Emotional VBAC After 2 Cesareans

To tell this birth story, I want to say a little about my first two birth experiences. My first child was born 10 years ago. He was breech and after some efforts to get him to turn, I had a c-section. My experience with the c-section was not good. Staff members were talking about their children’s soccer game, there were a number of students observing in the room. I remember my vitals being called out and it felt like I was not even a person, or at least not a person that was present and deserved some attention. My mother and husband at the time were present and tried to be comforting, but it was a very lonely experience.

Afterwards things did not go well. I was in a great deal of pain. Apparently the IV delivering morphine was not in my vein, so I was getting very little medication. I couldn’t hold my baby because of the pain. Breastfeeding got off on the wrong foot and I experienced postpartum anxiety and depression.

Seven years after that experience, I had divorced, remarried and was pregnant again! We were
very excited and I was sure that this time would be different. I told my doctor that I wanted a
VBAC and I thought for sure that it would happen. I felt so sure that I didn’t really do my
homework. I didn’t educate myself as much as I could have to know what some of the obstacles could be and what tools may or may not be available to me. I went in for a check-up on my due date, had an ultrasound to check on baby’s well-being and it was discovered that my amniotic fluid was low (oligohydramnios). We were told that I could have c-section that moment or I could come back in the morning, but those were the only options that we were given. I regret not asking more questions at that moment and seeing if something more could be done to prevent another c-section.

This is where I think having more knowledge could have come in handy, but we opted to come the next morning and have a c-section. I remember crying after that appointment and being so disappointed and worried that things were going to be the same as my last c-section. The c-section went smoothly, staff was more sensitive this time, and I did not have the issues with pain medication not working as I did before. My husband, Chad, was very helpful and supportive, and I did not experience the anxiety and depression that I had previously, but it was still a disappointment.

Two years later, Chad and I had discussed having another baby a lot. Part of me felt like our
family was not yet complete, but I still felt reluctant and that had a lot to do with not wanting
another c-section. We went for it anyway and I was soon pregnant again, this time with a girl,
we were tickled pink! My doctor said I would need another c-section after having two previously and I accepted that, not realizing that a VBAC after two c-sections was an option. We decided that we would make this the best c-section possible. I read about “family-centered” c-sections that supported methods of making a c-section as personal and benficial for mother and baby as possible. We made a family-centered c-section birth plan but ran into a little resistance from my doctor on some of the things that we wanted.

I started to feel discouraged and a little angry. Not only was I going to have a third c-section, but I was not going to be allowed to hold and nurse my baby immediately. To me, having a c-section took so much more away from me than just having my baby come out of my vagina. It took away my choices, freedom and power. Being told things had to be a certain way because its a surgery made me feel like I wasn’t giving birth at all.

Having heard other birth stories, I knew I was missing something special and that just made me
sad. I did not want to give up on having a c-section “my way” but felt like we needed more
support. I wondered if having a doula for a c-section was something that was ever done. A friend suggested that I talk to René. I gave her a call and had a long and informative conversation. She told me that VBAC was possible after two c-sections, especially with my history, since both of my reasons for previous c-sections did not indicate that I would necessarily need another one. I was delighted to hear this!

René encouraged me to talk to my doctor, but I was afraid of what I might hear. At my next appointment I told my doctor that I would like to try for a VBAC. I was immediately told about the danger of uterine rupture, especially after two c-sections, but this time because of my own research and having talked with René, I was able to respond with the fact that there is not a significant increase in risk after two c-sections versus one and that Chad and I wanted to VBAC. The doctor agreed to “let us try” but said that I could not be induced, meaning I would have to go into labor on my own by a certain date.

I was thrilled that it was even a possibility. As time went on, we continued to read and prepare for a VBAC but were starting to feel a little overwhelmed and knew we needed the help of someone with experience and knowledge. We met with René and knew we wanted her to be part of our birth. She got us going on a path that we both felt really good about. We signed up for a birth class, I started seeing a chiropractor and eating dates and doing yoga as much as possible. We felt very positive about how things were going.

As my due date approached, we were starting to feel a little nervous. It seemed like our doctor
was giving more and more restrictions, and I felt like there would be be some reason to have the c-section. We looked into switching doctors and hospitals, but none of those options worked out.

We were initially scheduled for a c-section just a few days after my due date. This made me nervous. There had been a few instances of contractions but nothing that had developed into real labor. René was encouraging that it all was leading up to the real deal, but I was worried that I would run out of time. I asked my doctor extend the c-section date to closer to 42 weeks, knowing that up to 42 weeks is still considered “normal” and she agreed. There was still reluctance to use pitocin, so I knew I needed to go into labor on my own.

