Thursday, December 18, 2014

Birth matters: Attempting a VBAC

This post has nothing to do with running but a lot to do with health and even more to do with lady business. Feel free to skip.

I don't know what a contraction feels like. I didn't feel my water break. I didn't push. I didn't cry out. With a cut and a tug, I was a mom.

On July 7, 2011, I didn't care that I hadn't experienced labor. I was just happy to have a 5-pound, 14-ounce baby in my arms who, by all accounts, was healthy. He had 10 fingers and 10 toes and rated high on the Apgar test. And, oh could he cry.

But in the months and years to follow, I began to wonder. I wondered if I had been able to have a successful, natural birth whether I would have had a better milk supply. I wondered whether I really needed to be induced that day and whether I could have been a better advocate for myself.

I never felt that by having a C-section that I was less of a mother or less of a woman but there was something missing. It wasn't tangible. I couldn't explain it — and I still can't — but Miles' birth story never sat right with me.

So when it came time for baby No. 2, even thinking about it, I knew one thing: I wanted to attempt a VBAC — a vaginal birth after Cesarean. Again, I couldn't explain why. I hadn't done extensive research nor watched any documentaries (though I since have). The most articulate answer I could give when asked why was that I just wanted a chance at the process. I didn't want to have a second Cesarean just because nor did I feel right choosing my child's birth day.

I just wanted to experience birth, what I could of it. The good, the bad and the ugly.

Of course, it's not that easy. "Mothers who deliver a first baby by C-section are about 90 percent more likely to deliver subsequent babies that way, too." {Source} I couldn't just go to my doctor and request a VBAC. I had some work to do.

It was in my best interest and that of the baby's to seek out a physician who was not only committed to avoiding C-sections when possible but had a good track record for VBACS. I switched to a new practice, led by a reputable doctor, that included midwives.

I started reading and watching. Just because is not a good enough answer for my friends and family when I share what I'm hoping to do. More importantly, it's not good enough for the doctor. VBAC candidates must show a commitment to education, whether going through a special workshop session by a local, non-hospital-affiliated group or doing it on her own. I can now say that I want a VBAC because it will enable me to parent better, avoid major surgery and is better for baby and me. (I'm also hoping that it will lead to a better milk supply this time around so that I can nurse happier and longer.)

I started building courage. It's not just because I will be delivering a baby for the first time, something unknown, if I'm successful. If I'm going to do this, I need to be mentally strong and firm in my decisions. I need to be willing to fight for myself and for the baby. I'm known to be stubborn but I can also be timid and afraid, and I find it difficult to stand up for myself. It takes work. It takes courage.

And I will need it.

According to the Consumer Reports piece cited above:
“What it boils down to is culture,” said Elliot Main, M.D., director of the California Maternal Quality Care Collaborative and former chairman of the department of obstetrics and gynecology at the California Pacific Medical Center in San Francisco. “Culture of the hospital, the nursing staff, even the patients.” He points out that hospitals with a culture of facilitating vaginal birth—those that allow vaginal birth after cesarean, for example, or those where 10 percent or more of births are attended by nurse midwives—have far lower rates of C-sections.

Why do I share this? I want to hear your stories, good and bad. I know very few people who have attempted VBAC and the success stories I read don't always resonate with me.


  1. LOVE this topic! You may remember I've got 4 kids. My first was a preemie, born at 34 weeks and breach. So C-Section it was. What a scary thing at the time. I'd skipped those sections in the books because I was NOT doing that. I desperately wanted a VBAC with my second many years later. My doctor (same doctor I had for all 4) was discouraging. But I was insistent. Like you I wanted the experience. I knew there would be more after this baby and didn't want to be condemned to multiple C sections. Alas, my doctor had a different opinion. Mid pregnancy unbeknownst to me he upped my due date by 1 week. I only found out because the nurse mentioned it late in my pregnancy. He told me up front he would only "allow" me to go past my due date for 1 week. Which basically just took me to my PROPER due date. I ended up going 10 days "late" .. but really 3 days before I was forced into another scheduled c section. Jackson was born weighing barely 8 lbs. He was NOT a 10 day late baby! My doctor stole my choice for VBAC. To this day I'm still pissed about it. So I've had 4 C sections total. I really do feel like I missed out on something that women should get to experience if they choose to. I never successfully breastfed ANY of my kids. Another thing I desperately wanted to be able to do. I really really wish you the best of luck and hope that you get the VBAC you're shooting for. It sounds like you're off to a great start with the switching to a DR that supports. I can't wait to see how it all plays out!

    1. Thank you for sharing! It's sad that doctors will do that but I have heard that it is not uncommon - a big reason why I switched. I didn't want to go through pregnancy planning a VBAC only to have the doctor back out in the third trimester. It's a shame.

  2. This is great! Stand up for yourself!!! :) I hope you are able to do a VBAC! I know someone who successfully had one, recently! :)

  3. If you can swing it, find a doula that you are in sync with, and who will support and advocate for you during the process. Late pregnancy and labor are extremely vulnerable times, and doctors can (either intentionally or unintentionally) be manipulative of their patients. A doctor might give their opinion on what they THINK would be the best way to do things, and in a vulnerable moment you might go along for the supposed well-being of the baby without being able to objectively consider the situation. Have someone in there who is experienced, medically knowledgeable, and in support of your goals. They'll keep the doctors off your back so you can labor in peace, but if a situation arises in which you DO need another c-section, they'll be able to support you through it emotionally as well.

    1. I have thought about this and, if it's financially possible, it is something I hope to do. I know that in stressful situations, I can lash out (sometimes irrationally) at Mark and know that I'll need someone outside of our relationship. I'm not sure how or if it will work but the practice is looking at adding a doula. I'm wondering if insurance will magically cover it then.

  4. I experienced a few of the regular delivery pains (lots of HARD contractions, my water breaking, and again horrible contractions). I made it to an 8 with my first born and then the delivery wouldn't progress after another 3 hours (Come to find out she was in the birth canal crooked and would never have come out the right way, this was with a midwife).
    My second baby I decided to try a VBAC and we didn't have to jump through any of the hoops its sounding like you had to. My midwife said it would be no problem and that they prefer doing VBAC's rather than another c-section. I was pumped the whole pregnancy and used hypno-birthing techniques that I never got to use with my first labor. My due date came and went (and I knew the conception date so my due date was legit) a week had passed and I went in to do all the tests they need to complete so that they know the baby is doing fine after being over due that long. One thing is that there is a history of miscarriage in my family and my mom had a still born that she carried full term. I was starting to get really nervous and even though all the test results came back fine I had a feeling that I should just schedule the c-section. So I did, and it was a complete 180 from the first c-section I had which was awesome.
    Now I'm pregnant with my 3rd and I'm going to just schedule the c-section. I would really love to try again for a VBAC, but with my history it makes me really nervous.
    One piece of advice I would have for first time moms is to NOT LET THEM INDUCE YOU. I didn't know that you chance for a c-section goes up significantly if you opt for induction. I had gestational diabetes with my first and so they wanted to get the baby out, and what I should have done is advocate for myself and done my research.
    I do agree that you should find a doula. One of my best friends is a doula and if I would have had her there for my first I think it would have gone much differently.
    I hope everything goes well, and there should be no reason why you shouldn't be able to have a healthy VBAC. I will definitely be following, good luck!

    1. Very good point about induction. They tried to induce labor with Miles, and it did not go well. Within an hour or two of being on the first med, they had to stop it because his heart rate was dropping. As the induction didn't work, it was a C-section. Period. My doctor and midwives have said that they will go to 42 weeks and I have an acquaintance who saw him and did, in fact, go almost to 42.

      I was lucky that my first C-section went well and I recovered quickly but I can't be sure of that a second time.

