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.
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:
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.