Ep. 448 Somersaults and a VBAC with Isabelle Kosciusko

Key quotes

“What I wanted was a healthy baby. So after two days of fetal decels and all that, I was just like, if that's what it takes, that's what it takes.”

“Page one is that birth that you dreamed of and envisioned and the last page probably is the one that you got. But it's still part of the plan.”

“This is just an exercise in resilience. I need to just let go of whatever I'm attached to.”

“I really wanna walk in there feeling supported by my medical team. Like I don't wanna walk in there feeling like not only do I need to deal with childbirth, but I also need to navigate your anxieties as a doctor.”

“At a certain point, it was letting go and believing that you can do it and just trying to do all the little steps that you can to make it happen your way. And then after that point, you just have to let it go and let it happen how it's gonna happen.”

Related episodes

• Ep. 269 Kate Pangos – A VBAC Birth Story
• Ep. 399 All About VBACs with Meagan Heaton
• Ep. 282 VBAC at Home – Danielle DuBoise
• Ep. 2 VBAC – Know The Facts

Transcript

AI-generated transcript with speaker labels — may contain errors, especially names and medical terms. Dr. Elliot Berlin, DC appears in blue; Isabelle Kosciusko in orange.

Download PDF of the Transcript

Dr. Elliot Berlin, DC [0:12] Welcome to the Informed Pregnancy and Parenting Podcast. I'm your host, Pregnancy Focus Car Director, Dr. Elliott Berlin. My guest today is a creative director and product designer. Today we're going to talk about her recent pregnancy where the baby would just not stop doing some results while she was trying to have a vaginal birth after cesarean. Isabel Koziuszko, welcome to the podcast.

Isabelle Kosciusko [0:57] Hi there. Thank you so much for having me.

Dr. Elliot Berlin, DC [1:00] My pleasure. Great to see you again. Well, for everybody else to hear you for the first time, but congratulations, you have your baby.

Isabelle Kosciusko [1:07] Thank you. Yes, it's been seven weeks today.

Dr. Elliot Berlin, DC [1:10] Wow. Happy birthday.

Isabelle Kosciusko [1:11] Something of a birth? Yeah.

Dr. Elliot Berlin, DC [1:12] Wonderful.

Isabelle Kosciusko [1:13] I haven't got the candles out just yet, but yeah.

Dr. Elliot Berlin, DC [1:16] This was not a simple story. So if we go back a little bit just to get an idea of who you are, where are you from and what do you do?

Isabelle Kosciusko [1:24] Yeah. So my mom's American, but I'm French. I grew up in France until I was about 18. Then I moved to England for 18 years, met my current husband. We moved over just before COVID. And yeah, here we are in Los Angeles now. We've been here since 2019. We started trying to have a baby pretty much very soon into our relationship. And I've got a toddler who's two and a half and a newborn of seven weeks.

Dr. Elliot Berlin, DC [1:51] Seven weeks wasn't the easiest journey for you, I would say, along the way you hit some.

Isabelle Kosciusko [1:56] Yeah. I definitely feel like my friend was saying like, oh, yeah, this card stacked against you a little bit, especially in this last pregnancy with having a vaginal birth. So we started pretty much immediately trying to have a baby, but we weren't really paying too much attention. And then about a year and a half into our relationship, I had an atopic pregnancy. I found out I was pregnant. It's kind of a long story, but I'll shorten it. I found out I was pregnant at my, I had the seven week, eight week visit the day after I got insurance in the U.S. So found out it was an atopic pregnancy and was advised to go straight to the emergency. And yeah, so that was that.

[2:33] That happens. A couple of months later, had an HSG, found out I had a hydrosalpings on the side that wasn't the atopic, actually. And so my doctor recommended that I get my tubes removed. So at least one, if not both. So I ended up doing that in December that year. And then obviously without tubes, you know, needed to do IVF. So I did two rounds of IVF and was very lucky. Actually, that was very, you know, a fairly as straightforward as IVF can be, I suppose, journey. And then I got pregnant in late 2021 with my first born daughter.

Dr. Elliot Berlin, DC [3:08] First of all, why two rounds of IVF?

Isabelle Kosciusko [3:10] Two rounds, because we kind of thought we wanted two kids and I had one embryo. Yeah, I did the genetic testing just because I was 38 at the time. So I kept being told advanced maternal age, advanced maternal age. So, yeah, I just figured it would save me some heartache. And yeah, I did two rounds, got three PGS tested embryos, figured that was enough and I could always just go back and do more if needed after. But, you know, they both took and, you know, so have two kids from two embryos.

Dr. Elliot Berlin, DC [3:42] All right. So then the next step is getting pregnant.

Isabelle Kosciusko [3:45] Yeah. So the next step, I gave myself the summer off, actually. And there's another thing. So just after I had my second round of IVF, I had a checkup with my IVF doctor, who is really amazing, Dr. Brower. And she said, actually, you need to get a myomectomy just to be on the super safe side. So that happened. And I gave myself the summer off. I just wanted to go out. I feel like I'd been so sort of like IVF, it takes over everything in your life. And I was like, you know what, I need a breather. I just need to go and have some fun and just like, you know, do whatever I feel like for a couple of months. I was also going back to Europe to see my friends and family.

[4:25] So I came back and did the first, you know, got pregnant basically in October that year. So that was 2021. That came fairly easy. Yeah. Obviously, IVF is a whole crazy journey. But I was very lucky in terms of how many healthy embryos I got from each round. And also the pregnancy happens, you know, straight away. Like it didn't take multiple takes for it to land. And I had a pretty healthy, easy pregnancy, I'd say both times for the majority of the duration, but especially my first one. Honestly, I was ecstatic to be pregnant. I was really embracing it. I was reading all the books. I was doing all the research into baby brains and like what they

[5:09] feel and think in the womb and just all these things. I really embraced it, honestly, in a way that I wouldn't have had my journey been easier. So in a way, I am not just in a way grateful with how it happened. You know, if I'd got pregnant after a month of trying, I wouldn't have the appreciation that I have for everything. And I wouldn't have embraced pregnancy the way I did.

