(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?
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
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?
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!