with your provider.
I take you through all of these things because I want you to really get that individualized care.
I don't find that a lot of people are teaching that.
How are you getting care that is fit for you? I want it to fit like a glove.
I want that sucker to be custom-made to your body.
No, literally, I'm serious.
I'm, like, not kidding at all.
It is medicine.
This is your healthcare.
This is the birth of your baby.
It should not look like the, every other person down the hallway in that L&D unit.
It should be very individualized to you.
This is a very serious event in your life.
You deserve something that is as unique as you.
I really do believe that.
And so, yeah, find your provider that is gonna support you in the way that you deserve to be supported and s- and support you because they believe that, not because they wanna let you, "I'm gonna let them try for a VBAC."
No we're not trying for a VBAC, we are VBAC-ing.
I am having a VBAC.
I'm not gonna try for shit, I'm going to have a VBAC.
You want a doctor that says, "We're not gonna trial of labor.
You're laboring.
You're going to labor, and we're gonna have a VBAC."
You know, you don't need a constant verbal reminder that the risk is that you have a C-section.
That's the risk with every birth.
Who cares whether you are having a VBAC or not? Of course you're having a baby, you might end up in a C-section.
That's true for everybody.
You are VBAC-ing.
We're not trying for a VBAC.
Stop saying that to you, to yourself, and put your preference in with your provider.
Kindly ask them, "I would really appreciate if we could tweak the language to say I am VBAC-ing, or we're going to VBAC."
And you can even say I appreciate it, but I don't need the constant reminder that a C-section is a possibility.
I had a C-section for my first birth, I know very well it is a possibility.
I am going to VBAC, and that's what we're doing, we're VBAC-ing."
I think every doctor would be super receptive and be like, "You know what? Hell yeah.
Cool, man.
Like, let's VBAC."
That is, that's all you need to do.
All right, you guys, I hope that's helpful.
Failure to progress is a really pervasive thing that happens, but I really do believe that in most cases it is a failure to wait and it is a failure to individualize care to make that person be able to have the pieces of their birth puzzle put together correctly.
So many times we're rushing these births, we are just throwing things at people's bodies that they don't actually need, or it's in a, a way or a system or an order that their body was not ready for certain things and we would've been better off making different decisions.
Yet we tell these women, "Failure to progress.
Your f- your body failed.
Your body didn't do it.
It couldn't get past this, this way."
Where in reality if we tried a couple of other things, some more individualized care, something that's safe and compassionate, chances are we mighta got, we mighta got some babies out of it.
So those are my thoughts.
All right, you guys, we'll link everything in the show notes that I mentioned today.
Thanks so much for hanging out with me.
I genuinely love these solo casts where I get to just chitchat with you.
I'm always, like, drinking my electrolytes, or I have my coffee from this morning on my desk.
So I'm just hanging and just chatting.
I love it.
All right, you guys, I'll see you in the next episode.
Be sure to follow me on social media.
You can find me at tranquilitybyhehe or the.birth.lounge.
Until next time, head to your app store and download the Birth Lounge app for evidence-based childbirth education and data-driven postpartum support delivered straight to your phone.
Bye.
Thank you so much for tuning in today.
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I'm HeHe, and this is the Birth Lounge Podcast.