Ep 240: Kelsey’s Birth Story – A Quick and Surprising VBAC

Dr. Nicole (00:00): In this birth story episode, Kelsey wasn't exactly planning for a VBAC, but a VBAC is exactly what she got and in quite the spectacular fashion.

(00:16): Welcome to the All about pregnancy and birth podcast. If you're having a baby in the hospital, you are giving birth in a system that too often takes away power from women over what happens in their own bodies. I'm Dr. Nicole Calloway Rankins, a practicing board certified OBGYN, who's had the privilege of helping well over a thousand babies into this world. I've been a doctor for over 20 years, and I'm here to help you take back your power, advocate for yourself, and have the beautiful pregnancy and birth that you deserve. This podcast is for educational purposes only, and it's not a substitute for medical advice. Check out the full disclaimer at drnicolerankins.com/disclaimer. Now, let's get to it.

(00:58): Hello there. Welcome to another episode of the podcast. This is episode number 240. Whether this is your first time listening or you have been here before, I'm so glad you're spending some time with me today. In today's birth story episode, we have Kelsey. Kelsey is a mom to two wonderful kiddos, her son and daughter. She was active duty Air Force for five years before jumping into the world of law enforcement. For the past four years, they have lived in Minnesota, Wisconsin, Texas, Florida, and now live in North Carolina. She's an avid workout person. She loves the mountains and any other outdoor activities. Kelsey had a planned cesarean for her first birth because her daughter was breach. Now, when she became pregnant with her second, she didn't really feel strongly about having a VBAC, and she really hadn't thought about it until her doctor brought it up.

(01:54): They came up with a plan where if she went into labor on her own, she'd try for a VBAC. Well, going into labor on her own is exactly what happened, and in fact, from her first contraction to when her son was born was under five hours, a fast labor can be great, but not necessarily great. And you're going to hear that in Kelsey's story. You'll also hear about how her recovery from her vaginal birth actually ended up being more challenging than the recovery from her cesarean, including some issues with something called granulation tissue formation in her vagina after birth. Now, another thing you're going to hear in the story is how Kelsey's Hospital actually had a process to help her make a birth plan, and that is great, but it is not typical. But don't you worry, I have got you covered for making a birth plan. All you have to do is take my free birth plan class, make a birth plan the right way. It'll teach you the questions you need to ask, go through in order to make a birth plan that actually works to help you have the birth that you want. You can check out that free class at drnicolerankins.com/birthplan. All right, let's get into this birth story episode with Kelsey.

(03:20): Thank you so much, Kelsey, for agreeing to come onto the podcast. I am really excited to talk about we're going to talk about your second birth and be back.

Kelsey (03:29): Yes. Thank you for having me. I'm excited to be on here.

Dr. Nicole (03:31): Yeah, so why don't you start off by telling us a bit about yourself and your family. Okay.

Kelsey (03:35): I am currently living in North Carolina. We just moved here last year from Florida, and it is me and my husband and my two kiddos. I have a five-year-old daughter, and now a one-year-old son. And yeah, we are a prior military family. I'm coming from Air Force, so we were in Florida for seven years and now North Carolina.

Dr. Nicole (03:57): What part of North Carolina?

Kelsey (03:58): Just south of Raleigh.

Dr. Nicole (03:59): Oh, yeah, okay. I used to live in Durham and I went to college in Greensboro, so I'm familiar with North Carolina.

Kelsey (04:05): Oh, awesome. Yeah, we're getting the cool weather right now. We aren't quite used to that yet.

Dr. Nicole (04:09): Oh, yeah. It's like cold, cold right now. It's unusually cold. Cold. Yeah. All right. So we're talking about mostly your second birth, which I'm going to spoiler alert say was a VBAC, but there's tons more to the story, so stay tuned, but let's talk about why did you have a cesarean with your first birth?

Kelsey (04:30): Yeah, so my daughter was identified as Frank Breach at I think our 34 35 week appointment, and they had made the suggestion to schedule a C-section, but they did give us the option to do an ECV, which I can't

Dr. Nicole (04:45): Pronounce what that stands for, external cephalic version. Just fancy way of saying try to turn the baby around.

Kelsey (04:51): Yes. So we actually did decide to try that, and we attempted that at 38 weeks, and she wasn't moving. Very stubborn. They tried two to three times, didn't move, so we proceeded with the C-section.

Dr. Nicole (05:04): Gotcha, gotcha. So was the version attempt painful?

Kelsey (05:09): It really wasn't. I know they tell you to be prepared in case something happens to go into labor, but I would say it was just more of a pressure. Okay. Okay. All right. It really wasn't too painful, so I was happy we tried it. Okay.

