VBAssC birth, a VBAC after a preterm classical incision

Ruth is one of those amazing mums (speaking Australian here lol!) who throws herself into doing the absolute best in everything she puts her hands to.  I met her through our Special Scars support group, and even though we are on complete opposite sides of the world from each other, I just absolutely love this girl and felt that heart connection.  She wanted to know everything she could about the possibility of VBAC'ing on her preterm classical incision, and committed herself to passionately researching.  Then she took her stack of studies, after being convinced that VBAC was not only possible, but that the benefits far outweighed the risks, and brought her armory of evidence to her opposition, a stern-faced panel of OBs at the hospital in which she intended to deliver. Obviously this was not received well, but firm and fiery, she stood her ground and eventually was passed to the supervising OB who would take over her care.  

Below she shares her birth stories, all of them in fact, to give reference and honor to the journey she has walked. It's a bit of a long read, full of difficulty, including loss of a twin, and the trauma of delivering a 25 weeker via classical cesarean and his long precarious NICU stay, but I promise worth every second, and at the end of it all, I cry tears of joy at her triumph and healing, and praise God with her for His grace and favor. The bigger the struggle, the greater the triumph.  And this indeed is triumph. <3

~The Birth of Jackson Lucas~

The birth of our third baby has been so healing, in ways that words cannot fully describe. The heartache and pain of our losses, of our preemie experience and of the surgery that brought our prem into the world has been with me daily. Since delivering our third baby, those pains and the distress they brought have gone. This birth has been such a blessing, and I am amazed and overjoyed at what my body has accomplished. It is such a natural act, yet that is too often taken from us during our experiences of labour and birth. Delivering our son was the most empowering and awesome experience, more than I could have asked for. God has given us such a gift!

I am looking at our precious baby boy and all I can do is smile. The birth was perfect, absolutely amazing and unlike anything I could have imagined! To know just how beautiful this birth was, you have to know about my previous pregnancies and births.

Our daughter Caitlin Rose was delivered 5:09am 30th March 2009. The pregnancy was tough, I needed progesterone injections the whole way to maintain the pregnancy, I had hyperemesis gravidarum and I felt movement super early. We had not planned to have a baby, so it was a great adjustment for us after only 3 months of being together! (And me being told I was infertile…ha!) I had antenatal depression sparked by the shots, and an irritable uterus causing daily painful contractions. There were episodes of bleeding and mucous plug loss, and the whole pregnancy was rather less than enjoyable. I felt overwhelmed at being pregnant and the prospect of being a mum. But that changed the instant I held her in my arms! The labour was 2 days, she was a posterior baby. Thankfully I laboured mainly at home (well, at the beach, then hosting dinner for my sister-in-laws at home) as I wasn’t convinced I was really in labour. My husband had to demand that I get into the car to drive me to hospital as I wanted to stay home longer. We allowed a student midwife that I had met previously to come to the hospital for the birth, and we had a midwife taking care of us. That was great! We did wind up with a lot of people in the room as our baby girl became distressed and she was stuck for a long time. The staff were being prepped to take me to theatre, thankfully with some hands on assistance (manual dilatation) my student midwife and midwife delivered her. I had been labouring to my comfort, in the shower, hands and knees, swaying, squatting, however I felt I needed. And we had planned to deliver her in a good position. Unfortunately I was not in a favourable position for the delivery, but we avoided the caesarean so it was a small price to pay. Only 6 hours after arriving and she was in my arms. And she melted my heart! I finally felt right about being a mum, it was such a breathtaking moment for me to have her handed to me. Despite emergency surgery a week following her birth (due to retained placenta) I thought I had experienced a wonderful natural delivery. She was birthed without drugs, and it was a spontaneous vaginal delivery at 37 weeks.

We then conceived a baby shortly after her birth, but the pregnancy was lost. We conceived fraternal twins when our daughter was 5 months old. Sadly we also lost one of the twins, and had a lot of complications during the pregnancy. On top of the daily injections, there was severe haemorrhaging from subchorionic hematomas, PPROM at 18+5 (when we were assured we would lose our surviving baby, thank the Lord that He kept our son safe!) infection and placental abruption. Our boy Jacob Kenneth was delivered via emergency classical (vertical) caesarean at 6:10am on March 2nd 2010. He was just 25 weeks + 2 days. I was in hospital on bedrest from 23+6 until his delivery, as 24 weeks is considered viable here. There was just 3cm of fluid surrounding our son, and as he was breech, we opted for the caesarean. The labour was horrible thanks to hospital staff, and also being strapped to monitors, catheter in place and unable to move with IV lines. When I knew I would be delivering him I called my husband. (I knew as the contractions were quite surprisingly as painful as those of my first labour. The pressure was centred on the cervix but the intensity was the same). As he slept next to me, the doctors on call loudly discussed my situation and the fact that I had refused narcotics to stop the labour. I had already been informed that such drugs would not prevent birth when the mother was already labouring, but could prevent a labour from beginning. I knew I was in labour, so I declined. They insisted that I would cause an unnecessary caesarean and potentially the death of our baby by refusing the drugs. It was very distressing. Another doctor examined me soon after and I was rushed for the caesarean, as I was indeed in labour at 6cm dilated. Because our baby had not flipped, we knew the chance for survival was slightly higher with the caesarean. The surgery was awful, I felt a lot of pain throughout and we did not know if we would be welcoming a live baby or not. He was delivered, we were told he was a boy, then I was left alone as my husband went with our son (and was promptly asked to leave NICU, so our baby and myself were both alone. Hubby didn’t know his rights as a parent to stay with our son at that time). A further 15 weeks and a lot of preemie issues elapsed before I was able to finally take our son home.

So I had now experienced two very different labours and deliveries, and was quite convinced I did not want surgery again. What I did not realise is how different spontaneous vaginal labours could be. When we found out I was pregnant again, I began researching vaginal deliveries after classical caesareans. Months of studying went into this, and many discussions with medical staff. I found Jessica Tiderman’s site Special Scars which prompted us into further research. Between Jessica and another special scar mum Katie Perez, I was given a lot of support and encouragement. My husband and I decided to try for a vaginal delivery, and conferred with our obstetrician to make this as safe as possible. Our obstetrician was fantastic, he took on our care against hospital policy, and had us sign a waiver after explaining the risks and benefits of a vaginal delivery in our situation. He was always respectful and encouraging while stating his concerns and helping us to create a birth plan. A great change from the experiences we had until he took us on! So we now had a birth plan in place for a vaginal delivery following classical caesarean. And we also hired a beautiful doula who we were hopeful would guide us through this birth.

At 1am on September 26th 2011 I was up walking around the house with contractions. They had been there for over a month, the same pain as my previous labours and could be timed 1-2 minutes apart, lasting 2 minutes. The joys of an irritable uterus! Our baby was beyond engaged and had been for a long time and I was getting around an hour sleep per night. And then my water broke. I had a quick panic when I thought I had peed myself, and then realised my waters had ruptured. So I called my Mum and asked her to come over to watch the kids. We knew they would be fine waking up to my Mum without us being there. Then I woke my husband to let him know it was time to head in. I would have laboured longer at home, but we had decided to head in early in the labour to have the cannula placed in case of complications. We called our doula to let her know we would be heading into hospital as my contractions were steady. At 3am we left the house and arrived at about 3:30am. A midwife took us through to the maternal and foetal assessment unit. I had to laugh when she insisted that a vaginal exam (which we declined) was necessary for her to let me know if I were in labour or not. I let her know that I would be birthing that day. She asked us about continual foetal monitoring, which we also declined, and a male staff member came in to insert the cannula. He was unable to get it in between the wrist and elbow, so the midwife sent us through to the labour suite where we would try again. I had dropped into a hands and knees position by now to deal with the contractions, and our doula set up the ground for me to be more comfortable. I had to get up and onto the bed to let the man attempt the cannula insertion again, so the bed was set up reclining and I was on my knees leaning against the bedhead. The contractions were lasting only 45-60 seconds, but they were coming on top of each other. There was a great deal of pressure, which I had only experienced with our other babies when they were descending. This was so different, very intense and more painful, but it much more natural and therefore comforting than my other labours. I extended my arm between each one and gave permission for him to insert the cannula wherever he could find a good vein, as he looked rather panicked about not being able to get it in! The midwife we were assigned bandaged it for me and bloods were taken. The midwife then asked to check the baby with a doppler, and I agreed. On the next contraction, I needed to make my way to the shower to cope with the pain. I was surprised at just how painful I was feeling them, it felt like the end of my first labour in comparison and I looked to my doula and told her I wasn’t sure that I could actually get through it this time. I wasn’t stressed, or losing control, just quite aware of how painful they already were and I thought I would need some form of pain relief to get through the rest of the labour. She smiled and said I would do just fine.

Our doula continued with her encouragement and gentle reminders to relax my pelvis and breathe into my belly. Once we were in the shower I was able to focus on the contractions knowing our doula was between the medical staff and my husband and I. That was so important to us, it felt like our birth space was protected by a woman we trusted and felt comfortable with. Very soon I thought I felt the need to empty my bowels, so I asked everyone to leave. The midwife went to get a doppler and my doula asked if I were sure I needed the loo, or if the baby was coming. Both my husband and I thought we had many hours of labour to go, but she insisted I keep my hand close just in case. And she was right! Once I realised my bowels were empty and it was indeed our baby, I made my way back to the shower immediately after the contraction. I called my husband into the bathroom and knelt down, one hand waiting for our baby, one hand on the floor supporting my weight. The force of the contractions was unbelievable, I finally know what the ejection reflex is! With our other babies, I could not control the pushing, but I could choose to bear down with them or not. This time, I had no control at all over the force. I was aware of how quickly the baby was descending yet I could not lessen the pushing. It was amazing! I delivered the head, which was rather blue just as my daughter’s had been, and I watched our baby turn slightly. It had taken a few pushes to get the head out, but one more forceful contraction and while still guiding the head I delivered the body with my other hand. I was able to bring our baby straight up onto my chest, and discovered that we had another son!

Our doula had notified our midwife of the imminent birth, and two midwives arrived after I had delivered him. One of them was a bit too quick to cut the cord (we had hoped for the benefits of delayed cord clamping) as our son was not yet breathing, despite being attached to the placenta and without any compromise. He cried within seconds of being pulled away from me and was promptly handed back. It was such a beautiful delivery, bringing my own baby up to my chest while my husband was by my side. This was the first birth he had actually witnessed, although he was present for all of them. That was just amazing and still brings tears to my eyes that he was able to watch his wife deliver his baby. It was so lovely to have our doula present also, she gave us both a lot of confidence and I believe having her present allowed my body to relax fully and experience a labour the way it is meant to be. What a wonderful difference to my previous labours!

Our son Jackson Lucas was born at 5:08am, September 26th 2011. I was 39+4 weeks into the pregnancy, far further than anyone had expected us to make. We have been abundantly blessed with this birth. The Lord Jesus had such mercy to give us this perfect birth, which has been so healing for me. From a pregnancy that began with the specialists not wanting to prescribe progesterone as they believed I was miscarrying, to make it not just to viability, but to term, was such a relief and a fantastic thing to experience. There had been complications with the pregnancy again, and I was very sick too, but I cannot find a single thing that I would choose to change about the labour. It is surely how I was meant to birth.

I needed surgery following the delivery due to retained products that were vascular, resulting in major haemorrhaging (one blood clot alone was 500mL!). I lost 1600mL by the time I was done in theatre. There was talk of a blood transfusion, and iron infusions. But thankfully the Lord saw us through without either as we had chosen to decline them unless I had another large loss. God blessed us greatly with the surgery, as we had our obstetrician take over my care and perform the surgery. My husband had requested him when I became upset at needing surgery, and I am so thankful! Our obstetrician did a wonderful job, and the theatre team were just lovely with me. They had me laughing, and the anaesthetist even played music for me on his phone. When I came out of surgery, I was met with our now qualified midwife who was our student midwife with my first birth. She is a beautiful young woman and it was an absolute pleasure to find her as my nurse. She was also on call the following morning, so she was there to book us out of hospital. It was great to see her and let her see our other children again. Given that the surgery was necessary, I could not have asked for better than to have both our obstetrician and our (ex student) midwife caring for me. And I was able to leave the morning following the birth. It was awesome to walk out of the hospital with my husband and all three of our children. And with my health. My scar was very thin, we saw this on the ultrasound that was performed to confirm the retained products. And my endometrium was presenting unusually.

We know we are not willing to have any more children now, as we believe the risks are too high after discussion with our obstetrician. Which makes it so much more meaningful that I was able to experience such a perfect birth. I had asked the Lord for a positive birthing experience for my husband and I. There could have been nothing better than the experience He gave us! No unwanted interventions, no foetal monitoring, no invasive vaginal exams, no managed third stage, and the joy of discovering we had another son for ourselves. Just a birth, completely natural and unassisted.  Despite the surgery, and initially needing to express breastmilk again (I had to pump exclusively for both our other children due to tongue tie and prematurity) until our son’s tongue tie was snipped, I am still so thrilled with the delivery. It was painful, it was intense, and it was perfect. There is not a moment of the whole labour I would change. It felt so natural, and to deliver our son into my arms the way I was able to was so beautiful, I wish that every woman could have this kind of experience in childbirth. I am sitting here with my son right now, our other children are in our room sleeping, and the way I feel is amazing. I have no signs of post natal depression, which I developed very quickly after delivering our other babies. Our son feeds well now and actually sleeps well too, which is a first for us. A nice first! I love wearing him in the sling and sleeping next to him (as we all sleep in our room). He loves it too. I finally understand the term ‘babymoon’ now. I was very scared becoming a mum to our daughter, and the NICU experience was extremely challenging with our son. To have another baby at term, healthy, and thriving is just lovely. And the birth, I will never forget how amazing that felt. The Lord certainly blessed us with His great mercy and kindness!

VBA3C, An Amazing, Victorious Birth!

It was a warm June evening in 2010 and I was glued to the computer, literally facebook stalking a fellow ICAN mama, hitting the refresh button over and over again every few minutes for updates. She was going for a VBA3C, and I was sitting in my upstairs game room, my heart aching for it to happen for her. Prayers going up, believing she COULD do this, and anxiously awaiting any update.

And then it was there, and it said ***VBAC!*** Another VBA*3*C!! Ahhhh, I was completely over the moon for her! My husband is giving me strange looks while I do my happy dance, and wow, I just praised God and just sat in awe of this amazing mama at what she had just accomplished.

It's long overdue that I post this particularly triumphant birth story, she has quite a story, going for the natural birth over and over and over again, dealing with the agony of two "failed" VBAC attempts, putting the pieces together to solve her own mystery, assembling the right team and PERSEVERING in spite of it all.

This story is amazing in its own right, it was not easy, and my friend fought the battle for her VBA3C in a way that was very different from my short and sweet VBA3C. It seems birth comes easier for some of us, but when it is SO HARD, the victory is especially sweet. She truly is a BIRTH WARRIOR, here is her story:



~The birth of Ava Sophia, A VBA3C~
You know that definition of insanity? Doing the same thing over and over and expecting different results. Yep, that one. I’ve gone over that saying so many times in my head. Am I crazy? Why do I even want this so badly? Am I willing to go through hours and hours, maybe days, of labor to possibly end up with another c-section? I could, and according to about 99% of Obstetricians, should have scheduled a c-section anyway.

I don’t know if I’m crazy so much as really, really stubborn. I wanted this “natural birth” in 1996, 14 years ago. That plan was foiled when my teeny baby girl stopped moving in utero and had to be cut out of me. It felt more like a tumor removal than a birth. I was terrified there was something wrong with my baby but the doctor reassured me that I would be able to wear a bikini after the surgery because the incision would be low. Sweet relief. My troubles were over! (Try to keep up, that’s sarcasm!) Yep, that was my welcome to motherhood. Sitting alone in that postpartum room pumping milk like crazy listening to other babies crying in the rooms next to me, while I had to wheel myself down the hall to visit my little girl. (Read the long version here.)http://www.blogger.com/img/blank.gif

In 1999, I almost got my “natural birth”, but after contracting for 5 days and reaching 9 cm, my cervix swelled and I was absolutely at my limit. I consented to c-section…firing my doctor in the process (He acted like a jerk the whole time I was in labor…all 12 hours it took for me to get from 6 to 9 cm) Anyone else would have done the same thing in my situation. The new doc who came to actually do the surgery told me that my pelvis was shaped like a “funnel” and I would never birth vaginally. So I guess my diagnosis was ‘failure to progress’ due to ‘cephalopelvic disproportion or CPD’. (Long version!)

I never paid any attention to that. Doctors do and always will misdiagnose…some more than others, they are human and humans make mistakes, doctors are no exception. I wish I had a dollar for every time a woman has had a c-section for a “big” baby and then VBACed an even bigger baby.

I didn’t make great choices for my next birth in 2005. I was very distrustful of OBs and hospitals. I decided that I would attempt a homebirth (An HBA2C). I was due Christmas day and hired a couple of midwives that I really didn’t feel 100% comfortable with. I just didn’t know of anyone else who was going to attend a VBA2C. It ended unfavorably. I started contracting on the 19th and kept going and going and going…just like the last time. On the 22nd I had reached my limit and was so exhausted, emotional, devastated. Upon realizing I wasn’t going to get the support I needed from my midwives, I reluctantly headed to the hospital, hoping for some intervention to help me birth. Unfortunately, the on-call OB gave me no choice and told me I had to have a CBA2C. So, I did what I knew I had to do and asked for an AMA (against medical advice) form and went back home. I continued laboring through the night and the next day around noon, surrendered, decided I was done and went back to the hospital to meet my precious little girl. (Read the whole story here.)

In 2009, I find out that I’ve had a fused sacrum my whole life. In other words, my sacrum won’t move. My pelvis is still normal in the front, but birthing for me is a whole other ball game. Labor will probably be longer and more painful. That had already proven to be true.

I felt a little robbed. Whatever. The only thing that information changed was that it gave me validation for what I’d been through. No wonder my labors were so long. No wonder I haven’t been able to get a baby through! I’m not having any more babies anyway.

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I’m pregnant. (bet you didn’t see that coming!)

I’m pregnant and I cannot, no way, no how, can I just schedule a c-section. It’s not in me. No matter how I look at it, no matter how much easier it would be, I just can’t bring myself to be ok with it. I can’t even say it out loud. Just thinking it makes me throw up in my mouth a little.

Ok. I probably am a little crazy…or a lot, when it comes to birth.

I’m at a crossroads. I want a homebirth so badly I can taste it but knowing what I know, I feel like I’m going to need an intervention beyond the capabilities of a midwife. I met a wonderful OB at an ICAN meeting some months before becoming pregnant. He was warm and kind and very human (not doctor-ish at all) and he said to me “you’ll have another baby”. At that time, even though I wasn’t planning to, I knew if I ever did, I would go and see him.

I’ve slept through the whole pregnancy. At 29 weeks I had an ultrasound that showed a smallish, golf-ball sized fibroid right in the front of my uterus. I’ve got so much built-up anxiety about this birth.

My “due date” is June 12, and while I’m not afraid to start labor, I’m afraid it will never end. I’ll be in labor forever. I really, kind of, believe that this baby will not make it out of my vagina. I did start having contractions on the 11th but ignored them as long as I could. On the 12th, I went and ate crab legs (contracting about every 3 minutes…probably 60 seconds long), went to the park with the kids, bending over a picnic table every few minutes. They continued to beat me down, well into the night. I’m handling things, but start thinking about the length of time it has taken me to get from point A to point B in my previous labors…oh wait, I never made it to point B, at least not on my own.

Now I’m beginning to feel foolish. Its 2-3am and I can’t sleep. I’d rather someone poke me in the eye with a hot needle than lay down or recline. I’m really beginning to doubt myself. I had to have a good cry…whine to my husband a little. He hugged me and loved me as only he can and I decided to suck it up, wipe my tears and get myself together. No matter how I looked at it, my baby would be here in the next couple of days.

I did some belly lifts and made and intricate arrangement of pillows on my bed so that I could take an ambien and sleep in as close to the hands-and-knees position as I could get. I used a long thin heated rice sock under my belly and a large square one on my low back. I guess I slept some because I had really weird dreams…maybe more like hallucinations. I was in Alice in Wonderland. There were bombs planted all around me and when they went off, I had really strong contractions. I got up quickly and practically ran out of my room to get away from the “bombs”.

It was morning and I must have totally relaxed allowing my baby to move into the optimal position because the contractions were coming hard and fast. I was able to check my cervix and realized that I was dilating and my mucus plug was dislodging. A couple of hours later, I was already at about 3 cm. I was excited but not too excited because I couldn’t really allow myself to focus on much more than the contractions.

I wanted to go ahead and head towards the hospital, yes, at only 3 cm. It was a 45 minute drive (the doctor made it worth it!) and I didn’t want to be in the car during transition…even though I was still technically in “early labor”. I went by my chiropractor’s house to get a quick adjustment. I know that she thinks I’m crazy for going so early in labor. I had to sit on my nursing pillow because it was so uncomfortable for me to just sit on the seat.

I waddled up to the nurses station at the hospital, get checked into a room and the nurse tells me that MY doctor is not on call.

Um. The other doctor will give me a c-section. I’ll just wait for him to call me back.

He’s not answering his phone. He was at the hospital 36 hours yesterday with another VBAC.

We will leave if he doesn’t call back. But I know he will call back so I’ll just wait.

The nurse is “ok” with me waiting because after checking my cervix (which seems to be in my throat) she assessed that I am still in “early labor” and at 3 cm. She asked me if I had a birth plan. I said “my birth plan is to VBAC, that is all.” She set me up with a heparin lock and put me on the monitors for a 20 minute strip. When she left the room, I ate a protein bar. My doula and birth photographer arrived and I went and walked/squatted in the hallway.

The nurse called me back in the room, my doctor was on the phone. He asked if I wanted to leave the hospital and go labor elsewhere. Ummm, no. I really don’t want to go. I really want to stay. I really don’t think I can handle leaving and coming back. These contractions are really strong and long and on top of one another. He said “ok” and he’d be up later.

My doula raised the bed into what looked like a throne to me. I started quoting Alice in Wonderland…being the Red Queen. “I need a pig here!” “I like a warm pig belly for my aching feet.” She pushed my knees toward my sacrum during contractions…It felt wonderful!