Dr. Elliot Berlin, DC [5:31] From the books that you read or the other research that you did, does anything stand out as being particularly helpful?

Isabelle Kosciusko [5:37] I mean, there was a book that I particularly remember. I think it was a guy called David Chamberlain. I might be wrong, but it was a book written in the 70s about how babies can feel and hear what you feel and, you know, the music you play and things like that in the womb.

Dr. Elliot Berlin, DC [5:55] I'll find it. We can put it in the show notes. I'm not sure which book that is, but along those lines, we have a film streaming on Informed Pregnancy Plus called Prenatal Memory, which is a doctor from Japan who, you know, kind of realized that he is an OB from Japan. He realized while he's talking to people about their care, about the pregnancy, about the baby, that the baby's also listening and kind of shifted to also address the baby.

Isabelle Kosciusko [6:19] Yeah, I watched that in my second pregnancy, actually, because I think you recommended it to me. And I watched it. It's so fascinating. I'm always just curious about, you know, what happens in their minds, what happens to them in the womb. And that was really insightful. You see all these little children who have all these prenatal memories. It's pretty magical.

Dr. Elliot Berlin, DC [6:37] Yeah, so that was helpful for you. What was your plan going into your first birth after you did all that research?

Isabelle Kosciusko [6:43] Yes, so I hired a doula. I did hypnobirthing. I really wanted to have a vaginal birth. So I did also Brenda Bushnell's birth course in person. I read that for a transformed by birth book. And yeah, I did hypnobabies birth course. I was doing hypnobabies with our doula, who was a hypnobirthing specialist, quote unquote. And yeah, that was my prep. I really wanted a vaginal birth. I just felt like because I was 39 at the time, I was just being pressured. And because of my journey, I felt just pressured into having a birth at hospital. Yeah, so that was my idea. I'm going to have a hospital birth, but it's going to be as intervention less as I can make it.

[7:27] Yeah, just not rely on, you know, not taking epidural, not have obviously not have a C-section, not have an induction, just avoid any of those hospital interventions as much as possible.

Dr. Elliot Berlin, DC [7:39] Well, how did things start off?

Isabelle Kosciusko [7:42] I was just containing my laughter. I would have said that because obviously that's not how it happened.

Dr. Elliot Berlin, DC [7:47] Well, we already spilled the beans that you went for a V-bex.

Isabelle Kosciusko [7:51] Yeah, that's true. Yeah, well, fate did not want that for me. So yeah, what happened is I was getting pressured by my doctor, who I would say is a very traditional doctor. She's on the slightly younger side. She's probably younger than I am. So she was saying, well, as a lot of doctors do, saying you need to get induced at 39 weeks, which I pushed back. I was saying, you know, 40 weeks. And then I said, look, I'll be comfortable getting induced at 40 plus five, thinking that'll give me plenty of time. What happened is at 40 plus two, I went in and also they were giving me a lot of fetal monitoring. And that was kind of my way of keeping them at bay.

[8:29] You know, I was just like, okay, cool, I'll come in and I'll have a checkup and you can put me on the fetal monitor and fine. You know? So like, if you're doing on stress tests, essentially they'll buy a few days of confidence. I was just like, yeah, like not even for me, it was more for them. I was doing it because I could hear that in here. Yeah. And I was just, you know, walking very confidently into the office. What happened is, and it's actually funny, my husband was all for it. By the time I was 40 weeks, his work, we're saying like, yeah, don't come in because we don't really want you here. We'll just get you replaced. I was still working because I was just like, whatever,

[9:06] you know, this baby's gonna come when she wants to come. It was a girl. And yeah, I went in at 40 plus two, literally left my lunch. I was still on my laptop, left my lunch on the table. My husband drove me to hospital and I was like, okay, see you in five minutes or you know, half an hour or whatever. And then I go on the heart monitoring machine and then my doctor came in and she said, oh, so you've got fetal decels actually. So yeah, she looked at me, she didn't look very happy and she was saying like, normally we induce people at this point, which was not what I wanted to hear, not what I expected to hear. I didn't really know how to deal with that

[9:45] because no one had really told me about fetal decels before. So I called my doula who was kind of not really helpful. And then I just decided I wasn't gonna be very comfortable going home when I've been told that my baby's in danger. And I was like, well, I could wait three more days and get induced in three days, but am I gonna sleep at this point? And I was like, no, I'm not gonna be able to rest. I'm not gonna be able to relax and put my feet up and watch TV, right? When you're like, well, maybe my baby's in distress in there, but I don't really know. So I decided to get induced with a balloon. Yeah, just a balloon at that point, which didn't really go well, it didn't really happen.

Dr. Elliot Berlin, DC [10:30] Meaning it didn't create any dilation or?