Dr. Nicole (05:20): Okay, good, good. And she was just like, no, thank you. I am where I am. So

Kelsey (05:26): Didn't even move a centimeter. Gotcha,

Dr. Nicole (05:29): Gotcha. Sometimes children declare themselves, they just stay how they're going to stay. Yeah. So when you got pregnant again, were you thinking that you wanted to try for a VBAC?

Kelsey (05:41): Honestly, I wasn't. I had my daughter in a military hospital and everything went great with my C-section. So she had said, if you want to try a VBAC for your next child, you can. But they were so far apart. I had kind of forgot about it and was now seen as doctor. So I was just hoping for a healthy birth, but almost kind of assuming it was going to be a C-section.

Dr. Nicole (06:03): Okay. Did they bring it up or did you bring it up? How'd the conversation come up?

Kelsey (06:10): I had a really supportive doctor, and she just had a conversation with me. She said, do you want another c-section? Do you want to try a VBAC? And it surprised me. I said, well, I guess I would like to try a VBAC, I think. And she said, okay, as pregnancy progresses, we'll keep talking about it, and if something comes up where it's not an option, then it won't be an option. But it was always on the books to try it.

Dr. Nicole (06:33): Okay. So she brought it up fairly early then?

Kelsey (06:35): Yes. Yeah. I would say my first appointment almost.

Dr. Nicole (06:38): Oh, that's outstanding. Because sometimes people don't bring it up until later, so that's great. Yeah. Okay. To have breach baby is a great indication to try for a VBAC because it's not something that's likely to recur, and I'm sure she told you about all of that. So then as your pregnancy and prenatal care progressed, what was your pregnancy and prenatal care the second time around?

Kelsey (07:03): Again, I had a great supportive doctor and physicians. I saw mainly my ob, but they had a couple other doctors that if something came up, I would see, and I loved my nurses. I was super sick with my second. I was wanting to throw up probably until almost six or seven months. So besides that, everything was healthy and smooth. We didn't have any issues, just tired and had a toddler running around.

Dr. Nicole (07:28): Gotcha. Did you notice any differences between military care and civilian care?

Kelsey (07:35): That's the golden question. I really actually didn't. My military care, I saw, oh man. So she was in her third year. Oh, resident. So resident, and she was overseen by the main ob, but I've really had a great experience with her, and she was there the whole time. She helped with the ECV procedure. She was there during the C-section and still checked in with me weeks after, and the hospital nurses delivery went great. I know some people have different experiences, but I really had a great experience and I would say similar with my civilian doctor. They were both girl experiences. I didn't really have issues.

Dr. Nicole (08:15): Okay, good. Well, that's great to hear. We like it. We like it. So as you were getting closer towards the end, then, what did you do to prepare for your birth? What were you thinking in your mind?

Kelsey (08:25): So some people would call us crazy. I actually moved from Florida to North Carolina by myself to start my new job when I was 34 weeks pregnant.

Dr. Nicole (08:33): Are you serious?

Kelsey (08:35): My OB was not extremely supportive, but understood that I needed to start my job. So my husband and daughter were still in Florida, and I was in North Carolina by myself from 34 to 38 weeks.

Dr. Nicole (08:52): Had you lined up a new OB already? No,

Kelsey (08:55): Actually did. They were great. I found an OB here who took all my records and said, we'll make it happen. I think because it's a military area, they're used to people being in and out. So she saw me for my 36 week appointment, and then I went back down. I drove by myself 10 hours from North Carolina to Florida at 38 weeks. So I did everything you are not supposed to

Dr. Nicole (09:18): Do at all. Not at all.

Kelsey (09:22): And so it was by myself for four weeks to start my new position in order to, it was like a fine line. I had a scrunch in to get my 12 weeks maternity leave, so I needed to start. And then I really wanted to have my baby in Florida, and my husband's job wasn't starting for a few months up here, so we made the decision to go back to Florida and have my son.

Dr. Nicole (09:44): Okay. So you moved at 34 weeks by yourself and then had one appointment in North Carolina because you're going to keep your prenatal care up and then decided to and then went back to Florida to have the baby? Yes. Wow. The things women do in order to make things work. Okay,

Kelsey (10:09): We say the stars aligned with everything towards the end of pregnancy. Luckily, it was healthy and I had no complications, and we had backup plans of backup plans in case something happened, but I was able to make it back at least by two days.

Dr. Nicole (10:22): Okay, so you made it back and then, okay, so then were you thinking, did you schedule a C-section or did you say, I'm just going to see how things go? How did that go?

Kelsey (10:33): Before I had left, she recommended, let's get you on the calendar for C-section, just in case. And she had scheduled me for one at 39 weeks,

(10:43): And we had had the discussions about how long I would want to try labor for if I wanted two hours, then a C-section if I wanted 10 hours, then a C-section if I wanted to give it longer than that. And then we had prepared that they would not, oh, what's the word? Not admit, induce induce me. They would not induce me because of the prior C-section, but if I had gone into labor by myself naturally, they were fully supportive of that. So the C-section was on the books and scheduled for the following Saturday. So a week after I got back.

