My VBAC Success Story
I ignored my doctor to have the birth I wanted
When I was pregnant with my son in 2007, I read articles, listened to radio broadcasts, and watched TV shows that all reported the alarming rate of C-sections. Since my pregnancy had been without complications up to that point, I assumed this wasn’t something I had to worry about. I was more interested in the increasing popularity of natural birth.
“Should I forego an epidural?” I asked my doctor.
He said, polite as always, that some women thought they’d decline an epidural, but once they hit active labor, “they realized why epidurals were invented.”
He tapped into one of my biggest fears: pain.
So after the obstetrician broke my water and told me I’d be in “excruciating pain,” I agreed to the epidural. She assured me that epidurals didn’t slow down labor as I had thought. Ten hours later, I was in the operating room. I had been given enough Pitocin to dilate, but the doctor suspected that my baby was positioned sideways and mandated a C-section.
When I got pregnant with my daughter almost two years later, I did not want another C-section. In fact, I was planning my VBAC (Vaginal Birth After Cesarean) only hours after my son was born. After all, my body was well-equipped to carry other human beings – both of my children wanted to stay well past 40 weeks – and I knew that I could labor successfully if given the chance. But, my doctor warned me, due to my first C-section, I was now considered a high-risk delivery case.
The biggest fear doctors and patients have with VBAC is a uterine rupture, where the scar tissue of the uterus opens, necessitating an immediate C-section to save the mother’s and/or baby’s life. This, of course, is to be taken quite seriously. But since the risk of uterine rupture is less than 1 percent, which means only 7 or 8 women in 1,000 will experience it, I thought I’d take my chances. After all, there are plenty of fatal complications that can occur in labor, like placental abruption, which affects women who have not had C-sections. Even women who have never had previous abdominal surgery are vulnerable to uterine ruptures. Furthermore, there are risks with C-sections, too – hemorrhaging, blood cots, bowel issues, and breathing problems for the baby – and I knew that having a second one could make those more likely should I get pregnant again. I also knew that a vaginal birth would come with a shorter recovery time and therefore allow me to be more attentive to my son during a transitional time.
For weeks I carried the weight of my decision in my chest, fretting about whether I was succumbing to unnecessary risks, whether I was being selfish in wanting to avoid surgery and somehow putting my life before my baby’s. The only way to face this labor, I decided, was to hire a doula, someone who would personally assist me before, during, and after delivery. I emailed one who was recommended by a friend and meanwhile continued to read more about the benefits of vaginal delivery as opposed to C-sections.
When I posed more questions to my doctors though, I became confused and overwhelmed. The male doctor who performed my C-section the first time around seemed eager to use this opportunity to convince me that a C-section was a better option, even though for my first two trimesters, I had told him I wanted a VBAC. He explained that many female obstetricians prefer to schedule Cesareans for their own births rather than endure the pain of vaginal labor. He also went into a story about women in third-world countries who labor for so many hours, their bladders collapse and urine shoots out of their vaginas. On my next visit, the female OB (the one who convinced me to have an early epidural) recounted how the doctors and nurses on call gulp down bottles of Pepto-Bismol when they have a VBAC patient in labor because they’re so afraid that something will go wrong. And when I told her I was considering avoiding the epidural, she told me that was not an option. It would be mandatory once I was three or four centimeters dilated.
Feeling discouraged, I wrote to my doula, Ellen, to tell her I didn’t think it would be worth it for her to be part of my labor. If I had to get an epidural that early, there wouldn’t be much pain management she could help me with. She called me before I even closed my laptop, angry for what she thought was my doctor’s dishonesty. I did not need an epidural, she said, and I had as much chance of succeeding at a VBAC as I did at a regular birth. In the more than 500 births she had attended, she had only seen a uterine rupture once, and it was for a first-time delivery. To my surprise, she told me I needed to leave my practice, or I’d end up in the same situation I did the first time around, with a stalled labor and a baby who hadn’t moved into position because of a premature epidural.
5 VBAC myths debunked — Danielle Elwood
VBAC or C-section? The question we’ve been dreading — John Cave Osborne
New study shows ways to increase VBAC success — Angela England
Who could I trust? And why did it seem that natural birthing advocates were on such opposing sides from the obstetricians I had entrusted to deliver my baby? This time I listened to my gut and took down the names of three practices that my doula felt would support my VBAC. But when I called, no one would schedule an initial consultation. Instead, they would only see me if I officially switched from my current practice. Not wanting my maternal health to be in limbo 10 weeks before my due date, I looked at the bottom of Ellen’s list, at the only name I hadn’t yet considered: the midwife who worked out of a hospital a half hour away.
