What are the real barriers to VBAC, and are they evidence-based or built on fear and bias? In Part 2 of this powerful two-part series, Dr. Kathleen Kendall-Tackett continues her conversation with Australian midwife, researcher, and author Dr. Hazel Keedle. They dive deeper into the systemic, emotional, and clinical roadblocks that women face when planning a vaginal birth after cesarean (VBAC).
From BMI bias to short interpregnancy intervals, big babies to special scars, Dr. Keedle unpacks the often-coercive medical narratives and exposes the power imbalances that still plague maternity care. She shares groundbreaking insights from her research and emphasizes how control, trust, and informed choice are key to transforming birth trauma into empowered birth experiences, whether or not a VBAC is achieved.
If you care about evidence-based, respectful, trauma-informed maternity care, this episode isa must listen.
In This Episode:
(00:00) Introduction to The Science Chick Report
(00:29) Concerns about inductions and VBAC barriers
(01:01) Body mass index and VBAC calculators
(01:28) Fat shaming in maternity care
(06:07) Impact of birth experience on mothers
(06:52) Challenges with big babies and VBAC
(09:16) Interpregnancy interval and VBAC
(12:07) Multiple cesareans and VBAC support
(16:30) Breech birth and ECV options
(18:07) Hospital policy changes and breech births
(19:28) Understanding special scars
(22:45) Birthplace choices: hospital, birth center, or home
(27:15) The importance of control during birth
(29:39) Positive birth experiences: beyond the outcome
(35:58) Final thoughts and resources
Notable Quotes:
(01:45) "A higher score was more chance of a VBAC the thinner you were. And it really went to quite a ridiculous weight." – Dr. Hazel Keedle
(04:24) "What annoys me is that this is about the baby and not the woman. We want to get the baby out of this woman who's larger and, you know, if she has complications afterwards, whatever, that's her fault." – Dr. Hazel Keedle
(05:31) "A live mother may well have a pulse. However, she can be traumatized." – Dr. Hazel Keedle
(12:15) "The data is very supportive for two. One or two cesareans…potentially the more caesareans you've had, the higher chance you've got of a uterine rupture." – Dr. Hazel Keedle
(22:58) "Sometimes being in a hospital doesn't feel safe for women, especially when they've had previous birth trauma." – Dr. Hazel Keedle
(25:58) "We're treating them like terrorists and they just wanted to have a natural birth.” – Dr. Hazel Keedle
(31:56) "You can have a cesarean and feel amazing. You can have a cesarean and feel bad, you can have a VBAC and feel amazing. You can have a VBAC and feel bad." – Dr. Hazel Keedle
(35:37) “There were women who had cesareans that felt okay about them, women who had vaginal births that described them as rapes.”– Dr. Hazel Keedle
Our Guest
Dr. Hazel Keedle is a Senior Lecturer of Midwifery at the School of Nursing and Midwifery, Western Sydney University. With over 25 years of midwifery experience, she completed her PhD in 2021, focusing on vaginal birth after cesarean (VBAC). Hazel is the author of Birth After Caesarean and The VBAC Clinician’s Guide. Her work blends research and lived experience to promote trauma-informed, evidence-based maternity care.
Resource and Links
Podcast
The Science Chick Report
Dr. Hazel Keedle
Dr. Kathleen Kendall-Tackett
Mentioned
INOSS Study – Largest European data on uterine rupture (0.22% rate)
Sarah Wickham – Plus Size Pregnancy
Interpregnancy Interval Study (Australia)
Special Scar Research Project (Qualitative study on uterine rupture)
Ever wondered what drives women to choose vaginal birth after cesarean (VBAC)? In this powerful first part of a two-part series of The Science Chick Report, Dr. Kathleen Kendall-Tackett sits down with Australian midwife, researcher, and author Dr. Hazel Keedle for an honest, eye-opening conversation about the challenges surrounding birth after cesarean, also known as VBAC. Drawing from her own experience, groundbreaking research, and two widely acclaimed books, Dr. Keedle explains why VBAC isn’t just a medical choice; it is a deeply personal and often political journey toward reclaiming power and autonomy.
Together, they dive into the complex mix of triumph and trauma that many people face in maternity care. They talk candidly about birth trauma, debunk some of the most stubborn myths about VBAC, and call out coercive practices that still get in the way of informed choice. This episode is a must-listen for anyone passionate about respectful, trauma-informed maternity care and making sure women’s voices are truly heard, especially in a system that too often tries to quiet them.
Be sure to tune in to Part 2, where Dr. Kendall-Tackett and Dr. Keedle continue this vital conversation and explore practical ways to support women on their VBAC journeys.