Isabelle Kosciusko [10:33] It didn't create any dilation. I told them to put it up to the max. She was like, normally people put it at 65%. And I was just so trying to be a hero. I was like, it's fine, carry on. And she was like, wow, 80%. Like, you know, you're, you guys sound pain pretty well. And my husband said he walked in the room and he was like, are you okay? And he could see me like gripping the sides of the bed. And I was like, but anyway, yeah, it didn't really do anything. The baby was still in distress, like intermittently in distress and nothing, no dilation, nothing. And I was also really choosing not to have an epidural. That was quite important to me. So I did that for about 12 hours,

[11:15] got admitted to labor and delivery. So I was in there for about 12 hours. And then at three in the morning, I remember just being in agony and going like, I need to have an epidural. So got that done during the night. The next day, still no progress. Nothing was happening, which was quite disheartening every time, you know, they come in and they tell you, no, still like maybe one centimeter or two centimeters, maybe three. My doctor came in about 24 hours later and said, look, if you want, I can break your waters, which we did. And then just carried on. And again, they just kept coming in and turning me over and telling me the baby was in distress

[11:54] that they had to turn me over. I was trying to do my hypno-babies course at this point, my hypno-birthing course. Oh, the other thing is my doula, when I messaged her to say I was going to labor and delivery, she told me, okay, I'm going for a nap, keep me posted. Which at the time I was kind of wondering like, why like surely now is the time that you should be showing up. But I didn't, I had so much going on that I didn't really pay attention. You know, I was just like, okay, I guess she knows what she's doing. Yeah, so fast forward to the next day. She hasn't come. The nurses kept asking me, where's your doula? Where's your doula? And I was like, I don't know.

[12:29] She's supposed to come, but she's not here. My husband was dealing with her. So I was just trying to focus on, you know, breathing and trying to work through this. Yeah, and no progress. Even after the waters broke, it was getting a little bit better. It was going up to maybe like three or four, but it was kind of like maybe 36 hours at that point. It was so stressful. It was, yeah. I'm feeling stressed. It was disheartening more than anything. It was just disheartening. It was so far from the experience. I think I thought I was also really flexible because everything I'd been told before was, you know, prepare for the unexpected. Like you think you're gonna be prepared, but you're not.

[13:08] So just be flexible and resilient. And I thought I was, but I really wasn't. I think I was very attached to what I wanted, which was a vaginal birth and hospital with no, you know, medication or anything.

Dr. Elliot Berlin, DC [13:20] Well, here we are at 36 hours into it. You are in the hospital, but you're getting all sorts of interventions and medications and things are still not moving all that quickly. Why don't we take a little break when we come back? We'll find out what happened at the end of that birth. We'll be right back.

Dr. Elliot Berlin, DC [13:47] Welcome back. We're talking to Isabelle, cause you scoop and guess what? We're 36 hours into what's supposed to be an unmedicated birth and a vaginal birth at the hospital. But it just started with some fetal decelerations during monitoring that concerned the doctor and then concerned the mother because the doctor was concerned and then landed in the hospital and tried a few different induction things. Nothing really seems to be creating a lot of progress or sounds a little bit like your uterus is in neutral, contracting a lot, but not really driving forward.

Isabelle Kosciusko [14:23] I was getting contractions and I was on the potassium at that point too, but it just wasn't progressing. And that was disheartening. I just kept getting fetal decels, but I was still thinking it might happen. The doula still wasn't there. Just all-

Dr. Elliot Berlin, DC [14:39] The doula after 36 hours.

Isabelle Kosciusko [14:42] Yeah, and it's kind of funny, one of the nurses, I think this is before actually, I took the epidural when the nurses, I was just in so much pain and when the nurses was saying, you know, picture your happy place. And like, I was on this birth ball and I was bouncing up and down. And she was like, where's your happy place? And I was like, on a beach in Mexico, on a beach in- And she was like making me bounce up and down, like going on a beach in- Which I think that, yeah, to an outsider would have been like pretty funny to see. But yeah, so fast forward to 36 hours, it's still not happening, still fetal decels during the night, I will say, because I was getting checked through the night.

[15:16] One of the nurses came in, this is like maybe at 6 a.m. the second night, so maybe about 40 hours into this. She checked me and she was like, oh, you're almost there, you're at eight centimeters. And I was like, oh my God, all of a sudden, I just had this moment of like, I didn't go through all this for nothing. But I felt also quite a lot of pain from one of the visits during the night that night. I started feeling pain again and I was like, okay, maybe it's just the intensity of the contractions because I've progressed more. So I just took it on board, but it was very painful. And she was telling me I was eight centimeters and I was super happy and just thinking,

[15:54] this is it, this is it, like 42 hours in, it's fine, it's gonna work out my way. And then the doctor came in at 9 a.m. to check me and she's like, you're not at eight centimeters, you're at like four or five.

Dr. Elliot Berlin, DC [16:07] Yeah, I guess it's possible that you were tracked, but it was like, I don't know what she's on, but she did not tell you the right figure. And also, what is this wire hanging out?

Isabelle Kosciusko [16:16] And it turned out one of the nurses had accidentally unplugged my epidural, which was like, oh, that explains why all of a sudden I started feeling pain.

Dr. Elliot Berlin, DC [16:24] Oh my gosh, but I mean, it's I guess a little funny, but not funny funny, it's just like a comedy of errors and still where's your doula?

Isabelle Kosciusko [16:35] Yeah, my doula showed up at 9 a.m. that morning as I was being told by the doctor like, you need to consider a cesarean at this point because it has been almost 48 hours and 24 hours since your water's broke. And honestly, I was just defeated at that point. My doula came in, I just wanted to cry. I just felt so defeated and exhausted. And I asked for a little moment on my own and the doula was saying, look, let's do some spinning babies exercises. But honestly, having her there actually was more triggering than anything else. I just wanted her to leave because I was angry with her for not coming earlier. It took me months to speak to her and ask her what happened.

[17:12] But regardless, I just felt like at that point I didn't really have a choice. Yeah, so I just took a moment to myself and spent like an hour or half an hour just crying basically on my own in the room because I'd asked everyone to get out. And yeah, just decided to say, okay, I just felt like that was all I could do. And also, to be fair, what I wanted was a healthy baby. So after two days of fetal decels and all that, I was just like, if that's what it takes, that's what it takes. I think I was particularly attached to a vaginal birth in retrospect because of doing IVF. I felt like I really wanted one thing that had less medical intervention.