I never thought I’d choose a midwife. I didn’t know they existed beyond history books and the birth center a few miles from my home. But from the first minute I talked to Ronni, I knew I was in good hands. She was willing to meet with me for a consultation so she could answer all of my questions. She explained the slight differences of treating a VBAC patient and a regular patient. She was honest with me, and she fully supported my decision without ever skirting around the reality of the risks involved. (It also helped that in all her years as a midwife, she had never seen a uterine rupture.)
When I expressed concern over my obstetricians’ feelings about the switch, Ronni told me that they probably wouldn’t know I was gone. She was right. The office charged me an arm and a leg for select photocopies of my record, but I never received a phone call from a doctor asking me why I left. At my new prenatal appointments, in a cozy apartment with warm, green walls and a counter lined with tea, my two-year-old was welcomed with a box of toys and the title of “midwife’s helper” as he squeezed my blood pressure pump. In our half-hour appointments, Ronni did all the things my doctors did, but we also compared iPhones and talked about our lives and her recent deliveries.
Though my prenatal care was great, my labor was not as fun. Seven days past my due date, my daughter still hadn’t arrived, and it was the hospital’s procedure to induce before she got too big. I could receive only a small amount of Pitocin (large doses increase the chances of uterine rupture) through an IV to help things along, and as I sat on a hospital bed that morning, I lamented that the labor was already not going as I had hoped. Would I ever have this baby?
After seven hours, contractions were intense enough that I knew my baby was on her way. Surrounded by my midwife, doula, a hospital nurse, and my husband, I breathed, moaned, and visualized the clouds of Paris to get through particularly painful contractions. My husband stood by my side, rubbing my back as I rocked, sat, and walked, trying to get the baby to move into position. When I finally started pushing, I tried as much movement as possible. I squatted, I stood, I rocked. When the pain got so bad, I did what most women do: I asked for drugs. Ronni told me I was 9 centimeters dilated, and it was too late for drugs. Knowing I had come that far along gave me the boost I needed to get through the rest of my labor. A little after 9 p.m., I started feeling the urge to push, but after an hour and a half, the baby had barely moved. I got a thigh cramp that was worse than the contractions, and that’s when I started to curse at my midwife. I wanted her to DO something.
But within minutes I realized that no one could do anything. It was up to me, and solely me, to push this baby out. I closed my eyes and reached into the darkness, into reserves I never knew I had, in order to bring my daughter into the world. At 12:34 a.m., three hours after I started, I felt her body leave mine, and Madeleine, my nine-pound, one-ounce baby girl, was laid on my stomach. She and I locked eyes, and I can still remember the new warmth of her, those chubby hands.
That night, despite my exhaustion, I couldn’t sleep. I relived the whole surreal experience over and over in my head, still in disbelief that a baby with a head that big could come out a five-foot two-inch body. All the adrenaline convinced me I was the most amazing person alive, practically a superhero. The memory of my painful labor didn’t go away for a long time, but neither did my amazement at what I was actually capable of.
If I had stayed with my obstetrics practice, there were a few things they would have done differently. First, I would have had an ultrasound in the last trimester to see whether my second baby was bigger than the first, and therefore not suitable for a vaginal delivery. Considering my first baby was 7.5 oz. and the second was 9.1, they would have probably forced me to have a C-section. Second, the practice would most likely not have induced me seven days after my due date. Instead, they would have wanted to perform a scheduled Cesarean if I didn’t go into labor soon enough. Lastly, most doctors are not willing to let a woman push for three hours. Even though the average pushing time for a first-time delivery is two hours, most doctors start mentioning the dreaded “C” word after much less time, which is not helpful for a woman’s mental and emotional state. Believe me, I wish I didn’t have to push for three hours, but I am glad I had a caregiver who let me finish what I started. In essence, I am convinced that my doctors would have looked for ways to encourage surgery, rather than allowing my body to perform its natural functions.
I look back on the birth of my daughter as the most difficult physical exercise I may ever undergo, as something that taught me the utmost limits of what a body – my body – can do. I was exhausted in the days and months after her birth, as all mothers are, but I was also triumphant, with a new inner confidence.
What better way to enter the next stage of motherhood?
This is a really interesting story glad you were able to listen to your body & needs and everything worked out!
