Any other VBAC-ers? - Page 2

[Ms. B. Sprout]

Hey VBAC-ers! How is everything going?

[Smurfy]

I talked to a friend who had a successful VBAC in Sept, she may have scared me out of the OB consult route but I'll wait to talk over my concerns with my midwife first.  I'm a big believer that women should labor naturally in whatever way they need to to deal with the pain and contractions, but she was saying that for VBACs they give you an epidural, a fetal heart monitor and you're confined to the bed for the rest of the time.  I want the option to move if I feel the need, I want an epidural only if I'm screaming for one, and I don't want it until I'm at least 5cm dialated, and I may want the option to try a water birth.  Guess I have a lot to discuss with my midwife.  I just wish they didn't treat VBACs like such a freak show, the rate for uterine rupture is still extremely low, I understand the increased monitoring but don't confine me flat on my back in bed without the benefit of gravity like it's 1970 all over again. 

[bignerpie]

I'm trying for a VBAC this time, too.

My first birth experience was... difficult. TWo years later, it is still hard for me to think about or talk about without crying. I did everything "right" and still had a c-section. My labor lasted 33 hours, with the first 24 unmedicated. When I finally did get an epidural, it kept wearing off. I dilated to 10cm, pushed for over 3 hours, and my son went from 0 to +1. That's when everyone decided that I needed a c-section. During the surgery, the epidural wore off again, and I could feel everything. The anesthesiologist knocked me out, and I didn't wake up for a couple of hours. My son was born at 3:59pm, and I didn't get to see him until sometime around 9:00pm. That's the short version!

It was mostly bad presentation (posterior) that led to my having a c-section, and a combination of interventions. Maybe if I hadn't let them break my water at 4cm, he would have been able to turn around. Maybe if I had refused EFM, I wouldn't have been stuck in bed and could have gotten us both in a better position. I've been going through this for 2 years!

I posted about this in the VBAC forum a while ago, but when I was pregnant with my son, I had a dream that I was in the hospital in labor, and I was strapped down to a bed, hooked up to IVs, they took my baby out, and I was left all alone. I was so determined not to let that happen, but it's exactly what happened.

I had another dream, only a few weeks into this pregnancy, that I was standing in my living room, leaning on my husband, and the baby just slid right out. I could see my midwife walking up to our door through the window- she had just missed the birth!

I'm still nervous about having a VBAC and a homebirth on top of that. I had some cervical damage during the c-section. Basically, my cervix was almost cut in half. The operating report lists a 5cm extension of the uterine incision on one side of the cervix, and a 4cm extension on the other side. My midwife does not seem concerned about it. She said that she has experienced this before, and evening primrose oil usually does the trick. So, I'm trying not to let it worry me too much.

I'm doing a lot of things differently this time. With my son, the initial bloodwork at the hospital showed that my iron was dangerously low. After the c-section, I was so anemic that I almost needed a transfusion. I'm keeping a close watch on my iron this time. Also, my son was a winter baby, so I was not very active during pregnancy. This time, I'll be pregnant all miserably hot summer long! But at least I'll be able to get outside and be active. I'm also drinking RRL tea.

I'm worried about how I'll handle it if I have to transfer or have another c-section. I was so disappointed and upset and angry and depressed and traumatized about my son's birth. I just don't know if I can go through that again.

Whew... that was a lot to get out!www

[Ms. B. Sprout]

Big hugs, bignerpie! You have really been through the birth wringer. Birth stories like your remind me of this post from the VBAC forum that has really stuck with me, from an MDC-er named jen6:

I guess the best analogy I can come up with that has worked for me is swimming the English Channel. Some people who swim get sunny skies and calm waters, others get the storm of the century and a leg cramp at the worst possible time. So who "tried" harder? The swimmer who gets the storm gets to talk about it proudly, gets applauded for overcoming the challenge, doesn't feel shame, etc. I find the emergency c-sections judgments horrific. No one wants to hear my birth story. Another bad analogy----going to war. Some people get thrown into the Normandy landing, some people get to march into Paris during liberation. Same purpose, totally different experience to deal with. . . .  And you know what, I would do it again, only this time I would know more and be able to make even more informed decisions. THAT'S YOU! You know so much more this time, and you will try as hard, and do fabulously. JUST LIKE YOU DID LAST TIME! You survived and thrived and are willing to face the challenges to have a third child. I hope you will be swimming on a sunny day, : )! You can do it!

I just LOVE that quote. She was writing it to me -- I also had a terrible malposition labor similar in some ways to yours -- but now I am sending it your way.

[rareimer]

*hugs* bignerpie.  birth trauma is so hard to overcome.  it's hard to get through all the "why's" and "what if's", i've done it (and still do) for both of my c-sections.  it's hard even when you are fully informed and do everything "right"...and in the heat of the moment, after many hours of labour, being pressured by doctors, it can be hard to make all the "right" choices.  and even if you do, things can still go wrong.  that's a hard pill for me to swallow. 

i also felt everything during my second c-section when the epidural was wearing off.  when they finally listened to me (they didn't believe me at first,) i told them explicitly that i did NOT want to be knocked out.  at the very least i wanted to be conscious for the birth of my baby.  they gave me fentanyl, and while i guess i was technically "conscious", i was so messed up that i didn't even realize where i was or what was happening, or that i was even having a baby. 

i hope you can have the birth of your dreams this time.  you deserve it, you've been through a lot.

[wombatclay]

Big hugs to those in need... it's been 6 years since my c/s and I still sometimes play the "what if" game.  And after 6 years of listening to and sharing birth stories through ICAN it seems like "what if" and "I did everything right but..." are the two things that haunt mamas most.  It sucks.

In my case, I was being attended by a wonderful family practice dr.  There was no pressure at all, I went into labor on my own at 42+ weeks (my water broke but contractions didn't start for another 12 hours or so and still there was no pressure from the doctor), I labored/belly danced with my partner and a doula at home, arrived at the hospital at 5cm and labored in the birth pool, on the birth ball, in the halls, on the stairs, in the rocking chair, etc.  But it was back labor all the way, and after roughly 32 hours (19 of those hours at 7cm despite the gods be damned double peaked tidal wave contractions) I had a c/s.  Looking back, there were lots of moments where the story could have gone a different way.  I walked a LOT after my water broke to try and get things going... maybe walking wedged dd1 the wrong way into my pelvis?  Maybe if we'd realized that dd1 was posterior and asynclitic sooner I could have done something differently, or I could have opted for a c/s before I'd reached and gone past the point of exhaustion?  Maybe if I'd been more careful with my diet she would have been smaller and would have had more room to squirm around or if she wasn't my first or if I'd been more aware of fetal positioning during the second/third trimesters?  All the maybes and what ifs.  And with hindsight I know (at least with my head) that so much of that was simply stuff that was outside my (or anyone's) control.

I gestate long... dd1 was 42+ weeks, dd2 was 40+ weeks, ds was 42 weeks.  And I grow big babies... with dd1 I gained over 70lbs and she was 9lbs6oz, with dd2 I gained around 45lbs and she was 9lbs even, then ds I gained about 35lbs and he was 9lbs8oz.  And I know plenty of moms who stopped walking when their water broke and ended up with c/s, and plenty of moms who didn't.  I know moms who pushed out posterior babes and moms who didn't.  I know moms who lay flat on their backs and had beautiful births and moms who were active and had c/s.  So much is just the random shift of the moment.  Not that that really helps at 2am when my brain shuts off and my guts take over the game.  But still.

Anyway, I've had two hospital VBACs and am planning a third.  It's true that some care providers and some hospitals go a bit overboard with VBAC moms.  It's worth looking around, talking with a local ICAN group maybe, and figuring out what areas are most importnat to you and which ones you can let go.  I know mamas who have driven 3 hours to the only out of hospital midwife willing to take vbac mamas and I know mamas who have gone in pushing and invoked EMTALA.  I'm not comfortable at either extreme, but I did shop around and am willing to drive 45 minutes to a hospital that offers midwife attended VBACs.  It's not my dream birth scenario, but it's ok.  I agree to the heplock and intermittent monitoring and they agree to let me use the birth pool and push in whatever position I like.  There is a 41 week limit that bugs me, but they have good VBAC stats and while they think natural childbirth is a big odd they're willing to keep the meds out of the room and they're polite to my doula. 

There was "game" I played at my doula training that addressed birth plans and preferences... there were lots of birth preferences written on index cards (like epidural on one side and no epidural on the other).  You'd go through and select all the preferences you wanted.  Then the leader informed everyone that they could only "keep" ten of those preference cards.  And after everyone had finally managed to narrow it down to ten the leader walked around and randomly "took" one card from each person, leaving you with nine.  The point was to start a discussion about what was an absolute need... what a mama HAD to have in order to feel like the birth had been a success while also pointing out that life is random and so bringing up wyas to help a mom who didn't achieve everything on her list of needs (let alone on the list of wants).  It's a harsh little game but one I've found really helpful in terms of planning my own VBACs.  With my first pregnancy and birth I just assumed that everything was going to go fine... I did everything 'right", I had the right provider and the right doula and the right birth classes and the right prenatal yoga and the right hospital and the right mindset and a family history of quick easy births.  So when it didn't go "right" I had that double whammy effect.  With my VBACs I wanted to feel like I'd done everything in my power to have a good birth no matter how that birth eventually played out.  So my birth plan included c/s preferences and preferences for situations other than the "ideal easy vaginal birth".  And I realized that I was ok with certain interventions (heplock, intermittent monitoring, laboring in the tub but pushing on dry land) but not others (constant monitoring, arbitrary gestational limits, augmentation or any induction other than foley cath/AROM, etc).  And I realized I didn't really like my one option for attended homebirth and so with ds's birth I switched to a hospital based midwife practice fairly late in the pregnancy and then didn't look back.

Anyway, I'm rambling, but maybe doing a birth plan/preference game will help in terms of VBAC planning and deciding where to fight and what you can let slide.  For each person and in each pregnancy that balance will be different and it's easy to let outside pressures push you one way or the other... but in the end you're the one who will be playing the "what if" game at 3am.

[Smurfy]

wombatclay thank you so much for sharing that, I think that's kind of the stance I've taken.  I'm in Canada and the hospitals here basically allow midwives to take control of the birth, they're using the facility, the OB on-call will check in but that's about it, if I don't want an OB I don't have to have one.  I've been given the option to consult with one beforehand though, which is where I'm torn.  If something were to happen that would require an OB to step in I would prefer it be the one who did my c/s, but I don't want that to limit my options.  I like your preferences, I'm ok with a heplock, I'm ok with intermittent monitoring, I just want to be able to labor and push in whatever way I find most comfortable, not be limited to lying in a bed on my back only.  So my next midwife appointment I plan to discuss all of this and see what my chances are that the OB would be ok with that or if I'd be better off keeping an OB out of it unless it was an emergency situation.  I like the game idea, that was a way better way to discuss unplanned birthing scenarios than what our prenatal class did, she had us paint a picture, half way through we had to put a black line through it, and that was to teach us to deal with a change in plans and the disappointment, I get it, but I'm not 6, I don't need the analogy of picture.  Plus the game gets you thinking about what's important to you personally and what's maybe not so important.

[wombatclay]

I have to warn you that the game can be pretty emotional.  This was part of a DONA doula training program and none of us were actually pregnant and even so two of us ended up in tears.  Come to think of it, the crying was done my myself and the one other doula-to-be who had had a cesarean so I'm sure that had something to do with it.  But it really is a good tool for provoking thought and getting to the real core of what "makes" a good birth.

