Caesarean Section to Vaginal Birth (VBAC)

By on September 25, 2013
By Adriana Schneider

Before I became pregnant with my first daughter I knew I wanted a natural birth and peaceful labor.  I think my quest began when I worked as an RN in the mother/baby unit and started seeing something alarming.  More and more women that I was caring for were having c-sections. Some days it felt as if I was surgical nurse and not a post partum nurse.  I would look at the assignment board for the nurses and see that half of the mothers had ended up with a c-section.  What was going on?  More and more women were also being induced.  I knew back then this was strange and it WOULD not happen to me.  My mother had all easy labors, so I would be the same right?

I had a very easy pregnancy, I breezed through the first trimester with barely any morning sickness.  As I approached my due date, the relationship with my Nurse Midwife started to get a little bit rocky.  Each final week of pregnancy felt like I had to defend myself for not wanting to be induced.   I made it to an unheard of 41 1/2 weeks without being induced.  Finally,  my water broke and contractions did not immediately follow.  A midwife friend told me I should go to the hospital right away.  So I followed her advice.  I ended up being on pitocin for almost 24 hours and pushed  for 2 hours. I hadn’t slept or eaten for 2 days.  This was the labor from hell!   Eventually my midwife told me it was time to throw in the towel and called the OB/GYN to do a C-section.  I was so upset.  Everything I didn’t want came true.  My daughter was positioned Posterior or sunny side up which made my labor difficult and hard for her to come out. But what also made my labor difficult was being in the hospital with all those interventions being done, not having a doula, being exhausted and not using good positioning.   I had a horrible recovery, losing lots of blood and returning to the ER after coming home with a severe urinary tract infection from the catheter.  I felt devastated and broken.  I did not want to go through another surgery to have birth.  I wanted to experience things normally and not be afraid of a horrible recovery from major surgery.  I began my quest to have a VBAC (Vaginal Birth After Cesarean).  I started searching on the internet and came across ICAN (International Cesarean Awarenss network).  I learned it IS possible.  I looked forward to having a VBAC with my next pregnancy.  During this time I learned that having a VBAC is a safe alternative to having a repeat c-section and is even supported by ACOG (American College of Obstetrics and Gynecology).
Repeat c-sections carry their own risks.  It is major abdominal surgery.  This means risk of infection, blood loss, need for hysterectomy and complications from surgery exist.  The more c-sections a woman has a higher risk for future infertility, placental abnormalities,and ectopic pregnancies ( see VBACFACTS.com for more information).   Having a c-section also makes breastfeeding difficult many times.
The benefits of having a VBAC are easier recovery from childbirth, better breastfeeding rates, less risk of your child being premature and having respiratory complications because your baby will choose its birthdate.  Often times when c-sections are scheduled, pregnancy dates may be off and a baby may be born premature.  There are risks to having a VBAC also, but the risk is small and has to be weighed with the risks of C-sections.   The main risk to having a VBAC is possible chance of a uterine rupture.  The risk of this happening is 0.5- 1% after one c-section with a bikini cut.  Yes, you read it right, less than 1% in most cases. The maternal mortality rate is the same for VBAC and for repeat  c-sections less than 1%.  According to VBACFACTS.com there is limited evidence that of the less than 1% of women who have a uterine rupture, there is a 2.8-6.2 % chance of infant mortality.
Once you make your decision to have a VBAC, it is important to support yourself with positive people that support your decision.  First and foremost,  you need to find a midwife or OB/GYN that is pro-VBAC.  Ask your providers how many VBACs they have attended in the past year.  If the answer is none or 1, it might be best to find another doctor.  It is important to also ask your doctor or midwife what their c-section rate is and what their VBAC success rate it.   Hire a doula, the money will be well worth it.  Having a doula increases your chance of having a positive birth outcome.   One thing to also remember is, it is not legal or ethical to force someone to have a repeat c-section and it is not ethical to place so called VBAC bans on hospitals.  There are many reasons why OB-GYNs do not want to perform VBACs.  Unfortunately, most of those reasons are benefiting themselves.  Timing convenience getting paid more money being a couple.
With my second pregnancy, I went on to have a successful VBAC. I  I was prepared this time. I interviewed many health care providers and found the right one.  I went to my chiropractor regularly to keep my body aligned and in balance.  Visiting a chiropractor helps keep the baby in an optimal position for childbirth.   I read Ina May Gaskin “Guide to Childbirth” , I found a supportive provider, practiced hypnobirthing and stayed positive even when I doubted myself.  I stood my ground when I went past 40 weeks again (FYI the average first time moms carry to the 41st week of pregnancy).
For more information on Vaginal Births After Cesarean contact your local or on line ICAN Chapter and go to ICAN-online.org or VBACFACTS.com and please also visit SpinningBabies.com for information on opitmal fetal positioning during labor and how to achieve that.
About Adriana Schneider, RN BSN IBCLC
Adriana is a Registered Nurse and International Board Certified Lactation Consultant.  She has been a nurse for 10 years and a Lactation consultant for 4 years.  She has 2 daughters who were both exclusively breastfed.  Adriana provides in home lactation assistance and teaches baby care and breastfeeding classes in the Palm Beach Area.  Adriana is a natural birth and
 breastfeeding advocate and she also runs a breastfeeding support group.  For more information from Adriana please visit her website www. Newbabynurses.com
Contact Adriana Schneider:

 

www.newbabynurses.com

 

561-809-5169

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