When I found myself unexpectedly pregnant in January 2011, a few things immediately went flying through my head and spouting out of my mouth:
And shortly after all that, I said — not in a panic, but in a complete state of calm — “I somehow get the sense that this kid is a boy and he’s going to be a c-section.”
I was right on both counts.
It wasn’t that I wanted a c-section. It was just one of the few instances of weird, prescient intuition that I’ve ever had… and since I don’t believe in weird, prescient intuition, I still did everything reasonable thing to minimize my likelihood of needing one, including, not least of which, finding a provider with a lower-than-average c-section rate. New York’s c-section rate was 34.7%; my OB boasted approximately 20%, lower if you factored out high-risk pregnancies. I minimized my time in the hospital, laboring 12 of 18 hours at home, where my only pain management was making sounds that I can only describe as being like those of an orgasming woodpecker. But once I got to the hospital, despite contractions every minute for another six hours, I had only dilated five and a half of the necessary ten centimeters needed to begin pushing. My water had been broken since 3:00 a.m., and my “sunny side up” baby was in distress. So when my OB looked at me and said that she would advise a c-section, I trusted her and thus, my prophecy came to pass.
Emergency c-sections can be scary, painful, and traumatic. So many women feeling coerced into them by myopic and uncaring doctors. I was extremely fortunate in feeling none of those things. I felt my doctor worked with me and listened to my questions and concerns. I joked with the anesthesiologists during the surgery itself. When my son was born, I felt that euphoric rush of hormones women talk about when they describe their natural births. My recovery went blissfully well, thanks to good luck and some awesome painkillers. It was a beautiful, happy birth.
The only time my skeptical self is ever tempted to believe in fate, it’s usually when I think of how my two children came into the world. My son arrived exactly as he was “supposed to,” and so was my daughter, who was born via VBAC — vaginal birth after cesarean — 33 months later. Just as I “knew” my son's birth would be a c-section, I “knew” my daughter's would be different. It wasn’t out of a sense to reclaim my body or my birth experience or heal from a traumatic c-section birth (though it can and is absolutely that for many women). It simply made the most sense for me. the American College of Gynecology and Obstetrics states that VBACs are a “safe and appropriate choice for most women” and between 60-80% of women who attempt one will be successful. Thus began my attempt to procure one of them fancy, new-fangled vaginal deliveries.
But anyone who has tried this for herself can tell you there’s a lot more that goes along with this decision that simply deciding one day “you know, when I go to the hospital, I’m just going to tell everyone that I’m going to push it out of my vagina.” Much, much more, with lots of accompanying emotions.
It used to be, across the board, that if a woman had one c-section, all future births would have to be as well (more on that in a bit). But from 1985 to 1996, the VBAC rate in the U.S. rose from just about 5% to 28%. But by 2006, it had dropped back down to a little over 8%. As such, it’s not something a whole bunch of people know a lot about, either academically or from their own experience. So if you want to go for a VBAC, you need to read up, which is fun at first, but then…
As you delve into getting the 411 on babies coming out of you, it becomes clear quickly that many doctors will not take you or retain you as a patient if you want to attempt a VBAC. So then you enter the next emotional stage…
I actually wound up going with a midwife. Once you find a healthcare provider who is willing and happy to work with you (they do exist!), you enter...
OK, back to the whole “one c-section = all c-sections” thing. This used to be the standard operating practice due to the fact that the c-section incision was vertical, starting below your belly button and extending down to your pubic region. Nowadays, barring unusual circumstances, the incision is horizontal across your lower abdomen. (All things considered, they are crazy small: My son was 8 pounds 4 oz and my scar is less than 4 inches long. HOW IS THAT EVEN POSSIBLE?!)
Why does this matter? Because with a bigger, vertical scar, you are more likely to risk uterine rupture due to a weakened uterus. This is still a risk with the low, horizontal (transverse) scar, but the chances are seriously slim (less than 1%). Despite advances in medical practice and technologies, the idea that VBACs were too dangerous to attempt has stuck in both public opinion and, unfortunately, among many practitioners. I have not met another woman who has had or tried a VBAC who has not heard any or all of the following:
“How are they letting you do that?! I thought once you had one all of them had to be!”
This is the least offensive of the bunch since it just comes from misinformation.
“OK, but even if the risk is small, it’s still a risk. Why would you risk even a little bit?”
I sort of hate to break it to these people that any kind of birth carries a degree of risk.
“That is selfish! The important thing is a healthy mom and baby! You’re risking your life and your baby’s life for an "experience"!”
Honestly I either roll my eyes at or troll these people, because they have obviously never experienced the thrill and excitement of all that research I outlined in stage one!
But sometimes the more obnoxious people’s skepticism gets to you which hastens…
At which point, you need to have a heart-to-heart pep talk with your healthcare provider. (This is where my midwife was a damn champion.) It also helps to experience…
I had to do some degree of convincing myself that my body was capable of a vaginal delivery. Other women sharing their own successes is a powerful motivator. And, of course, remembering that darling little fact that most women who are good candidates for a VBAC will have one. This usually carries you through your pregnancy, and even labor, right up until…
As someone who had never had the opportunity to push with her first birth, this was quite the education. Fortunately it passed and…
Because regardless of how they make their grand entrance, any emotion you have about that pales in comparison to the vast panoply of emotions you have in being a mom to these monstrous little angels.
Images: Erin Vest/Flickr; Giphy(7); Jamie Kenney