Dr. Nicole (11:18): Okay. Okay. Okay. All right. So then was there anything, what did you do to prepare for your birth? Or did you feel like you were already ready?

Kelsey (11:27): I don't think I was ever ready for birth. I listened to almost all of your podcasts, probably before birth, just in preparation of all the things that could happen, things that could go great, things that could go wrong, the differences between having another C-section and trying four VBAC and the complications that could occur. So I try to educate myself as much as possible. We also expected a full week of preparations. I really didn't think my body would go into labor naturally. So we were pretty set on the C-section. And I thought the week that I had between when I got back from North Carolina when the C-section was, we would prepare and we would practice what labor would be like and how to breathe through it. And I would tell you we did not get to that point, so we did not practice. That's the one big regret I have, is that we did not practice what labor and breathing and contractions would feel

Dr. Nicole (12:22): Like. Gotcha. Gotcha. So is there anything in particular that you wanted for your birth or was it kind of more go with the flow or

Kelsey (12:29): It was really a healthy baby. We had actually had three losses in between my two children and an infertility workups. So we really just wanted healthy baby, healthy mom. We were okay with anything that happened.

Dr. Nicole (12:42): Okay. Okay. So speaking of what happened, you alluded to there was not a week if that happened, well, I guess I should back up and say, was there anything you were afraid of or worried about for your birth?

Kelsey (12:55): Just the unknown. I think I knew what a c-section would be and the idea of labor and a child coming out down there scared me. Gotcha.

Dr. Nicole (13:03): Like a whole human coming out of your body.

Kelsey (13:05): Yes.

Dr. Nicole (13:07): So then what exactly happened then? You did not have a scheduled, so how did things unfold?

Kelsey (13:14): So I had gotten back late on a Friday night from North Carolina, and Saturday was fine. I didn't have any brax and hicks or false labor. And Sunday, we decided to host my four year old's birthday party, which looking back might've sent me into labor, but I didn't feel anything that day. I was just on my feet and moving around, and I had gone to bed and woke up around midnight, and I thought I was dreaming that I had felt some sort of pain in my stomach. So I kind of got up and was like, wow, was that a dream? Did I actually feel something down there? I'll just get up. So I walked around the house for a little bit, kind of went into the guest room, just so I wouldn't wake my husband up and fell back asleep probably for an hour or two.

(13:57): And then by 2:00 AM I woke up and knew that something was going on. I was like, wow, I really feel like the pains that I think are contractions. So I pulled out my contraction timer and started attempting to track them and see how far apart they were, and I was anywhere from 15 minutes to 12 minutes back to 17 minutes. So I thought, I wonder if I'm just having Braxton Hicks or false labor. I'm going to lay back down for a little bit. So I tried to lay down again, and then I kind of had the urge to go to the bathroom. So I got up and went to the bathroom and there was blood. So I knew something might've been up. I decided to call my doctor's office and they said, come in, because your contractions are so far apart. It might not be for a while, but you have blood, so let's get you checked out.

(14:50): So I woke my husband probably around three o'clock now, and I said, Hey, I think I'm going to drive myself to the hospital. I think it's false labor. Braxton Hicks, you stay with our daughter, get her to daycare in the morning. I'll probably still be there. They're going to check me out, and then you can come up after that if you want, but I don't think it's really happening. So just pack a bag and I'll grab mine just in case. So I left the house at probably three 15, and it's a 50 minute drive to our OBER that we had. You said 50 50. Oh, wow. Okay. And probably about 20 minutes into it, I was having immense pain and pulling over to the side of the road and putting my flashers on and trying to still time these contractions, which I had actually got down to five minutes apart, and I thought I was doing something wrong. So I kept driving. I put my husband on speaker, it's pitch blackout, and I said, I just want you to be on speaker in case something happens. But I would pull over, put my flashers on, try to breathe through whatever was happening, and then keep driving. My husband was starting to get a little worried at this point, I think something's going on. I said, I don't know. I've never been in labor. I still don't think my body knows how to do labor. We're good. We're good. Okay.

(16:10): So I got to the hospital by four o'clock, pulled in, barely made it into the lobby, and kind of hunched over, threw another contraction, and the security guard came over and said, are you okay? Do you need help with something? And I'm like, I need to get to the OB er. He is like panicking, trying to get me in a wheelchair, get me up there, and I check in. And it was surprisingly calm. I've never been in an OB er, but they just kind of check you in, ask you who your doctor is. But I was full blown panicking at this point and in a lot of pain. And my husband was on speaker, and I said, okay, just let me get checked and I'll call you back and see what's going on. So the doctor comes in and she said, well, are you here for a scheduled C-section induction?

(16:58): Are you due soon? I said, well, I have a scheduled, but I have a VBAC plan with my doctor as well. And I had done the hospital birth plan, so I had all my paperwork with me. I was prepared. Oh, the hospital had a birth plan. I had to meet with the hospital. I don't know what her title was, but I had to meet with them to go through it as well. So I had multiple documents ready to go and handed 'em over, and she said, okay, well, if you are having a VBAC, we can't find your VBAC paperwork, which you have to sign a lot of documents saying you accept the risk of what's going on. And I said, no, I filled it all out. I have it somewhere and still trying to breathe through this pain. And I am like, something needs to happen. Do you have pain meds? Is there something that we can do? Because I can't handle what's going on right now. And she said, well, let me just check you. And she checked, I've never had a cervix checks. I didn't know what that was at this point. I didn't care. E. And I said, so just check me, see what's going on down there. And she checks and she says, well, you're on a seven, eight

(18:03): And listening to your podcast. I said, oh, that means the baby's probably coming soon, right? She said, you want to call your husband? You're getting admitted. Yes.

(18:14): Oh my gosh. So it's four 30 in the morning, and luckily we had some great friends down there. We didn't have family close, but we had got ahold of our friend at four 30 in the morning. She sped to our house in five minutes, got to my daughter and my husband hit the road. And in between that, they had started trying to wheel me over to admit me. And then I felt the very warm gush happening and water broke. Never had that happen, didn't know what was possible. And I think I just started screaming, something's happening. I don't know what's going on, but it's wet down there, and they're so calm, they're so calm. They said, it's okay. We're getting you there. We'll get you on the bed. We'll get you checked in. Again, still panicking, still not knowing what's going on with me or the baby. So they had got me into delivery room and they said, just get whatever position's comfortable for you, you can start going into that position. So I think I was on all fours. I was the woman in the hospital screaming bloody murder at this point though.

Dr. Nicole (19:24): Okay. Okay. Were you thinking epidural or were you like, yes. Did it even, okay.

Kelsey (19:30): If I ever planned to have the VBAC, I said, when I start feeling the pain, I want the meds. So natural was never,

Dr. Nicole (19:37): It wasn't in the carts. Okay.

Kelsey (19:39): Never in the carts. I knew I kind of wanted the meds and to have it be a little bit calmer and not feel as much pain. But I didn't realize at that point, once you get to a nine or a 10, you can't have,

Dr. Nicole (19:52): It's very challenging to, can't have

Kelsey (19:54): The, okay.

Dr. Nicole (19:55): Okay. So then did you ask And they were like, ah, it's not going to happen.

Kelsey (20:02): Because I think I was still at a seven eight when they wheeled me over. They had got me onto the bed and said, we'll start trying to get the anesthesiologist up here, but we have to get your blood drawn first. And I didn't have IVs in me. The blood draw team wasn't there yet. They're still having me try to sign my VBAC paperwork at the time. As I'm breathing through contractions, I'm like, okay, can we please do pain meds? And she's like, okay, here they are to take your blood. At the same time they're checking my blood. And this was a span of maybe 20 to 30 minutes when I got wheeled over taking my blood, and the doctor comes back in to check me and says, you're at a nine 10.

Dr. Nicole (20:43): So yeah,

Kelsey (20:45): And I just screamed. I said, does that mean when can I have pain meds? And she said, oh, honey, it's too late. You can't have any pain meds. So I think I screamed at one point, can we just go to a c-section? Can you knock me out? And they said, no, youre going to do it. You're fine. Which not fine. At that point I was in so much pain. Oh,

Dr. Nicole (21:10): And how far away was your husband at this point?

Kelsey (21:12): I think at that point he was on the road, so maybe still had 30 minutes in his drive, and he was on speakerphone the whole time listening to me scream, which he said at the end he did not appreciate that. But I think at that moment we had both realized that he might not make it for the birth. So I said, I want you to be here in Casey's born when you're not here, at least you can hear it and hear the cries. So I think then she said, we need to get you ready and prepped at least an IV in and ready to start pushing. I think I had asked, when do I push? How do I push? Because we hadn't practiced breathing techniques, and I had no idea really the pain that it would be. And it's so hard to still describe. A friend actually said, well, I had a great description. It was like everybody is hooking your limbs up to four different vehicles and just trying to pull you apart because there's so much pain coming from so many different directions that I had no clue how to control my body.