Dr. Elliot Berlin, DC [17:52] I hear that a lot.

Isabelle Kosciusko [17:53] I think that was an important component for me. But it didn't happen. I was slightly traumatized after. I think people I know have very happy C-sections. Honestly, I felt like someone was pounding really hard on my chest. My husband said it was funny because he was there and he was holding my hand. It was just crazy because they pulled the baby out and then they were like, do you wanna cut the cord? Do you wanna take a photo? And he was like, look, I feel like my wife is about to die. There was a lot of blood. He was a little bit traumatized and they were so used to it that they were just treating it very matter of fact, in a good sense, probably a good thing

[18:32] because it means they're so used to it that they do it very well. But yeah, for us, it was very like, what is going on? It just felt completely crazy.

Dr. Elliot Berlin, DC [18:41] Sorry, I had such a challenging experience. It takes a lot of strength sometimes to let go of your dream and do even though you want that healthy baby, it's hard to let go and to even accept that that's what's healthiest for your baby. Sounds like you didn't have a lot of support that you had planned for. And then also just sometimes, even right out of the gate, you don't get the experience you want and it's a flow chart. I say this on the podcast all the time. Page one is that birth that you dreamed of and envisioned and the last page probably is the one that you got. But it's still part of the plan. The plan is if your baby needs to or you need to have a necessary birth

[19:22] then of course you're gonna do it. Doesn't mean it's a great experience. So after that birth experience, how soon till you decided to have a second?

Isabelle Kosciusko [19:33] Yeah, so after that, we waited about a year and a half. In fact, exactly a year and a half. And at the beginning of last year, I was thinking, look, I don't wanna wait until I'm too much older. Like I'm 42 or I was 41. I don't really wanna have kids too late because I still wanna have more energy, et cetera. And I thought, is this year or nothing? Should I do it? Should I not? Also it felt like a year where as much as having a toddler is tiring, it felt manageable to have another kid and I didn't wanna leave too much age difference between them. So early last year, I started thinking about it again and yeah, got pregnant in April. So we waited a couple of months and then yeah, just-

Dr. Elliot Berlin, DC [20:16] Embryo did its thing?

Isabelle Kosciusko [20:18] Yeah, exactly. The embryo did its thing and got pregnant in April. And different pregnancy in that the first trimester, I felt extremely nauseous, very tired. I felt like the first pregnancy was a little easier to manage the first trimester. But besides that, I still swam a lot. I was obviously very happy. I was very much less focused as I'm sure everyone is in their second pregnancy because you're dealing with a child already. I would find myself, where's my first pregnancy? I was like, I'm 12 weeks and three days. And knowing every week what size my baby was, this pregnancy, I was kind of like, what week am I again? Just trying to keep track.

[20:58] So it was very different in that sense. But besides that, very happy, healthy pregnancy, just less time to focus on it, I suppose.

Dr. Elliot Berlin, DC [21:08] I mean, after you have a cesarean birth, you have, I guess, two options to plan for a repeat cesarean or vaginal birth after cesarean. Had you put thought into that?

Isabelle Kosciusko [21:17] Yes, so ignorance is bliss. I didn't know VBACs are such a big deal. I just thought that's what everyone does. You just opt for a vaginal birth and then if it doesn't work out, you have a cesarean, which I thought is what the majority of people do. I didn't really realize it was a thing. I think my doctor asked me, so do you want another C-section or do you want a VBAC? And I was like, oh, of course, yeah, I want a VBAC. And then I think at 32 weeks, I came to see you just because I swam a lot and I felt like my joints were quite stiff. My back was very tense. So I came to see you for a chiropractic visit. And at that point, the baby was breached,

[21:55] but I wasn't concerned because it was just 32 weeks. I felt like more and more people go, okay, you want a VBAC. I remember you told me about episodes to listen to and how to prep and I was just kind of like, do you need to prep for this? Is there such a thing as, do you need to read up about it? Why is this a big deal? And the more I looked into it, the more I realized looking at the figures was quite alarming. I think it's like one in 10, can't remember what it is, but it's a very low rate of people who go for VBACs.

Dr. Elliot Berlin, DC [22:27] It's interesting. It's a low rate of people who go for it and a high success rate among those who do.

Isabelle Kosciusko [22:32] Right. And I was just really confused and honestly quite shocked and all of a sudden I kind of went down this rabbit hole of like, why is this such a big deal? And then my doctor also increasingly started talking to me about the risks and everything that could go wrong. And basically every time I would go for a visit from about 31 weeks onwards, I feel like I would get told, which was from every four weeks to every week at a certain point, you get told about risk of uterine rupture and all the various other things, but mainly that one where I ended up feeling the way it was being talked about was like, you've got a 1% chance of dying. And if this happens and she told me,

[23:15] one of my friends had this happen to her and it very nearly killed her. Which is obviously not what you wanna hear.

Dr. Elliot Berlin, DC [23:22] Yeah.

Isabelle Kosciusko [23:23] I was trying to mitigate like feeling anxious about it whilst trying to inform myself for the best possible birth. But every time I would read more about it, I would get more figures that are, you know, not heartwarming or yeah, just confusing.

Dr. Elliot Berlin, DC [23:39] Now at 32 weeks, breach is not a huge deal, but it's definitely a time to start tracking it, you know, put your finger on the pulse of it. Even from that perspective, how did things go?

