My first baby was an unexpected Cesarean section—and by unexpected, I mean it was never even a thought on my birth plan “radar,” if you will. So, what was my first thought after I found out I was pregnant the second time? “Oh no, I don’t want another c-section!” So, I guess one could say my initial feeling was less bliss and more a confused mix of fear and excitement.
First and foremost—I knew I did not want another cesarean, but what does that mean exactly? Is it even possible to have a vaginal birth after cesarean? If so, how can I make it happen? Could I possibly do something differently to get a different result this time? Can I still have a midwife?
First, in most cases, it is quite possible to have a vaginal birth after c-section—also known as a VBAC (vaginal birth after cesarean). That being said, it is always a conversation you should first have with your provider, who is instrumental in helping you map out options, because he or she knows your case personally and is intimately involved with all aspects of your care. There are certain circumstances when a VBAC is not possible, and because it varies from person to person, I won’t list them all here. The good news is that having a VBAC never prohibits your freedom in choosing a midwife for your care during pregnancy and birth.
My experience the second time around began very similar to the first. Again, in the middle of the night, my water broke. Filled with excitement, fear, joy, and terror at that very moment, my new plan was to attempt a VBAC. I decided to do things very different than the first time around. I decided I wanted no pain medication, no epidural, and no Pitocin (a drug commonly used to induce labor). I can’t say I was sure how to make that plan stick, but I placed that as a mental forefront goal.
For the most part, my labor began as planned. Though I had lots of back pain, the shower and massage seemed to help. I didn’t feel like I needed an epidural, though I did settle on a bit of Nubain to help with pain. It seemed to be just enough to get my cervix fully-dilated.
My ultimate plan seemed on track until the baby’s heart rate began to dip whenever I pushed. It went so low in fact, that they needed to help me get the baby out sooner. They gave me the option to try vacuum extraction, which helps guide the baby's head out of the birth canal and is sometimes used when the baby's health depends on an immediate delivery. I opted to try the vacuum and episiotomy, an incision made to assist in vaginal birth, knowing that if that didn’t work, I would likely have another c-section. Again, none of it was what I expected or hoped for, but a healthy delivery was of utmost importance. The baby came out with a healthy scream soon after the vacuum was used—and that scream was joy to my ears.
The baby was put right on my chest—skin-to-skin (before it was actually referred to as that). Now, though I would love to tell you that it was a picture-perfect moment, to honestly share the reality of that blissful day—along with my happiness, came a great deal of discomfort down below. I felt like a loser at the time—I mean really, just giving birth means you should be the happiest person in the world, right? But the pain had my mind preoccupied. Like everything else, however, I went with the flow and it the pain subsided.
The best thing to take away from my experience is this: go with the flow. Don’t be so fixated on a set plan, because more often than not, it won’t go the way you plan. A healthy, safe mom and a healthy, safe baby should be the ultimate priorities. Be educated, be prepared, and by all means ask as many questions as you’d like—but don’t be so fixated on the small details or your perfect mental plan—those thoughts can control you. Instead embrace flexibility…realizing that labor and birth are not black and white; instead there’s a great deal of gray in the mix. Above all—remember: every labor and birth experience will be unique and special.