Allie's Birth
What was the reason for your initial Cesarean birth?
My body wasn't ready for labor, but I asked my OB to induce me. She
really didn't want to... she encouraged me to wait a few more days. According
to her my cervix was "high and tight." However, she agreed to induce and after hours and hours of labor, hardly
getting anywhere, Charlie, my baby, just wasn't making it down the birth canal.
Even when I was 10 cm dilated, I pushed for three hours and he was too far
up the birth canal and also his face was turned toward my inner
thigh... so after unsuccessfully attempting vaginal birth with the vacuum, my OB said we needed to just get him
out.
Why did you choose a VBAC?
Honestly, I wanted a VBAC
soooooo bad... mostly for the reason that so many doctors I know of won't do more
than three Cesareans, resulting in no more than three babies if you go with
those doctors, and I really wanted the option for four babies if possible.
What were your fears and concerns (if any)?
I
think going into it, I was scared and so desiring a VBAC, but also
trying to hold it with an open hand, not wanting there to be any
frustration about the birth or negative feelings surrounding Joey's
arrival. But, I wanted it so bad and felt like I
had done certain moves, hired a doula, etc. to do my part to make it
happen and then just let the rest go.
What was the biggest challenge during pregnancy and then during labor and birth?
This pregnancy with Joey so different from my first pregnancy with Charlie. Starting at 34 weeks, I was already
dilated 2-3 cm. At 38 weeks I went in and my OB said, "You
are 6 cm dilated! This is crazy! I can't in good conscience keep
letting you walk around like this!"
I was induced shortly thereafter. Similar to Charlie, my body
wasn't going into labor. This time, though, my cervix was at least ready, but my
body wasn't cooperating. I called my doula and she met me at the
hospital. They broke my water and immediately my contractions came on. After an hour of contractions, I opted for the epidural and within an
hour I was 10 cm. My OB asked me if I wanted to let his head come
down further or if I wanted to start pushing. I asked Morgan, my doula, and she suggested that I just try a few pushes and if we needed to stop
and let him progress further, we could. I started
pushing. Morgan was an incredible support and there was one point where she
said something (I don't remember what) that made me think I could
actually do this. I think maybe that she could see his head and that I was
pushing correctly and making progress. I was so
encouraged. The best thing she told me in terms of pushing was to try
and poop. I think most women are so scared to actually poop while
delivering, but she made it seem completely normal and said if I could
actually poop, then that's the exact right type of pushing I needed to
be doing. My last labor people kept saying 'bear down' and I had no
idea what they meant. After a half an
hour, there he was! It was wonderful. I called my mom immediately
and just started crying and whispered, 'He's here! He's here! I did it,
mom!!"
It still remains one of the biggest accomplishments of my life.
How did you prepare for your VBAC?
I interviewed a couple doulas and none of them ended up working out
for me. Then I asked a girl I knew who is a L&D nurse if she would be my doula and she said yes. It was
the perfect fit for me. It took so much pressure off my husband, Josh.
How did you find your care provider and were they VBAC supportive? If
so- how? If not, did you think they were and they ended up not being
so? How did you respond?
I think my OB was relatively supportive, but I'm not sure that she has strong
feelings against C-sections. From some of our conversations prior, I
wonder if she's had a patient lose a baby in childbirth because
I think she wanted to let me have a VBAC, but also seemed to just want the baby
out.
What would you say to a woman who's considering a VBAC? How would you encourage her?
I would say- you can do it! I would encourage women to not just opt for the Cesarean because of fear of what might
happen if you ended up needing a repeat C-section. Most of my friends at least, have just scheduled their second C-section because they're afraid of having to have another
emergency or unexpected one... but they have no idea what could happen this time
around!! So, I think I would just say go for it and if you need another C-section, no big deal... you've done that before and everything
worked out OK.
4.30.2013
4.15.2013
Why I Chose a VBAC :: Megan
Megan's Birth
(Megan is an MD who specializes in Obstetrics and Gynecology... she did want to clarify that she is sharing her story and not implying that a VBAC will apply to everyone)
What was the reason for your initial Cesarean birth?
Fetal Bradycardia
Why did you choose a VBAC?
Spontaneous vaginal delivery is the safest mode of delivery after one Cesarean. This is followed by elective Cesarean, but I wanted to optimize my chances of having more than two kids.
What were your fears and concerns (if any)?
Placenta accreta is a life threatening concern for any VBAC-ing woman. I made sure my placenta was not on the front of my uterus, where it would have the potential to grow into my previous Cesarean scar and cause life threatening bleeding. Uterine rupture is a second major complication with VBAC, and the most common presentation is uterine scar pain. I paid close attention and never had this. I was also three years out from my previous Cesarean which makes a big difference.
What was the biggest challenge during pregnancy and then during labor and birth?
Ironically I had a thankfully A+ delivery this time. The first labor caused all of us a bit of Post Traumatic Stress Disorder. For this entire pregnancy, I worked hard to eliminate family members and friends' discouraging thoughts. I surrounded myself with realistic encouraging resources to help me cope with different stages of labor. I also explained a lot to my husband so he could help me in labor this time without being overwhelmed with anxiety.
How did you prepare for your VBAC?
I worked until the night before I went into labor- very literally. I read about Gate Theory for coping with pain: the brain can only process so much input at one time. If overwhelmed by pressure on the lower back or another sensation, pain gets 'forgotten' essentially. I decided I DID want an epidural so that in case I needed emergent Cesarean, my anesthesia would be ready. I planned to cope with pain in a variety of ways, planning to delay epidural until active labor of 6-8 cm, not breaking my water until at least 6 cm. Until the epidural, my husband pressed on my lower back for every painful contraction, until I was 4 cm, then I got one shot of Nubain, which took me to 6 cm, at which point I got an epidural.
How did you find your care provider and were they VBAC supportive? If so- how? If not, did you think they were and they ended up not being so? How did you respond?
My OBGYN doctor already was supportive, thankfully. So was her group.
What would you say to a woman who's considering a VBAC? How would you encourage her?
I would say that every woman and her condition is different. Reading about this topic and how each woman's condition applies is very important. The inherent risks associated with VBAC need to really be taken into consideration. That being said, every woman needs to consider why she really truly wants a VBAC. Do I think avoiding a Cesarean to be "au naturale" is worth putting my life on the line? No. Do I think that if I'm planning to have 3 or more kids, that avoiding surgery on my uterus is worth it? Yes. VBAC works best when labor happens on its own. Additionally, every woman ideally would like a healthy baby; and so with being a VBAC, it's important to accept up front that a Cesaeran might be the best option at some point for a healthy baby. If that's the case, women should take pride that they've made the correct decision for their baby's safety. Guilt can start springing up for WHATEVER reason here, or the sensation that "I did something wrong", but taking pride in protecting a baby when a Cesarean is imminent is the beginning of a parent's opportunity to nurture someone special, and there is definitely no shame in that!
(Megan is an MD who specializes in Obstetrics and Gynecology... she did want to clarify that she is sharing her story and not implying that a VBAC will apply to everyone)
What was the reason for your initial Cesarean birth?
Fetal Bradycardia
Why did you choose a VBAC?
Spontaneous vaginal delivery is the safest mode of delivery after one Cesarean. This is followed by elective Cesarean, but I wanted to optimize my chances of having more than two kids.
