VBA2C

[carlycarlson]

Hello fellow mommies!

I'm new to this community and already feel so blessed to have stumbled upon these boards!

To make this as brief as possible, here's a Reader's Digest version & I would so appreciate any input. Thanks!

In 2007 I had my first c-section after a failed induction (I could write a novel on this experience... but will spare you for now!) I had my second c-section in 2010, which was scheduled and I was actually thrilled with how smoothly everything went. My healing has been just perfect and the whole experience was so much more pleasant and spiritual and awesome than my first unplanned c-section. But... I want so badly to have a vaginal birth.

My husband and I are planning our next pregnancy for early 2012, we'd like to start TTC in February or so. There are many factors involved here so I may add comments if you need me to fill in details later. But basically I live in a very small rural community, our hospital is tiny and the nearest "big" hospital is over 2 hours away. Our small rural hospital has an insurance agreement that prevents them from offering VBAC as an option. There are a few midwives in the area but I hesitate to go that route, simply because I have no experience with them and the risks are overwhelming to me. At this point I want to A) Become fully educated about my birth options (at home? with midwife in hospital - which I need to check if that's an option... etc) and what the risks / benefits of each would be. B) to hear experiences of women who've successfully (or non-successfully even) done VBAC after 2 c-sections. and C) Determine all that I need to do to prepare my body for a successful VBAC (are there specific exercises, yoga practices, bindings I should wear- heck I don't know- just anything at all that can help me be successful with this).

Thank you in advance, I look forward to reading and responding and hopefully learning, too! :)

-- Carly

[TrumpetMom]

Well, I could almost write your story myself, except my second c/s was not planned, and I had a rougher recovery than my first. But the years line up and my first was a failed induction. :-)

Anyway, I had an HBA2C 2 1/2 weeks ago. For me, it was a matter of birth at home or I'd end up with another c/s which I didn't want. Knowing that the risk of rupture after 2 c/s was only slightly higher than after 1 (0.9-1.9%, depending on the study you read), I knew the likelihood of that was low; 98% likelihood of NO rupture.

As for going the "midwife route", if you will, your best bet is to simply call or email them and ask questions. Tell them your story and ask what your state's policies are and whether they can and are willing to take you. (I say to ask about state policies because my state, Colorado, does not permit direct entry midwives from attendind VBAMCs unless the mom has had at least one vaginaly birth.) One of the DEMs I contacted referred me to a CNM who ended up being willing to take me, even after my HMO doctors found a marginal cord insertion on the placenta which was also near the cervix. We weighed the risks and decided to continue with the HB.

Basically what you want to find is someone that you are comfortable working with, whether an OB or a midwife. There are a lot of online resources about VBAC in general and a fair amount of info on VBAMC. You'll find a lot more stories of successful VBAMC than you will research, but it's more, I think, because it doesn't happen quite as frequently and so there isn't as much actual research.

Here are some resources you can look into:

International Cesarean Awareness Network (ICAN): ican-online.org

vbacfacts.com

Books: Silent Knife, VBAC Companion, Natural Childbirth After Cesarean, Ina May's Guide to Childbirth

Check out birth stories of VBACs and VBA2Cs on YouTube by searching for VBAC and/or HBAC (HBAC brings up some church related stuff too, so VBAC is better to search for),

Also if you're on Facebook, there are a few really good support groups; just search for VBAC (you'll find me on a couple of them :-)

Good luck! Be sure to make the decision that you and your family are most comfortable with and don't let people try to scare you into an RCS if it's not what you want.

[CordeliaLynn]

Hi Carly!  I also had an emergency c-section in 2007 - followed by a planned c-section in 2009.  I am now planning a home birth VBA2C in May, with midwives.  If you have any questions, or are interested in how it all turns out for me, send me a message.  In the meantime, please keep me in your prayers. :)

[0m Mama]

I am so glad to hear from other mothers that have such similar stories.  I really think that I had some form of PTSD after my first pregnancy, and it wasn't even the labor that was so devastating.  My husband at the time was in Iraq, and it was his mother and step-mother (who hate each other) competing for grandmother rites.  That was stressful, and then I apparently chose the wrong mother (the one who was actually nice to me throughout my pregnancy) to come into my emergency c-section.  Afterwards, nurses told me to give up on breastfeeding and start giving formula.  I was only 21 and was completely ignorant. 