(22:20): The nurses were great though. They said, it's okay. We're going to teach you how to breathe again, get in whatever position is comfortable for you. When you get the urge to push, just you have to let us know first. And I had heard the term, the ring of fire, and I think maybe 10 minutes after they checked me, I said, I think I have to push. I'm feeling a lot of pressure. I'm feeling something going on down there. So the doctor came back in. I think at that point, the OB doc had switched out with my on-call doc, not my original ob, but whoever was on call at the clinic at that time. And she looked at me and she said, when you called me, you said your contractions were 12 to 15 minutes apart. I said, they were wasn't

Dr. Nicole (23:09): Lying, they, I'm not lying. I wasn't making it up. Yeah. She

Kelsey (23:13): Says, okay, well, we need to start pushing. And husband was still not there. And they looked at my phone and they said, who do you have on the phone right now? I'm like, it's my husband. He is trying to drive here. He is trying to deliver. And she's like, okay, you can keep him on, but we have to get you in position and start pushing. And they said, okay, when you start to feel the pressure, we're going to push and I think they want you to count to three and try to hold it. And they said, you have to keep ramping up the pushes. This is a marathon and a sprint all in one. You have to keep pushing harder and harder and harder to get him out. And I felt like I was in the twilight zone that it was all such a dream and it wasn't happening because it came so fast. So thinking back now, I'm like, wow, I don't know how we did it. I don't know how I pushed.

Dr. Nicole (24:06): That is okay. I just have, so, okay. So your husband's on the phone this whole time. Okay. So in retrospect, he says, was that just too much for him to be driving and hearing you screaming, someone's trying to kill you all at the same time?

Kelsey (24:28): My husband's not a crier, and I'm not usually someone who's ever been in that much pain. I've gone through a lot, but I don't think he has ever heard that sound in my voice, and

Dr. Nicole (24:41): It was too much. Yeah. So then you start pushing. How long did you push?

Kelsey (24:49): Well, I had asked the question. I said, how long is this going to take? Because I don't know how long I can push for. I think I asked multiple times again, can we just go for the C-section? They had looked at the monitors and said, well, we're seeing some variations, but at this point it's too far. We have to keep pushing and pushing. Depends on the person. It could take 10 minutes, it could take an hour. It really depends on where baby is and the positioning. So I think I started pushing around 4 45 and my husband came sprinting in the room at five

Dr. Nicole (25:26): O'clock,

Kelsey (25:28): So he got to be there for some of the pushes. He was in tears. They stopped at one point and looked at him and said, are you going to be okay? I think he was shaking the bed more than I was from coming into that situation. And they mentioned that I had a lip. So they said, you keep pushing, but there's a lip he has to get over. That's the correct term. And then the doctor looked up at me and said, are you okay if I make a cut? And I broke down in even more tears than I was already in just something I wasn't expecting to hear and wasn't prepared for. And she said, okay, nevermind. We'll wait. So I started at 4 45 by five, my husband got there and he came out at five 17.

Dr. Nicole (26:26): Okay. Wow. Okay. That is a lot. That is a lot. Okay. So then when he came out, was he screaming happy? All of that

Kelsey (26:42): Stuff? He started pretty quick, but they had mentioned as soon as he came out, they said, oh, he had a double ncle. So the cord was actually wrapped around twice, which shocked us. But they said we were monitoring, I think they had at one point done an internal monitor of his heart rate, because I don't even know if I had gotten hooked up to all the machines required. So I think they did that as a quick measure, and they said, it's okay. He's totally fine. He's up, he's screaming. They put him on me The second he came out and we could tell he was okay, and just in shock. But yeah, we weren't expecting a double nucle either, which we had to ask questions about after because we didn't know what it was.

Dr. Nicole (27:27): Yeah. Sometimes the cord just, it's actually, it's not uncommon that the cord gets wrapped around the baby's neck. So how did you feel once he was out, how

Kelsey (27:41): It was so much emotions because of how fast it happened? It was amazing just to have him there that we had made it through the pain and the contractions and my husband had the biggest sigh of relief on his face, and we just sat there in a moment of silence almost, and the doctors and nurses were still working down there, but it was just such a big sigh of relief that it was over and done right.

Dr. Nicole (28:06): And then the pain was not there anymore. Hopefully

Kelsey (28:10): As soon as he came out, they gave me fentanyl to help because they had to. I had asked her, I think shortly after he was born, oh, how bad was it down there? I had heard of all the levels of tearing, and she said, oh, did you have a second degree tear? And I said, oh, that's not the worst.

Dr. Nicole (28:28): Right, right, exactly.

Kelsey (28:30): She said, it's not the worst. I think the next painful part was the check if all the placenta had come out and the pushing and the grabbing. I wasn't prepared for either. But after we made it through that, yes, it was just pain-free and it felt amazing.

Dr. Nicole (28:48): Okay. All right. So, and I know you had a little bit of issues postpartum with healing, and we'll talk about that, but how are you feeling in those first few days after birth?

Kelsey (29:06): Still shock. I think we had texted our family and I think made some calls a couple hours later and said, guess what? They all were like, you're not in the hospital, you did something happen? Are you checked in? Are you in labor? We sent the picture and they were like, oh my gosh, he's here. What happened? You didn't call us to tell us you were in labor. You tell us

Dr. Nicole (29:31): You didn't have, were at the hospital.

Kelsey (29:33): And we said, yeah, we're still process. It took us probably a week or two to just process what had happened and how quick it came. But we were excited and my daughter was thrilled to come and meet him, and as soon as they wheeled us to recovery, it was just relief and shock. We hadn't even picked out a name officially until probably 10 minutes after he was born. Right, right.

Dr. Nicole (30:01): You feel a mix. Some people feel a mix of when it goes so fast, some people are like, oh, I want it to go fast. You think you want it to go fast, and then it actually happens. For some people when it happens, it is incredibly overwhelming because it's like you have zero control over what's happening in your body. All of these things are just happening and you can't stop it. You just have to just move with it. Is that how you felt?

Kelsey (30:27): Yeah, looking back, I feel like it got stolen from me a little bit because it went so fast. I think the pain kind of made me black out parts of it, so I wish I could have had it go slower and remember it and know what contractions were like, and I don't even remember who the delivery nurses or doctor was because it went so fast. So I was a little sad about how fast it all went.

Dr. Nicole (30:56): Sure, I can understand that. I can understand that. So then what was the postpartum period in terms of your healing?

Kelsey (31:01): This was my reason for wanting to come on the show actually, is because I had heard about recovery after feedbacks or just after natural births in general. And I will say it was way worse than my C-section. My C-section was very easy in my opinion, recovery, and I think the worst that had happened is I thought I had a hernia, and it just ended up being the end of a stitch that I could feel in my stomach. But otherwise, everything went so smooth and the first week or two was really hard. It's just a different sort of pain and pressure and scariness to go to the restroom after having that type of birth. And I almost had the sinking feeling that something wasn't going right. So by my six week appointment, I went in and it was my normal ob, and she was great, and she did a check and she said, I don't want to scare you, but we have a little bit of granulation tissue.

(32:09): And I said, well, what does that mean? I thought everything was going good. I didn't have pain. At the six week point, I was back to light lifting and working out, and she said, oh, it's just when your body over heals itself almost. So I had had it along where they sewed my tear on the inside, so it wasn't something you could see, and I didn't have pain with it, which a lot of people do. I learned after. So she said, it's okay, I'm just going to use some silver nitrate and essentially burn it off. I said, okay, I guess we'll do that. I don't know what it is. So she burnt it off, and then at that point, we had moved to North Carolina, so she said, go do a follow-up when you get there and just make sure everything's healing correctly. And I still had a sinking feeling something was wrong, but no pain. Again, just in the back of my mind, I'm like, oh, man, I wonder if something's going on. And then at my 12, it was probably 10 or 12 weeks at that point with a new ob, and he did a check and he said, oh, I hate to tell you, but there's probably three or four spots of granulation tissue still.

Dr. Nicole (33:28): Okay. Okay. Was it painful at all?

Kelsey (33:34): No, I didn't notice it at all, and you can't see it. Mine was all internal.

Dr. Nicole (33:41): Had you had sex at all? Was sex painful?

Kelsey (33:43): So I hadn't been cleared yet.

Dr. Nicole (33:45): Got it. Because

Kelsey (33:46): Okay. And they said, I probably wouldn't have noticed it, the pain or the extra bleeding that can come along with it until that point or until you use tampons again. So I had no clue, no pain, no bleeding, but they said it can cause some issues, so we really want to get it taken care of. So he didn't want to just burn it again. He wanted to go have a procedure in office, which they did a local numbing and then cut the tissue out and then put the silver nitrate on the cut lines.

Dr. Nicole (34:19): Okay. Okay. So that's more extensive then. That wasn't just a little spot that was, yeah. Yeah. So then how was the healing after that?

Kelsey (34:31): So I had started to do my research on it at this point, and learning that I was the lucky, probably 5% that got granulation tissue, and it seemed to only be after a forcep delivery from what I could find, or very, very traumatic deliveries

Dr. Nicole (34:46): Or more complicated tears sometimes. Yeah. I'm

Kelsey (34:49): Like, oh, I'm the lucky. I'm the one. My mom told me to go buy a lotto ticket

Dr. Nicole (34:54): At that point,

Kelsey (34:57): But unfortunately, I went back in for my checkup again and he said, wow, it came back again. So he said, we need to put you under and we need to go in and surgically remove these portions, which I was like, wow, I couldn't even get put under or anesthesia for my delivery. Now I'm getting put under for the postpartum recovery process.

Dr. Nicole (35:23): That's not fair.