Isabelle Kosciusko [23:50] So yes, that's the next thing. I was thinking based on my previous birth where I felt like I did everything I could and then got an outcome that was very medically heavy. I thought, you know what, this pregnancy, I'm not gonna do anything, I'm not gonna study anything. So when I realized that VBACs were kind of a big deal and you need to be a little bit ready and prepare yourself and your mind, and if anything, you know, know how to deflect, you know, doctors and anyone in the medical establishment who tries to dissuade you. So you need to be informed in that sense. I then was dealing with, the baby was head up at 32 weeks and then I went for my next visit

[24:31] and he was head down and I was like, great, I can focus on all this VBAC information so that I can be informed and, you know, walk in confident. And then the next visit, I went in and the ultrasound tech was like, oh, he's breached. And I got really, I was like, wait, what? He was head down a week ago. And she was like, no, he's frank breach, very matter of fact, went into the doctors confused and she was saying, yeah, he's breached so you need to start thinking about scheduling a C-section, which I was not happy about and also confused about, but he was head down two weeks or a week ago. And that happened. So I felt like that took me away from being able to focus on the VBAC and feel relaxed.

[25:17] You know, I think a lot of big component of this is feeling relaxed enough that you're able to just go with the flow and let the baby come when he wants to come and all those things. So not only would detracting me from being able to focus on the VBAC, but it was also just every time that would happen, I would have to think about how I'm not gonna have a C-section because very few practitioners in LA want to give a breach birth, right? It's not really-

Dr. Elliot Berlin, DC [25:47] Almost none.

Isabelle Kosciusko [25:48] Yeah, there was just one practitioner that my friend used, but I believe he's no longer practicing. And yeah, my impression was that it just wasn't an option. So I wasn't able to focus on the VBAC. I had to focus on getting him back to being head down. So that happened a couple of times. I wanna say every week between 34 and 39, he was moving around, right? So one week it was breach, one week it was head up, one week it was transverse. There was a lot of transverse. I was coming to see you every week, trying to get help to bring him head down. Then I'd go to my doctor's and he'd be head up or he'd be head down again, usually after our visits, he'd be head down, but then he'd move back.

[26:33] Also, I feel like it confused my confidence in what I felt because I thought I could feel his head a certain way, or then I thought I'd feel contractions. And I remember going to the doctor's and she was like, oh, that wasn't contractions. That was probably him moving back to being head up. So I lost a lot of the confidence I had in my body and my connection to him at that point, which obviously is a big deal when you're pregnant and trying to connect with your baby and trying to be intuitive about how things are going. So that was going on. And then it's 37 weeks. I think the previous week he was head down. I came in for a visit at 37 weeks and he was back to being head up

[27:15] and she again insisted on, I think it was like 37 and four days or something for my visit. And she said, look, you need to schedule the C-section, like, you know, workout when. And I asked her if I could do an ECV, which previously every visit that I'd have where he was head up, I would ask for an ECV and she said, no, I don't really do those for V-backs, which I guess she was afraid of opening the scar, which I remember talking to you about and you were saying, really something, and I spoke to another-

Dr. Elliot Berlin, DC [27:46] Well, just so many OBs in town don't consider that a contraindication.

Isabelle Kosciusko [27:51] Yeah.

Dr. Elliot Berlin, DC [27:52] Especially when your baby's flip-flopping all over the place by itself.

Isabelle Kosciusko [27:56] Right. And one of the reasons we established he was flipping so much is because I had very high levels of fluids. I was like between about 23 to 25, which is the very utmost part of the frame.

Dr. Elliot Berlin, DC [28:08] Yeah, the top of the frame.

Isabelle Kosciusko [28:10] Because, I mean, I have a sweet tooth anyway, but I had a really bad sweet tooth during pregnancy. So they told me, well, one of the ways you can try and get your baby to stay head down is cutting sugar, which did not go down well for me.

Dr. Elliot Berlin, DC [28:24] It's not your favorite.

Isabelle Kosciusko [28:25] I was like, I can't drink. I can't drink cut. I can't do all these things. This is all I have left, but okay. But at that point I was like, this matters more than my chocolate habit. So, okay, I'll do what it takes through gritted teeth. Especially like between Thanksgiving and Christmas when you're like at your most-

Dr. Elliot Berlin, DC [28:46] Everyone's eatings.

Isabelle Kosciusko [28:47] Exactly.

Dr. Elliot Berlin, DC [28:48] And you want to too.

Isabelle Kosciusko [28:50] Yeah, going to these Christmas parties, not that I had that many, but yeah, going to like Thanksgiving celebrations and just going no, no to the desserts, which yeah, but anyway, I told myself like it's just for a month.

Dr. Elliot Berlin, DC [29:03] Yeah. And then your doctor kind of came around to doing an ACV, right?

Isabelle Kosciusko [29:07] She did, yeah. So when I asked her for an ACV at 37 and a half weeks, she was like, you know what? He's transverse and his head is towards the bottom. So, okay, let's come in tomorrow. Do an ACV tomorrow. I wouldn't do it past 38 weeks, but because it's 37 plus five, which kind of makes no sense in my mind, but yeah, okay. So I think I came in for a treatment with you that morning and then went for the ACV, which for people who haven't had an ACV, it's like you have to go to the hospital at 7.30 a.m. You have to pack your hospital bag. You get told like, this could be the day this happens. If the ACV doesn't work, your baby might actually get delivered today.

[29:44] So that's already a huge shift in your mind. Well, in my mindset anyway, I was packing my hospital bag, thinking, well, this could be it, which is kind of crazy because at 37 and a half weeks, I didn't feel like it was gonna be the moment, but I go in, they put you on a drip. They do all these things as if you're going through surgery. So you have to get there two hours ahead and you're getting all prepped. And then the doctor came in and she did the ultrasounds ahead of the ACV and she's like, oh, his head's down. But I came in yesterday. But anyway, I was excited. I was super happy at that point, obviously, because I was like, yay, I don't need to do an intervention.

Dr. Elliot Berlin, DC [30:23] And back on track for your VBAC.

