October 18, 2011 8:06 am

Operation: VBAC

Don’t get me wrong – I’m not pregnant. I’ve just been pondering my birthing options should we eventually decide to have another baby.

There are no words to explain how disappointed I am that my first pregnancy ended in a c-section, primarily because it closes so many doors. My local hospital formally bans VBACs. My mom, who is a Labor & Delivery nurse, says that it’s because of liability with regard to anesthesia – in order for the hospital (and their insurance company) to endorse VBACs, they need to have an anesthesiologist on staff at all times to cope with an emergency c-section if the VBAC is not successful.

I am having a hard time wrapping my head around this, because wouldn’t not having an anesthesiologist on staff be a problem for any emergency complications? Let’s say it’s 2am and a mom having a textbook pregnancy has been laboring for a few hours. Her water breaks! Whoosh! And… she has a (NSFW illustration) cord prolapse. Emergency! C-section! Go! But wait – it’s 2am and the anesthesiologist is on call at home.

HOW IS THIS ANY LESS BAD? It’s a liability regardless of the emergency happening. I am not allowed to try for a normal birth because the hospital is ill-prepared to cope with an adverse outcome to any pregnancy.

My best chance for having a hospital VBAC is if I make sure to plan my labor so that the anesthetist will be physically in the hospital while I am laboring, and to make sure I deliver before he or she leaves.

Right.

My best chance for having a VBAC would be a homebirth or delivering in a birth center, attended by midwives.

Earlier this summer, my aunt (who is also a L&D nurse) told me I am going to have a “gorked baby” (her words) because I stated the above. She and my mom conceded that I would have a hard time being allowed to deliver in a hospital setting and may have to labor in the operating room (can you IMAGINE anything more uncomfortable? Steel table and bright surgical lights? No thank you.) but would not agree that it would be a better choice for me.

If you have a healthy pregnancy, have a low horizontal scar on the uterus and go into labor on your own at term you have about a 70% to 75% chance that you and your baby will have a safe normal birth. – VBAC.com

The problem I start running into is the “healthy pregnancy” part. I had preeclampsia. That is most emphatically not healthy. If I do come down with preeclampsia, my chances for a VBAC drop dramatically, since I will likely have to be induced and that carries a much greater risk of uterine rupture.

Out of the eleven most significant risk factors for developing preeclampsia, I have two:

  • Previous history of preeclampsia
  • Obesity, particularly with Body Mass Index (BMI) of 30 or greater.

Clearly, I can’t control the fact that I have a previous history of preeclampsia, but the obesity is something I can control.

I haven’t mentioned it here for fear of being embarrassed should I have failed, but I have lost twenty pounds since February. This is an amazing accomplishment, especially for me given my history of weight-loss struggles, and one that I am incredibly proud of. However, I need to lose another 10lbs before I am merely “overweight” and not “obese.” This leads me to my new plan:

Operation: VBAC

I would like to get my body and mind ready to be a good candidate for a subsequent pregnancy and VBAC. This does not mean I am going to become an Olympic athlete or compete in CrossFit or something, but it does mean I am going to lose those ten pounds. Hopefully more. (I’m taking a bit of inspiration from Theresa’s Get Body Ready For VBAC series, since I think it’s a great idea to prep your body for the outcome you want.) The further away I can get from being obese, the better.

I’m going to look into HypnoBabies, because I’ve read so many great birth stories in which HypnoBabies seemed to help tremendously. I have a Hypnobirthing book, but didn’t bother getting any kind of CDs – I’m now going to consider doing so.

I will make sure my healthcare providers are on board with my plan.

——

Since nobody knows what causes preeclampsia for sure, it’s hard to find things to do to “prevent” it. But if I can lower my chances, even a little bit, and up my chances for having a successful VBAC in the future, I’m willing to do it.

File Under: , ,

9 Comments

  • Audrey says:

    1985: I was a c-section birth. My mom was 31.
    1993: My sister was a normal vaginal birth. My mom was 39.

    When it comes to birthing there’s so much of a stigma now-a-days. The problem is that the person that delivers your baby is liable until the child turns 18. Someone can come back and sue that person at any time in the child’s life (pre-18) for something they think was caused by birthing doctor. This absurd liability makes doctors reasonably more skittish than in the past about things like VBACs. That said, it is your body, baby, and birthing experience. No one has the right to make decisions regarding those things but you (and the daddy).

  • Meagan says:

    WOOT! I’m proud of your weight loss (your pants look GREAT!), and excited for your plan! Roan and I will help in any way we can!

  • Danbob says:

    I’m super proud of you, and I love you SO much! I’m honored to have you as my wife, and I’ll support you in any way I can. *Smooch*

  • Gretchen says:

    Way to go and I’m proud of you too! That’s a huge accomplishment and an even getter goal. Keep up the good work!