Kelsey (35:25): So it was really, really hard postpartum because you just don't feel like you're yourself yet when you know something's wrong, even though I couldn't feel it and there was no pain,

Dr. Nicole (35:35): It's

Kelsey (35:36): Just you get defeated a little bit.

Dr. Nicole (35:38): Sure. Yeah. Yeah. So then after that, was that the last

Kelsey (35:43): Time? Yes. So I got put under, did the procedure and got released that day, and my follow-up, I was all clear, and I looked at my OB and said, I'm sorry, but I don't want to see you for a very

Dr. Nicole (35:55): Long time. And then physically, do you feel okay sex painful or anything?

Kelsey (36:05): No, I feel great now. It seems like a blur looking back because I didn't get cleared probably until 15, 15 or 16 weeks. I wasn't really cleared. But no, I'm back to exercise and nothing is painful.

Dr. Nicole (36:20): Gotcha.

Kelsey (36:20): No issues. Now,

Dr. Nicole (36:21): Did they recommend pelvic physical therapy at all?

Kelsey (36:24): So none of my doctors recommended it, but I also have a husband who's a strength coach who works. He's a strength coach for the military, so he works with physical therapists, athletic trainers, and he is done a lot of that knowledge himself. So he did my workout plans during pregnancy, during postpartum, which he incorporated a lot of that anyways, so I never really had the core issues or the pelvic floor issues, I think, in part to following a plan like that.

Dr. Nicole (36:53): Sure, sure. That's great. That's great. Oh, and I guess I should ask, did you have any issues? Did any of that interfere with breastfeeding or that kind of thing?

Kelsey (37:04): No, it didn't. I made my breastfeeding journey until probably eight and a half, nine months with him, and then we just kind of naturally weaned. But no, I had no issues with that in breastfeeding. Breastfeeding was very smooth first and second time around. Okay,

Dr. Nicole (37:18): Good, good, good. So then when you look back, how do you feel about everything?

Kelsey (37:25): I really wish I could almost do it again, but we're done with two kids. You said

Dr. Nicole (37:30): Two and through. That's what my husband and I said. We would say two and through we were done. Yes,

Kelsey (37:34): Two and through.

Dr. Nicole (37:36): But

Kelsey (37:37): The part that makes me want to redo it is feeling like it got stolen. I had the C-section and I had the VBAC and my doctor walked in after and said, you got your VBAC. Yay. Not many women get the VBAC experience. And I said, I don't really feel like I got it. I feel like I got a two hour contractions and a 30 minute push and he was out. But

Dr. Nicole (38:02): Yeah, because it was What time did you have the first contractions?

Kelsey (38:07): I think around one or two in the morning is when I felt them,

Dr. Nicole (38:12): And then by five 15 ish he was here. That is, oh my goodness. And I still can't get over you driving yourself. There's so many things that are just pulling over and putting your flashers on at four o'clock in the morning trying to get to the hospital. I know,

(38:32): I know. Oh my goodness. Oh my goodness. Well, I'm glad everything turned out well, and I'm glad you came on to share your story. And you're right, it's not something that, I know I haven't talked about granulation tissue and how some of those things can happen in healing postpartum. So now I'm going to have to have an episode about it. So it's definitely a good thing to bring up. So I'm glad you were able to, come on. There's so many things to learn from your story. So then what would be your one favorite piece of advice that you would give to someone who's about to have a baby?

Kelsey (39:03): Oh, I would say prepare for a plan A, B, C, D, and E. Try to learn and know as much as you possibly can because I thought I had learned enough and knew enough, and I still wasn't fully prepared. I wish I would've tried to learn a little bit more about a VBAC or a C-section or everything that goes on, but the podcast was great way for me to learn some of the different options.

Dr. Nicole (39:32): Gotcha, gotcha, gotcha. All right. So where can women connect with you? You can say nowhere if you're not on social media or not interested.

Kelsey (39:39): I'm not on social media, but if women ever have questions about the granulation tissue, it's very rare and it's hard to find information for me. So if they ever want to reach out via email, I'm completely okay with that.

Dr. Nicole (39:51): Okay. Yeah, just folks can reach out to us and we can connect with you. Well, thank you so much for coming and sharing your story. This was really informative educational. I'm so glad that you were able to come away.

Kelsey (40:03): Yeah, thank you for having me.

Dr. Nicole (40:11): Wow, wasn't that a great birth story? I so appreciate Kelsey coming on and taking the time to share her experience with us. Now, every time after I have a guest on, I do something called Dr. Nicole's notes where I talk about my top takeaways from the conversation. Here are my Dr. Nicole's notes from my conversation with Kelsey. Number one, there was some good and not as good things about her VBAC experience. So the good parts were that it was great that her doctor brought it up early because it definitely needs to be discussed early. It was also great that her doctor and hospital were generally supportive of VBAC also something that should be happen. Now, the things that were not as great, it's not true that you can't be induced with the VBAC. Her doctor told her they don't do inductions with the VBAC, and that's not true.