What were your fears and concerns (if any)?
Placenta accreta is a life threatening concern for any VBAC-ing woman. I made sure my placenta was not on the front of my uterus, where it would have the potential to grow into my previous Cesarean scar and cause life threatening bleeding. Uterine rupture is a second major complication with VBAC, and the most common presentation is uterine scar pain. I paid close attention and never had this. I was also three years out from my previous Cesarean which makes a big difference.
What was the biggest challenge during pregnancy and then during labor and birth?
Ironically I had a thankfully A+ delivery this time. The first labor caused all of us a bit of Post Traumatic Stress Disorder. For this entire pregnancy, I worked hard to eliminate family members and friends' discouraging thoughts. I surrounded myself with realistic encouraging resources to help me cope with different stages of labor. I also explained a lot to my husband so he could help me in labor this time without being overwhelmed with anxiety.
How did you prepare for your VBAC?
I worked until the night before I went into labor- very literally. I read about Gate Theory for coping with pain: the brain can only process so much input at one time. If overwhelmed by pressure on the lower back or another sensation, pain gets 'forgotten' essentially. I decided I DID want an epidural so that in case I needed emergent Cesarean, my anesthesia would be ready. I planned to cope with pain in a variety of ways, planning to delay epidural until active labor of 6-8 cm, not breaking my water until at least 6 cm. Until the epidural, my husband pressed on my lower back for every painful contraction, until I was 4 cm, then I got one shot of Nubain, which took me to 6 cm, at which point I got an epidural.
How did you find your care provider and were they VBAC supportive? If so- how? If not, did you think they were and they ended up not being so? How did you respond?
My OBGYN doctor already was supportive, thankfully. So was her group.
What would you say to a woman who's considering a VBAC? How would you encourage her?
I would say that every woman and her condition is different. Reading about this topic and how each woman's condition applies is very important. The inherent risks associated with VBAC need to really be taken into consideration. That being said, every woman needs to consider why she really truly wants a VBAC. Do I think avoiding a Cesarean to be "au naturale" is worth putting my life on the line? No. Do I think that if I'm planning to have 3 or more kids, that avoiding surgery on my uterus is worth it? Yes. VBAC works best when labor happens on its own. Additionally, every woman ideally would like a healthy baby; and so with being a VBAC, it's important to accept up front that a Cesaeran might be the best option at some point for a healthy baby. If that's the case, women should take pride that they've made the correct decision for their baby's safety. Guilt can start springing up for WHATEVER reason here, or the sensation that "I did something wrong", but taking pride in protecting a baby when a Cesarean is imminent is the beginning of a parent's opportunity to nurture someone special, and there is definitely no shame in that!
4.14.2013
Why I Chose a VBAC :: Kristi
Kristi's Birth
What was the reason for your initial Cesarean birth?
My firstborn was footling breech at 39 weeks.
Why did you choose a VBAC?
Honestly, I was much more afraid of having another needle in my spinal cord than of giving birth naturally. Also, I had a mild allergic reaction to the morphine in my spinal, and my memories of the first few hours after my son's birth are hazy, at best. I did not want to repeat that experience.
What were your fears and concerns (if any)?
My biggest fear was that I wouldn't be able to have a VBAC. Since I hadn't "given birth" before, I was worried that I wouldn't go into labor and that I'd end up having another Cesarean. I think I walked around 300 miles the last week of my pregnancy trying to jump start contractions!
What was the biggest challenge during pregnancy and then during labor and birth?
I was sick throughout my entire pregnancy. By 40 weeks, I was so tired of throwing up that I was eagerly anticipating labor and birth. The biggest challenge the night my daughter was born was finding an open entrance to the hospital at 1am (funny story now - not so funny at the time!). My labor was very quick, 5 hours total, and I was already at 7 cm by the time we got to the L/D floor, so it would have been a natural birth even if I hadn't wanted one!
How did you prepare for your VBAC?
How did you find your care provider and were they VBAC supportive? If
so- how? If not, did you think they were and they ended up not being
so? How did you respond?
Fortunately, my OB/GYN is VBAC supportive. He performed my C-section and knew the circumstances surrounding that experience, so he was very encouraging about my VBAC request. He also shared that one of the reasons he supports VBACs is that the hospital where I was going to deliver has an anesthesiologist on site 24 hours a day (versus just having one on call), so he knew that if things started to go badly for whatever reason (fetal distress, rupture, etc.) he could do an emergency C-section very quickly. It was also comforting to me that my OB delivers all of his patients' babies instead of rotating nights with the partners in his medical practice. Thus, I knew that I wouldn't have to do battle with one of his colleagues (who is less VBAC supportive) when I went into labor.
What would you say to a woman who's considering a VBAC? How would you encourage her?
Do it! I had a very easy recovery from my Cesarean (didn't need prescription pain meds, just Motrin for a few days afterwards), but the recovery from the VBAC was still so much better. It is truly a night and day difference. Also, my daughter was so much more alert immediately after birth, and she latched on and breastfed for a half hour right away. The VBAC was such a better experience all around (for both my daughter and me) that I would strongly, strongly encourage it. Finally, I would recommend doing some research to dispel the "once a C-section, always a C-section" myth and put concerns about uterine rupture in their proper place.
What was the reason for your initial Cesarean birth?
My firstborn was footling breech at 39 weeks.
Why did you choose a VBAC?
Honestly, I was much more afraid of having another needle in my spinal cord than of giving birth naturally. Also, I had a mild allergic reaction to the morphine in my spinal, and my memories of the first few hours after my son's birth are hazy, at best. I did not want to repeat that experience.
What were your fears and concerns (if any)?
My biggest fear was that I wouldn't be able to have a VBAC. Since I hadn't "given birth" before, I was worried that I wouldn't go into labor and that I'd end up having another Cesarean. I think I walked around 300 miles the last week of my pregnancy trying to jump start contractions!
What was the biggest challenge during pregnancy and then during labor and birth?
I was sick throughout my entire pregnancy. By 40 weeks, I was so tired of throwing up that I was eagerly anticipating labor and birth. The biggest challenge the night my daughter was born was finding an open entrance to the hospital at 1am (funny story now - not so funny at the time!). My labor was very quick, 5 hours total, and I was already at 7 cm by the time we got to the L/D floor, so it would have been a natural birth even if I hadn't wanted one!
How did you prepare for your VBAC?
I found a doula that I really liked and also talked to my OB/GYN about it at every appointment.
Fortunately, my OB/GYN is VBAC supportive. He performed my C-section and knew the circumstances surrounding that experience, so he was very encouraging about my VBAC request. He also shared that one of the reasons he supports VBACs is that the hospital where I was going to deliver has an anesthesiologist on site 24 hours a day (versus just having one on call), so he knew that if things started to go badly for whatever reason (fetal distress, rupture, etc.) he could do an emergency C-section very quickly. It was also comforting to me that my OB delivers all of his patients' babies instead of rotating nights with the partners in his medical practice. Thus, I knew that I wouldn't have to do battle with one of his colleagues (who is less VBAC supportive) when I went into labor.
What would you say to a woman who's considering a VBAC? How would you encourage her?
Do it! I had a very easy recovery from my Cesarean (didn't need prescription pain meds, just Motrin for a few days afterwards), but the recovery from the VBAC was still so much better. It is truly a night and day difference. Also, my daughter was so much more alert immediately after birth, and she latched on and breastfed for a half hour right away. The VBAC was such a better experience all around (for both my daughter and me) that I would strongly, strongly encourage it. Finally, I would recommend doing some research to dispel the "once a C-section, always a C-section" myth and put concerns about uterine rupture in their proper place.
4.04.2013
Why I Chose a VBAC :: Patty
Patty's Birth
What was the reason for your initial Cesarean birth?
The reason for my C-section was the baby's heart rate dropped too low for too long, and despite manual stimulation, they were unable to stabilize him. I had been in labor for about 18 hours at this point and was 6cm. Ultimately, the reason for the C-section was being induced too early (the doctor broke my water to initiate labor) even though I had no medical issues for induction. Now I know:-) And, based on my first VBAC, I do believe cervical scar tissue was a factor as well.
Why did you choose a VBAC?
I chose a VBAC for several reasons. One, I had a VERY tough recovery from the C-section, both physically and emotionally, and I just knew birth didn't have to be like that. Second, I felt very inadequate after the C-section. Like something was wrong with me and my body. Third, I felt like cattle being shuffled around during my C-section birth and knew that I wanted a birth where I felt in control of the process/decisions, etc. And, finally, I felt like it would help me heal from the emotional scars of my C-section.
What were your fears and concerns (if any)?
My biggest fear in preparing for the VBAC was uterine rupture. That is, until I did my research and got a supportive doctor. Once I learned how rare it really is and that there would be warning signs, I really felt very comfortable that I was an ideal candidate and had a great chance of being successful.
The biggest challenge during pregnancy was overcoming my mental fears. No matter how much research I did, there was always a voice in the back of my head thinking that I must be missing something!
What was the biggest challenge during pregnancy and then during labor and birth?
The biggest challenge during delivery was second guessing myself after 17 hours of labor and seeing the same signs as before... only 6cm dilated. Once my doctor rubbed out scar tissue, I dilated and birthed within a few hours! After the 17 hours, I got an epidural and was really upset because I thought that meant I wasn't going to be successful. Having a doula there was great because she reminded me my goal was to have a VBAC, not no epidural. She assured me that a VBAC was possible with an epidural so she helped so much to get me through it mentally.
How did you prepare for your VBAC?
I prepared by hiring a doula, joining ICAN and going to meetings, hearing all the success stories I could and reading absolutely all the data available.
How did you find your care provider and were they VBAC supportive? If so- how? If not, did you think they were and they ended up not being so? How did you respond?
I found my doctor through referrals from ICAN. Yes, he was VERY VBAC supportive! At the first appointment, he said, "you can and will have this baby through your vagina!!" I knew it was the right fit. He never discussed a C-section with me. He never discussed "due dates" or anything like that. Instead, he said, "the baby will come when he's ready," and... he did!
What would you say to a woman who's considering a VBAC? How would you encourage her?
EDUCATE yourself. Hire a doula. Find a supportive care provider based on referrals from actual patients who had VBACs with him/her. Surround yourself with those supportive of this process rather than the naysayers. And, TRUST your body, trust your instincts and know that it IS possible!!
What was the reason for your initial Cesarean birth?
The reason for my C-section was the baby's heart rate dropped too low for too long, and despite manual stimulation, they were unable to stabilize him. I had been in labor for about 18 hours at this point and was 6cm. Ultimately, the reason for the C-section was being induced too early (the doctor broke my water to initiate labor) even though I had no medical issues for induction. Now I know:-) And, based on my first VBAC, I do believe cervical scar tissue was a factor as well.
Why did you choose a VBAC?
I chose a VBAC for several reasons. One, I had a VERY tough recovery from the C-section, both physically and emotionally, and I just knew birth didn't have to be like that. Second, I felt very inadequate after the C-section. Like something was wrong with me and my body. Third, I felt like cattle being shuffled around during my C-section birth and knew that I wanted a birth where I felt in control of the process/decisions, etc. And, finally, I felt like it would help me heal from the emotional scars of my C-section.
What were your fears and concerns (if any)?
My biggest fear in preparing for the VBAC was uterine rupture. That is, until I did my research and got a supportive doctor. Once I learned how rare it really is and that there would be warning signs, I really felt very comfortable that I was an ideal candidate and had a great chance of being successful.
The biggest challenge during pregnancy was overcoming my mental fears. No matter how much research I did, there was always a voice in the back of my head thinking that I must be missing something!
What was the biggest challenge during pregnancy and then during labor and birth?
The biggest challenge during delivery was second guessing myself after 17 hours of labor and seeing the same signs as before... only 6cm dilated. Once my doctor rubbed out scar tissue, I dilated and birthed within a few hours! After the 17 hours, I got an epidural and was really upset because I thought that meant I wasn't going to be successful. Having a doula there was great because she reminded me my goal was to have a VBAC, not no epidural. She assured me that a VBAC was possible with an epidural so she helped so much to get me through it mentally.
How did you prepare for your VBAC?
I prepared by hiring a doula, joining ICAN and going to meetings, hearing all the success stories I could and reading absolutely all the data available.
How did you find your care provider and were they VBAC supportive? If so- how? If not, did you think they were and they ended up not being so? How did you respond?
I found my doctor through referrals from ICAN. Yes, he was VERY VBAC supportive! At the first appointment, he said, "you can and will have this baby through your vagina!!" I knew it was the right fit. He never discussed a C-section with me. He never discussed "due dates" or anything like that. Instead, he said, "the baby will come when he's ready," and... he did!
What would you say to a woman who's considering a VBAC? How would you encourage her?
EDUCATE yourself. Hire a doula. Find a supportive care provider based on referrals from actual patients who had VBACs with him/her. Surround yourself with those supportive of this process rather than the naysayers. And, TRUST your body, trust your instincts and know that it IS possible!!
Why I Chose a VBAC :: Nona
Nona's Birth
(Nona is an MD who specializes in Family Medicine)
What was the reason for your initial Cesarean birth?
I went past my due date. At 41w5d, my OB recommended that I undergo an induction of labor. Once my contractions started, my doctor ruptured my membranes. She said there was "some meconium" but she was confident everything would be fine. I still wanted to forego the epidural, but Pitocin can really intensify the pain. I was only dilated to 3 centimeters when the contractions were stronger than I could bear. For 10 hours I labored, blissfully ignorant of the pain. I fell asleep for about an hour. When I woke up, I felt rather warm and I could hear the fetal monitor beeping at what seemed to be a rapid rate. I asked my husband to read the monitor and he told me it was reading in the 170's. The nurse took my temperature and told me that I had a "low grade fever." By then I was 7 cm. The doctor came in and told me that she was going to give me another hour, but if I wasn't fully dilated by then, I may need a C-section. Unfortunately, I only dilated another cm over the next hour, to 8 cm. The baby's heart rate persisted in the 170-180's. My doctor returned and told me that we could wait a little longer, but she was concerned that if the baby continued to be tachycardic that she may have to do a crash C-section. She reminded me about the meconium she had seen earlier. Frightened and emotionally exhausted, I consented to the surgery. My 9 pound baby boy was occiput posterior. He was pink and healthy and latched on to nurse as soon as they brought him to me (an hour later). The official reason for my C-section was fetal distress.
