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Monday, January 18, 2010

Positive VBAC Story: Sarah's birth

It dawned on me that, after blathering on about successful VBACs and what not, that I had really neglected to tell my own birth story. And after posting the video of the "VBAC gone wrong," I was concerned that people visiting the site might decide they don't want to VBAC based on the bad experience of someone else.

I began my second pregnancy set to do another c-section, although my doctor initially offered me the choice. I think he was silently relieved when I decided to do a repeat section. I don't remember him going into any details whatsoever about the benefits of VBAC, just the risks - which made me not want to do it immediately. Nor did he tell me any risks about a c-section when my first child was born. If he had, I think I would have gotten up and ran away right then and there.

But back up a moment. When my first child was born, he was breech - most likely due to the fact that I have a bicornuate, or heart-shaped, uterus. This can be a problem for some, depending on the degree of defect. In serious cases, it can cause intrauterine growth restriction or even infertility, because the uterus is so divided that there isn't enough room for a baby to grow. In my case, it merely meant that, depending on the position of the baby, it might not allow enough room for him to turn, and he'd be stuck in a breech position. Which he was.

When they did the c-section the first time, he was stuck. Really stuck. His head was mostly lodged in my ribs the entire second half of the pregnancy, and at one point, I felt very violent motions like he was attempting to turn but just couldn't do it. Of course, my doctor never offered an external cephalic version, and being the idiot that I was at the time, I didn't ask. I just knew that breech vaginal births carried risks (like everything else, it seems) and I didn't want to do it, especially if my doctor hadn't performed many births like this in a long time. (As a side note, an ECV is usually not recommended for a woman with bicornuate uterus.)

Anyway, fast forward to my second birth. I was adamantly against a VBAC and thought it was just too dangerous. Somewhere along the way, my baby decided to be head down, something I found interesting, considering I thought that all of my babies would be breech because of my uterus' shape. I had also been very active on's birth forums, and one poster who routinely contributed on VBACs and home births (she was preparing for an unassisted home birth) got me thinking. At first, I'll admit, she boiled my blood a little bit, but something in me decided to research VBAC and give her a second thought. And once my baby was in the right position, it got me thinking.

When I told my doctor at 37 weeks that I was considering a VBAC, I thought he was going to swallow his teeth. Of course, he went on and on about the risks, and how he'd seen two ruptures. He almost got away with completely downplaying the risks of a repeat c-section until I decided he wasn't going to mention it at all, and I respectfully ripped him a new one with the information I'd done about it. I hired a doula, read all I could, prayed and waited. Despite having a few discouraging words from my care providers, (one midwife told me flat out "She didn't want to be doing this!") I pressed on.

I approached my 39th week and we did the routine vaginal exam at my prenatal appointment. Of course, there was no dilatation or effacement at all, which had me a bit discouraged. But I realized that this really didn't mean anything, since I had been about 3 or 4 cm dilated for weeks before I went into labor with my first baby, who wasn't even head down. A week later, I was in the hospital having my baby!

My labor began on the morning of a full moon LOL - I distinctly remember having trouble sleeping and looking out the window at the moon. Early in the morning I had back pain and was uncomfortable in bed, often changing positions and getting down on all fours to relieve the discomfort. After a few bowel movements in the middle of the night, I thought maybe something was going on. (I have ulcerative colitis, which can flare up under stress, so the bowel movements at 3 a.m. were not a sign to me right away that I was in labor. Merely I just thought, 'Oh great, what a wonderful time for this to start!!') Duh. LOL

Once I realized I was in labor, I stayed at home for a few hours and showered, puttered around and paced, which I always do while in labor. I was having some back labor, which we anticipated because we could see my daughter slightly turned on an ultrasound I had just had to check for position. Aside from my mom asking dumb questions during this point LOL, I managed to get through them okay. I decided to eat a piece of bread with butter on it (contrary to the 'starve yourself of food and water' theory in labor) and we decided to head to the hospital. We actually stopped at the grocery store on the way and picked up a few things for my labor bag, and I think the walking around helped me to dilate more.

Upon arriving at the hospital, I realized we had totally forgotten to call the doctor. LOL Whoops! I walked into labor and delivery and announced I was a VBAC, which they needed to know. I do feel kind of bad about not preparing them ahead of time, but perhaps that ended up being a good thing - because it possibly discouraged them from treating me like an anomaly or a problem, but rather like any laboring patient. Hospitals will often ban VBACs, but really, as long as they have the capability to do an immediate c-section on any laboring woman, what difference does it make? You can have any number of emergencies arise during a traditional vaginal delivery!

I labored for about three hours in the hospital before giving birth. The nurse checked me at my arrival and announced that I was six cm dilated and waters 'were bulging.' The doctor did break my water, which can cause an increase in prolapsed cord. Did he inform me of this? No. I should have researched it beforehand, probably, but at some point our physicians need to give us this information, too, as our healthcare providers. In fact, I don't even remember him asking me if he could do it.

I never felt the need to push (with any of my labors), nor did my doctors explain to me why I didn't. Had I known even more about it then, I probably would have waited until I did have the urge. I had no epidural; I remember thinking I might want it, and then decided it was too late. I wanted to see how far I could get without one, and seem to have a high tolerance to pain as it is. I did get Nubain, which the nurse accurately said 'won't do anything for the pain,' which it didn't. But since I had been awake since about 3 a.m., it helped me to rest in between contractions and gear up for the next round of pushing. My daughter was born after about an hour of pushing.

If anything, my labors - all different - taught me how to appreciate the powerful abilities of my own body as it was designed. I learned what I was capable of doing, and it was an amazing experience. It also opened my eyes about the maternity care in our country (world, maybe?) and how few of us are really willing to be our own advocates -- not only for ourselves, but for our unborn babies. So many women are adamant about not even taking Tylenol in pregnancy, yet submit - without question - to tests, poking and prodding, and endless interventions during labor. Why is that?

As they say, 'knowledge is power.' I'm hoping to encourage other women to seek that knowledge and use the power they gain from it.

Other positive VBAC stories can be found here: