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Micaela’s VBAC

Two years ago this month, my older son, M. was born. He came into the world via a necessary, though unanticipated, cesarean birth. His birth left my husband and I feeling fairly traumatized and uncertain if we would be willing to take a gamble on another birth experience. I initially felt like I would be too scared to try again for a vaginal birth, but, over time, became more and more certain that if we were to have another child, I wanted to have a VBAC (vaginal birth after cesarean). My primary motivations for wanting a VBAC were twofold: 1) I wanted to be able to come home from the hospital and actively parent my toddler (and this seemed like it would be exceedingly difficult while recovering from surgery), and, 2) I wanted to have a healing experience that would leave me feeling confident about my body and about birth.

Once we decided we felt comfortable going through birth again, I started thinking about assembling my team. I knew that it would take a village to have a non-surgical birth. I started attending the VBAC/C-section support group at BABS more regularly. I also met with a local OB who I had heard was very VBAC-friendly. I decided I liked him and that we could make this happen. We conceived and began making plans.

Our Birth Team: We hired a fantastic doula – one who had experience with lots of kinds of births, including VBACs. I met with her, early on, to try and decide if we wanted to have a hospital or home birth and she gave me great advice. She told me that the most important thing was to be in the place I felt safest. For me, that was the hospital, so that’s what we decided to do. I also knew I wanted to labor at home until I was in active labor. Although I wasn’t worried too much about uterine rupture,*** I was concerned enough that I knew I’d be nervous laboring at home by myself. My doula helped me set up an agreement with a local direct entry midwife where she was on call to come to our home during labor to listen to heart tones and check my progress, if I wanted. Just knowing she could listen to the baby’s heart made me feel very safe laboring at home (heart tones are often the indicator that a UR is happening).

With our OB, doula, and backup midwife all accounted for, my husband and I felt like we had the perfect birth team. But I also knew I still had a lot of physical and emotional work to do before the birth of our second child.

Physical Preparations: As I had in my first pregnancy, I went to prenatal yoga at BABS at least twice a week throughout my pregnancy. I also saw a chiropractor that regularly works with pregnant women, Dr. Brandon Osmon. This time, I saw him earlier and more often than I had in my first pregnancy. Once again, I had an anterior placenta, meaning that I would be very likely to have a posterior baby (for more info about how baby’s position can affect birth, visit spinningbabies.com). So I knew that I needed to make as much room as possible in my pelvis for this baby to turn and get into the right position during labor.

Near the end of my pregnancy, I also did multiple sessions of craniosacral therapy with Melissa Larimer and Molly McDonald. They are both gifted practitioners and I am convinced that their work is what helped my son move into a better position for birth. They also helped me with my emotional work, helping me process through some of the trauma from M’s birth that I was still holding in my body.

Emotional Preparations: Not everyone who has a surgical birth is traumatized by it, but I sure was. Additionally, we had been very worried about M’s safety during my labor, and I was very fearful as I thought about going through anything like that again. At my doula’s suggestion, I met several times with a counselor (Rosie Falls from Bloomingfamilies) who really helped me work through the trauma from my first birth. She helped me think about turning points, things I wanted to do differently, trigger points that might bother me during this next birth, and so much more.

And, of course, how could I forget my dear husband? He was 100% on board from the beginning with our decision to try for a VBAC. He listened to a lot of processing, worrying, second-guessing, reading aloud from websites, and more during our pregnancy.

Finally, I had to get my head in the right place. I read several books that helped me – mostly because they had stories from other women who had tried for VBACs (some who had had VBACs and others who had to have repeat c-sections). I also spent a lot of time talking with my unborn baby. I told him that I was going to do everything in my power to keep him safe and I asked him to do what he needed to do to be born. I really saw this birth as a joint effort between the two of us – something I hadn’t really considered the first time I was pregnant.

As the arrival of our baby approached, I would often vacillate between being sure I’d have a VBAC and certain everything would go wrong….I’d usually change my mind 3-5 times a day. Ultimately, I felt like it would just be what it would be. I knew going into the birth that there would be factors I could control and factors I couldn’t and make a conscious decision to simply do everything I could to make the controllable factors work for me. I also reminded myself over and over again that my chances of having a non-surgical birth this time around were virtually identical to what they had been during my first labor – 75%. Those are pretty good odds.

The Birth: After months of preparation, I was thrilled when I finally went into labor just a few days after my due date. Once labor began, I mostly stopped thinking about this birth being a VBAC. Instead, I felt like any other woman working to bring her baby into the world. The only time I thought about it was when the contractions got extremely difficult to manage and I found myself thinking, “I can’t do this. It hurts too much. Maybe I could just have a c-section and this would all be over.” That’s when I knew I needed to have an epidural. I had always been a big supporter of having a drug-free birth, but I wasn’t ashamed to use all the tools at my disposal to get to the goal of having a non-surgical birth. After about 24 hours of laboring (mostly at home) with the epidural giving me some much needed rest I was able to begin pushing our son into the world. Since I hadn’t pushed at all with our older son, I was absolutely over-the-moon to be finally experiencing this part of childbirth. After a few hours of pushing, we welcomed our son to the world. Weighing in at just over 10 pounds, he looked like he was about 6 weeks old already! As the doctor placed him on my chest, my husband and I both cried tears of joy and he said to me, “You did it. You really did it.” And I thought, “No, we did it. This was a team effort from beginning to end.”

Sometimes – no, all the time, I think – it takes a village to birth a child. If you are preparing to give birth it is my hope that you will find your village and move together towards a birth that helps you feel empowered and supported as you become a mother.

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***Uterine rupture is the thing most folks are worried about when they opt to (or are forced to) have a scheduled repeat cesarean. UR is less likely when the scar is low-transverse (as mine is and most are these days). UR can be a total rupture (which can have serious implications for baby and mama – including infant death and emergency hysterectomy), but it can also be a simple pulling of the scar that has no effects on baby or mother. Stats about the likelihood of UR vary based on all kinds of variables. There is a great chart here with more numbers than you can shake a stick at. In really simple, non-numerical terms, I reminded myself that while the chance of UR was higher for me as a woman with a scarred uterus, it was still VERY low compared to many other dangerous things that could happen to any mother/baby during labor (including placental abruption, cord prolapse, and shoulder dystocia – see info here).