Why did you choose a VBAC?
Even with my first pregnancy, I had wanted the most natural experience possible. I came to motherhood as a medical profession in my late 30s. As a medical student and resident, I had personally delivered over 100 babies. I was curious about what the experience must be like as the patient and wanted to have the least medical intervention possible. Having my first baby by C-section sent me into a bit of an emotional tailspin. When I found out I was pregnant with my second son, I was really confused about what to do. My OB told me she would support me if I wanted to try for a VBAC, but on a subsequent visit, I saw one of her partners who told me a "story" about the last VBAC she had attended. In summary, she told me that the woman had suffered a uterine rupture, but the doctor had found it in time and the baby was fine, the woman "just had to have a hysterectomy, that's all". I left the office that day very unhappy. At that point, I was already 29 weeks pregnant and didn't even know if I had any options. By chance, I ran into my friend that night who is a doula, Annely Allen. She became my doula and was so encouraging. It was through her recommendation that I found Dr. Cobb. I had to jump through some hoops with the insurance company to change providers so late in my pregnancy, but we made it happen.
What were your fears and concerns (if any)?
My biggest fear was one I think many health care providers that attend VBACs have--the possibility of uterine rupture leading to fetal and/or maternal death. Of course, childbirth can be dangerous under the most ideal circumstances, but the added risk of allowing a scarred uterus to labor is something to consider. My other concern was regarding damage to my genitourinary system. Having already suffered surgery and a scar on my abdomen, it seemed almost silly to also risk the urinary incontinence and chronic pain with intercourse I had heard some women complaining about after a vaginal delivery.
What was the biggest challenge during pregnancy?
Not to give in to the fear that I was making the wrong decision. Personally, I'm a Christian, so I found a lot of peace in prayer. Every time I was fearful, I asked God to care for me and my unborn baby. He brought me a lot of peace during that time as I trusted Him and learned to let go of something that I had no control over. I also was careful to only read things that would encourage and uplift me. I read Ina May Gaskin's Guide to Childbirth--I would highly recommend this book just before delivery. It's like a giant pep rally right before a big game. It contains the birth stories of dozens of women, written from a very positive perspective.
What was the biggest challenge during labor and birth?
How did you prepare for your VBAC?
I did a lot of research. I talked to a lot of moms-- including some of my patients! I tried to keep in shape and not to gain too much weight. I did a lot of stretching to keep my hips and pelvis flexible. I spent a lot of time in prayer. I prayed for the safety of my child and myself, I prayed for peace and calm. I did a lot of reading about different methods for dealing with the pain. In the end, it was the face of my doula that kept me calm. Her moment to moment encouragement and support made the labor bearable.
How did you find your care provider and were they VBAC supportive?
(Nona is an MD who specializes in Family Medicine)
What was the reason for your initial Cesarean birth?
I went past my due date. At 41w5d, my OB recommended that I undergo an induction of labor. Once my contractions started, my doctor ruptured my membranes. She said there was "some meconium" but she was confident everything would be fine. I still wanted to forego the epidural, but Pitocin can really intensify the pain. I was only dilated to 3 centimeters when the contractions were stronger than I could bear. For 10 hours I labored, blissfully ignorant of the pain. I fell asleep for about an hour. When I woke up, I felt rather warm and I could hear the fetal monitor beeping at what seemed to be a rapid rate. I asked my husband to read the monitor and he told me it was reading in the 170's. The nurse took my temperature and told me that I had a "low grade fever." By then I was 7 cm. The doctor came in and told me that she was going to give me another hour, but if I wasn't fully dilated by then, I may need a C-section. Unfortunately, I only dilated another cm over the next hour, to 8 cm. The baby's heart rate persisted in the 170-180's. My doctor returned and told me that we could wait a little longer, but she was concerned that if the baby continued to be tachycardic that she may have to do a crash C-section. She reminded me about the meconium she had seen earlier. Frightened and emotionally exhausted, I consented to the surgery. My 9 pound baby boy was occiput posterior. He was pink and healthy and latched on to nurse as soon as they brought him to me (an hour later). The official reason for my C-section was fetal distress.
Why did you choose a VBAC?
Even with my first pregnancy, I had wanted the most natural experience possible. I came to motherhood as a medical profession in my late 30s. As a medical student and resident, I had personally delivered over 100 babies. I was curious about what the experience must be like as the patient and wanted to have the least medical intervention possible. Having my first baby by C-section sent me into a bit of an emotional tailspin. When I found out I was pregnant with my second son, I was really confused about what to do. My OB told me she would support me if I wanted to try for a VBAC, but on a subsequent visit, I saw one of her partners who told me a "story" about the last VBAC she had attended. In summary, she told me that the woman had suffered a uterine rupture, but the doctor had found it in time and the baby was fine, the woman "just had to have a hysterectomy, that's all". I left the office that day very unhappy. At that point, I was already 29 weeks pregnant and didn't even know if I had any options. By chance, I ran into my friend that night who is a doula, Annely Allen. She became my doula and was so encouraging. It was through her recommendation that I found Dr. Cobb. I had to jump through some hoops with the insurance company to change providers so late in my pregnancy, but we made it happen.
What were your fears and concerns (if any)?
My biggest fear was one I think many health care providers that attend VBACs have--the possibility of uterine rupture leading to fetal and/or maternal death. Of course, childbirth can be dangerous under the most ideal circumstances, but the added risk of allowing a scarred uterus to labor is something to consider. My other concern was regarding damage to my genitourinary system. Having already suffered surgery and a scar on my abdomen, it seemed almost silly to also risk the urinary incontinence and chronic pain with intercourse I had heard some women complaining about after a vaginal delivery.
What was the biggest challenge during pregnancy?
Not to give in to the fear that I was making the wrong decision. Personally, I'm a Christian, so I found a lot of peace in prayer. Every time I was fearful, I asked God to care for me and my unborn baby. He brought me a lot of peace during that time as I trusted Him and learned to let go of something that I had no control over. I also was careful to only read things that would encourage and uplift me. I read Ina May Gaskin's Guide to Childbirth--I would highly recommend this book just before delivery. It's like a giant pep rally right before a big game. It contains the birth stories of dozens of women, written from a very positive perspective.
What was the biggest challenge during labor and birth?
I went into labor at about 11pm. The pains became very intense
rather quickly. As soon as my doula arrived (about 90 minutes
after the contractions had started), she took one look at me and told
me it was time to go to the hospital. When I got to my hospital
room about an hour later, I was already at 8 cm… where I remained for
the next 5 hours. Five hours without progression, still getting
intense pains every 2 to 3 minutes was the most discouraging part of
the process. I gave in and asked for the epidural--I even used
my "panic word." My doula looked at my doctor
and they both told me I didn't need it. Dr. Cobb offered me a
shot of Fentanyl, which I accepted. It helped me to relax which
allowed Gabriel to finally descend into the birth canal. It would
be nice to say I had an entirely "unmedicated" delivery, but
I did the best I could. I had hated the feeling of the epidural with
the first delivery and was happy not to have to deal with that.
How did you prepare for your VBAC?
I did a lot of research. I talked to a lot of moms-- including some of my patients! I tried to keep in shape and not to gain too much weight. I did a lot of stretching to keep my hips and pelvis flexible. I spent a lot of time in prayer. I prayed for the safety of my child and myself, I prayed for peace and calm. I did a lot of reading about different methods for dealing with the pain. In the end, it was the face of my doula that kept me calm. Her moment to moment encouragement and support made the labor bearable.
How did you find your care provider and were they VBAC supportive?
Yes and at the recommendation of a friend/ my doula, Annely.
If your VBAC became a repeat Cesarean birth, how did this feel?
Fortunately it didn't. I certainly considered how I might have
felt if my delivery had gone in that direction. For me, I felt
that I had done everything possible to have the VBAC. I was prepared
to take it easy on myself and let it go if I was unsuccessful.
That's how I try to deal with most of the challenges in my life.
I think that is the encouragement I would leave with any woman considering
a VBAC. I believe that a vaginal delivery is really the best way
to have a child. Do what you can to try. If it doesn't work
out, it's okay. I'm sure we will all agree that having a healthy
baby is the most important outcome when the day of our delivery comes.
How was your experience different with the VBAC compared to the Cesarean?
(Nona asked that I include this additional question and answer)
I had both of my children later in life (ages 37 and 40), so that
may have affected my healing time, but I recovered so much more quickly
from the VBAC. After my C-section, it took me more that 6 weeks
to feel like I could even go for a walk without being in pain.
After my VBAC, I sat on an ice pack and sprayed numbing solutions on
my vulva for a week and that was it. I had recovered. I
could lift my baby and my toddler. I could do chores (although
I didn't have to-- thanks to my husband, Robert). It was a big difference.
My body healed so quickly when I had my baby the way I was created
to have him.
Also, even though labor and delivery hurts, I really "enjoyed"
the sensation of Gabriel being pushed out of my body. It was a
cathartic experience. I had a real sense of accomplishment when
it was over, that I lacked with the C-section. I was able to hold
and nurse my baby immediately after delivery (as I mentioned above,
I had to wait for an hour to see my first son). I was definitely
left with a sense of empowerment, a feeling that this is how it's supposed
to be, and the idea that what had been taken from me with my first delivery
had been returned to me unblemished. It's almost as if, without the C-section, the gift of the vaginal delivery would not have been as poignant…
4.02.2013
Some Thoughts on VBAC
One year ago, I had a first in my life as a doula. I supported my first VBAC or vaginal birth after Cesarean. I remember the day vividly for a number of reasons. I won't go into all of the details here, as that birth and all that transpired that day are another woman's story to share. Suffice to say, the experience was pivotal and memorable for me.
Since that time, I've had the opportunity to support more women that are seeking a VBAC and VBA2C. In working with each of these women and their families, it's clear to me that though the reasons for their first births by Cesarean vary, each of them wanted the freedom to choose something different for their next birth.
I've also supported women who've given birth via Cesarean and choose a repeat Cesarean (RCS). As a doula, I support women in the birth they choose. What matters is that the woman is making the choice that is best for her baby and for her specific situation. For some, this is VBAC and for others it is RCS. While I am a very big supporter of VBAC, I am not anti-Cesarean or RCS birth. What I am not okay with is when women don't have the option to choose or when they are coerced into a RCS with fear based information from their care provider or other source.
I'm thankful that I live in an area that has hospitals that are staffed appropriately to accommodate VBACs (24 hour on site anesthesiologists) and even more so, that there are a handful of doctors who are committed to supporting their patients' wishes to give birth vaginally. I'm also thankful that there are some skilled midwives that attend women who've chosen to give birth at home and are seeking out a VBAC at home or an "HBAC." I'm quite aware that there are areas around the country and even here in California that simply "do not allow" VBACs. The lack of options and freedom to choose is frustrating, especially when ACOG (American College of Obstetricians and Gynecologists) issued this statement as part of their latest VBAC guidelines released in July of 2010.
"Attempting a vaginal birth after cesarean (VBAC) is a safe and appropriate choice for most women who have had a prior cesarean delivery, including for some women who have had two previous cesareans..."
You can read the press release on ACOG's website here and the full Practice Bulletin on ACOG's site here
It is also covered in this statement from the National Institutes of Health
There are a number of organizations that are working really hard to bring awareness, advocacy and change to the state of maternal child health care in this country. A few are focused on Cesarean awareness and the need for VBAC to be made available as an option to all women who are seeking one. Here are a few of them:
International Cesarean Awareness Network- ICAN
VBAC Facts
VBAC.com
Cesarean Rates
American Pregnancy Association
Birth Without Fear (an online community dedicated to supporting women's choices in childbirth- whatever they may be)
I'm a part of San Diego's ICAN Facebook group and have thoroughly enjoyed reading women's stories and journeys they've shared. There have been dozens of VBAC stories shared, as well as some who've chosen RCS. I've asked a few of these women if they would be wiling to share their VBAC birth story with me, so that I can share it with you. I felt like it would be helpful for others to read women's experiences of why they chose a VBAC and what the process was like for them. I'm excited to share these stories in this series: Why I Chose VBAC.
Since that time, I've had the opportunity to support more women that are seeking a VBAC and VBA2C. In working with each of these women and their families, it's clear to me that though the reasons for their first births by Cesarean vary, each of them wanted the freedom to choose something different for their next birth.
I've also supported women who've given birth via Cesarean and choose a repeat Cesarean (RCS). As a doula, I support women in the birth they choose. What matters is that the woman is making the choice that is best for her baby and for her specific situation. For some, this is VBAC and for others it is RCS. While I am a very big supporter of VBAC, I am not anti-Cesarean or RCS birth. What I am not okay with is when women don't have the option to choose or when they are coerced into a RCS with fear based information from their care provider or other source.
I'm thankful that I live in an area that has hospitals that are staffed appropriately to accommodate VBACs (24 hour on site anesthesiologists) and even more so, that there are a handful of doctors who are committed to supporting their patients' wishes to give birth vaginally. I'm also thankful that there are some skilled midwives that attend women who've chosen to give birth at home and are seeking out a VBAC at home or an "HBAC." I'm quite aware that there are areas around the country and even here in California that simply "do not allow" VBACs. The lack of options and freedom to choose is frustrating, especially when ACOG (American College of Obstetricians and Gynecologists) issued this statement as part of their latest VBAC guidelines released in July of 2010.
"Attempting a vaginal birth after cesarean (VBAC) is a safe and appropriate choice for most women who have had a prior cesarean delivery, including for some women who have had two previous cesareans..."
You can read the press release on ACOG's website here and the full Practice Bulletin on ACOG's site here
It is also covered in this statement from the National Institutes of Health
There are a number of organizations that are working really hard to bring awareness, advocacy and change to the state of maternal child health care in this country. A few are focused on Cesarean awareness and the need for VBAC to be made available as an option to all women who are seeking one. Here are a few of them:
International Cesarean Awareness Network- ICAN
VBAC Facts
VBAC.com
Cesarean Rates
American Pregnancy Association
Birth Without Fear (an online community dedicated to supporting women's choices in childbirth- whatever they may be)
I'm a part of San Diego's ICAN Facebook group and have thoroughly enjoyed reading women's stories and journeys they've shared. There have been dozens of VBAC stories shared, as well as some who've chosen RCS. I've asked a few of these women if they would be wiling to share their VBAC birth story with me, so that I can share it with you. I felt like it would be helpful for others to read women's experiences of why they chose a VBAC and what the process was like for them. I'm excited to share these stories in this series: Why I Chose VBAC.
