The VBAC Link · Lily Wyn & Paige Lloyd

Episode 450 Midwife Katie's Birth Center VBAC + Shoulder Dystocia HBAC & BIG Baby + Cesarean Awareness Month

April 1, 2026·1 hr 3 min·5 clips

Katie pushed for 90 minutes in the tub, delivered her large baby at the birth center, and her first words—charted in her record—were '32% my ass, Dr. Kahn.'

1. The VBAC Link Episode 450, aired during Cesarean Awareness Month, features Katie, a certified professional midwife from Southern Oregon, sharing her first C-section and two subsequent out-of-hospital VBACs. 2. Hosts Paige and Lily open by acknowledging the emotional complexity of Cesarean Awareness Month—Lily describing early feelings of frustration at being part of yet another 'awareness month'—before framing it as a space to honor and hold grief. 3. Katie's first birth in May 2020 was complicated by COVID restrictions that canceled her hospital doula program, her childbirth class, and allowed only her partner as support; she labored in a hospital with large birth tubs but ultimately agreed to an epidural after stalling in transition. 4. After napping through the epidural, Katie woke up complete and pushed three to four hours before her OB noted the baby's heart rate pattern and suggested a C-section; Katie cried and agreed, describing it as her worst nightmare, though both she and baby had no serious complications. 5. Katie reacted poorly to morphine postpartum and was not fully present for the first 12 hours after birth; she left the hospital four to five days later and struggled emotionally despite a healthy outcome, deciding immediately that she did not want another C-section unless necessary. 6. Before her second pregnancy, Katie visited a birth center in Southern Oregon—the only out-of-hospital birth center in her area—interviewed a midwife before she was even pregnant, and committed to delivering there; her first baby had been sunny-side up (OP presentation), and she focused her second pregnancy preparation on positioning. 7. At a 35-week MFM consult for her second pregnancy, with her baby measuring in the 92nd percentile, the doctor told Katie that if anything went wrong at the birth center, 'your baby's dead and you're next,' and the VBAC calculator gave her a 32% chance of success. 8. Katie ignored both warnings, went into labor after using the midwives brew at 40 weeks and two days, labored for 11 hours, and arrived at the birth center at nine centimeters after a 45-minute drive in transition, with her doula, her mother, and her best friend all present. 9. Katie pushed for 90 minutes in the birth center tub, delivered her son vaginally, and said immediately afterward, '32% my ass, Dr. Kahn'—a quote her midwife charted in her medical record; she describes this birth as checking every box she had hoped for. 10. Six weeks after her first VBAC, Katie asked to work at the birth center; she completed doula training at two months postpartum, took a few doula clients, then began a certified professional midwife apprenticeship through the PEAK process in January 2023 when her son was six months old. 11. Katie became a full-time birth assistant on call 24/7 by May or June 2023, attending five to seven births per month, and completed her required birth count, exam count, and clinical situations ahead of the two-year minimum timeline. 12. Katie passed her national CPM licensing exam in January 2025 and received state licensure, becoming a practicing midwife at the same birth center where she had her first VBAC. 13. For her third pregnancy—conceived in March 2025, about six weeks after licensing—Katie planned a home birth offered by her midwife colleague and employer, the first pregnancy she did not have a growth ultrasound because as a VBAC on a standard consult schedule, one was not required. 14. The same MFM doctor, now a colleague, ran the VBAC calculator at her request during the third pregnancy and got approximately 92%, saying it would be 'criminal' to perform another C-section; he acknowledged he presents risks as a professional obligation but is personally supportive of out-of-hospital birth. 15. Katie labored starting December 26th after a membrane sweep and a single dose of castor oil; contractions started close together but mild, and her team arrived at 10 PM when she was five centimeters. 16. Progress stalled dramatically—from five centimeters at 10 PM to six centimeters at 2 AM—then Katie rapidly reached nine centimeters and requested her water be broken, which released a large amount of fluid suggesting possible polyhydramnios. 17. After the rupture, Katie entered the tub but no baby appeared; she tried multiple positions, developed intense back labor, and at 6 AM received an IV for energy while repeatedly telling her team 'something is different'—comparing the experience unfavorably to her previous VBAC. 18. Katie explains from a midwife's perspective that her birth center has emergency transport protocols, maintains strict low-risk parameters, keeps an ambulance service nearby, and has worked to train local EMTs on midwife-assisted birth calls; the local large hospital across the street regularly receives transfers from out-of-hospital providers. 19. The episode is warm and clinically informed, with Katie moving fluidly between recounting her own emotional experiences and providing midwifery-level context for the decisions made around her care. 20. Women considering out-of-hospital VBACs—especially those who have been given low statistical odds or discouraging language by MFM specialists—and birth workers curious about the CPM training path will find this episode directly applicable.

As heard by us

A practical VBAC discussion about transfer care, hospital bias, and community support.

This discussion centers on VBAC prep, cesarean awareness month, transfer care, and the realities of rural maternity support. It acknowledges hospital bias, including the sense of being treated as the unsafe patient, while also showing how midwives build trust through EMT and…

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Listen for a VBAC story that meets hospital reality head-on.

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