Preparing for a VBAC

Michelle is a guest writer here on my blog.  I asked her to write about her approach to getting a much wanted VBAC (vaginal birth after c-section) after 2 scheduled non-labor c-sections.  Here is her plan - mapped out in her own words.  This is excellent advice for those planning a VBAC and for every birthing woman planning to go the natural route. 

"I approached this fairly systematically, methodically.  I also took on preparing for my VBAC as a job. I did work on it every single day. Some days it was reading, some days it was visiting forums, some days it was prental yoga or walking....but it was always something.....at least until out 7 mos. along.  When I realized I had gained some confidence & felt like I had some mastery over the knowledge of the birth process, then some nights I gave myself permission to just sit in the living room with my hubby & relish being pregnant, contemplating what a privilege it was for me to be carrying my baby and being excited about the process that would bring him to my arms.

My intro to VBAC came from "The Business of Being Born."  It opened my eyes to what birh in American hospitals is.....and more importantly, what birth could/should be.  It was a reality check & the beginning of my paradigm shift.  Great thing about a video is that it's fairly easy to get hubby to watch it.  My hubby isn't gonna read birthing books but he will watch TV!  I have found that most local libraries have this availabe for check-out. I know Netflix has it, too.

After that I just googled "Risks of VBAC, " "VBAC," & "Risks of Repeat C-sections." This began to lay the factual, scientiic groundwork in my mind about the risks & benefits of vbac & repeat c/s. It further lead me to:
mothering.com forums re: VBAC. I learned a lot from those ladies, and gained comfort & strength & support, even tho they were faceless & anonymous to me.
www.ican-online.org. I perused all the studies and information they have posted on there.  I also joined the forum and began to visit that.
www.vbacfacts.com.  I perused this.  I recognized that it was not a scientific website.  But it was more perspective.
I went to the Mayo Clinic's website and also Johns Hopkins, I believe, as well as ACOG's website. I wanted to see for myself what the ob party line was on it.

Thru the forums I received reading list recommendations. 

The first book I read was Birth After Cesarean: The Medical Facts by Bruce L. Flamm.  He conducted the largest study on VBAC in the US and wrote about his findings.  I needed to know what the science said about VBACs....not the insurance companies or the ob's....the science.  I had to decide for myself if it was safe.

Then I read DON'T CUT ME AGAIN! True Stories About Vaginal Birth After Cesarean (VBAC) by Angela J. Hoy. This was a compilation of birth stories, most of them successful VBACs but some were CBAC stories. I was discouraged by them sort of but also knew they were a good reality check for me and a reminder that nothing is guaranteed to me and I couldn't control everything.

After all this I had decided VBAC was safe for me & I would do it.  So the next book was "The Thinking Woman's Guide to a Better Birth" by Henci Goer. It did a great job educating me on the risks of all the common American obstetrical interventions employed today.  It also began to clarify personal circumstances under which I would agree to any of them.  Further, it had a fantastic list of interview questions for a provider. It was also during this book that I decided upon & committed myself to a completely natural childbirth.  Anything beyond that carried risks that could derail my effective labor & lead to a cascade of interventions that were neither safe for me nor my baby. I mentioned in passing to my husband that there would be no epidural. He made an expression that made me feel like he didn't believe me and I was crazy but he would go along with it for now. I knew I could do it, tho....I just knew.

So now that I had committed to a natural birth, I knew I needed some tools to manage labor successfully.  I researched Bradley, Lamaze, Hypnobirthing & Hypnobabies. I read women's assesments of how these had worked for them. I trid to choose the method that would help mitigate what I knew were some of my personality weaknesses....the need to always be in control, my acculturation that birth was dangerous and painful and scary.  In the instant I decided I would use Hypnobabies, a sense of peace came over me b/c I KNEW I'd have the tools to handle anything labor threw at me.  I felt powerful & confident.

Next I read "Painless Childbirth: An Empowering Journey Through Pregnancy and Childbirth" by Giuditta Tornetta. The title alone sounded great to me! It further encouraged me that I could alter the acculturation I had been raised with. But it was a bit too new-agey for me so kind of a challenge to get thru it but I took some good things from it.

"Birthin from Within" by Pam England and Rob Horowitz prompted me to face some of my own internal birth trauma and demons.  It also taught me that I could decide how to feel about birth. I could decide to fear it or I could decide to honor and accept it for the beauty and power that it intrinsically is.

"Ina May Gaskin's Guide to Childbirth" by Ina May Gaskin taught me to relax my mouth and hands during labor and also to visualize my cervix dilating during labor.  More importantly, it taught me that "normal" birth has a really wide array of orders and timing.  Two births could be extraordinarily different and both could still be absolutely, completely normal and effective.  This was big for me in accepting the course of my own labor and not questioning how my own body & my own baby were choosing to do things.

Somewhere along the line, probably earlier in 2nd trimester I googled "Optimal Fetal Positioning." I read some random websites about it and spent a lot of time on spinningbabies.com. I bought a 65 cm exercise ball and began to sit on it daily. I would do pelvic tilts and not slouch on the couch after about week 28, I think. When my huge tile kitchen floor got dirty, I scrubbed it on my hands and knees.  I wanted my baby head-down and anterior. 

Being on all 4's felt GREAT to me during pregnancy. I spent a lot of time kneeling on the floor and leaning on my birth ball.  Sometimes I would even stack pillows under my chest in bed and sleep like that for a bit. Not surprisingly, what felt great to me during pegnancy also happened to feel great to me during labor. I spent all 6.5 hrs of my labor on all 4's and I delivered in that position as well.
 
I also bought a prenatal yoga DVD & did it periodically thru-out my pregnancy. I also signed up for a pre-natal yoga class on Saturday mornings with a local doula & yoga instructor. It was probably only 6 or 8 wks but I felt good about myself that I was doing it. I also took a water aerobics class during the last trimester at the jr. college down the street. It was twice/week.  Getting into the water felt SOO good and getting out was really hard b/c my belly would get soo heavy.

We also hired a doula.

I did the Hypnobabies home instruction class as the program stated. It was way more time consuming than I had expected and I found that irritating.  I would do it at nite after kids in bed. I fell asleep 95% of the time.  During labor, I did not hypnotize myself.  However, I did, indeed, have a "fast & easy" labor!! The program was amazingly effective at rewriting the script in my head about what labor & birth had to be.  It reprogrammed my subconscious. I can not overstate how much this helped me and how it benefitted me. So even tho it was time consuming, it was worth every second!  (Incidentally, my girlfriend did Hypnobabies, too, due at same time as me. Her labor was 7 hrs. Her first labor was 34 hours so 7 was a big difference!).

That is the journey I designed & the thought progression I used to get my VBA2C.  Finding a provider was an entirely separate and traumatic experience for me.  Getting my hubby on board is a different chapter.  Dealing with unsupportive family members and others is yet another chapter.

There are, of course, lots of ways to go about all of this that are equally effective. There are also lots of other good books out there.  I think each woman has to chart her own path while still leaning on other supportive women for advice, experience & wisdom.  It can be an isolating journey...women have got to find support from somewhere."  ~Michelle