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