  • BreAnna says:

    I think a VBAC is a great goal and definitely good motivation for getting as healthy as possible. I’m proud of the progress you’ve made!!
    Did you know Adam was a HBAC baby? His mom is an L&D nurse and after being bullied into a c-section decided that she’d never birth in the hospital again. The next three (or maybe four) babies were born at home. I know everyone is different, but I figure hearing more success stories might be encouraging. :D

  • Jem says:

    Go Meggan! While I’m busy piling on the pounds because Isabel is weaning (remind me to blog about that) you’re doing the opposite. I won’t even bother pretending I’m not jealous (but then we all know my problem begins with the letter ‘c’!)

  • Melissa says:

    Go Meggan! When I read the title, I thought you were going to say you were pregnant!

    Congrats on the weight loss and good luck to losing the additional pounds. I’m with Jem in that I’m jealous of you because all I want to do is lose weight, but now that I have another alien growing inside me, that won’t be happening until next spring!

  • Brianna says:

    I was so happy to FINALLY talk to you about our experiences, in person. We really do need to talk more about this topic. It is so important (for me) to have the support.

    WARNING…This is so long. Sorry! (had a lot to say I guess)

    My mind hasn’t stopped spinning since Piper was born. Over the months, I’ve learned to accept her birth but my heart still aches that I ended up with a c-section.

    All that kept me going during my labor was the promise that my baby was coming–that I would meet her in no time! I remember my midwife checking me and, in between my howling, I remember him telling me that I had reached 9cm’s. In my head, I was so excited…I figured it would only be another hour. Then I watched the sun rise. Then I thought I was going to DIE. All that kept me going was the visualization running through my brain of me pushing my baby into this world. I endured 36+ hours of labor only to have someone else, a stranger, pull her from me.

    Later, friends and family would say: “well at least you’re safe and you have a healthy baby…that’s all that matters”. NO. No, no no. That is not all that matters.

    For some women, sure. Yes, that’s all that matters. Some women just want “it” OUT. But for the women who plan, who dream, who play out their dream birth over and over in their minds throughout their pregnancies and end up with a surprise c-section, it is crushing. It can make post-partum depression all the more real. We can have harder times adjusting to life as a mom. Breastfeeding can be more of a challenge. Bonding can be more of a challenge.

    For me, not birthing my daughter vaginally left me feeling like less of a woman (among so many other things). I KNOW that if and when we are blessed with another child, I will do everything in my power to have a HBAC.

    In my opinion, based on my experience with my prenatal and labor/birth attempt outside of the hospital…DO IT…that is, birthing center or home birth. I cannot recommend it enough. I was shocked to hear a friend tell me recently that her doctor only spends about 20mins (tops) with her each prenatal visit. I spent about 1.5h every time. I never felt like a patient.

    I totally encourage you to interview midwives in your area who are willing to do HBAC and discuss the risk of preeclampsia.

    I can imagine it’s difficult to bring this all into reality with your mom and aunt sharing with you their opinions. BTW, the whole laboring and delivering in the OR seems absurd. It’s really hard to believe that’s real.

    I understand just how important this is and fully believe YOU CAN DO IT! Let’s please keep in touch about all this.

  • Katherine says:

    While I have never been pregnant (or ever plan to be for that matter) I do enjoy consuming pregnancy and birth related information, one thing that I have heard from multiple friends in my graduating class who are starting to have children revolves around how most OBGs and doctors almost immediately move for a C-section as opposed to allowing the mother to experience a true vaginal birth.

    Furthermore while having a VBAC baby is entirely possible (durr!), many women are tricked into believing that once they have a C-section, vaginal birth is no longer an option for them-EVER!

    Out of the 6 women that I keep in touch with on facebook who have had children in the past 2 years, 5 of them had C-sections, and the stories revolving around them are a little scary.

    While 1 scheduled a C-section of her own accord, 3 of were in labor for between 2-4 HOURS and were sent in for a C-section without so much as an explanation, only that “the OR is ready and we have to hurry”, what two of them found out afterwards because their doctor apparently didn’t have the time to deal with having a woman be in labor for 6-8 hours. The other woman who had a C-section had been experiencing complications regarding her birth and had an emergency C-section which she later found out could have been avoided with a little more care from her doctor.

    I’m more concerned that it appears that even if a woman plans out her vaginal birth and schedules to be induced, doctors seem to be forcing c-sections on women without reasonable explanations which is one of the reasons why I’m scared to have children. Sure, a vaginal birth isn’t the most lovely feeling thing in the world, but if I choose to have a vaginal birth and the doctor who is being paid by both my medical coverage as well as myself doesn’t “have the time” to deal with it, then I should have rights to demand either a different doctor who is willing to do his job or withhold paying them for services that were previously agreed upon and not rendered.