My contractions started spacing out a bit, and were perfectly manageable. This was the nicest labor ever! I got up a few times to go to the bathroom having a couple of contractions en route and on the toilet. My doula became concerned that I was losing steam and labor was slowing down. She suggested I leave the hospital to labor or take a nap. I was NOT leaving. Not now. She and my photographer went to get something to eat and my hubby took over the knee presses. I ate a honey stick and kept cracking jokes. This was so easy! I took a trip to the toilet and decided to check my cervix. WHOA! This was different! It was actually opening…a lot! Soft, slimy, at least 5-6 cm and my bag of waters were bulging out. I hurried back to my throne. The nurse came in and checked me and SAID I WAS AT 7cm and gone from -3 station to -1 station!!! I’d been at the hospital for about 3 hours! This was probably the happiest moment I’ve had in a very long time. I was ELATED! I started to tear up and told the nurse “You have no idea what this means to me!”

About an hour later, my wonderful doctor walks in and says “you were 7 an hour ago; I thought you might be complete by now.” I’m thinking, How do you know I’m not?...

At that moment, a contraction came on fast and furious. It only seemed to last a second and then fizzled out really quickly. It felt very different and made me nauseous. I said “Ew, that was weird. That one just made me want to puke.” I was ready to start pushing and my doctor knew it. He said “keep it up” and left the room.

I started to feel kind of drunk. Everything is getting hazy. Contractions just shifted gears and made me feel HOT, sweaty, and sick to my stomach. I made lots of references to Alice in Wonderland and continued making jokes even though I was feeling so weird.

I got in all kinds of positions to push. I followed the directions of my doula but wasn’t really loving pushing. I was in on my hands and knees and a contraction started that really hurt, I guess it was the pressure because all of a sudden my water exploded all over the bed. I laughed because this is probably one of the coolest things that have ever happened to me. It was a huge victory to have my water break all on its own. It felt awesome to have all of it gushing out. Now I could focus my energy into making the water move from my body and know I was pushing in the right place.

Also, just to clarify, these contractions hurt, they sucked, and I only pushed because it felt better than not pushing, but I did NOT like it.

My doula instructed me to get into the ‘dangle’ position. The bed is up as a chair and my husband sat in the chair. I get to wrap my arms around his legs and hang limp, letting my lower body completely relax during contractions. YUCK! This felt AWFUL, so it must be getting the baby down, right? I got suckered into doing that for 5 contractions. There were more Alice in Wonderland references for this one since it looked like I was doing the ‘futterwacken dance’. I told my doula “This is the best birth you’ve ever been to!” then I though about that for a second and added “Today, anyway.” I guess the pain made me goofy.

The baby had been having some heart decelerations and my doctor wanted to see where her head was. I was up on the squat bar when he checked me. It HURT! He informed me that my cervix was high and around the baby’s face. She wouldn’t be born if I wasn’t able to move it down around her head. Great. I had to lean over the squat bar, facing the bed, do a pelvic tilt and push to save my life during the next set of contractions. It felt like I was doing this forever because it hurt so bad that the endorphins must have really kicked in. I felt like I was floating. I flipped around to face the other way on the bar and kept pushing. All of a sudden there was a mention of oxygen and people started moving fast. I heard “lay on your left side!” “Wait!” (I’m in the middle of a contraction. I can’t move.) I was quickly thrown onto my side anyway and my leg lifted up. Baby’s heart rate came back up, but that really sucked!

At this point, I’m in and out of half-asleep mode. Things are really hurting, I’m working so hard and everyone starts saying “it’s time to really start working now.” WHAT? I’m working harder than I ever have in my life!! I’ve got my eyes shut and even though my doula told me to open them, I kept them shut. I couldn’t focus on pushing with my eyes open. Everyone starts saying “PUSH!” “I AM pushing!” I honestly don’t know how this could get harder.

It did. A lot. The nurse starts reciting my baby’s heart rate with each contraction. That can’t be good. My doula got a towel for me to pull on while I push…to help the head move under my pubic bone. That took so much concentration, and strength. And it didn’t even work.

My doctor says “Abbey, I might have to use forceps to help the baby come down.” I said “ok, do what you have to do” I really didn’t care, I wanted to be DONE. I asked him if he’d have to cut an episiotomy and he reassured me that he hardly ever does them and no, just because he was using forceps, didn’t mean he would.
Of course, it wasn’t going to be over until it got even harder. I was instructed to NOT push for 3 contractions. Yes, in other words, eternity. (This was to give the baby oxygen before her descent through and out the birth canal.) After all I’d done to make it to this point; I honestly didn’t know if I could just DO NOTHING for a few minutes. I started to hyperventilate and was told to slow my breathing…oh yeah…I forgot that I was breathing. OK…that’s done…what’s next?
Somebody says “it’s time to really start working now.” Who said that? If I wasn’t completely incapacitated I would be in a very lively argument with that person right now. But I can’t think straight, can’t see straight, not even sure I’m still in my body.
My doctor put in a quick catheter to drain my bladder before a contraction starts and he positions the forceps. Push through the pain has a whole new meaning to me. I cannot begin to describe the power and force, the inhuman strength it took to do what I was doing. I needed everyone yelling “push!” to keep me going. That contraction ended and the forceps were removed. The baby’s head is under my pubic bone and I feel tons of pressure.
The baby’s head is down and I have another contraction. One of the nurses started counting and I yelled at her “no counting”…she says “then you have to push”…I say “I am!” Everyone is yelling at me. “Push through the pain!” “Push her out!” “Grab your legs!” “NO!” “Wait!” “NO!” I think my doula grabbed my hands and put them under my knees even though I needed just a second to catch my breath, there was no time. My doula asked my doctor if I could touch the baby’s head and he replied “no, I need her to push”. It was ok, I didn’t want to anyway. I really didn’t care. I just wanted it to end. (The nurse is reciting the heart rate, in the 50’s and dropping) My doctor tells my doula “I’m sorry, I have to do this” she tells me, “Abbey he’s going to cut an episiotomy” I say, “ok. That’s fine.” I have never been so ready for anything to be over in my life.
5:13 pm. Suddenly, it was done. It was probably the quietest moment of my life. There was so much energy, so much force and then right at the moment of birth, it seemed so still, so quiet…it was time for me to rest.
I hear my doctor tell the nurses “nuchal cord x2 and tight body cord”
A few minutes pass, I felt like I’d just been hit by a truck. My eyes are still closed and my doctor is working on my vagina... Whatever he is doing is awful. He says, "Here comes your placenta." I was pretty much ignoring him, at least trying to. He gets my attention, I look up at him and he says “Abbey, I’m holding onto your fibroid.” Oh, that’s nice. The placenta tore to pieces and his entire arm is inside me. My fibroid is the size of a SOFTBALL!!! The placenta had attached directly to it! NO WONDER I had a hard time pushing her out!!! (As soon as he was able, he drew a picture of what my uterus looked like with the fibroid and where the placenta was. Unbelievable.
I am in disbelief and a bit of shock. I laid there not able to sit up because I would have passed out…I couldn’t believe how light headed I was. I think I had lost quite a bit of blood (because of the fibroid), but my doctor still didn’t require I take the routine pitocin after delivery since I had preferred not to.
Wow, that was hard and painful and certainly not intervention free. But the interventions used, I was grateful for. I still did it without pain medication! I got my “natural birth”!!! It was not at all what it was ‘supposed’ to be like. But I did it. I FINALLY did it! I have had a combined 250+ hours of contractions adding together my 3 attempts at VBAC. This was a long time coming. I could not be happier. Nothing is going to steal my joy. (Not even the hematoma I developed a week later and 3 weeks postpartum had to have surgically removed. My anesthesia was a spinal. The same kind used for c-sections.)

