A Mother’s Experience with Vaginal Birth After Cesarean Delivery

Despite having a C-section scar from the past and facing my doctor’s policy, I was determined not to let these factors prevent me from a natural childbirth, marking my unique journey as a mother’s experience with vaginal birth after cesarean delivery.

In 2011, when my twin sons were born through emergency C-section, I did not feel like I had given birth. A team of physicians had no choice but to avoid a vaginal delivery to preserve my infants and me. I could not do anything but lie there, clenching my husband’s hand with a white-knuckled grip. Even with my eyes closed, I could not block out the fluorescent lights since they were so bright. My sons, who were six weeks early, were taken away to the NICU while I was required to remain in the recovery room for four hours. I was not even the first person to hold them.

I knew that my friends and relatives were correct when they insisted that it did not matter how my sons entered the world as long as they were healthy. Nonetheless, I could not help but feel tricked, as I had always desired a vaginal birth. (I recognize that not all C-section parents feel this way.)

The Subsequent Pregnancy Was Different

My recovery was slow because I had to spend the remaining two months of my pregnancy in the hospital on bed rest. I was unable to walk or touch both of my infants at the same time, and the separation from them hindered my ability to breastfeed. When I saw two pink lines on a home pregnancy test 18 months later, I was determined to attempt a vaginal delivery. I yearned to experience labor, including its discomforts.

I told my OB-GYN that I believed a VBAC (vaginal birth after cesarean) would heal the emotional scars from my prior labor and delivery and that it would be best for my health and my child’s health.

“You are an outstanding candidate,” he replied. Many birthing parents are ineligible for VBAC for medical grounds, especially if the reason for the C-section is likely to occur again, such as not dilatation sufficiently. However, if she wants a VBAC, he would not be able to deliver her.

Why Many Hospitals Avoid Vaginal Birth After Cesarean Delivery

My physician emphasized that a VBAC necessitates certain safeguards that increase the risk for physicians. VBACs are associated with a higher incidence of malpractice lawsuits, resulting in higher insurance premiums for doctors who do VBACs. My doctor’s office had a stringent “no VBACs” policy, which was not unusual. Within a 40-mile radius of my house in Temecula, California, I could not find an OB-GYN who would support my desire to labor naturally.

This tendency directly contradicts National Institutes of Health recommendations (NIH). “We wish for the patient to have options. “We want doctors to inform patients that the treatment is relatively safe, disclose the risks and advantages, and then let the patient decide,” adds F. Gary Cunningham, M.D., who chaired the committee that drafted the 2010 NIH consensus statement on VBAC. However, I do not believe this to be the case since, if it were, I feel the VBAC rate would be higher.

In fact, hospitals are considerably more likely than physicians to have such policies. Dr. Aaron Caughey, professor at Oregon Health & Science University, says, “Just as many small hospitals are not equipped to handle major traumas, they also lack the resources to perform the emergency surgery that may be required during a VBAC.”

Pros and Cons of VBAC

According to the American College of Obstetricians and Gynecologists (ACOG), vaginal birth after cesarean (VBAC) is a safe and reasonable choice for many women giving birth. In fact, according to a study published by StatPearls Publishing, “VBAC is associated with less maternal morbidity and with a decreased risk of problems in subsequent pregnancies” when compared to repeated C-sections. Additionally, sixty to eighty percent of laboring parents who seek a VBAC are successful.

Despite these statistics, most first-time C-section parents choose to undergo another C-section. According to the Centers for Disease Control and Prevention (CDC), only approximately 13% of births following a first C-section are VBACs, down from 28% in 1996, when a surge in malpractice lawsuits prompted the first hospital bans.

The Dangers Associated With A VBAC

The most serious medical risk associated with a VBAC is uterine rupture, which occurs when the scar from a prior C-section rupture due to the pressure of contractions. If the ensuing tear penetrates all layers of the uterus, it can be fatal for both mother and child. However, the incidence of uterine rupture is extremely low—approximately 1%—when the preceding cesarean scar is horizontal in the lower uterus, as it is in the majority of women who undergo the surgery. This is comparable to the risk of any significant birth emergency.

