VBAC Victory!

By Stacey Escoffery
Issue 138, September-October 2006

Although I was never happy about the cesarean section I had in my first pregnancy, I at first accepted it and considered it a necessary precaution. I even used to tell people that my scar was not a big deal; I called it my badge of honor. However, more than a year later, when I was ready to get pregnant again, regrets about my C-section surfaced for the first time.

The anger and sadness I felt about the labor and delivery of my firstborn daughter became overwhelming. Once, at work, I came close to breaking down in the middle of a meeting, and many times I awoke in the middle of the night to find myself feeling the foreign and permanent bump on my bikini line—the thick, red, raised scar of a hypertrophic keloid. To me, the keloid seemed a manifestation of my underlying, unresolved anger about the C-section.

Perhaps we should rename keloids "angry scars." I was angry because someone had, without cause, invaded my body and robbed me of the experience of a natural childbirth. At first, my anger was directed solely at my obstetrician, but then I realized that I was also angry at myself. During my first pregnancy I was scared of the pain of childbirth, and uneasy about not being in control of what kind of birth I would have. So when my doctors told me that my labor would need to be artificially induced, I felt a bit relieved. A scheduled birth would mean that I would have more control over the process.

Or so I thought.

A series of events led up to my C-section. Toward the end of my pregnancy, I had a slightly low blood-platelet count of 113, which I now understand is not threatening at all (150 is considered a normal count). My obstetrician told me I could risk hemorrhaging during labor if labor was not induced about ten days before my due date. During my second pregnancy I had the same blood-platelet count, but the several doctors I consulted told me that it was no reason to induce labor.

My doctors told me that my baby would be large—at least eight pounds. This surprised me. Everyone in my family weighed about five and a half pounds at birth, and I had gained only 23 pounds during my pregnancy. I should have trusted my instincts—my baby weighed only 5 pounds, 14 ounces when she was born—but I ignored the small voice inside that told me not to listen to them.

The day I checked into the hospital, my platelet level had returned to normal, but the doctor proceeded to induce labor regardless; I felt pressured to go through with it to avoid inconveniencing my doctor or the hospital. Again, that small voice inside told me to leave, but having been already admitted, it seemed like too much trouble. I stayed.

They gave me Cervidil, which prepares the cervix for uterine contractions, injected Pitocin to stimulate my uterus to contract, and manually broke my water. But because my baby was not yet ready to be born, the Pitocin-induced contractions resulted in fetal distress. Watching my new daughter's heart rate fluctuate was terrifying. The doctor told me that she needed to perform an emergency C-section to save my baby. After I was rushed into the operating room, I was told that my daughter's heart rate had stabilized, but the doctor proceeded with the surgery anyway, as a "precaution."

When I saw my daughter for the first time, it was a miracle. I'd never felt so happy in my life, and cried and cried with happiness to see her. I yearned to hold her with every fiber of my being, but the medical staff would not give her to me. My doctor said that I would have my whole life to hold her. After a few minutes, they did briefly put her on my shoulder, but then took her away again and wheeled me off.

Back in my room, I was in agony. The nurses would not lift me from the bed but made me get up on my own. I knew something was wrong—the pain was so bad—but not once during that long day did my doctor check in on me. The next day, she finally came to see me, read my chart, and noticed that "someone" had forgotten to give me postsurgical pain medication. After the surgery, the pain, and the much-needed but late-administered drugs, I didn't feel confident about my ability to take care of my baby that first night. I decided to start breastfeeding her the next morning. When I did, I was so exhausted and in so much pain from the surgery that I had a very hard time.

The more I learned about what my choices could have been, the more bereft I felt. Through this grief I realized how much I needed to respect my own body, honor my feminine power, and cherish my womanhood. Respecting my body meant protecting it from unnecessary surgeries, and fighting for my right to stay with my baby in those early hours after birth.

Most people did not understand my grief, let alone its depth. They told me that I had a healthy daughter, and that was what mattered most. Many women even prefer C-sections because they can schedule them at a convenient time (although the six weeks needed to recover from the surgery is not what I call convenient). With C-sections, doctors can also control their schedules—no 2 a.m. calls or long, arduous labors—and they're paid more for the procedure. They are also understandably scared of lawsuits. It is rare for a doctor to be sued for a C-section, because it is considered a baby-saving procedure. The problem is that C-sections are no longer used solely for emergencies. The 2004 rate of cesarean sections in the US was 29 percent, up 40 percent since 1996.¹ In anticipation of my next pregnancy, I tried to find a practitioner who would support my desire for a vaginal birth after cesarean section (VBAC).