I wrote a while back about how lucky I feel to be living in a community - and I know many of you don't - where having a VBAC is a real option. I feel even more gratitude now, having had one last week.
At some point in the immediate period following our daughter's birth, my doula said to my midwife, "Tanya prepared for a VBAC like people prepare for the LSAT." And it's true that I did everything I could think of to give us the best odds.
I did chiropractic, acupuncture, prenatal yoga, hired a wonderful doula, took a full day VBAC class, read the VBAC book, listened to the VBAC CD, read the books I hadn't read during my last pregnancy (Hypnobirthing, Ina May's Guide, The Doula Guide, etc.), meditated, spent hours on my hands and knees and in inversions, scoured the Spinning Babies site, sat on the birth ball and kneeling chairs and reclined as little as possible, talked to moms who had had VBACs, read VBAC stories on the ICAN website, took a ridiculous number of supplements, and walked and walked. Every night my husband and I played "guess the baby's position," and I started calling him Ira May Gaskin after he read Ina May Gaskin's book and wanted to read me a birth story every night. I also made a point of peering as far as I could into the operating room at the hospital, and at home I visualized what it would be like to have another c-section.
All of that helped, no doubt. My baby didn't end up in a posterior position, which was one of the factors contributing to my c-section with my first child. My cervix was ready to go. I felt more or less prepared when my labor started. I didn't go 'post dates,' which would have jeopardized my chances of having a VBAC because I couldn't be induced. I labored for a long time at home with the help of my husband and our doula.
But reflecting on it now I can see that the most important factor which contributed to the birth was the attitude of the staff at the hospital. Everyone, from the OB to the midwives, to the nurses, understood how important it was to me to avoid another c-section. This made me feel like I could trust the process, even at unexpected moments. And while safety was always the first consideration, I believe that this spirit made a significant difference in the outcome.
It's hard to pinpoint a moment which illustrates this; I feel like the belief that a VBAC was possible was somehow in the air the entire time I was there. The closest I can come to an example was when my baby's heart rate dipped with a few contractions. Both my husband and I held our breath while listening to the monitor, and my own heart sank. This was the reason why I had a c-section with my son, and in that moment all seemed lost. But in a few minutes the doctor said that everything looked fine and things moved along from there.
Do I think that safety was ever sacrificed to intention or ideology? No. But do I think that two doctors could have read the same information differently? Yes. And might doctors who attend lots of VBACs view it differently than doctors who see virtually none? Probably. Can parents' wishes be respected and fully integrated into the care they get without compromising safety? I really think so.
The day after the birth there was a virtual parade of nurses, midwives, and doctors who came to tell me how happy they were that things had worked out as we had hoped. Two nurses whose shifts had ended during the labor told me that they called in on their days off to find out what happened. One OB told me that she wished she'd been there. One nurse said, "I'm just so happy that we could help your birth wishes come true."
This is all making it sound like a remarkable feat, when the fact is that 3 out of 4 women who attempt a VBAC at this hospital end up having one. I'm so grateful to be counted in that number, and I wish that all women who want a VBAC had the same odds, and the chance to birth in the same supportive environment I had.
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