Wow, I am glad you stuck with it. I also had a VBAC, but my doctors were all supportive. It was a much better experience than the c-section I had after 18 hours of labor.
Congratulations!!! What strength and determination you have–not just to push out your baby (which is its own type of superhero strength) but also to listen to your gut and switch practices late into your pregnancy. I did just that during my last pregnancy (also a VBAC), and I know that switching care providers is ALSO a huge feat in and of itself. But it’s worth it when you can get the type of care that you are seeking!
Thank you so much for sharing your beautiful and inspiring story!
Thanks for sharing! I’m pregnant with my second and planning a VBAC. In my case though, my obstetrician (I’m going back to the same one) was telling me I was a great VBAC candidate a mere hour after needing a c-section with my first. He’s very supportive of VBACs and I’m glad I have him as a care provider.
It’s so sad in this day and age that we have to fight so hard to get what most would consider basic medical assistance and rights. More doctors should listen to their patients, and not just focus on covering their own butts or what’s easier for them. Not saying that all docs or hospitals are bad or that sometimes C-sections aren’t absolutely necessary, just that my recent experiences with my previous doctor has led me to a birth center run solely by midwives for the birth of my first child. Like you, that is not something I would ever have thought I’d do, but if they’ll actually listen to me, and take me and my concerns seriously, I can suck it up and have some pain. Congratulations on standing up for yourself – you should be very proud of that!
Kiki: Just a note though that the reasons why doctors and hospital behave the way that they do (in the US) has ALOT to do with risk management, insurance companies and a litigious happy culture. It isn’t so much about simply not listening to their patients or what is ‘easier’ for them but it’s to be sure that neither the hospital nor they will be the recipient of a million dollar lawsuit. Midwives and birthing centers have to deal with the same thing and many of them close up shop due to astronomical insurance rates of a complete lack of insurance.
My mom delivered my brother via emergency section, Christmas Eve 1990. When she was pregnant with my sister in 1994 there was not a question or thought to whether or not she needed another section. Her doctor never even mentioned it and they went along as if there had been no section at all. I asked her if they had even considered her “high-risk” and she said, if they did no one ever told her. My sister was a VBAC in September of 1994. She was my mom’s easiest and fastest labor. Now a days, if you have one section, too many doctors are scheduling all births as future sections. I understand that it may definitely be due to liability, but just because you are “in control” of the section doesn’t mean things can’t go terribly wrong. The difference is that the mother or spouse has to SIGN a form releasing the doctor from all damages which makes it “safer” for doc. Not always for mom or babe.
Snakecharmer, I’m so glad that your doctors are supportive of your decision. That’s all any patient can ask for.
And the fact that you’re a Snakecharmer will no doubt help things along.
Jana, thank you so much for sharing your story. About to have my first child it is motivating to hear how you overcame your struggles with your OB. I too switched practices to find a Dr. And hospital i was comparable with and met my needs.
I don’t understand what the deal is with American women pushing for two hours. The practice in my country is 30 minutes at most- and third stage usually lasts for five minutes. I don’t even know whether 2 hours of pushing is doable- and I mean active, productive pushing, not just the “training” pushed you are allowed to do. Doctors wait until the baby is almost born, then pushing it out takes only two contractions.
Thanks so much for sharing Jana. I had two awesome experiences with midwifes that were connected to the office of my ob/gyn. Great experiences!! My second son was breach during the end of my pregnancy. I had a consult with a Doctor who said he would try to do a conversion which was scheduled a few weeks out and there was a very high risk I would have to go into emergency surgery. My midwifes gave me some natural techniques to get the baby to turn. When I went back in for the conversion, it was canceled because the baby had turned!!! No need for the procedure and I was able to go to term and have the baby with the midwife. My girlfriend had a forced C section when she was an army wife, it is just what they did. When she had her second, she knew she would have to convince her Doctor to to do a VBAC. SHe did and is so thankful to have that experience.
Thank you, Jana, for this article. I am pregnant with my second child and want a VBAC for all the same reasons you mentioned. The practice that originally performed the cesarean in the first place, gave me no choice but to have another cesarean. I refused and found another practice. In hindsight, there were alot of things they did that I was not experienced enough to argue about or question. What a relief it has been to move to a practice that is supportive of VBACs. They were honest enough to make sure I knew a cesarean could still happen, complications can always arise. But they never batted an eye or argued with me about a VBAC. It took a huge weight off my shoulders and I look forward to welcoming my child into the world instead of being slightly terrified about surgery and recovery.