Why I Chose a VBAC :: Brooke
Brooke's Birth
What was the reason for your initial Cesarean birth?
This
one is a little touchy for me. My surgical reports say CPD (Cephalopelvic Disproportion) and failure
to descend. However, I truly believe I was cheated on my experience. I
was induced and I believe my body and baby just weren't ready yet. I was
uneducated and too trusting of my then care provider. My previous OB kept
pushing my due date up saying baby's growth was ahead and I didn’t
think anything of it. Towards the end of my pregnancy he kept talking
induction and I kept saying I wanted to wait and let my body do its
thing. At one of my last appointments he said, "If you don’t induce by
Friday, I’ll be upset," and used several scare tactics. Note here that I
had a perfectly healthy, textbook pregnancy. So, in I went that
Friday. (Thankfully I woke up that Friday with very sporadic
contractions, which gives me the tiniest peace about my son's
birthday). I was extremely scared of Pitocin, so asked for my water to
be broken instead (*hitting face with palm!*). My labor was pretty textbook. I walked
in at 3cm, water broken at 7am. I wanted to go without drugs but had
horrific back labor and got the epidural around 10am when I
was 5-6cm. I was complete by noon and was told to start pushing with
each contraction. Of course I couldn’t feel anything, so I was just
pushing-- who knows how effectively. I was on my back and continued
this for two hours. Nobody told me to roll to my side, etc. My baby
got to crowning and just wouldn’t budge. My OB tried forceps and the
vacuum, albeit very gently because I was scared of these, and I could
feel my son almost coming out but just wouldn’t have it. So,
after 3 hours of pushing, the C-section was called. The room fell. At
this point it was full of nurses and people waiting to take care of a
baby about to be born! I didn’t know what to do. I just felt as if my
body failed and I wasn’t built to have babies. Throughout the whole
pregnancy and birth I didn’t feel as if I had a choice or voice, so I
just did whatever my doctor said.
Why did you choose a VBAC?
This
was really easy for me. I chose a VBAC because I felt that giving birth is
what my body was made to do and my first attempt at delivering was a 'failure.' I wanted my second shot at it. The thought of rupture was
never a fear for me.
What were your fears and concerns (if any)?
My only fears in pursuing my VBAC was not getting it! I wanted it so badly that fears of my body not cooperating were always lingering in the back of my head. Mostly, fears that my baby would be malpositioned. I guess that's not really related to a VBAC per se, but just labor in general. However after my first birth and being told that baby was asynclitic and that it was my body's fault for it, I had a fear that my body wouldn't know what to do. My son was breech/transverse up until around 34 weeks, so I was pretty nervous about this. Once he flipped I tried to keep my stress levels down and just have confidence that things would progress positively. It was definitely a mental battle at moments but I just tried to keep as positive as possible.
My only fears in pursuing my VBAC was not getting it! I wanted it so badly that fears of my body not cooperating were always lingering in the back of my head. Mostly, fears that my baby would be malpositioned. I guess that's not really related to a VBAC per se, but just labor in general. However after my first birth and being told that baby was asynclitic and that it was my body's fault for it, I had a fear that my body wouldn't know what to do. My son was breech/transverse up until around 34 weeks, so I was pretty nervous about this. Once he flipped I tried to keep my stress levels down and just have confidence that things would progress positively. It was definitely a mental battle at moments but I just tried to keep as positive as possible.
What was the biggest challenge during pregnancy and then during labor and birth?
Having the confidence to know my original provider wasn't supportive/truthful and seek out the proper OB. When
I got pregnant the second time I was still with the same OB. At my
initial appointment they said, "Your last delivery was at 39w3d." My jaw
dropped. I mean, I knew what my original due date was, but somehow I
believed all that talk about baby growing ahead of schedule and therefore
needing an earlier due date. But I was lied to, all that pushing
forward was BS. I was PISSED to say the least. I felt so, so cheated
at my first birth and immediately asked about VBAC. I always saw the
Physician’s Assistant and she said I could definitely go for it.
However, after my 20 week ultrasound I began discussing a VBAC with
my OB. He pretty much said, no go. He scared me with shoulder
dystocia, that my pelvis was too small, that I would severely harm or
kill my baby, that if I were his daughter he wouldn’t ‘let’ me have a
VBAC. Well, I had been researching VBACs, births, the female body, and I
knew at this point that what he was saying wasn’t true. I knew in my
heart of hearts that I was going to get my VBAC, but at this point I
wasn’t sure who I was going to get it with. My husband and I left that
appointment and after the tears dried, I began exploring my options.
I had done a little provider research earlier in my pregnancy and had read about Dr. Cobb here and there. I went home and started doing my due diligence. I scheduled a meeting with Dr. Cobb and also with another local doctor that came recommended from a few friends. My husband was scared to switch because of the scare my previous OB gave us. However, after we met with Dr. Cobb, we just KNEW he was for us. My husband knew I wasn’t crazy for wanting the VBAC, saw the truth in what I've been saying and I think felt relieved that we had a doctor on our side and that he wouldn’t have to be my spokesperson. He felt completely railroaded during my first birth and was a little scared about how we’d be treated again. A weight was off our shoulders after that.
I had done a little provider research earlier in my pregnancy and had read about Dr. Cobb here and there. I went home and started doing my due diligence. I scheduled a meeting with Dr. Cobb and also with another local doctor that came recommended from a few friends. My husband was scared to switch because of the scare my previous OB gave us. However, after we met with Dr. Cobb, we just KNEW he was for us. My husband knew I wasn’t crazy for wanting the VBAC, saw the truth in what I've been saying and I think felt relieved that we had a doctor on our side and that he wouldn’t have to be my spokesperson. He felt completely railroaded during my first birth and was a little scared about how we’d be treated again. A weight was off our shoulders after that.
During labor and birth, my biggest challenge was continuing to have confidence in my body and also dealing with the pain/exhaustion since I was hell bent on going natural. My contractions started in the afternoon and I distracted myself by having my final moments with my son. We went to the park, had dinner and put him to bed. Then things picked up and I labored through the night; so I was EXHAUSTED. My team was amazing. They all had faith in me and when I asked for something ‘to take the edge off’ they all just said ‘you’re doing it, you’re almost there, you’ve got it.' No one gave in and I had 100% support, even in the nursing staff. Since I was so determined to go natural, everyone supported that, even when I was a whiny youknowwhat.
While pushing, I wasn’t sure about my body and I didn’t know if I could have 100% confidence in it. I was a scared my baby would get stuck again. I think if I didn’t have such a supportive team, I would’ve been much more emotional about this. Dr. Cobb just kept reassuring me that I was doing it, the baby was coming and to be patient, that my body was working. My mom reiterated saying that the baby was further than my first ever got. I feel so lucky to have had so many cheerleaders in the room! Every single person was positive and supportive. Without that I think I would’ve had a lot more emotional hurdles to jump. They gave me confidence when I started to second guess myself.
How did you prepare for your VBAC?