(40:59): Induction can absolutely happen if you've had a prior cesarean. Also, if you want to give someone the opportunity to go into labor with a VBAC, then the C-section shouldn't have been scheduled at 39 weeks. So in Kelsey's case, it was scheduled at 39 weeks and we schedule a repeat c-section at 39 weeks in general because most people actually haven't gone into labor at that point. And that's when we know that the baby is ready to come out. If you want to give someone the opportunity to go into labor with the VBAC, then you really need to schedule the repeat section about three or four or five days, even past 40 weeks. So you really want to schedule that repeat C-section after the due date in order to give people the most opportunity to go into labor on their own. And if you're thinking about a VBAC, then do check out episode 2 29.

(41:55): If the podcast is dr nicole rankins.com/episode 2 29 where I go through all the questions you need to ask if you are considering a VBAC so that you know have a supportive doctor hospital, and you really set yourself up for success. Okay, next thing is there were some good things about her hospital that I want to point out. I love that the hospital had a birth plan process and that it was discussed prior to birth. Most hospitals do not have that now without knowing what was in it. Sometimes I do get concerned that hospital birth classes, maybe this process is about getting people into the hospital ecosystem. So you really still need to do your own to make sure you have something that works. Of course, check out my free birth plan class, dr nicole rankins.com/birth plan. If you find that the hospital and what I teach is similar, then you know you're in great shape.

(42:47): If not, then you're also in great shape because you know what to do after taking my class. I also liked that the hospital encouraged her to get into whatever position she felt comfortable with to push that is excellent. Also, loved that she said folks were a calming presence for her in the midst of her having challenges managing the pain. And they encouraged her that she could have that vaginal birth even if she didn't think she could. Everyone should have that sort of calming presence and encouragement during their birth experience. Now, the one thing I didn't like, and this is the fault or a fault of all hospitals, our obsession with paperwork and signing forms is absolutely ridiculous. Sometimes we are always asking people to sign paperwork when they're screaming in labor. It makes absolutely no sense. So I wish we could back away from our obsession with paperwork and consent forms.

(43:39): Alright, next up is epidurals. Just a quick note, the epidurals take time. You have to be prepared to manage pain without an epidural for a period of time. They can take anywhere from 30 minutes or longer to get set up for the anesthesiologist to be there. Sometimes they may be delayed. Epidurals are considered an elective procedure. They're not like a mandatory medical procedure, so they don't take precedence in terms of if there are other emergencies happening in the hospital. So you do need to be able to manage pain without an epidural for some period of time. Check out dr nicole rankins.com/pain. I have a free guide that you can download that goes over all your options for pain management. So you can check that out, dr nicole rankins.com/pain. And the companion podcast episode to that is episode 1 29. That's dr nicole rankins.com/episode 1 2 9 where I also go over all of your options for pain management during labor.

(44:38): Last couple things I want to say is my Dr. Nicole's notes. I have several for this conversation. As you can hear, prepare that your partner should be prepared to see you in pain. You need to talk about that before you go into labor. It can be really overwhelming for husbands partners to see their wife or their girlfriend or loved one in pain, or it can be hard for family members to see someone in pain. We are used to that because we know that that's what labor looks like. But it can be very difficult if it's not something that you're used to seeing. Know that it is not a danger or a threat to your health. It's actually a normal part of the labor and birth process. So your partner really needs to be prepared to see you in pain and something maybe that they have never seen you in before.

(45:32): And then the final point that I will say is about the granulation tissue. It is a rare thing that happens. Her experience of needing to go to the OR is not typical, but I do want to let you know about things that can possibly happen. And most of the time, as in her experience, it does end up getting treated easily and recovery is not difficult or prolonged. Do consider pelvic physical therapy though if you have any issues after birth. Really, everyone should see a pelvic physical therapist after birth. We just don't have that set up in our system. So this is another place where pelvic physical therapy can be helpful to help you get in your best shape after you have a baby. So there you have it. Do me a solid share. This podcast with a friend sharing is caring and helps me to reach and serve more people.

(46:20): And be sure to subscribe to the podcast wherever you're listening to me right now. And I would love it if you leave a five star review. And Apple Podcast helps the show to grow, helps other women to find the show. And do check me out on Instagram. I'm on Instagram @DrNicoleRankins. I so love when y'all send me dms about what you think about the show or when you send me dms that are pictures of you and your baby, they really, truly warm my heart and keep me going when things sometimes can be challenging. So shoot me a message on Instagram. I'm @DrNicoleRankins and follow me there as well. I provide great little bite-sized snippets of pregnancy and birth information to help you there too. So that's it for this episode to come on back next week and remember that you deserve a beautiful pregnancy and birth.