a VBAC, we did it

When I delivered my first little girl in 2009 my plan was to have a natural child birth.  I went in determined to make this happen, but after 19 or so hours of grueling labor things didn’t go according to my “plan.”   I ended up having a Cesarean (C-section) despite all my efforts in trying to avoid one.  It was an exhausting experience and not what I may have wanted, but thankfully we had a successful and healthy arrival of little Adeline – you can read about my first delivery experience HERE.  So when we got pregnant with our second, I was bit apprehensive about delivery.  Should I just schedule another C-section?  Do I try a Vaginal Birth After Cesarean (VBAC)?  Will my doctor allow me to even try a VBAC?

If possible, I did not want another C-section.  My recovery was horrible . . . I couldn’t sit up for several days, function without prescription pain medication and tasks such a breastfeeding, laughing, coughing were all very difficult.   Truth be told I also felt a bit cheated, I wanted that experience of having a “normal” delivery.  I wanted to be able to immediately hold my little girl in a hospital room as opposed to an operating room and have the opportunity to do skin to skin as soon as she was born.  I have heard from others that they had a wonderful (well at least a not so bad) C-section experience, but that was not the case with me.  Regardless of the method I would just be thankful for a safe and healthy delivery, BUT if I could have a choice, I would prefer not to go through major abdominal surgery again.  I find it surprising that many moms, including celebrities, are given an opportunity to choose a method of delivery and (MANY) are opting to have a C-section for convenience rather than a medical justification.  C-sections in reality are a riskier choice for mom and baby.  Many don’t realize that they actually have more harmful medical effects over a vaginal birth.

Studies state that even if a mother has a C-section with the first pregnancy,  attempting a vaginal child birth with future pregnancies can be very successful.  The American College of Obstetricians and Gynecologists came out with an updated list of guidelines (July, 2010) stating that not only women with one previous C-section could attempt a VBAC, but women with up to two previous C-sections, women carrying twins and women with an unknown uterine scar.  A VBAC has it’s risk, but definitely not any more than a C-section.  In fact, a successful VBAC has fewer complications than a elective repeat C-section.  Unfortunately, VBACS are not the norm in hospitals.  Despite the positive findings, the majority of doctors and hospitals do not encourage VBACs -  if they even allow them at all.  It is easier for the medical practitioner and hospital to perform another C-section than attempt a VBAC – but sometimes you have to ask who’s best interests do they truly have in mind?  Cesareans are at an all time high in the United States.  Doctors are too quick to preform them and mother’s are not fully informed of the risks involved in a C-section or the benefits of a vaginal birth.  C-sections are a life saving medical procedure for both mom and baby, but should be done at the right time for the right reason.

So what do I do?  I knew that I wanted to at least try a VBAC.  I discussed this with my midwife (I attend a medical midwife/doctor practice) and the plan we came up with was to schedule a C-section right at the end of my pregnancy (the day after my due date) and if I would go into labor naturally prior to this date – I could try a VBAC as long as there were no major complications.  Still vividly remembering the complications I had with my first delivery, I wasn’t overly hopeful, but it sounded like a good plan to me.  As the months progressed I had myself convinced that I would definitely go into labor early this time (I was 3 days late with the first one), which would mean a smaller baby and hopefully a better possibility of a VBAC.  But before I knew it I was VERY pregnant . . . and despite running after a 2 year old and participating in lots of outdoor adventures . . . my C-section was scheduled in 2 days and there was no sign of this baby coming out.  Ugh, I was so anxious about it, knowing that I had a scheduled surgery to deliver my baby was nerve wrecking to me.  I remember staying up the evening of June 19 stressing about the pre-op appointment I was to have the following morning.  I was just praying that whatever was going to happen with this delivery, C-section or not, that God would have his hand on it because it was out of my control (but to at at least allow me to go into a labor on my own and for this baby to come out when she was good and ready!)

Well, the next morning I woke up my husband around 6 AM with contractions and by 7 AM we were heading to the hospital with contractions minutes apart.  My midwife came in, examined me and said that the baby was a lot lower and in a better position than my first one was – I got the green light on the VBAC if I still wanted to try it.   But then there was the pain, the excruciating pain… ugh, labor sucks.  I was vividly recalling my previous 19 hour labor experience and the doubt just settled in, I really didn’t think I would be able to try and push another large child out.  A nice, quick C-section sounded SO appealing and I was SO tempted to just call it quits.  I mean, seriously, who tries a VBAC on their due date with a previous 10.4 pd child?  Why put myself through this torture? But I had to try it, especially since I fought for it in the first place.

This whole experience was just surreal.  I remember walking around the hospital room with contractions (in extreme, almost intolerable pain), holding on to the most loving husband in the world and being cheered on by the greatest midwife, thinking that there is no way this was going happen.  Before I knew it (and not a moment too soon), I was on that hospital bed pushing out a baby.  It’s almost a blur, what an absolutely incredibly amazing experience.  Amelia was born at 9:39 AM – through a VBAC at 9lbs 13 oz and 20 1/4″.  We did it!  I still cannot believe. I had a natural VBAC with an almost 10 pounder on my due date with a C-section scheduled for the next morning (crazy!!!)  I am so thankful that I had a doctor and midwife who let me try this (I think the nurses all thought my midwife was nuts), the support system around me that I  needed, that I didn’t give in to my doubts and allowed myself to try this.  As much as I would like to believe that I just became some kind of super mom, I really can’t take any credit as it had nothing to do with me – God allowed this little girl to come into this world like she did.  I like to plan things and think that I have some control over these events, but I don’t.

So would I do a VBAC again or opt for another C-section?  If I had an option, I would try the VBAC again.  I wouldn’t say that either method is exactly ideal.  I had to have an episiotomy, definitely not fun. I was sore like crazy and it hurt to sit and walk for weeks.  I pray and hope that things are still “normal” down there – ha!  Little Amelia also broke her clavicle, most likely from being such a big baby.  The pediatrician caught it at her first doctors appointment (it was missed in the hospital) and although he wasn’t concerned and it has healed with no complications, I was still very distraught by it.   But I’m now 6 weeks postpartum and overall I feel good (you know, besides for running after a toddler, taking care of an infant and completely lacking in sleep)  My body finally feels like it’s going back to normal. I would definitely say that my recovery is much better this time around than it was with the C-section.  I feel as if I could move around much more and be more hands on with Amelia from the start. I also know that if we want more children in the future, the fact that I had a VBAC, would make this decision less riskier and healthier for my body.  Again, I’m SO thankful that my doctors let me attempt this and that I had the God given strength to do it.

So if you are thinking about attempting a VBAC – go for it! It can be done!  At the end of the day there is only so much you can do or try and “plan.”  But at least be informed on what your options are so you can make the best decision for you and your baby.  Every delivery is different and each experience is unique to its own.  Both of my experiences, from labor to delivery, were worlds apart.  Choose a good doctor/midwife, it makes a world of difference, and remember that you have a voice in the way you want to try and deliver your child and ultimately, God’s in control.

 Sources:

HealthGrades 2011 Obstetrics & Gynecology in American Hospitals. July 19, 2011

The American College of Obstetricians and Gynecologists “Ob-Gyns Issue Less Restrictive VBAC Guidelines.”  July 21, 2010

(Eeeeek!!  The picture above was taken walking out the door on my way to the hospital…already in labor with contractions 5 minutes apart. Emotions on overdrive with anxiety, excitement and crazy nervous all at the same time)