I decided I’d better call my sister and tell her I’d had the baby.
She didn’t answer, but I left her a voicemail. It went something like this;
“I just had a baby. Out of my VAGINA!!!!” I think I made a few more phone calls making that announcement. I took great joy in saying those words!
Ok, so that wasn’t the ideal birth, and would probably be way more traumatic for lots of women than a c-section…but it was MY birth and like an ugly child with a face only a mother could love, I am so happy it was what it was. I just had to do it…and according to my “birth plan”, I got everything I wanted. I couldn’t be more thankful.

So maybe my new mantra will be, “if at first you don’t succeed, try, try again”. That’s much better than the definition of “insanity.”


Abbey is a doula (still on maternity leave), passionate VBAC advocate, and is very involved with our local ICAN chapter and our local birth network, the Tarrant County Birth Network. Here is blogsite, www.victorybirth.blogspot.com, and the direct link to her birth story here.

also, here is a link to her birth slide show.  I cry still every time I watch it!

Full Circle, Golden Birthday Blessings

September 12th, 1999, the day oldest, Lina, was born. It was a beautiful day, but a defining one in my life, the day I was marked with my inverted T, the scar that started this all.

Just about every year, the celebration of her life and birthday is dampened by a touch of sadness about her birth, the longing for a better birth for her (and me), the desire for it to have been different, the going over and over in my head to replay and see if there was anything at all I could have done differently. The haunting of the painful memories often linger closer on that day, always in the background of my mind, in spite of rejoicing at how blessed I am with my precious miracle.

Well, not this year!

It's September 12th, 2011 and I got a call just after 2am from a client's husband, saying she's in labor. Her's has been a birth I've especially looked forward to, a precious mama going for a VBA2C, and delivering with the same doctor I used for my VBA3C, so I knew it was going to be amazing. Since things still seemed pretty early and manageable, I told him to update me in an hour or when contractions got closer together.

Ok, I do have to confess here, I was a touch bummed. Lina and I had made elaborate plans for the day of her "golden birthday" (12 years old, born on the 12th, to kids this is apparently a BIG deal!) and we had been praying for God to hold the space for her day for a couple of months! Our 10am Starbucks date, shopping at the mall for Toms, some girl time over lunch, it was going to be special! I said out loud, "well Jesus, you knew the desires of our hearts, I just have to trust you will work it out and give my girl grace."

I try to go back to sleep, but something tells me I better not. Right about 3am I get another call from my client's husband, saying she was still managing well, but had thrown up in the bathroom, her water broke about 5 min after the last time he had called me, and was now in the shower, contractions are now coming every 4 minutes and are more intense, but tolerable. I ask if we should just plan to meet at the hospital. I tell them if we get there and it still seems early-ish, we can walk around before checking in. He asks me what should we look for, just to make sure they still have some time. We run through the list of signs and symptoms of transition, and other than throwing up that one time, and the fact that her water broke, she doesn't seem to think she's in transition. I tell him I'll start heading their way since it seems she's ready for extra support, and if they decide to start heading to the hospital just to call me and I'll turn around and meet them (they live about 25 min south of me, and the hospital was about 25 min north of me).

I wake my birthday girl and tell her I got called, and give her a big hug and tell her we'll reschedule since it appears I won't be available by 10. She says she's going to pray it all goes quickly. I nurse my toddler and get on the road.

I have been on the interstate about 5 minutes when I get another call from the dad. I assume they are heading to the hospital and before I even answer I'm checking lanes to get off at the next exit and start heading back north toward the hospital. What my client's husband said caught me a bit off guard to say the least... "uh Katie... she's feeling like pushing and says she can feel the head only about an inch inside..."

What?!?!

me: "uhh... ok.... well.... we have 3 options then.... we can call 911 and have EMS come, go to the nearest hospital, or I can try to find a midwife to meet us hopefully before baby gets here"

I hear him ask her and comes back and says she says to try to find a midwife. I tell him get her out of the bath, throw a shower curtain on the bed and have her lay on her side and try not to push till help arrives.

Now I am flying down the interstate (the only time I *ever* speed is to births, and now even more than usual, dear Jesus, now is *not* the time to get pulled over, ok??) It takes a couple of calls, but I get one willing to come, she's a bit farther, but Kim is my all-time favorite midwife and the one I'm hoping to apprentice with, and I feel peace about it.

I violate my personal policy about not texting and driving and send her my client's address. Dear Jesus, take the wheel while I do this, ok?

I arrive at 4:10ish and let myself in. S is on laying on her side, doing amazing.
Me: "So, are we having a baby today or what?"
S: "Who, me? Uh, nah, I think I changed my mind."
Haha! Glad to see you still have your sense of humor hon!

I remember a pair of gloves I had tucked in my purse (you never know when you'll need a pair of gloves, right?). I take them out and put them up on the dresser. In Jesus' name I'm not going to need these.... because doulas don't catch babies, right??

I update Kim that we can't see baby's head yet. That begins to change really quick and by 4:25 it becomes clear that baby is coming soon, and that Kim likely won't make it. I had a touch of fear, and reverence for the fact that even though I'm NNR certified, I am not yet trained to do this, but I feel God's presence and peace. I grab for those gloves after all and pray, "Jesus, this needs to go perfect, please!"

I put her on speaker phone so she can walk dad and I through this. Crowning at next contraction, then head born with the next one, then a bit of a lull, (all normal, but a bit unnerving to mom and dad) then with the next contraction, one shoulder then the other, then at 4:38am, baby *GIRL* is here, born right into her daddy's hands, with a bit of doula assistance, and then right on mom's chest!

Baby pinks up right away, and lets out some sweet little cries. She's had a perfectly gentle birth, no one pulling or poking at her, or rushing to clamp her cord, no bright lights, no loud voices. Its a beautiful moment, and I am in awe of what God just did for this family. Just simply amazing! Praise You Jesus, You rock!! :D

HBA2C, mama S is a rockstar! She just birthed like a pro who had done this 10 times before! :D

Kim arrives about 5 minutes after the birth. Placenta is born a few minutes later, and mom and baby are both perfect.

Then the birth photographer gets there (whoops!)

My clients' oldest wakes up a little while later, comes in, and says she could hear a baby crying, what an amazing moment! Funny side note, my client's childcare that she had lined up for their older girls never did answer the phone. So had they tried to leave, they would have had 2 tiny spectators along for the ride! Jesus provided a way to work out all the details, and every loose end was tied up!

We all marveled at how the common theme was that Jesus provided for *everything*, even if it wasn't exactly how we had planned it to go! (or actually, even close to how we had planned LOL!)


I got to my babysitter's house to pick up Lina and Sergio at 9:45, then we had our Starbucks date and an amazing birthday celebration day. :)

So, before even starting my apprenticeship, I helped catch a baby. :) Unfortunately it won't count, but I will never forget it. And I'll have my daughter's birthday to remind me year after year, with another sweet wonderful memory to reminisce. :)

If anyone had asked me 12 years ago, what I would be doing 12 years from then, this would have been the farthest thing from my mind. But this day will go down as another defining moment in my life. Thank you Jesus for golden birthday blessings for me too. :)

 (My 12 year old snuggling with baby Q a few weeks later)

Picture Gallery

 (bmjevents.blogspot.com)

VBAC after preterm vertical incision, *triumphant birth!*

so for those of you who may not know, i am blessed to be a co-mod of an incredible support group for women with special scars like myself. the link is posted on the bottom right hand side of my blog if you are interested! this group of women are some of the bravest, most courageous i have ever met. they (we) trust birth, they (we) trust their bodies, and they (we) are just plain awesome! we'd have to be to attempt a vbac after nearly every doctor in the world has told us we're a walking time bomb, our uteri destined to explode at any moment! (rolls eyes)
but with what little concrete research there is out there, we arm ourselves with information, and with a bit of spit and determination, we give our bodies a chance to show us what we're made of. and the outcomes have been marvelous.
this is an amazing birth story of a mama who VBAC'd on a preterm classical incision. now for those who don't know, a classical incision is a midline vertical incision that has a higher risk of uterine rupture than the standard low transverse. most studies put it at about 2%+, compared with .4% on a low transverse. with a preterm classical, the risk is a bit higher still, bc the lower uterine segment is not developed until later in pregnancy, so it is theorized that these incisions are likely totally in the upper uterine segment and fundus of the uterus, which is said to be weaker.

here is this amazing mama's story:

the birth of Lenore Calais
February 22, 2011 12:42 pm
8 lbs 1 oz 20.5"

I'm the sort of person who recognizes patterns. I don't have to try. I simply see them. My children are slowly teaching me that it's okay to break them.

I noticed several similarities between my first two pregnancies and births. Both children were born on their due dates. In general, the pregnancies were straightforward, despite some first trimester bleeding in each case. Both labors were on the long side, 16 and 18 hours respectively, but ultimately were uncomplicated. Even the things that were opposite about them could have been patterns. My first was a boy, and my second a girl. My first was a summer baby, and my second a winter baby. My first was born under a full moon and my second a new moon. My first was a typical hospital experience that I hated, and my second I was only there long enough to push her out.

And then there was my third child. I conceived in October again, with a due date within a week of my first's birthday. There was the pattern again. This one would be a boy too. I had some first trimester bleeding again but I was expecting it this time. I did worry about an oscillating pattern, where my first birth was traumatic, and my second one a good experience. That's part of the reason I planned a home birth. I wanted to stay away from the interfering hospital. But it turns out my fears were well founded. The first trimester bleeding turned into second trimester bleeding which then turned into a placental abruption and delivery by c-section at 26 weeks. My second boy spent 3 months in the NICU before coming home near his original summer due date.

I should have learned from him that it's okay to break patterns. But some lessons need to be repeated. Despite loads of trepidation and a lot of work to find supportive care providers, I became pregnant with my fourth child, and planned a VBAC. Sticking to patterns, I had a due date within a week of my second's birthday, and I was having another girl. The due date was on a Saturday. All of my previous children had been weekend babies: two Fridays and a Sunday. Breaking past patterns, I had no bleeding at all during the pregnancy. That was a welcome break. Still, there were other expectations that needed to be let go, most notably, that I expected this baby to be born on her due date.

Friday February 18th, 39 weeks 6 days, I had a prenatal appointment with my doctor and my midwife who would act as doula. My doctor was getting anxious as I neared my due date, having not been totally on board with my VBAC plans to begin with. My vertical scar had given everyone pause to say the least. During my appointment, my blood pressure was slightly elevated. That gave my doctor the leverage he wanted to pressure me into an induction. He wanted to start by stripping my membranes. I'm proud of myself that I got out of there and never took my pants off! I told him if my blood pressure wasn't enough of a concern to send me to the hospital right away, then I wanted time to go home and prepare. But I did schedule an AROM induction for the following Thursday, the 24th, as well as a prenatal appointment for Monday. I didn't expect to need either. When I got home, I asked Kurt for a blessing, wanting this baby to come before she was forced out.

That night I woke up around 2 with strong contractions. I celebrated! It was my due date and we were rocking and rolling! Excited, I got up and began to time them. 5 minutes apart! Yay! Then they were 6 minutes...then 7...then 10... After an hour, they had all but gone away. Disappointed, I went back to bed.

Later that morning, I met with my midwife, and I allowed her to attempt to strip my membranes. Ow, ow, ow. I don't ever want to do that again. But we still hoped to see results from it. She said she didn't guarantee before midnight, but it should help things. She also told me it was kind of too bad to kick me into higher gear already. If we let things go, I would likely have a few more sessions like I had the previous night and then when labor really started, it would be quick. Well, I thought, that is too bad, because it's my due date and I'm having a baby!

The rest of the day passed peacefully. Too peacefully. I also slept fairly well that night and woke up the next morning thinking, this is officially the longest I've ever been pregnant. We went to church and I was impressed how few comments I got along the lines of "You haven't popped yet?" After church I fell asleep for an hour or so. When I woke up, I was having strong contractions again. Could it be? Might we still have a weekend baby? Probably not. They spaced out again. But I did have some bloody show this time. So surely it couldn't be too long. That night, I was up for about 6 hours with regular strong contractions. The only problem was they never seemed to get closer or stronger. They let up by about 5 and I grabbed a couple of hours of sleep.

The next day, President's Day, Kurt and I dropped off our three older kids at a friend's house. Then we headed over to my prenatal appointment. We learned that my induction date had been bumped up to Tuesday the 22nd. The doctor also wanted to strip my membranes again. Now that I had experience with it, I did not want to do it again. I didn't even want him to check dilation. I was more than a little delirious and emotional from lack of sleep and the start-and-stop labor, so I wasn't in the mood to be cooperative. I felt the induction was a huge concession and that was all I was willing to give. We went back and forth about the dilation check a bit, mainly because the method of induction was AROM, which would only be really effective if I were already dilated. I was sure I was, based on the previous membrane sweep, and also the fact that two days of on-and-off labor couldn't have left me untouched.

In the end, I prevailed and left with my pants on again. My midwife, who had been with us, advised me to go home and get some sleep. I didn't need to be told twice. The kids were still stashed, so our house was abnormally quiet. I slept for three or four hours, knowing it would likely be the last solid sleep I got. When I woke up, Kurt and I reclaimed our kids, and we had dinner together, and since it was Monday, we had Family Home Evening as well, our last before our family expanded.

That night, I again woke up with strong regular contractions. This time, I ignored them. I did not want to spend my last night before caring for a newborn waiting for my fruitless labor to pick up. They still woke me up every few minutes, but I felt much more rested than I had over the weekend.

We woke up early that morning, the 22nd, and packed our three older kids off to another friend's house for the day. I remember thinking it was ironic that it was the school holiday week, so it was sort of like a weekend. We got the the hospital at 7 and met our midwife. I don't know why I forget how slow hospitals are, but I was amazed how long admissions and all the prep took. Although I'd slept better the previous night than I had that weekend, I was still exhausted. I had pictured getting in and napping while we waited for the induction to take effect. Oh well.

In our prep work for this birth, I had drafted a birth plan, gone over it with my midwife, had it signed by my doctor, and sent ahead to the hospital. I think that really paid off. My nurse turned out to be a midwife in training, having had all of her children at home. I know that wasn't just luck of the draw. Unfortunately, while I liked her in general, she botched my IV. She put it in my wrist and hit a nerve. I almost passed out, and I'm sure I looked a bit pathetic, that here I was planning a drug-free birth and I couldn't even handle an IV, but wow, did it hurt. And it still does, if someone grabs my wrist. Part of my index finger is also numb. Who knows how long that will last. But I digress.

After I had the IV in place and had my full history taken, and repeated for a resident, the doctor finally came in after 9 to break my water. That was the only check I had for the labor, and he declared me 3-4 cm and 80% effaced. My midwife sounded relieved, as that meant the AROM was likely all it would take to get labor into high gear.

Afterward, I kicked everyone out with the plan to sleep. Ha. Contractions started right off, strong and regular. I got a good 20 minute strip on the monitor, and then the nurse said I could take it off. I was quite surprised. We had expected continuous monitoring, but we weren't going to complain. I got up, used the bathroom, and sat on the birth ball for awhile. That's when the anesthesiology resident came to talk to us, giving us the whole rigmarole of what would happen should I need her services, and why it was so important that I not eat or drink anything. (Later, my midwife and I had an eye-rolling conversation about that.) I wish she had stopped by earlier. I had to take several breaks from the conversation to deal with contractions. But I'm convinced hospital time exists outside the experience of ordinary mortals.

