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!