I was at a VBAC birth class (led by the OB who attended my first VBAC actually) and she asked the group to call out all the things they wanted/needed in their VBAC birth BUT you had to use positive language.  That was actually really difficult. I didn't think it would be so hard, but just switching things from "I don't want...." to "I want..." proved to be really tough.  But what was really interesting was that we then went through the list as a group and realized that there were ways to get a lot of those "things" even in a cesarean birth.  You just had to KNOW that those were things you needed.... like "I want to hold my baby all gooey and messy and smelly and wonderful" is totally do-able but you need to know you want that BEFORE the birth since otherwise you'll be handed a clean little blanket wrapped babe (and knowing L&D nurses, many have said they scrub the c/s babies up and have them ready to go as a way of trying to make c/s mamas feel better... not realizing that many c/s mamas look back on having missed out on the messy baby moment with a lot of regret).  So again, there's another "game" to help in birth planning. 

[Ms. B. Sprout]

Thanks for your thoughtful post, wombatclay.

[bignerpie]

I was glued to the computer all morning... The Feminist Breeder (http://thefeministbreeder.com/tfbs-live-homebirth-blog-event/) had her baby this morning! I've been following her pregnancy, and she just had an HBAC. This was her second VBAC, first at home. It was very inspirational to watch it unfold this morning, and it couldn't have come at a better time for me. I've been going through a minor freak-out lately, and it was pretty awesome to see a successful HBAC today.

[NDFanatik]

I saw TFB!!  YAY!!!  I love it bc her story is so similar to mine- CS, hosp VBAC, and now a HBAC!!  :D

[wombatclay]

TFB was amazing!  And the birth is archived for anyone who missed it.  There are a few fantastic collections of birth videos, including some that are more or less "just" vbac/hbac.  I'm trying to remember the name of the site I used a lot last time... it was helpful since individual birth videos were "rated" so I could find the most appropriate ones for my kiddos to watch too (ratings included nudity, which isn't a big deal for us, but also rated how noisy a mama was or how bloody the birth was... and at the time my 4yo hated hearing other people cry/moan and my 2yo was deathly afraid of people with blood on them so knowing ahead of time what was in a video really helped introduce ideas like moaning or bleeding gradually).  Until I remember the name:

http://wonderfullymadebelliesandbabies.blogspot.com/2008/07/birth-videos.html

http://www.pregnancy.com.au/birth-choices/vbac/vbac_videos/index.shtml (includes a vba3c)

http://www.pregnancy-and-giving-birth.com/childbirth-video.html (scroll down to the bottom)

[Ms. B. Sprout]

I really enjoyed reading The Feminist Breeder's birth posts and seeing her pix. Amazing!

Thanks for the links, wombatclay. Watching birth videos is the one area of birth-junkie-ness that I have not yet ventured into (but I want to).

[Smurfy]

Is it bad that I don't feel any need to read any books or take any VBAC classes?  I remember all the stuff from my first prenatal class, but I just feel like I want to take everything in stride as it comes, listen to my body and do what I need to do.  Normally I'm an info junky but I have no motivation for this.  Should I be getting more prepared? 

[NDFanatik]

Originally Posted by Smurfy 

Is it bad that I don't feel any need to read any books or take any VBAC classes?  I remember all the stuff from my first prenatal class, but I just feel like I want to take everything in stride as it comes, listen to my body and do what I need to do.  Normally I'm an info junky but I have no motivation for this.  Should I be getting more prepared? 

Have you had a vaginal birth before?  I think that a VBAC is very different from a normal vaginal birth personally from my own experience- mainly because of all tehe hoops you have to jump through and all of the emotional issues that can arise.  I know for me I HAD to prepare by listening to god VBAC stories, building myself up, learning all of my options so that i could fight if I needed to and preparing at the same time for the worst.  That was for my hosp VBAC.  Now that I'm planning a homebirth VBAC I don't feel NEAR the need to prep, but I am still teaching myself new things that I didn't know from my last birth and going through the same routine of lifting myself up and readying myself emotionally.