Isabelle Kosciusko [30:26] Exactly, and back on track for my VBAC. I was thinking I can finally focus on this VBAC now. Yeah, and lo and behold, the following week, I go in and again, he's had a transverse, by that point he was more transverse. And at that point I was just like, you know what? This is just an exercise in resilience. I need to just let go of whatever I'm attached to. And I just felt again, kind of defeated and kind of over just trying to make things happen my way. And then at the next ultrasound, so I agreed to schedule a C-section and at the next ultrasound after that, he was head down again, so yeah.

Dr. Elliot Berlin, DC [31:03] What an insane mental roller coaster.

Isabelle Kosciusko [31:05] It really was, and also I felt a little bit unsupported with the VBAC just to wind back a little bit from my doctor. And I feel like I ended up almost like not having an argument with her, but kind of one day when he was actually head down and she was like, okay, we can focus on this, but are you sure you wanna have a VBAC? And I ended up just kind of being angry with her and telling her, look, you know, I feel like all my energy isn't spent on navigating, like VBACs is spent on navigating your requirements and what you're comfortable with and not comfortable with. And, you know, I really wanna walk in there feeling supported by my medical team.

[31:43] Like I don't wanna walk in there feeling like not only do I need to deal with childbirth, but I also need to navigate your anxieties as a doctor.

Dr. Elliot Berlin, DC [31:53] Right, because she seemed almost more anxious than me about the VBAC.

Isabelle Kosciusko [31:56] And I think from that point onwards, I think that was probably around 36 weeks. She apologized and she was really nice about it. And she said, okay, actually, I'm really sorry. This isn't at all the impression I wanna give you. I want you to understand that my priority number one is your health and your baby's health. And, you know, we're in this together. But from that point onwards, our relationship did shift a little bit. But then having said that, again, the baby was still flipping. I got a second opinion from Dr. Chavira and he seemed really experienced in VBACs and a lot of the boxes I take, which is advanced maternal age, quote unquote,

[32:34] VBACs, you know, breach babies. So I contacted him, had a consult with him and he was saying, okay, at this point, first he completely put me back in confidence because at a certain point with my doctor, I started thinking, do I even wanna VBAC? Like she was really scaremongering. And he really put me back in a good mental space with it. And the other thing is he told me when I contacted him at 38 weeks, saying, oh, my baby's head up again, he said, okay, well, after 39 weeks, if he is found to be head down, I would just induce then so that he-

Dr. Elliot Berlin, DC [33:10] Yeah, that's not uncommon, you know, with the flip-flopping.

Isabelle Kosciusko [33:14] Yeah. And I was like, okay, this is what we're gonna do. Having said that, at 39 weeks when he was head down, I tried to get a membrane sweep because I was like, okay, let's get things moving. And the doctor tried and she was like, he's so high up, you can't even do a membrane sweep. So there's no point.

Dr. Elliot Berlin, DC [33:30] That's also something that happens with a large, generous swimming pool, a lot of fluid.

Isabelle Kosciusko [33:36] Really? Yeah, cause I brought my fluids down a little bit from not having sugar down to about 2022, but there was still a lot in there. So yeah.

Dr. Elliot Berlin, DC [33:47] Still a generous swimming pool.

Isabelle Kosciusko [33:49] Exactly. One of the best on the block.

Dr. Elliot Berlin, DC [33:53] Well, all right, but I mean, look, at least with a head down baby, that close.

Isabelle Kosciusko [34:00] Yeah.

Dr. Elliot Berlin, DC [34:01] You have a shot again. And it sounds like with Dr. Shavira in your pocket, you have confidence again.

Isabelle Kosciusko [34:05] Yeah.

Dr. Elliot Berlin, DC [34:06] So potential seems to be building.

Isabelle Kosciusko [34:08] Yeah, totally. I felt more confident, although at that point I felt like case-a-rosse-a, you know, that I couldn't control anything. And I felt like even if he was head down, the next appointment, I'd been through it so many times at that point. I was like, I don't know what's gonna happen in the next appointment. So let's not get too excited either way.

Dr. Elliot Berlin, DC [34:26] For me, it was a roller coaster of emotions and I was just there to support you. But you know, we were texting and emailing you like, yeah, head up, head down, head up, head down. You'd come in, your baby would swim head down and you know, you'd leave it on blank. Okay, she's good. And then all of a sudden, you know, head up, you know, a day later. For me, it was intense. And you know, you're a lovely person. I really feel honored to work with you and I want things to go great for you. But as much as I want that for you, like I cannot begin to imagine, I was actually very, very impressed by how overall level headed you stayed with everything, you know,

[35:03] spiking the peaks and valleys that you went through. I do wanna take one more break and then we come back. We'll find out how this birth actually went down. Welcome back. Well, if you enjoy roller coasters then you're enjoying Isabel's birth story. And at the end, the baby is head down. You try to get a membrane sweep. They can't even reach your cervix. So what happens next?

Isabelle Kosciusko [35:34] Right. So at that point I went home. That was a Friday. This is a Friday before Christmas. And I thought, okay. And at that point I was doing everything I could. I was walking like maybe 15,000 steps a day, just doing all the exercises that I had, like, yeah, everything that I could to keep him head down and to try and induce him naturally. Because I was like, okay, he's head down now. Let's just try and, you know, get things moving. And then I had another appointment on the Monday for just a fetal monitoring appointment again. And just to see where he was at that point because who knows? And so I went in, but I also thought I might get induced

[36:17] based on what Dr. Shavira had said. I thought, well, you know, I'm like 39 plus four at that point. So as Dr. Shavira said, if he's head down, I should just get induced. But I was really trying to tug myself into it. I was not really ready for him to come mentally. I was obviously ready, but I just didn't feel like that was the moment. But I was just trying to go like, yeah, this is it. You know, this is the day, yay.