Dr. Shannon Clark, associate professor of maternal-fetal medicine at The University of Texas Medical Branch in Galveston, explains that when rupture does occur, there are almost always warning symptoms that can be detected by fetal monitoring as long as the mother is hospitalized. These include a decrease in the infant’s heart rate and the mother or father experiencing pain, blood, a quick pulse, or sudden nausea and vomiting. A doctor will perform an emergency C-section in this situation.

The Dangers Of Repeated Cesarean Sections

Repeat C-sections have their own unique disadvantages. Each one raises the chance of future pregnancy difficulties, including placenta accreta, for the delivering parent (when part or all of the placenta remains too firmly attached to the uterine wall). “Some patients have perished as a result. This is related to approximately 14% of maternal deaths from bleeding, according to Dr. Cunningham. Placenta percreta and placenta increta pose significant dangers. In addition, C-sections are associated with a higher incidence of infection and blood loss, as well as a shorter recovery and chronic discomfort, according to California OB-GYN and VBAC supporter Stuart Fischbein, M.D.

And although I had no plans for a third pregnancy, I was concerned that another C-section would hinder my ability to nurse and chase after my twins when I returned home from the hospital.

After examining the advantages and disadvantages of vaginal birth after a caesarean section, I chose to switch from my longstanding OB-GYN to a 50-mile-away solo practitioner affiliated with a different hospital. I also hired a doula whose VBAC success rate was great. Together, we meticulously designed a comprehensive vaginal birth plan that included meditation, massage, and multiple labor positions. Then, I had no choice but to wait.

My VBAC Experience:

When my labor began early one morning in the middle of my 41st week of pregnancy, contractions came quickly, initially every 15 minutes and then every five. I contacted my husband, who was at work, as well as my doula, before attempting to calm down and breathe in my bed. As expected, my water broke.

I was resting in the back of our Ford Fusion, holding the front seat for support, minutes after he returned home. After around 40 minutes, the automobile came to a stop. We were stuck in traffic on one of San Diego’s most congested routes, and I had an overwhelming need to push. Brandon, channeling his inner racing car driver, sped to the hospital on the highway shoulder.

There was no time for the typical components of a VBAC, such as an IV or continual blood pressure monitoring. Many pregnant women would have panicked, but I enjoyed the tight schedule. I had to forego the scheduled meditation and music, but I was able to avoid unwanted medical monitoring. The nurses were barely able to place a Doppler around my abdomen to determine the heart rate of the baby. My OB hadn’t come yet, so I informed the on-call physician that I wanted to stand up to encourage the baby’s delivery with the aid of gravity.

“You are undergoing a VBAC. I am unaware of your past. He said, “You’re not standing up,” and then he put my legs into stirrups. As nurses surrounded me, I had a flashback to my C-section – to the sensation of being bound, of medical experts taking control, and of losing my freedom. “I want my doctor,” I responded firmly. Then, as though he had just heard me, my OB entered the room.

“Amy, the baby has arrived!” he exclaimed. “Two strong pushes will get him out.”

Whether I had a birth plan or not, whether I used stirrups or not, I knew this VBAC would occur and would be a stark contrast to my first delivery. The lighting was gentle and reassuring. I have not prescribed any medication. And I was creating a moment that I would cherish for a lifetime.

France was born barely 19 minutes after we arrived at the hospital, and within a half-hour, he was blissfully suckling at my breast. As I smelled his newborn scent that night, despite my tiredness, I repeatedly relived the amazing, hectic moments. The experience was not what I had anticipated, but I’ve learned that sometimes real life is sweeter than the best-laid plans.

Meaningful articles you might like: Causes of Nosebleeds and Congestion During Pregnancy, What Does Molar Pregnancy Mean, Managing Cramps and Swelling from Pregnancy Leg Pain