But I don't think everyone has that NEED to prepare- just as long as you know your options, esp for your birth setting :)

[rareimer]

i feel like i did all the preparation last time.  i read all the books, did all the research, feel like i did everything i could to prepare.  this time, i'm feeling more like i am just going to take it as it comes, listen to my body, and just try to stay focused and relaxed in the moment.  i think for me it was harder when i ended up with the 2nd c-section, after doing all that "work", and having it go that way.  and it taught me that no matter how much you do everything "right", you still have very little control over it in the end.  i think this time i am putting less pressure on myself, and am going at it in a completely different way.

[channelofpeace]

I am planning my third vba2c with this baby, as long as things are looking ok.  We have a blood incompatibility to contend with, so that is a challenge, but I was able to be non-chemically induced with my first vba2c and my doctor said he was game for that again, if necessary.  That one ended up being a really long induction and he felt confident that it wouldn't take as much this time. 

Hugs to all you mamas preparing for your first vbacs- I hope you find supportive care providers and comfortable places to give birth

Oh, here are my vbac stories, in case you are interested.  I give considerable back story both times, so you might want to skip it the second time

My induced hospital VBA2C

My homebirth VBA2C

[channelofpeace]

Originally Posted by rareimer 

i feel like i did all the preparation last time.  i read all the books, did all the research, feel like i did everything i could to prepare.  this time, i'm feeling more like i am just going to take it as it comes, listen to my body, and just try to stay focused and relaxed in the moment.  i think for me it was harder when i ended up with the 2nd c-section, after doing all that "work", and having it go that way.  and it taught me that no matter how much you do everything "right", you still have very little control over it in the end.  i think this time i am putting less pressure on myself, and am going at it in a completely different way.

Yes. This was exactly how I approached my second vbac attempt.  I knew that I wanted to try and give myself every chance but I wasn't going to let it break me if I ended up with another c-section. 

[Ms. B. Sprout]

Yes, this is how I feel too after having been through the big prep/buildup for my first VBAC attempt.
 

Originally Posted by channelofpeace 

Yes. This was exactly how I approached my second vbac attempt.  I knew that I wanted to try and give myself every chance but I wasn't going to let it break me if I ended up with another c-section. 

I would like to note that while I don't need to extensively research VBAC safety, statistics, etc. (because I've done all of that before!), I am still prepping in a huge way physically. My second c/s was for malpositioning and I'll be damned if I'm going down without a fight this time. So I am doing lots of chiro, spinningbabies techniques, no couch time, etc. I am prepping in a way, just not the same way as last time.

Another VBAC prep that I think is worth everyone's time is emotionally processing our prior births. For me that was going to ICAN meetings and telling my birth stories.

Another thing I am doing is reading VBA2C stories (like these!).

I'd like to second Robyn's observation about control, or lack thereof. I read Ina May, read Birthing From Within, hired a doula, did all that "doing it right" stuff before both of my prior c-sections.

There's no one right answer about prep, I guess. Just depends on where you are in your journey.

[konayossie]

This is exactly how I feel (except that this will be my first VBAC attempt). I feel like I did everything "right" the first time, read everything I could get my hands on during the first pregnancy and since, and I really haven't read anything with any new information in it in quite a while. I know I need to go to ICAN meetings, but I feel like that's the only really helpful thing I could be doing that I am not (or haven't already done). I am also quite the birth junky, so to feel so apathetic with regard to getting new/more info is a bit strange for me too...
 

Originally Posted by rareimer 

i feel like i did all the preparation last time.  i read all the books, did all the research, feel like i did everything i could to prepare.  this time, i'm feeling more like i am just going to take it as it comes, listen to my body, and just try to stay focused and relaxed in the moment.  i think for me it was harder when i ended up with the 2nd c-section, after doing all that "work", and having it go that way.  and it taught me that no matter how much you do everything "right", you still have very little control over it in the end.  i think this time i am putting less pressure on myself, and am going at it in a completely different way.