  5. I had a very prolonged, horrible labor with my first son that resulted in a C section. My doctors said that it was probably a one time thing and that there was no reason that I most likely could have a VBAC the next time (I think he was facing the wrong way and was actually stuck, so I had no real progress after pushing for hours). I was fortunate to have doctors that were very encouraging; it seems like doctors now are afraid to even let women try to have a VBAC. Two years later, I had a VBAC with my second son with no complications. I had a doula as well, who was fantastic in dealing with the nurses, who were not vey helpful during my labor. This was 14 years ago, and I think things have definitely changed. As long as you go into it with the mindset that ultimately all you want is a healthy baby, you should be allowed to at least try to have the birth experience that you desire, but be willing to change your plans should a complication arise. I hope that it all works out for you and are able to have a VBAC. Good luck!

  6. Your post shows how much you have thought through this. I work with women in the "birth world" here in my area as a peer counselor for a birth trauma organization. If I could tell you anything it would be this:

    1. Your second baby will be like having a first baby if you choose this option. So don't be surprised at how long it might take. But it will be okay and you can totally do this. The best thing to have is patience - patience to let the baby decide his birthdate, and patience to trust your body to work (even when medical staff don't exhibit the same patience).

    2. If you can get your hands on books by Ina May Gaskin, I highly recommend her work. Her Birth Matters was really helpful for me when making sense of my own experience with childbirth and what I'd want to do differently in the future.

    3. There is no "they won't let me" or "they will let me". This is YOUR body, and it's your choice start to finish. If you can hold onto that, trusting your own instincts and all the work you have done to educate yourself, that will stand you in good stead when you have to deal with medical people who tend to practice maternity medicine with fear and liability being their first focus. Know your rights over your own body, and make sure your husband knows them too.

    4. Hire a doula. My personal preference is to find one who is not DONA certified because they have become more medicalized and limited in what they can do or say, but is independent.

    5. While she isn't in your area, this resource may be helpful for you to explore as you consider choosing a doula. She's who I would choose, and I know her very well through my volunteer work. If you check out her "educational articles" section, you may find some good encouragement from that.

    You can totally do this. Trust your body; trust your instincts; and trust your baby.

  7. I was lucky enough to have both my births go according to plan. I love sharing my birth stories because I find them so incredible and empowering. The amazing things your body can do. Does it hurt? Sure, temporarily. More than anything, it's incredibly intense both emotionally and physically.

    I too am stubborn..shocking I know. When I set my mind to having unmedicated births, no one was going to dissuade me. Like you I found a practice that was in line with my desires and truly cared for both me and my baby. LOVE midwives.

    Suggestions, Ina May's Guide to it. While some stories freaked me out at first, the second time I read it, I was just in awe of these amazing women and the power of the body. I also liked Birthing from Within which provided tips on dealing with the pain of labor outside of lamaze. Honestly, never used the lamaze techniques.

    Think about a doula. I didn't have, but have a friend who has a successful VBAC and said her doula was critical. She was there to advocate for the parents which was helpful in their particular hospital.

    Jot down and discuss with your provider a birth plan. It doesn't have to be long and detailed, but that way everyone is on the same page. It's important that Mark knows too as there may be times where you're not capable of vocalizing what you need. For me this included things like no IV, no offering of medications (if I wanted it, I'd ask), dim lights, no constant fetal monitoring, a variety of tools such as a ball, squat bar, birthing stool, tub, etc.

    While in labor, get in a bathtub if you can. A-maz-ing. If I could have given birth in the tub I would have. It helped so much with contractions.

    Strange one...remember not to clench your jaw. Apparently when you clench your jaw, your perinium also tightens. Making roaring sounds...strange I know, really helps keep the jaw loose.

    I wish you a beautiful birth experience. :-) Trust your body, it knows what it's doing.

    Also, any questions/concerns about nursing, happy to talk about too since I've been nursing for over 3.5 years with only a two month reprieve.

  8. Love this! Go you! I always love hearing women being an advocate for themselves, no matter what kind of birth they feel is best!

    I read Thinking Woman's Guide to a Better Birth and it really helped me make decisions for my birth that I was comfortable with!

    Can't wait to find out how it goes!