Dr. Elliot Berlin, DC [36:45] You weren't feeling it.

Isabelle Kosciusko [36:46] Yeah, I wasn't feeling it. But go to hospital, get checked and try and get a membrane sweep. And again, the doctor's like, I can't do a membrane sweep, he's too high. He's lower, but he's still too high. This is not gonna go how you want it to go if we do this. So I can't even touch it anyway. So there's no point in getting induced. And so she sent me home and I got really weirdly, even though that's not what I wanted, I got really emotional about it. I got home. My husband sent our toddler away with her granddad and her grandma to Long Beach where they live. So it was just the two of us and I just couldn't stop crying. I was really upset that I hadn't been induced,

[37:29] even though that's not what I wanted. I just had this huge surge of emotion. Don't get me wrong, I'd been emotional for a lot of this. You know, you were talking about being level-headed. Like I did not feel level-headed at all. I felt completely all over the place for the last two months, but you know, I just got on with it, I guess. But yeah, I just felt like it was like a huge release of emotion. And I was just really upset. I don't know why that I hadn't been induced because I think I just tried to pressure myself to mentally be ready for it. And then when it didn't happen, I was like, oh my God, another week. And also I just felt so huge from, you know,

[38:03] like you feel like your last week's a pregnancy and having all that fluid. So yeah, got really upset, didn't sleep. And the next day was Christmas Eve, went to pick up our toddler in Long Beach, had like a kind of mini Christmas dinner with my husband's family. And I just felt during the day, I kept feeling contractions, but because I completely lost, not completely, but I feel like I'd lost confidence in my ability to read my body because I kept telling my doctor, oh, she was asking me all this all along if you had contractions. And I was telling her, I feel contractions, but they last like five to 10 minutes. And she was saying, well, that's not a contraction then.

[38:42] That's probably something else. So I felt these things that day in particular, I was walking around with my husband, we did a really, really long walk, like maybe 10 miles along the beach to the point I was completely exhausted. But I was just feeling all these things, but then I was like, well, I don't know what it is. Who knows, you know, at that point, I don't really know. And then that night at this dinner, again, I just felt really strong contractions. But then I was like, again, I don't know, maybe this is a good sign, but what do I know? Almost, you know, came back with our toddler and put her to bed and we're watching television and at that point I was just feeling

[39:21] like really intense contractions. And I was on my birth ball kind of furiously trying to relax. And I was just like, okay, well, we just brought our toddler back from Long Beach because we didn't think it was gonna happen anytime soon. So I can't go to hospital now, even though I really felt like I probably should. And I was like, well, also I was at the doctor's yesterday and she told me it wasn't gonna happen, you know, because she couldn't even sweep my membranes. Like this isn't gonna happen now. So I just need to calm down and I'm gonna go to bed. And if I keep feeling like this, I'll just drive to hospital tomorrow, but I can't go now because we just picked our toddler up

[39:56] and, you know, I can't have my father-in-law drive all the way back to pick her up again, two days in a row. So I'm bouncing on the birth ball and my husband is sitting there with me and all of a sudden at 9.30, my water's broke. I just felt like a huge gush and oh my God, oh my God. And Christmas Eve and I stand up and there's just like so much fluid that comes out and also some bloods, which was very disconcerting to me because I did not know that in your amniotic fluids can have blood. So that immediately was quite scary.

Dr. Elliot Berlin, DC [40:32] Nervous.

Isabelle Kosciusko [40:33] Yeah, it was quite scary because I didn't know that piece of information that sometimes, I don't know if it's all the time, but it can be a thing, but I got really scared. Also, I was thinking, well, it's Christmas Eve. I could call my doctor, but I know that the switchboard goes, if it's an emergency call 911 and then based on experience after that, it sends you through to the doctor who's on call, but it takes like five minutes on the switchboards to get you to the doctor on call. And I was like, I don't have five minutes right now. I'm like gushing out blood and water and yeah, I didn't feel confident waiting. So I called 911 and the fire department came over

[41:11] within about five minutes.

Dr. Elliot Berlin, DC [41:12] Well, you don't know how to just have a baby without drama.

Isabelle Kosciusko [41:16] It was very dramatic and it was Christmas Eve and it was just crazy. They all arrived and they were like, checking me, checking the baby's not crowning, luckily not. And then they said, well, you need to go to hospital now. And yeah, so it was kind of funny actually because when they arrived, I was like, yeah, my water's broken. There was lots of blood and they said, where? And my husband, bless him, he didn't really know how to deal with it. So he took the mop out and he was furiously mopping under me. So there was nothing there except what was still coming out and gushes. And yeah, they got a little confused, but we're like, no, it was there,

[41:53] but it's just been mopped up. And he was mopping as I talked. So it was kind of a funny scene. But yeah, everything was fine. I got to the hospital, everything was fine. Got admitted to labor and delivery and spent the night there. And yeah, I got told I was one and a half. When I arrived, got an epidural because it was getting increasingly painful. And initially I thought, I'm not gonna take any medication again. But I'd spoken to a friend who'd gotten induced and she told me, I took an epidural because it really helped me sleep. And at that point I was so exhausted because I hadn't slept the night before. I was like, you know what? It's not gonna come in my favor if I don't do this.