Great story! I had a successful VBAC and it is great from others. I was actually too late to get an epidural and am proud to say I was completely drug free during the whole birth. Wow what pain but it was super fast so definitely do-able. Congrats again!
Great article. Your description of transition and delivery is amazing. It’s so hard to put that experience into words. I gave birth to my first at home, and although the pain really took me off guard (I think I bought too much into the ecstatic birth stuff) it was the most awesome experience ever. Reading this made me want to give birth again. Like, really badly.
As a loyal reader of An Attitude Adjustment, I’m not surprised at how well written this is, but I still need to commend you on it anyway. My favorite line: ” All the adrenaline convinced me I was the most amazing person alive, practically a superhero.” I think we forget we’re superheroes — as parents — no matter how we got there. Thanks for sharing your personal story with us.
I cant say how inspiring your story is! I had a c-section with my first bc he was breach and I had a scary high blood pressure. I am now pregnant with our 2nd child and want nothing more than to have a VBAC. With my c-section I was so doped up that I dont even remember the first 2 days of my sons life. My husband, bless him, literally breast fed our son. I have zero memory of this. Then we go home and my incision opens up. We spent so much time on my recovering and I refuse to let that happen again. I am thankful to say that I have a wonderful OB that supports my decision for a VBAC. I pray that its possible.
I love this article. Have had two unmedicated births and the way you describe labor and the “rockstar” feeling that lingers with you gave me chills. Thank you
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For all of the reasons you stated, and some you didn’t, I chose a midwife. I didn’t want to be just a number in the baby factory. Most OBs just want to get in and out of there. My midwife spent time with me, got to know me and made me feel comfortable. It is amazing to me that the rate of C-section has climbed so high. Our bodies were made to birth babies and there is nothing more amazing than making it through a natural birth. The student nurse that was in my room the second time had been on rotation for 3 months and had not seen a natural birth! I was shocked. Kudos to you for standing up for what you wanted and getting the experience you knew was possible.
My comment was too long so I wrote a post
http://bit.ly/qoEuHh So what happens if you are the 1% that would rupture? You have no way of knowing. I was one of them.
This is a beautiful story, and one that is particularly inspring to me. I was also forced into an unwanted (and I believe unwarranted c-section) with my baby. I feel terrified at the thought of trying to have, but failing at, a VBAC if I decide to have a second baby. It helps to read that it can be done and there are still professionals, like your midwife, who care.
Wonderful story, Jana. I am also in the Philadelphia area, and I had by beautiful son via VBAC with Ronni just days after this article was posted. My birth with Ronni was everything I’d hoped it would be, even with pushing for 3 hours like you did.
I am glad you got your VBAC. It sounds like your midwife was very in tune with you and the baby, which makes all the difference. After 2 hours of pushing during my VBAC and then a very thorough exam, my doctor felt that a c-section was necessary and I had to trust him. I am certainly glad I did because when I got to the OR, they had lost my baby’s heartbeat and moved as quickly as possible to get her out. Thankfully she only needed a little suctioning and was ok–but my uterus was not. My uterus was completely open at the site of the previous incision. I am glad I had the experience of trying a VBAC, but I’m very glad that I trusted my doctor and that God was looking out for us. You DO have to find a medical professional you trust and who is tune with you and you have to trust their medical expertise. Many VBAC’s are successful, but there are situations where they aren’t. Thankfully my uterus was repaired and I went on to have a 3rd child who was delivered by c-section at 37 weeks.
Have not found anything an need adive my dr is trying to force me to do a vbac and i dont feel like im a good canidate i am barly five foot at one hundred four punds delivered a ten pound boy emrgancy c section sixteen months ago after his head was stuck on my pelvis and pushed for four hours! I moved to a new state and this doctor is telling me i have to do vbac but she has no clue what i went through last time no way do i wanna do that again and have a repeat! Any advice or incouragment?
No, you can’t know if you’ll be that .7% who rupture — whether you have a VBAC OR no history of c-section. Birth is risky, PERIOD. Whatever your choice, you’re taking a risk that something will go wrong. It’s a fact that your chances of rupture with one previous c-section are about the same as your chance of rupture with no previous c-section and a Cytotec induction. Yet doctors don’t take Cytotec out of their toolboxes simply because there’s a risk associated with its use. Neither should women take VBAC out of our toolboxes.