Research
research research! Because of my previous birth and what I was told,
in the back of my head I wanted to prove everyone else wrong and prove
that I COULD give birth. Give my baby all those added benefits, avoid
major surgery and also bond with my child right away. I did everything
I could to align my body. Yoga, swimming, Spinning Babies,
chiropractor, and acupuncture. My husband thought I was crazy. My thoughts behind all of this preparation was if I ended up with another Cesarean, I wanted to know I did absolutely
everything I could and not look back and say ‘what if I tried this?’ I
became a VBAC and birth expert. I knew it would be more beneficial to
go natural and studied Hypnobabies to help with pain management. I also
had a very supportive family. My husband was my coach, as was my
mother and younger sister. They all got familiar with my plan and made
sure they knew what I wanted.
How did you find your care provider and were they VBAC supportive? If so- how? If not, did you think they were and they ended up not being so? How did you respond?
I
guess I touched on this above. I found Dr. Cobb just through online
research. I was actively on the Babycenter VBAC Support Board and they
often referenced ICAN chapters, so I joined San Diego’s. After reading
about Dr. Cobb online, then hearing what all the lovely ladies of ICAN
had to say about him, I met with him. I’ll admit, at first I was like
‘what’s with everyone drinking the Cobb kool-aid around here? How
different can an OB be?’ Ha! Little did I know. The best part about
Dr. Cobb is his faith in the female body and his respect for his patients.
Very rarely do you find a doctor that doesn’t want to take control or
have some sort of a God-complex. But here he was, this quiet soul in
the corner, your cheerleader, telling you that you are whole, that you
are healthy and that you can do it. What was also comforting to my
husband and I was that he was so smart and medically trained, that God
forbid something went wrong, we knew he could handle it. What more
could you ask for? My VBAC with him was such a beautiful experience.
I couldn’t believe what childbirth could be like! I
felt empowered, I guess, but really it just felt right. My sister, who
is 23 and studying to be a nurse, said afterwards that ‘this is
what I want to do!’ She was a part of my first birth as well so she has
seen both sides and knows I was cheated the first time. My mom said, "now that’s how a baby
should be born." She was completely blown away. So, those little
things were very cool to add to my experience. If I had stayed with my
previous OB the amount of stress carried would’ve been massive. It
would’ve been a completely opposite experience.
To sum it up, my first labor was a medically orchestrated event and I
was just a puppet. My VBAC was mine, nobody elses, and my baby and I
were the main event.
What would you say to a woman who's considering a VBAC? How would you encourage her?
In my circle of friends, I’ve become the VBAC/natural birthing
girl. I'm pretty outspoken about it. A close friend of mine told me
that if she didn’t see me do it, she would’ve just had another C-section. She
went on to VBAC successfully. She then tells others about her
experience, so it really makes me happy that I’ve made this teeny tiny difference... that maybe this little ripple will do something
eventually. I have really become a cheerleader for VBACs and women
knowing they deserve to have control of their births. When I talk to
women along the way or when I have friends who face the choice, I have
no problem telling my story and I offer to talk with them about it if
they would like. I tell them that I did a ton of research and if they
want me to pass anything along to them I’d be happy to. I open the door
and if they want to take it, then great! But it is also hard for me
because when I hear people scheduling a RCS for no reason, specifically
because their doctor scared them into it, it makes me scream inside. I wrestle with how can I can be the encourager without stepping on toes. I try to
tell them it’s so safe and best for mom and baby, but I leave it at
that. It’s hard for me, but understand that they are grown adults and each
make her own choice.
Why I Chose a VBA2C :: Robin
Robin's Birth
What was the reason for your initial Cesarean birth?
I think it was probably the interventions. I was young and I trusted my doctors. My first baby's birth was hurried along with Pitocin, drugs, and breaking of my water. As a result, my baby boy went into distress and I had an emergency Cesarean birth. My second was a scheduled repeat C-section.
Why did you choose a VBAC?
I had two C-sections and felt that I was missing out on the experience of birthing my child, of acting on my own to bring my child into this world. Had the C-sections been truly necessary I'm not sure I would have felt as strongly about this.
What were your fears and concerns (if any)?
Initially, fear of uterine rupture, but I did my research this time.
What was the biggest challenge during pregnancy and then during labor and birth?
I was totally stressed out about having to justify my decision for a VBA2C when I reached the hospital. I was told upfront I would need to sign a waiver when I got there. Choosing a home birth resolved this fear and I was able to enjoy the rest of my pregnancy.
How did you prepare for your VBAC?
Reading books on natural birth, especially by Ina May Gaskin. I did the Hypnobabies home study and daily prenatal yoga exercise.
How did you find your care provider and were they VBAC supportive? If so- how? If not, did you think they were and they ended up not being so? How did you respond?
I was with Kaiser, so I saw the midwife at my local office. She was pretty supportive, but let me know that not every doctor would be, so it was good that I knew all the facts and would be able to get them across to them. I didn't want to have to do that while I was in labor when I wanted to concentrate of everything going right. I got recommendations for homebirth midwives from local ICAN members and never looked back.
What would you say to a woman who's considering a VBAC? How would you encourage her?
It was an absolutely life changing and a life affirming experience. I'd recommend a natural birth with LOTS of preparation. It more than paid off.
What was the reason for your initial Cesarean birth?
I think it was probably the interventions. I was young and I trusted my doctors. My first baby's birth was hurried along with Pitocin, drugs, and breaking of my water. As a result, my baby boy went into distress and I had an emergency Cesarean birth. My second was a scheduled repeat C-section.
Why did you choose a VBAC?
I had two C-sections and felt that I was missing out on the experience of birthing my child, of acting on my own to bring my child into this world. Had the C-sections been truly necessary I'm not sure I would have felt as strongly about this.
What were your fears and concerns (if any)?
Initially, fear of uterine rupture, but I did my research this time.
What was the biggest challenge during pregnancy and then during labor and birth?
I was totally stressed out about having to justify my decision for a VBA2C when I reached the hospital. I was told upfront I would need to sign a waiver when I got there. Choosing a home birth resolved this fear and I was able to enjoy the rest of my pregnancy.
How did you prepare for your VBAC?
Reading books on natural birth, especially by Ina May Gaskin. I did the Hypnobabies home study and daily prenatal yoga exercise.
How did you find your care provider and were they VBAC supportive? If so- how? If not, did you think they were and they ended up not being so? How did you respond?
I was with Kaiser, so I saw the midwife at my local office. She was pretty supportive, but let me know that not every doctor would be, so it was good that I knew all the facts and would be able to get them across to them. I didn't want to have to do that while I was in labor when I wanted to concentrate of everything going right. I got recommendations for homebirth midwives from local ICAN members and never looked back.
What would you say to a woman who's considering a VBAC? How would you encourage her?
It was an absolutely life changing and a life affirming experience. I'd recommend a natural birth with LOTS of preparation. It more than paid off.
Why I Chose a VBAC :: Jessica
Jessica's Birth
What was the reason for your initial Cesarean birth?
The baby was posterior, stuck at -1 station after 2 hours of pushing. I had an epidural for many, many hours (labor was 29 hours total until the C/S). The OB said I could try to keep pushing, but she didn't think he would budge and suggested a C/S. Turned out the baby was 9lbs., 1oz and had a very big head. I was also very swollen from the pushing. I guess the official "reason" was failure to progress.
Why did you choose a VBAC?
At first I was leaning toward a repeat Cesarean (RCS) due to a lack of enthusiasm from my care provider and fear on my part. But I saw how much easier it was for a few friends who had vaginal births and I also started doing some of my own reading. I learned about the risks of repeat cesareans and the benefits of vaginal birth. I also desperately wanted to succeed at breastfeeding (which I hadn't with my first), and I knew vaginal birth was a major factor in that as well.
What were your fears and concerns (if any)?
My major fears about VBAC were that I wouldn't be able to have one after all! My major fear about having an RCS was a repeat postpartum hemorrhage or other complications that had happened with my first. Also, thinking about the recovery time while caring for a two-year-old was another consideration. After my C-section, I had a delayed postpartum hemorrhage, and my OB at the time said I probably shouldn't risk labor if I had another baby, because she felt my uterus would be too weak or damaged and labor would put too much stress on it. The CNMs and OBs at Kaiser when I was pregnant with my second didn't seem concerned about it when I told them my history.
What was the biggest challenge during pregnancy and then during labor and birth?
My pregnancy was pretty textbook and fairly easy until about 36 weeks when my blood pressure went up. They started talking about emergency C-section or induction. At 37w5d, they decided to induce and I thought my dream of VBAC had gone out the window. Fortunately, a Pitocin-induced labor turned out to be quite easy and quick and the VBAC happened after all.
How did you prepare for your VBAC?
I talked with a friend who was a doula and student nurse. I talked with my care providers. I read about it online. I wish I was a part of ICAN (International Cesarean Awareness Network) back then!
How did you find your care provider and were they VBAC supportive? If so- how? If not, did you think they were and they ended up not being so? How did you respond?
I was and am with Kaiser, so I didn't have too much of a choice. I mostly saw a CNM, who was neutral on the topic but not discouraging. The OB they had me see kept suggesting I schedule a C-section. I was reluctant and asked if I could schedule it for 39w5d or something. I guess I was hoping I'd go into labor spontaneously before they could cut me open! Then I saw a different OB toward the end of the pregnancy who was much more pro-VBAC and reassuring about it and said he thought I was a good candidate and there wasn't any reason I shouldn't have a trial of labor. Then I ended up being induced at 37w5d and having the VBAC after all.
What would you say to a woman who's considering a VBAC? How would you encourage her?
I would let her ask her questions and express her fears. I would tell her my story (stories, actually - I've had two VBACs). I would talk about the easier recovery time and the benefits to mom and baby. I would tell her about the risks of repeat C-section, especially multiple repeat C-sections. I would tell her there's no reason not to try. If she has a supportive birth team and her birth ends up as a repeat C-section, she'll know she made the right decision and go into it willingly and with eyes open. I would also tell her to come to an ICAN meeting.
If your VBAC became a repeat Cesarean birth, how did this feel? Were there differences this time?
It didn't, but I definitely considered how I would feel if it did. With my first VBAC, I was so gung-ho and determined that I think an RCS would have been, at the least, a real bummer. I would have been upset about it but I also would have known it was necessary. With my second VBAC, I think I was more relaxed about the whole thing and willing to take what came. As it happened, I had a spontaneous natural birth, so I had nothing to worry about. But again, I knew enough about C-sections by that point (and was involved with ICAN) that I felt I could make an informed decision if one was suggested or needed.
Jessica write about birth, babies and related issues on her blog- jessicaonbabies
What was the reason for your initial Cesarean birth?
The baby was posterior, stuck at -1 station after 2 hours of pushing. I had an epidural for many, many hours (labor was 29 hours total until the C/S). The OB said I could try to keep pushing, but she didn't think he would budge and suggested a C/S. Turned out the baby was 9lbs., 1oz and had a very big head. I was also very swollen from the pushing. I guess the official "reason" was failure to progress.
Why did you choose a VBAC?
At first I was leaning toward a repeat Cesarean (RCS) due to a lack of enthusiasm from my care provider and fear on my part. But I saw how much easier it was for a few friends who had vaginal births and I also started doing some of my own reading. I learned about the risks of repeat cesareans and the benefits of vaginal birth. I also desperately wanted to succeed at breastfeeding (which I hadn't with my first), and I knew vaginal birth was a major factor in that as well.
What were your fears and concerns (if any)?
My major fears about VBAC were that I wouldn't be able to have one after all! My major fear about having an RCS was a repeat postpartum hemorrhage or other complications that had happened with my first. Also, thinking about the recovery time while caring for a two-year-old was another consideration. After my C-section, I had a delayed postpartum hemorrhage, and my OB at the time said I probably shouldn't risk labor if I had another baby, because she felt my uterus would be too weak or damaged and labor would put too much stress on it. The CNMs and OBs at Kaiser when I was pregnant with my second didn't seem concerned about it when I told them my history.
What was the biggest challenge during pregnancy and then during labor and birth?
My pregnancy was pretty textbook and fairly easy until about 36 weeks when my blood pressure went up. They started talking about emergency C-section or induction. At 37w5d, they decided to induce and I thought my dream of VBAC had gone out the window. Fortunately, a Pitocin-induced labor turned out to be quite easy and quick and the VBAC happened after all.
How did you prepare for your VBAC?
I talked with a friend who was a doula and student nurse. I talked with my care providers. I read about it online. I wish I was a part of ICAN (International Cesarean Awareness Network) back then!
How did you find your care provider and were they VBAC supportive? If so- how? If not, did you think they were and they ended up not being so? How did you respond?
I was and am with Kaiser, so I didn't have too much of a choice. I mostly saw a CNM, who was neutral on the topic but not discouraging. The OB they had me see kept suggesting I schedule a C-section. I was reluctant and asked if I could schedule it for 39w5d or something. I guess I was hoping I'd go into labor spontaneously before they could cut me open! Then I saw a different OB toward the end of the pregnancy who was much more pro-VBAC and reassuring about it and said he thought I was a good candidate and there wasn't any reason I shouldn't have a trial of labor. Then I ended up being induced at 37w5d and having the VBAC after all.
What would you say to a woman who's considering a VBAC? How would you encourage her?
I would let her ask her questions and express her fears. I would tell her my story (stories, actually - I've had two VBACs). I would talk about the easier recovery time and the benefits to mom and baby. I would tell her about the risks of repeat C-section, especially multiple repeat C-sections. I would tell her there's no reason not to try. If she has a supportive birth team and her birth ends up as a repeat C-section, she'll know she made the right decision and go into it willingly and with eyes open. I would also tell her to come to an ICAN meeting.
If your VBAC became a repeat Cesarean birth, how did this feel? Were there differences this time?
It didn't, but I definitely considered how I would feel if it did. With my first VBAC, I was so gung-ho and determined that I think an RCS would have been, at the least, a real bummer. I would have been upset about it but I also would have known it was necessary. With my second VBAC, I think I was more relaxed about the whole thing and willing to take what came. As it happened, I had a spontaneous natural birth, so I had nothing to worry about. But again, I knew enough about C-sections by that point (and was involved with ICAN) that I felt I could make an informed decision if one was suggested or needed.
Jessica write about birth, babies and related issues on her blog- jessicaonbabies
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