VBAC: A Success Story

To have a successful VBAC- you need more than tolerance, you need support

Every birth is special and important. Every birth is a story and I have had 3 very different births.  My plan was to have an all natural delivery with each birth, however that didn’t happen with any of my children.  I have had two cesarean births and one vaginal birth.  If you have a Cesarean (C-section) first, it is unfortunately very difficult to attempt to have a vaginal birth afterward, this birth type is called a Vaginal Birth After Caesarian (VBAC).  Today you get to hear my story and about my fight for a VBAC. 

A VBAC is a very real possibility for many women, but many are unaware of or are scared of the possibility.  There is a lot of fear placed onto expecting moms by family, friends and even their medical providers; much of that fear comes from the labor process.  There are risks with vaginal births, there are risks with epidurals, there are risks with major abdominal surgery (C-Sections are major surgery people), and there are risks of VBAC; however most women only hear the risk of VBAC. The US had a cesarean rate of 31.8% in 2020, in 1996 the cesarean rate was only 20.7%.   So as health care is supposed to improve, our need for major abdominal surgery in order to give birth has increased by over 10% in 25 years? Does anyone really believe that one third of births are EMERGENCIES and need major abdominal surgery? If all of these are truly emergent, then something else in how we provide care to laboring mothers is wrong…. I could go on a long tangent here but that is for another day

I have had a Cesarean after induction and ‘failure to progress’ with my first child.  Again, I could go on about how so many women have ‘failure to progress’ but that is for another time. After my first C-Section I was hoping for a VBAC or Trial of Labor (TOL) for my next birth, however with my second I had an emergency C-Section due to sudden onset of Pre-eclampsia. With my third child I again was hoping for a TOL and a vaginal birth after two cesarians (VBA2C), and…… I did it!!!!    BUT I had to work HARD for it, not just in labor but to find a SUPPORTIVE provider that didn’t use fear tactics and non-conservative measures to limit my options.  It was work even with trying to find a VBAC supportive or tolerant provider after my first, but it becomes significantly more difficulty to find a supportive provider for VBA2C.  

After my first C-section I had to switch out of the two rural hospitals closer to my home because as a hospital they do not allow TOL for VBAC.  Luckily there was a OBGYN group that employed midwives and was known to be more VBAC “tolerant” than other similar distanced hospitals.  I hired a doula to help provide support to myself and husband during labor, also to help us focus on our VBAC goal and not become victim to inappropriate fear tactics or rushing of a normal birth process.  With the sudden onset of pre-eclampsia that I had, I unfortunately needed to an an emergency C-section without ability to have a TOL.  I had always worried when preparing for my second birth that I would feel like a failure if I ended up with another surgical birth.  However what made me feel comfortable with what happened was that I would have needed a C-section with my 2nd child, even if my first had been an all natural, easy home birth.  My 2nd C-Section had NOTHING to do with the fact that my first child was 10 lbs or that the reason for my first surgery was “failure to progress”.  I often worried getting closer to the due date of my second about how I would feel if “I couldn’t take it”, “If I got pushed to be scared, or if my husband did”. I sadly was relieved that I didn’t have to worry about “failing”.

After finding out my husband and I were pregnant with our third child we started care with the providers that delivered our second child.  Now that I had a history of two C-sections I would no longer be able to have the midwives deliver my baby and would need to have the OBGYN’s provide labor and delivery care.  Even though this was a large group of providers it turns out that there are only a few OBGYN providers that were supportive of VBAC/TOL, even less would be likely to allow for TOL after VBA2C.  Since all the providers rotate whoever was on-call, there was a very low chance that a VBAC or VBA2C “tolerant” provider would be present at my child’s birth.  Much of the time, the reasons that I was not “ideal” for VBAC was so restrictive that I doubt 5% of C-Section mamas would qualify. Luckily I am part of VBAC support group and learned so much about what to look for when finding a supportive provider and not a tolerant provider.  I had heard AMAZING things about a truly SUPPORTIVE MD in the eastern suburbs from countless Mamas in the group.  I wanted support, I wanted a provider that was patient with the process, and I wanted for my baby and me to be safe.  After my husband and my first meeting with Dr. Anderson we felt at ease, I felt heard, I felt SUPPORT. So at about 30 weeks I started driving 60 min 1 way for my OB appointments. I never questioned switching doctors after our first meeting, I had never felt that comfortable with an OBGYN or midwife before him. 

In preparation for VBA2C we hired the doula we hired for my 2nd birth, attended a VBAC specific class, as well as the typical birth preparation things. As of course these things go, I ended up getting high blood pressure and needing to go on medication 32 weeks and eventually on bed rest at 35 weeks.  I ended up getting Ultrasounds and stress tests multiple times a week.  I had to be induced at 37 weeks due to high blood pressure which is pretty standard for all birth providers. 

My doctor explained the induction process he follows would allow my body to slowly start labor to try and use the least amount of interventions possible to increase my chances of VBAC.  The nurses- well all but one- seemed to be much on the same page as myself and my doctor.  I had cheer leaders with me all day and night. Long story short…. My son was born 4 days later after 4.5 hours of pushing.  Although there are difficult and painful things to consider recovering from a vaginal birth, my husband and I both believe that I was more comfortable and was able to be more active much faster than after my C-Sections. It was ALL worth it, yes I would choose that path again in a heartbeat.

Guest Writer: Lindsey Johnson