Maybe an hour later, our nurse came back and said I could go without the IV for a little while. That meant I was completely unhampered as I changed positions. I did spend some time in bed, partly due to a questionably high blood pressure reading. I rested until it was normal again, then I wandered back into the bathroom and found quite a bit of bloody show. I tried the shower as well. There was absolutely no water pressure, which makes me wonder just how often those showers are used. But still, the warm water trickling down my back felt great.

Somewhere around noon, I was back in bed resting on my left side when I started vocalizing through contractions. My midwife encouraged me through that, helping me focus and relax. But things were getting intense. After one particularly long strong contraction, I opened my eyes and said "Is it alright if I admit I don't want to do this for hours?" I still had it in my mind that this labor would be like my previous labors, and I would be at this at least until late evening. My midwife said that was fine, we would take things one contraction at a time. She also said she wouldn't tell anyone I said that. Minutes later, she told the nurse what I'd said, which confused me at the time, but looking back, that was code to the nurse to get everything ready. And indeed they did get everything ready. The equipment was brought in and set up on the corner table. I watched and shook my head, thinking they were getting ahead of the game. That was right before I had a contraction that included a push. I was incredulous. Could I really be that close? "Is that a push?" I said. "You tell me! It's your body!" was my midwife's response.

The exact sequence and timing of things at that point are a little fuzzy. I remember a new resident coming in and saying "Are we ready for a check?" My midwife held her off and said we needed the doctor. This resident obviously didn't know who my midwife was because she launched into an explanation about how important it was to make sure I was fully dilated before I started pushing or I'd swell my cervix. If my body hadn't been working on pushing out a baby RIGHT THEN I might have laughed at her. As it was, I was thinking "Congratulations, you read your OB text. Now throw it out and watch how it's done with an unmedicated woman listening to her body!" Thankfully she was called away. I think she needed to finish up for my doctor who had been in the OR with a set of twins.

My midwife was stationed at the foot of the bed, holding the place in case any other residents decided to plant themselves there. She told me she could see the baby's hair. Now I knew she was pulling my leg. My previous pattern included bald babies.

Contractions had really spaced out by this point, giving me a second wind, but I could no longer deny that I was indeed about to give birth. I don't know exactly how many times I pushed. I only remember two and a half. The half one was the one that first caught my attention. The other two were Lenore's head and body emerging. Either way, the pushing phase was not very long. I was again hooked up to the IV, for third stage pit, and the doctor finally came back just as Lenore was crowning. My midwife did move aside for him, but they were both side by side as I pushed my baby out. Lenore had a loop of cord around her neck, but that was easily slipped off, and she was handed straight to me.

I was in awe. I'd done it. I'd pushed out my baby, despite all the naysayers. I had read many VBAC birth stories and always marveled when the woman said she never worried about her scar. Now I can say the same. I was well into labor before I even remembered I had a scar. And even that thought wasn't worrisome. I can also say that I honestly never entertained the thought of asking for any pain meds. I'd had one drug-free birth already, and by the end had been begging for something. But I didn't this time. I think two things made the difference. One was that this birth was much quicker. Transition and pushing took me by surprise, and having to grapple with just what state my body was in drove out thoughts of asking for intervention. The other was my midwife. She was by my side the whole time, talking me through contractions, feeding me ice chips, massaging my back, and being there to help me let my body do what it had to do. Things would have gone much differently without her.

As I was basking in the afterglow and holding my minutes old baby, I thought of a more practical matter. During pregnancy, we had been scared by the possibility of placenta accreta. That was the main reason for the third stage pit. If the placenta didn't come right away, there would need to be more intervention, the ultimate of which was a hysterectomy. So roughly 5 minutes after birth, I looked up and said "At what point do we worry about the-" My midwife didn't let me finish. She said the placenta was right there and would come out with a quick push. And indeed it did and looked whole. That spiked me right back up on my high. Not only had I successfully pushed my baby out with my vertical scar, my anterior placenta had behaved perfectly. Things couldn't be better. I had a beautiful healthy baby who was nursing well and would be mine to take home to rejoin the rest of the family.

Hours later, in a sort of debriefing conversation my midwife said "You really didn't know how close you were, did you?" Nope, I really didn't. I was so set on expecting patterns to repeat themselves that I was completely taken by surprise. Not a bad thing at the end of the day, but one more piece of evidence that I need to let go and let be.

It's been one month since my victorious VBAC. I have had an easy recovery and the the whole family has loved getting to know Lenore. Six-year-old Dorian eagerly showed her picture at school. Five-year-old Faith loves having a sister. Almost three-year-old Quinn doesn't quite know what to do with her, but he is slowly learning. We all keep learning. That is the point.

What Does It Take-- My Personal List

What does it take to have a successful VBAC, or a successful NCB for that matter? There are a lot of things I did to prepare for my last shot at natural birth, all of which I think have great value. I realize you can't control every detail of birth, and I concede there are times when factors out of our control dictate an undesirable outcome. We can only stack the cards in our favor so high, but I'm a firm believer in doing the possible, and leaving the rest in God's hands.
When preparing for my VBAC, I knew there was a huge road with lots of obstacles and mountains ahead. I began with research, reading everything I could, wanting to know what people did who had successful VBACs. This leads to my personal list of recommendations.

#1. Choose a *truly* supportive provider. There is a nifty guide under my links (bottom right) to help you gauge if your provider is really supportive, or maybe not as much as you thought. It’s such a shame when you think your doctor is on your side, and you get to the end of your pregnancy and are harassed and coerced into something you said for months you wouldn't do, because you might have a "big baby" or you are "overdue".
Or even worse, showing up in labor and being badgered by unreasonable hospital protocols like constant monitoring, restrictions on food and fluids, or mandated epidurals. No mama wants to or should have to fight during labor! It’s so much better to switch earlier than later.
I'm a huge advocate of out-of-hospital births, I believe low-risk moms should seriously consider birthing at home or in free standing birth centers, but whatever type of provider you choose, make sure it's a good fit, and someone who truly supports you!

#2. Take a childbirth education class. Labor is such a mental thing and being prepared makes such a huge difference. Couples who take childbirth education classes learn valuable tools to cope during labor, know the in's and out's of natural labor, can make informed choices on suggested interventions and know how to smell out and avoid the unnecessary ones.

#3. Hire a doula! I should have made this one my #1, haha! I could not have made it without my fantastic doula. Study after study affirms that having a doula reduces the chances the birth ends in cesarean, the need for drugs during labor, increases the involvement of dads during labor, and increases the chances of breastfeeding success, just to name a few! The support is invaluable, and if finances are tight, find one still in the certification process who offers a discounted rate. You won't regret it!

#4. Get chiropractic care. During my research and reading I kept coming across stories of malpositioned babies being the culprit of cesareans. A misaligned pelvis *greatly* increases the chance of a malpositioned baby. Baby just can't seem to get into that ideal birthing position!
I read so many stories of this sabotaging VBAC and NCB attempts. There was no way I was going to do all this work to prepare for my VBAC and have it blown because baby was malpositioned and labor took so long I exhausted myself, or baby got stuck, or the pain from back labor was so bad I caved and got the epidural which started the cycle of interventions that lead to repeat cesarean, etc.
Its amazing how much easier and faster labor can be if baby is aligned correctly in the pelvis! The labor for my first vaginal birth was only 5 hours and 25 minutes. I attribute this to the chiropractic care I received my last trimester! I love my chiropractors!

