In order to better understand the birth of my daughter, Gwen, let me tell you a few things about the birth of my first-born, Theo, two years prior. I had been planning for an un-medicated birth at a birth center, but at 37.5 weeks, I developed some complications that led to a long induction, hours of pushing, a stuck baby, and ultimately, a cesarean birth.
As they wheeled me in into the operating for the birth of my first child, I began planning a VBAC for my second.
Of course, the planning became more concrete once I was actually pregnant. This time, I wanted to be at peace with how the birth went, even if it ended in the operating room. I put a lot of care into selecting a provider who, in the event of another surgical birth, would honor my preferences for a family-centered cesarean.
I wanted a clear drape so that I could see my daughter from the moment she emerged. I wanted delayed cord-clamping and skin-to-skin in the OR. But what I really, really wanted, though I didn’t care to admit it, was a VBAC, or Vaginal Birth After Cesarean.
I had a hard time even saying that out loud. I was nervous to write a birth plan, only for it to be completely derailed. I was terrified to try for a VBAC and was worried about how it would end. I didn’t want to re-live that awful moment in my son’s birth when the energy in the room shifted and it became clear that the baby was only coming out one way, and it was not in the way we had hoped.
As my due date loomed nearer, I talked everyone’s ear off about whether or not to try for a VBAC. My grandma was horrified—she thought it sounded way too dangerous. The rest of my family wanted to support me in whatever I decided. But that was the problem: I couldn’t decide. It was too hard to weigh the potential benefits of a VBAC with the idea of enduring a long labor that ended in the OR again.
I came close, so close, to scheduling a planned cesarean at 39 weeks. But I knew that even if it was a beautiful, family-centered cesarean, there would always be a little part of me that would wonder: “What if? What if I had tried?” So I decided to schedule a cesarean for a little over a week after my due date. I would try for a VBAC if my body went into labor naturally.
My pregnancy with Gwen was uneventful, and every day that I made it past 37.5 weeks felt like a gift. I would have a full-term baby! My blood pressure, which had caused so many problems the first time, was still normal! Now I just needed to go into labor.
At 40 weeks and 2 days, I had three mild contractions about 10 minutes apart, and that was the extent of my early labor. I continued to labor at home for another three hours. The contractions were intensifying, but I was still in denial that it was really happening. I tidied up my room and checked a few things off my to-do list, trying not to get too excited. I paid a bill for the pediatrician. I texted with my sisters about my mom’s upcoming birthday. Things were getting more intense and I asked my husband to come home, but told him to bring his computer with him in case this was a false alarm. Then my contractions, which had been coming about 5 minutes apart, were suddenly 1-2 minutes apart. It was time to go.
On the drive to the hospital, my contractions were strong with very short breaks in between. It was just about rush hour and there was a lot of traffic on our route. Only an hour before I hadn’t been willing to admit that I was in labor. Now I wasn’t sure if we would make it to the hospital in time! Thankfully, we did make it, and when the elevator doors opened and I saw my doula’s face, I honestly have never been so thankful to see another human being in my life. Just the simple act of holding her hands and looking into her reassuring eyes was everything. As we went through the motions of intake questions, getting an IV placed and fetal monitors hooked up (both requirements of hospital VBACs), I used nitrous oxide and it felt like a life-saver. It forced me to breathe more deeply and it took the edge off the contractions.
Forty-five minutes after we arrived at the hospital, my body started spontaneously pushing. It was the craziest sensation I have ever felt. Sometimes people call birth an out-of-body experience, but that was the most in my body I have ever felt. In all of my planning, I thought that when I reached the pushing stage, I would be wrought with fears of my baby getting stuck again or my scar rupturing. Instead, all I could think was “GET HER OUT!” I heard someone say I was fully dilated and I started to push again. With the first push, my bag of water exploded, narrowly missing one of the nurses. I felt the pressure of the baby’s head and decided to give it my all. Another push for her head and one more for her body. Out she flew, onto the bed. Nobody even had time to catch her! I had really done it, she was here, and it was over! Two years of wondering if I would ever get to experience this moment, of research, fear, and hope. I was in total disbelief, shouting, “What? What?” over and over again as she was placed in my arms.
Gwen’s arrival was the most shocking, electrifying, triumphant moment of my life. I am forever grateful to each and every person who walked this path with me, whether they lent an ear or asked questions that made me think deeply about my options. Her birth was a cake-walk compared to the choice of whether or not to attempt a VBAC. To anyone out there trying to make a similar decision, my heart goes out to you. The evidence tells us that for most women, a VBAC is a safe option that carries less risks than a surgical birth. But that doesn’t mean that it’s the right decision for everyone. Only you can determine how to best protect your heart. My wish for you is that you are well informed, well supported, and at peace with whatever you decide, and however your babies are born.