When I got pregnant the second time, I still had no idea why I had a c-section the first time- only that I didn't want to talk about it or think about it ever again.  I was more than happy to have a repeat and have some control and peace of mind in the situation. 

However, little did I know then that it is so close to impossible to find a doctor or birth center that will consider a VBA2C, because of this supposed fear of rupture. 

I feel as though my only options at this point are another repeat, or homebirth. 

Luckily, I have been making phone calls and have been put in contact with an organization called ICAN.  They are the International Ceasarian Awareness Network.  They have local meetings and apparently have lists of midwives and doctors that will help you.  You can also probably try to attend a meeting or two, if they are convenient enough to get to.   If they aren't there is still an incredible online forum community where I have been getting some really great information on your legal rights.

I think that the hardest part is trying to rationalize this idea that medical journals state a need for more VBACs, while doctors flat out say no.

Good luck to us all.  I would love to hear your stories about how everything turns out.  

[border stories]

I had a home birth after 2 c-sections.  I am now planning my fourth babies birth, due in September, hopefully my 2nd VBA2C's :)

For me too it was either going to be a home birth or another section.  I *knew* that I would never be able to labour normally in a hospital hooked up and on my back.  The two previous c-sections had happened as soon as I got to hospital and my contractions tailed off.  I feel very insecure in hospitals and I don't trust people.  It's too bright.  Everyone connected to the hospital had said to me, oh no, after 2 c-sections you will never birth normally.  So yeah, the great advice really sealed it for me and I booked myself up with midwives.   I knew I could never labour normally and quickly unless I was at home.  After two c-sections I knew I wanted to labour quickly.  

During my pregnancy my midwife encouraged me to massage my belly daily with macerated oils, comfrey and st, johns wort I think.  To imagine the criss-crossing fibres of the uterus being firmly connected, flexible and strong as I did so.  We went through my fears and apprehensions at every meeting and she helped guide me through new ways of viewing the fears (everything and anything, from bleeding to death, to transferring).  My biggest fear of all and the chill I had down my spine was worrying that another c-section would kill me.  Major abdominal surgery is not to be sniffed at and complications after c-sections are the leading cause of maternal death here in the UK.  So my fears were pretty justified.

By the time my labour came I was in the zone.  In my own world and didn't fear anything.  10 hours in and my dd was born with me standing up holding on to the towel rail in my bathroom.  I was so shocked I just sat down stunned, not really understanding and believing I had done it :)

My midwives said that the best way to monitor a VBAC woman and baby during labour is to take the woman's pulse every 15-30 minutes and also the babies heart rate.  I didn't even notice my midwife doing this after a while.  She said any uterine problems present themselves early and can be detected like this if one pays attention.  She also reminded me that no surgery/ theater is prepped and ready to go 24/7 that people need to be paged and scrubbed up, and even in the event of a troubling situation arising we could transfer and call ahead to the hospital in good time (I live about 30 minutes away).

~  all this is very different this time around.  For my VBAC I paid independent midwives to be with me.  Here in the UK NHS (Natinol Health Service)  midwives are the norm and are who care for women during pregnancy and birth.  BUT they are not really like the midwives I employed.  They are more like OB nurses.  And come with their own set of hospital guidelines/protecols.  I thought since I had now had a normal vaginal birth I would go and check in with them and hopefully they would be more chilled with me.  No such luck.  Even after a successful home VBAC I am still considered high risk - as I will always have a scarred uterus!!  So annoying.   I think I will have to go back to the midwives I used last time.  Even at the tremendously high financial burden they incur :)

Let us know how you get along, i found the section on VBAC on the homebirth.org site to be useful too.

Claire