What does VBAC stand for?
VBAC stands for Vaginal Birth After Cesarean, which is sometimes referred to as the Trial of Labor After a Cesarean Delivery.
What did you do to prepare for your first birth?
Regretfully, not a lot. I ate healthfully and took prenatal vitamins. I also went for frequent walks with my husband, but I didn’t even have a birth plan going into it. I’ve always been a pretty laid back, “Que Sera, Sera” personality type, and I didn’t approach birth any differently.
Under what circumstances did you have a cesarean first time around?
My OB voiced concerns from the early on about the size of the baby. I had a “sizing ultrasound” around 37 weeks that placed baby at 8 pounds or so (although they told me this could be +/- a pound). At a petite 5’1, my doctor told me she was concerned about shoulder dystocia and/or baby getting stuck, so she wanted to induce me at 39 weeks. I had done a bit of research on induction, and knew that an induction might increase my chances of ending up with a c-section, so I respectfully requested not to be induced until I absolutely had to be… I hit 41 weeks and 5 days, and my doctor insisted that I be induced the following week. I begrudgingly scheduled my induction, but found out the hospital wouldn’t have the staff available to allow me to come in the night before to start the prostoglandin gel, as originally planned by my OB, so they had me come in bright in early and with the plan to start me on pitocin at 7 am.
On the big day, we loaded up our hospital bags, and headed in. The entire pregnancy leading up to this morning, I had looked forward to the moment when I got to tell my husband “Babe.. I think it’s time!” before deciding to go to the hospital to deliver our baby. So, my darling husband let me stand in our entryway and say my line (with tears in my eyes). On the drive there, I sat with my feet on the dashboard, breathing Lamaze-style, while he pretended like he was speeding to the hospital with a woman in labor. It was a light-hearted start to a long, long day.
To summarize, I labored for about 18 hours with pitocin-induced contractions (ouch.), but never progressed past 3 cm. By 1:45 am, baby’s heart rate started to show some signs of distress, and I was in the OR 15 minutes later delivering my 9 pound, 6 ounce beautiful baby boy.
Finding yourself pregnant again (hurray!) what were your feelings about birth and labor?
I was a little (okay, a lot) bitter about my first attempt at labor. Initially, my husband and I decided that we would just do a scheduled c-section the second time. I originally thought that the risks of a VBAC were really high. The doctor I was seeing at the time also encouraged that it was probably the “safest” option, given my history. I had other mom friends tell me how easy it was to just schedule it and not have to think about “when am I going to go into labor?” or “how long am I going to be in labor?” After making it through first trimester, I started having a lot of second thoughts about not even giving myself an opportunity to attempt a vaginal birth, so I started talking to my husband about it. I felt a little ripped off by my first attempt, and mad at myself for not trying harder to “make” it happen naturally. He told me he’d support any decision I made.
I was lucky to work with midwives my first birth and it was emphasized from the very beginning that preparing for birth is like preparing for a marathon, and we did a lot of mental and physical education- both my husband and I. What are you doing to prepare for labor?
Motherhood has certainly taken its “toll” on my easy going personality. I’m much more into structure, planning, and preparation in all areas of my life, in general, since having my son. After I made the decision that I was at least going to “try for a VBAC”, I talked to the provider I was seeing. She told me that it was an option, but if something were to go wrong, it would be “catastrophic”. My next appointment, my usual doctor was gone, so I saw one of her partners and I asked him what he thought about allowing me to try for a VBAC. His response was the same, word for word – “could be catastrophic”. I was clearly in the wrong place for support.
I went back to researching. Everything I read, had one very consistent and strong message… Hire a doula. So, I did. She asked if I would consider switching to a different hospital, one that is known for its birth center and putting moms first. I was really hesitant at first as it’s a 30 minute drive, and the other hospital is less than 10 minutes. I ended up finding the cesarean rates online for both hospitals I was considering, and the new option had a 20% lower c-section rate. They had also won the “Women’s Choice Award for America’s Best Hospitals Obstetrics”, two years in a row. It became a clear choice for me, and at 24 weeks along, I switched. At my first appointment with my new doctor, he walked in and said “So, we’re going to have a VBAC?” His attitude was completely encouraging and positive the entire appointment, and he even excitedly shared “I just delivered two VBAC babies last night!” He also complimented my choice of hiring a doula. It’s amazing what a difference a supportive provider can make.
Other things I’ve been doing include practicing yoga, walking 3 miles daily, doing squats, lunges, getting regular chiropractic care, acupuncture, and listening to a hypnobirthing podcast. I think a lot of it is mental too, preparing for a birth without interventions (avoiding induction if possible), and in my case, even saying no to an epidural. From what I’ve read, an epidural won’t affect your VBAC success rate, but I want to be able to walk around during labor and deliver this baby in whatever position works the best, especially if it’s another 9 pounder! I also recommend reading positive success stories wherever you can find them – the
Birth Without Fear blog is one of my favorites. My doula also recommended the book “Artemis Speaks” by Nan Koehler.
I’ve also been eating dates (rumored to decrease the length of labor), drinking raspberry leaf tea and taking a lot of baths. Even with a wild two and a half year old running around, self-care seems like a very important piece of preparing for any birth.
The million dollar question- Why bother? It’s certainly more convenient (for you and your doctor) to just schedule the next surgery/delivery and get your abs stitched back together.
Because of the chaotic, emergency-nature of my first c-section, I listened to my son cry for a good 5 minutes (well, it felt that long), before I was even able to see him for the first time. I didn’t get to hold him for probably an hour later because I was in recovery (a.k.a. a dark, hospital basement at 2 am). I feel like I missed a lot by not having the immediate placement of baby on my chest. The drugs from the c-section made me nauseated and shaky, and I had (and continue to have) a lot of pelvis alignment issues postpartum, likely related to my weak and recovering muscles. This time around, I just don’t want to deal with the recovery time, either – it seems like it would make caring for a toddler pretty difficult.
I had a really hard time even thinking about labor and delivery for a long time. To this day, if I ever come across “A Baby Story” on TV, I roll my eyes and change the channel, because it just brings up a lot of feelings of bitterness and jealousy for me. I’ve heard a lot of women refer to their successful VBACs as a “healing birth”. I’m hoping it will be that for me. I know there’s still a 30% chance that I’ll end up back in the OR, but I am really looking forward to getting to try!
This really hit home for me at 6 weeks (tomorrow) post partum after a c-section!!!! Thank you for posting!