Thursday, February 4, 2010

An attempt to VBA2C (vaginal birth after 2 cesarean sections)

Now that my third baby is almost six months old I have allowed myself to reflect back on all my birth experiences.

My first was an induced labor at 41.4 weeks gestation. The induction was started at about 9 am. I experienced labor pains for the first time and after many hours of laboring the decision was made for me at about 10:30 pm that I can not achieve natural labor and so "needed" a cesarean section. I was 4 cm dilated. The reason has ever since haunted me: failure to progress.

My second time around I silently vowed to deny any medical attention "when the time came". Unfortunately my baby was breach. This and the fact that where I live it is difficult to get a doctor to deliver a breach baby, imagine a VBAC (vaginal birth after cesarean) with a breach baby. Not to mention the bold stamp on my medical records "failure to progress". So my hands tied with my options I unhappily allowed myself to be cut open again. He at the moment of birth ended up into a transverse position instead of breach. He was still comfortable moving and turning around in there when he was aggressively pulled from my body.

After this I slowly drifted into postpartum depression. Breastfeeding difficulties with latching on problems. It seemed endless. And I openly blamed myself but mostly blamed my husband. I felt that if he would have some how supported me more or maybe forced me the out come would have been different.

Cesarean sections don't just scare you physically they scar you emotionally and mentally.I was under psychological treatment for months. And when I was advised to stop breastfeeding I crashed and met my low point. I did not stop breastfeeding but it made it all the more difficult.

With my third unexpected pregnancy I was determined more than ever to achieve my VBA2C. I chose to be attended by a midwife. The only draw back here is in the last weeks of pregnancy you are referred to a Ob/Gyn of your choice. Because we live on a small island the midwives do not attempt VBAC. Whether you achieve a VBAC or become a repeat cesarean section is up to the doctors and how hard you are willing to fight for it.

So I choose my doctor and inwardly hoped that because she was young and new not to mention a woman she would leave me attempt my VBA2C. My luck when I went in for my visit she was on vacation and another doctor was in her place. He immediately  started to prepare the "necessary" paper work for the repeat cesarean section. I stood my ground regardless and told him I will not have a repeat because I want a VBA2C. He blankly looked at me and started the old lecture of the "risks" a VBAC can bring. I gladly told him I am well educated on the risks and know all the facts. He was not glad about it but let me leave with the paper work to VBAC. I felt empowered. I had achieved my short term goal. I will be allowed to VBAC.

I left the office and proudly called my husband to announce my triumph. Upon arriving home I plotted with my sister-in-law how to try and coax my body to achieve a VBAC. I will admit to trying caster oil and some herbal teas. I wanted for my body to dilate without any trouble. I did not want to be labeled "failure to progress" anymore.

On the night of August 19th after a regular evening we settled in to go to bed. My husband fell right into a deep sleep. Within about 10 minutes of him falling asleep I felt my first ever non-medically induced contraction. At the moment I didn't even realize that it was a contraction, I actually thought it was cramps because of not having a bowel movement that day. Well sure enough about a half an hour later I was on the toilet with what you can only label as open bowels. My body was preparing itself. I started having slightly harder contractions. And decided to take a shower and see if that would help me relax or if the contractions would stop so I could go to sleep.

The shower didn't help and the contractions were getting increasingly more uncomfortable. I was so uncomfortable that I decided to wake my husband after just over an hour in labor. I was very uncomfortable at this point, not wanting to sit or lye down. I just wanted to lean on things, just lean and slowly swing my hips from left to right. I was praying in each contraction while doing this pleading with my body and baby for the birth I so longed for.

We finally decided to go to the hospital. Home births are rare, and VBAC are not at all done here. If I had known that after arriving to the hospital I would be held there no matter how my labor was progressing I wouldn't have gone in assuming to get some pain relief and sent back home. I was truly naive. So I was put on my back to be attached to monitors even after I pleaded with the nurses to let me stand or sit. They said it's impossible to monitor a baby that way; sure and I thought I was naive. Well left on my back my discomfort was a thousand times worse than if I had stayed home to ride the tides of the contractions. This led my babies heartbeat to fluctuate because the main nerve supplying the much needed oxygen to the placenta was compressed.

The doctor came and checked me and I was praying, praying for some sort of dilation. He concluded that I was still only 1 cm. I was 1 cm dilated the week before at my 39 weeks appointment. He broke my bag of water and again I was praying for clear fluid. It wasn't. It was slightly tinted with meconium. This led to yet another cesarean section.

It is after the birth of my baby that I found out that caster oil could also affect your baby and urge them to have premature bowel movements. I till this day believe that this is what happened with me. And my own enthusiasm to achieve my natural birth led to my down fall in the end. As of today I am studying to to be a Doula and know that I would be able to encourage other moms to achieve the birth they want, without making the mistakes I did.

If I do have a number four someday it will be a non-assisted HBA3C ( home birth after 3 cesarean).
Yes I do refuse the label "failure to progress" that was given to me :)


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