In This Episode:
(00:02) Introduction and guest background
(02:08) Dr. Keedle’s personal VBAC story and research motivation
(05:06) Book cover imagery and symbolism
(06:57) Stories of triumph and community
(08:28) Defining VBAC and its importance
(11:21) Women’s motivations for VBAC
(12:31) Birth trauma: prevalence and impact
(13:18) Factors contributing to birth trauma
(16:32) Obstetric violence and blame
(19:22) Comparing models of care
(20:13) Fear tactics and coercion in VBAC counseling
(22:00) Actual risks of uterine rupture
(23:59) Conclusion and closing remarks
Notable Quotes:
(03:37) "When I pushed my baby out, I felt amazing. I felt like I had just, I don't know, I'd won Olympic gold." – Dr. Hazel Keedle
(06:16) "I felt like it was a bit of a secret language that was going on in the VBAC world." – Dr. Hazel Keedle
(11:56) "The biggest reason was to experience birth, to go through that experience and have that experience." – Dr. Hazel Keedle
(16:58) "What's the high expectation is that you get treated with respect. The high expectation is that you make an informed decision." – Dr. Hazel Keedle
(22:31) "If your wife plans a VBAC, you will end up with a dead baby, a dead wife, and a toddler to raise on your own." – Dr. Hazel Keedle
Our Guest
Dr. Hazel Keedle is a Senior Lecturer of Midwifery at the School of Nursing and Midwifery, Western Sydney University. With over 25 years of midwifery experience, she completed her PhD in 2021, focusing on vaginal birth after cesarean (VBAC). Hazel is the author of Birth After Caesarean and The VBAC Clinician’s Guide. Her work blends research and lived experience to promote trauma-informed, evidence-based maternity care.
Resource and Links
Podcast
The Science Chick Report
Dr. Hazel Keedle
Dr. Kathleen Kendall-Tackett
Mentioned
INOSS Study – Largest European data on uterine rupture (0.22% rate)
Birth Trauma Inquiry – New South Wales, Australia
Did you know that during the peak of COVID-19 in New York City, 67% of frontline healthcare workers reported moderate to high levels of moral injury-related guilt?
In this debut episode of The Science Chick Report, Dr. Kathleen Kendall-Tackett takes a closer look at something we haven’t talked enough about: how the COVID-19 pandemic impacted the emotional well-being of healthcare providers. Specifically, she focuses on moral injury—a term originally used in military settings—that helps explain what many frontline workers experienced during the crisis.
Through a review of 36 studies from around the world, Dr. Kathleen Kendall-Tacket shares how nurses, physicians, and other care providers felt deep distress when they couldn’t give the care they knew their patients needed. Many described feeling helpless, unsupported, and in some cases, betrayed by their institutions. These aren’t just signs of stress or burnout—they point to something more complex and lasting.
But it’s not all bad news. Dr. Kendall-Tackett also highlights what helped: strong team support, open communication from leadership, and practical resources that made people feel valued. She wraps up the episode by encouraging organizations to reflect on what went wrong, take meaningful action, and commit to supporting their teams—not just in a crisis, but every single day.
This episode is a powerful reminder that behind every hospital badge is a human being—and that caring for healthcare providers is just as essential as caring for the patients they serve.
In This Episode:
[00:00] Introduction
[01:16] Defining moral injury and its origins
[02:21] Applying moral injury to healthcare providers
[03:22] COVID-19 policies and institutional collapse
[04:30] Moral injury in healthcare vs. military
[05:29] Frontline experiences during COVID-19
[06:47] Emotional impact and patient isolation
[07:56] Moral injury in maternity care
[09:07] Prevalence and effects of moral injury
[10:23] Institutional betrayal and burnout
[11:37] International perspectives on betrayal
[12:44] Burnout as a unique outcome in healthcare
[15:10] Resilience and protective factors
[16:17] Organizational lessons and recommendations
[17:32] Individual and organizational healing
[18:33] Conclusion and resources
Notable Quotes:
[01:45] "Moral injury is not a diagnosis yet, but it recognizes that people in combat experience symptoms beyond PTSD, dealing with issues of right and wrong." – Dr. Kathleen Kendall-Tackett
[02:51] "They felt that patient care was severely compromised, and they were witness to it but couldn't do anything to stop it.." – Dr. Kathleen Kendall-Tackett
[08:12] "In extreme cases, staff can feel that they have become instruments of inhumane treatment of women and babies, active perpetrators of psychological and physical harm." – Dr. Kathleen Kendall-Tackett
[11:25] "We got a lot of lip service and no actual action. It was demoralizing and disheartening.s." – Dr. Kathleen Kendall-Tackett
[12:39] “If I die, they don't care. They'll just get somebody else in my shoes tomorrow.”– Dr. Kathleen Kendall-Tackett
[18:44] "Apologize for what happened. That really goes a long way toward repairing relationships and re-establishing trust with your staff and your team." – Dr. Kathleen Kendall-Tackett
Resource and Links
Podcast
The Science Chick Report
Dr. Kathleen Kendall-Tackett
Referenced Studies
Fisher et al. (2022) – NYC frontline moral injury and guilt
Hors et al. – Swiss maternity providers and ethical trauma
Nieuwsma et al. (2022) – Comparison of veterans and healthcare workers
U.S. & Netherlands ICU provider studies
NHS (UK) nurse experiences with systemic betrayal
Hosted by Dr. Kathleen Kendall-Tackett, The Science Chick Report brings women’s health research you can trust to the people holding it all together: birth workers, lactation consultants, doulas, midwives, mental health providers, and nurses. Every episode turns the latest science into practical tools, helping you advocate, recover, and stay grounded in the work you love, even when it feels like you’re doing it alone.