[42:33] If I try and be a hero and not take an epidural and try and deal with this throughout the night, I just feel so tired already and I'm only one and a half centimeters. It's just not gonna work in my favor. So I got an epidural and I was able to just really relax and sleep and listening to meditations. In fact, I listened to your birth meditation like throughout the night, like about 50 times. And I was listening to sounds of the ocean and just going in and out. And it was actually amazing. It was really beautiful. It was like a psychedelic journey. I wanna describe it for me, that part of labor. I really, really just loved it. Being like half awake, half asleep

[43:13] and just feeling my baby, working through it together. It was really amazing. And the other amazing thing that happened, a doctor called Dr. Fabi, who's like a kind of holistic. Yeah, very sort of like a midwife OB. So she was like my dream doctor, but I wasn't able to get her. But I'd heard a lot about her and I always thought I was very much aligned with her principles of natural birth. Like, you know, just her principles. And I'd never met her. I tried to have a consult with her when the baby was flip-flopping, but I was too far down and I think she has quite a long wait list. And lo and behold, in the middle of the night, when I get checked once,

[43:55] they said you need to get a UPCI or a PCI.

Dr. Elliot Berlin, DC [43:58] Oh yeah, to monitor the pressure, look at the internal.

Isabelle Kosciusko [44:01] Right, yeah, exactly. At about 6 a.m., they said, okay, you haven't really dilated much, so you need to get a pitocin and we need to put one of these in. And I was kind of like in my head going, oh, like intervention, intervention. And I was like, no, just calm down. Like, okay, let's just do this. It's fine, I've got it. You know, I've got it under, it's fine. So I said, okay. And lo and behold, Dr. Fabby walks in and she's like, hi, I'm Dr. Fabby.

Dr. Elliot Berlin, DC [44:27] Oh, so she came to your birth anyway.

Isabelle Kosciusko [44:29] I had no idea that she worked at the hospital where I gave birth and I was so ecstatic. I was just like, oh my God. Like, I feel like I probably scared her away. I was like, oh my God, I love you. I know you. And she was a bit like, oh, hi. Anyway, she was amazing. She was really, all the doctors I will say that I saw during that birth were really wonderful because there were the doctors on call because it was Christmas. Yeah, and then she was like, oh, you're already three centimeters. Like, you're totally gonna do this. It's totally fine, you've got it. And fitted the little instrument and just left. And I was just texting my friend at that moment

[45:07] who's one of her clients. And I was just, this is unreal. I was texting her a minute before she walked in and I was like, oh my God, Dr. Fabby just walked in. And that just said, yeah. I felt like it was also just another magical moment for me, carried on. And then I was just progressing really well. Like every time they'd check me, they were like, okay, you're five, you're six. Just carry on, relax. And I would just carry on and relax. And then at about midday, I guess like around one or two, finally the nurse came in and I was, the last check they'd given me was about eight or nine. And I was like, you know, I just feel different. Like, can you check me?

[45:48] And she said, well, we're not supposed to check you for another half hour, but I can if you want. And I said, yes, please do. Cause I feel different. And she checked and she said, oh, you're complete. You know, we can start the pushing.

Dr. Elliot Berlin, DC [45:59] Oh my goodness.

Isabelle Kosciusko [46:01] Yeah, I was so happy. It was really just an amazing experience, that labor.

Dr. Elliot Berlin, DC [46:06] How did the pushing go?

Isabelle Kosciusko [46:08] It went fine. It was an hour, you know, it was my favorite part, but yeah, we got through it. And then the baby came out and he was healthy. I think like eight pounds, 10 or something like that. Yeah, that's the other thing is all along, they kept telling me all through the pregnancy, oh, he's in the 99th percentile. He's like a huge baby. He's gonna be, you know, 10 pounds, whatever. And he was eight pounds, 10. Even one of the nurses who was actually amazing, but she was like, okay, let's get this giant baby out. Like, can you not say that? Like, but yeah, he was healthy. He was just fine. I mean, he was beautiful. Everything was great, so.

Dr. Elliot Berlin, DC [46:49] Okay, well now there was a big payoff cause now I have all sorts of tingles going through my body. I mean, what was that moment like when you were with the baby out and held your baby?

Isabelle Kosciusko [46:58] It was so special. It was really amazing. And yeah, I just kind of felt also like, oh, was that it? You know, I felt like, I don't know. I just felt like after like my experience with the first one, it had become such a huge thing that I just thought there was all this like huge amount of pain involved and then overwhelming. And then I just thought actually once it was done, I felt like the pushing phase was actually pretty short, not short, but not too long. And I was just proud and happy.

Dr. Elliot Berlin, DC [47:26] Yeah. I'm so happy for you.

Isabelle Kosciusko [47:28] Thank you.

Dr. Elliot Berlin, DC [47:29] As we're winding down, like what's your takeaway from your experiences?

Isabelle Kosciusko [47:33] I mean, my takeaway is if you want something to just carry on trucking through for a V-bag, just carry on like inform yourself and also just carry on believing, you know, because I feel like I had a lot of the flip-flopping and being advanced maternal age and having a doctor that wasn't really holistically minded and all these things felt like a little bit stacked against me. But you know, if you think you can do it, it's not gonna work every time. I'm not under any illusion, but at the same time, I feel like at a certain point, it was letting go and believing that you can do it and just trying to do all the little steps that you can to make it happen your way.

[48:16] And then after that point, you just have to let it go and let it happen how it's gonna happen.

Dr. Elliot Berlin, DC [48:21] Well said. I feel honored to have been a part of your journey.

Isabelle Kosciusko [48:25] Thank you so much. Thank you for your help.

Dr. Elliot Berlin, DC [48:27] My pleasure. And thank you for joining us and sharing your story, you know, the ups and downs and the persistances. It's inspiring. And I think a lot of elements of your story will relate to people who listen to the podcast and your takeaway message to get informed is also wonderful. I wish there was some kind of podcast that could help with that. I don't know, I'm thinking about you. Thank you again.

Isabelle Kosciusko [48:52] Thank you so much for having me.

Dr. Elliot Berlin, DC [48:53] My pleasure. At home, thanks for listening to the Informed Pregnancy podcast for more pregnancy and parenting information. Just like this, visit us online at informedpregnancy.com.

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