My due date passed, then 41 weeks passed. I had been due on Nov. 1 and on Thursday the 10th I started to feel more contractions. My mother came and spent the night. I could not sleep so we stayed up watching The Crown on Netflix while I sat on the birthing ball. On Friday morning it seemed like the contractions had decreased in intensity and I was really disappointed. We walked up and down the street throughout the day, and by that evening contractions were intensifying again. At 6:00pm the contractions were suddenly more intense and 3-5 minutes apart.

We decided to go to the hospital, and René met us there. Contractions were 3 minutes apart and lasting 90 seconds but I was only 2 cm. That was disappointing but we did not want to go home, there would be too many distractions at home and the hospital gave some comfort. Labor continued through the night. Contractions were definitely becoming more difficult to cope with.

René and Chad were sources of constant support. René gave many options of positions and things to try. I leaned on Chad or the birth ball during some contractions, then sat on the toilet, which really made the contractions more intense. We got in the shower, leaning over the birth ball while spraying warm water on my back. At 10:20pm, I was still just 2-3 cm and feeling discouraged. We decided that a half dose of a narcotic may help me to rest. I was a little reluctant to do this because narcotics make me feel strange in a way that I don’t like, but I was not ready for the epidural. My goal was not necessarily to have a natural birth, but René had explained that less intervention was our best chance of having a VBAC and epidurals can slow things down.

After the narcotic wore off, the contractions had spaced out for a time and then returned with intensity. At 2:30am I was 4 cm, and was starting to feel like I could not go on much longer. By 3:30am I asked for the epidural. I think not knowing how much longer labor would go on and feeling like at 4 cm I had a ways to go, made me opt for the epidural. If I had been 7-8cm perhaps I would have not gotten the epidural, I guess I will never know.

By 4:30am I had gotten the epidural, and as predicted, it did slow down labor. I was
positioned in the bed with the peanut ball, and at 6:20am I was still 4 cm. At 8:00am I
was 5 cm, and my water had broken. The OB on-call came in at 8:40am and reiterated
the risks involved in a VBAC after two c-sections and there was a part of me that felt
some fear. If uterine rupture is not likely, then why do all the doctors keep making me
feel like it was very possible? Chad and I both felt like we had been repeatedly told that
uterine rupture was possible and could be catastrophic, but don’t recall ever getting
these type of warnings for the c-section, which actually carries with it more risks than a
VBAC.

By 10:15am my cervix had not changed, and the doctor decided to use a low dose of pitocin.  At 1:00pm, contractions are picking up and I am placed on my side with the peanut ball. By 2:30 pm, I was 7cm.  René, Chad and my mom all helped with relaxation and massage, but their really hard work was about to begin!

At 4:40pm, my cervix was still dilated 7 cm and the doctor told us that if there was no change in two hours we will have a c-section. The thought of that at this point was devastating. We had been in the hospital laboring for almost 24 hours, and that was not what anyone wanted to happen.

At this point, my mom shared with René a special prayer book that she had brought along. It had belonged to her Uncle Clem, whom she had always felt was a kind of angel. He spent most of his life living from place to place with no real possessions, and what he did have he gave to others. I think of him as a sort of St. Francis. My mother took René's hand and placed it on the prayer book, and René said she could feel the energy coming from that book.

At that point I was crying. I felt cold and could not stop shaking. My mom covered me with her sweater, which had the prayer book in it and continuously rubbed my back while sending me all her positive energy. René told me to focus on visualizing my cervix as the bud of a flower that easily opens into a full blossom. She then suggested that we try something different than the peanut ball and had me placed in the “pretzel position” with plans to change positions every 20 minutes. She was like Mary Poppins, with an endless number of “tricks” in her bag.

René, Chad and the labor and delivery nurses work extremely hard at moving me into different positions as I envisioned myself walking through my garden at home. Every time I came to a different flower, I would pause and watch it blossom in my mind, from azaleas to gardenias and roses.

When the doctor came in to examine me at 6:45pm, I was fully dilated! Everyone’s hard work and positive energy had paid off! It was time to push! The room seemed full of positive energy and within a short time of pushing Marguerite McKenzie Chenier came into the world.

It was such an amazing moment that had been so long awaited. There were so many people that helped make this VBAC a success. I don’t think it would have happened without René
and a doctor that was willing and patient enough for the vaginal birth to occur. And the
hard work of Chad and my parents meant everything. I feel very lucky that things came
together as they did and we were able to have the birth we did not think possible.