#5. Diet and exercise. This is not to be downplayed! Keeping yourself as low-risk as possible does so much for getting you to that finish line! I personally followed the Brewer pregnancy diet. I'm a huge believer in high protein for pregnant mamas, at least 80-100 grams a day, and a LOT of water! My doctor had me drinking a gallon of water a day, and it helped my irritable uterus SO much! These 2 things I greatly credit for getting me my first full-term baby (along with chiropractic). And our babies are made up of what? protein and water. So get your protein, drink up that water, and eat a healthy diet of lots of organic fresh veggies, fruits, and whole grains, grass fed and free range meats, healthy dairy, with as little processed foods as possible.
And for the exercise. Keep moving! A walk, a swim, a little time in the gym, do something active every day that raises your heart rate and gets your blood circulating! It will keep you feeling good, help with energy, and has so many other benefits. My VBAC baby was due in early September and we live in Texas. It was crazy hot and the pool was oh so wonderful, so I swam a few laps a few times a week. The extra cardio helped a ton on birth day too!

#6. Deal with emotional and psychological barriers. Especially if you had a traumatic experience the first time around, felt like a failure from your cesarean, or were told you "couldn't" for whatever reason birth naturally. This is unfortunately so many of us. We need to cast off these lies, face these fears, and conquer these mountains! Our bodies were created to grow and birth babies! Sure, things can go wrong in the process, but that doesn't mean it’s going to happen that way again! WE AREN'T BROKEN.
For me this meant joining ICAN and the Special Scars support groups. Hearing the stories of other women who had been through what I had, who understood where I was and what I was facing, brought so much comfort. And hearing success stories gave such a boost of strength and encouragement that I could do the same!
The road to healing was a long one for me, and most of the hard work took place during the pregnancy of my VBAC baby, because I never properly processed the hurt I experienced the 7-10 years earlier with my other births. As a strong Christian, I wrote out scriptures and read them to myself almost daily for a long time, to renew my mind, cast out the fear I was feeling, and afraid of feeling during my labor, to throw off the lies I had been told that I would "certainly rupture, bleed out, and die" if I ever attempted a VBAC (like other doctors had told me), and really addressed the anger I had at my prior providers for the way my care was handled (honestly I'm still working on this part.) On birth day I had one fast-fleeting thought of rupture when I first started pushing, but dismissed it easily, and it was all peace and joy and wonder and awe.

#7. Read Read Read. I don't put this last because it's least important. The more knowledge you have, the more ammunition you carry into the battle. Join forums and read others' stories. Read blogs. Read research and the latest studies. Read books, there are a ton of good ones out there, email me if you want some suggestions!

All these things really help to set us up for the greatest chance of success in our quest for a triumphant birth. Yes, they sometimes do challenge our commitment and our determination. I did them all because I did not want to have any regrets. If my VBAC attempt ended in another cesarean, I wanted to be sure it was not because I should have done so-and-so or such-and-such. I wanted to be able to rest in the fact that I had done what I could, so it just wasn't meant to be. I'm glad it was successful and I don't have to deal with any other outcome, but I try to convince myself that even if my VBAC attempt was unsuccessful, I would not have felt defeat, but empowered that I had given my baby and my body the very best shot at a vaginal birth, and I think there is peace to be found in that. Blessings to all the mamas out there!

Amazing VBA2C in Saudi Arabia

Over the summer I got to be "internet doula" to an American mama I met on a VBAC forum who was living in Saudi Arabia. The medical system is very different there, and she was told since she had 2 prior cesareans that she must have a third for this delivery. I cringed when she told me that her doctor informed her that earlier that week she had done a *sixth* c-section on a mama there and there was no problem doing so many!
She really wanted her VBAC, educated herself, read any information she could get her hands on, and continued to insist on getting a shot to VBAC. Her husband was an amazing support, and went to her doctor repeatedly to insist that she get to try. She was prepared to refuse the cesarean if necessary, labor at home till she was pushing if necessary, but ideally would have loved to get the support of her medical team. She also knew that she would be facing this alone, because in Saudi Arabia, husbands are not allowed in the labor and delivery ward! Her bravery and courage are such an inspiration!
About 3-4 weeks before her due date, ACOG released their new guidelines for VBAC and I emailed her the info. She and her husband brought the information to her doctor and she finally got the official OK! I could tell she was so relieved and excited from her email and so was I!! Here is an excerpt from her very triumphant birth story:

"On August 14th I woke up at 1pm with mild contractions, oh by the way, it is the month of Ramadan where all Muslims fast for the entire month during the day, which means no food, water and only pure thoughts. I get out of bed and time a few contractions just to see where I'm at. They are every 10-15 mins. apart. I text my husband and tell him I think today is the day. He called and asked me if I wanted him to come home. I said no cause everything is fine. About an hour later I went to the bathroom and I lost my mucas plug. I never thought I'd be so happy to see blood and yucky glob! haha Hubby came home and we had dinner around 6:30pm. At 9pm we went to my NST. (different working hours due to Ramadan) They do the test for 30 minutes then the doctor comes in to check me because I've been contracting. She checks to see if I'm leaking any fluid. She said that I am and continues to check for dilation. When she checks me my water breaks. The doctor tells me that I will be admitted now. How nice, cause I was told that I would have to be monitored the whole time I'm in labor which means that I have to stay in bed. Not my plan at all. I wanted to labor at home where I could use my birth ball, the shower and be with my hubby. (husbands are not allowed in the room during the delivery of the baby) By this time it's 10pm and I'm getting hungry again. lol My contractions are still coming about the same 10-15 minutes apart and are still mild but I have to stop moving when I get one.

"Around 4am the doctor checked me and I was at 4 cm in active labor. Now the contractions are hard and fast. I started asking for releif but they didn't have anything. I started begging for a c-section about 6 am because the pain was so bad. They put the catheter in, shaved the lower belly, checked my vitals and brought the bed in for the OR. At shift change, 7am, is when my supportive doctor which I never met before came in and seen me. She checked me and said Shari you've come so far just wait a little longer. She waited and checked me again and said get that bed out of here she's at 9cm and will not have a RCS. If it wasn't for this new doctor I would have chickened out again and had a RCS. They don't let you push in any position. You have to have you knees under stir-ups while pushing. I started to push I think around 8am. I couldn't really keep track of the time cause it was really intense. My hubby came to the hospital and was in the hallway trying to talk to me. I had texted him saying I was going for c-section. The doctor got the vacuum and showed it to me cause I wasn't pushing good and was stopping in the middle of contractions. My hubby asked the doctor to give me a few more minutes to try before she did the vacuum. She agreed and I started to push harder and longer. Everyone in the room was saying push Shari push. Good girl. Don't stop now. They were a great team. I could feel the baby's head starting to come and I felt a burst of energy. I felt his head come out and the doctor said 1 more push don't stop. So I pushed and my baby boy was placed on my belly at 8:43 am born naturally. He weighed 9 pounds 3 ounces and was 20.5 inches long. They took him to NICU for 24 hours because he was so big. (Saudi babies are smaller) I was able to see him after a few hours and try to nurse him about 6:30 pm. He did great and was able to room in with me after 24 hour observation. He started to nurse like a pro and is gaining weight.

"Without God, my husband this group and the new staff that came on duty I wouldn't have been able to do this. I was the first person to try VBA2C in the hospital and I hope it will help other women to at least try labor. Thank you all for the support and information. God bless you. "

I got a call from her husband at about 5:55am (central time) that her VBA2C was successful. It was the best wake-up call I could have received! What an incredible triumphant birth in the face of such odds! Congratulations Shari, you rock, and thank you so much for letting me be a part, even from the other side of the world!