- Dr. Brandy Ross
This post has been a long-time coming...hold on, it's a long one! In March 2017 I had a vaginal birth after cesarean (VBAC) delivery. It wasn't an easy road and my story reinforces my belief in informed choice. My first two labors were rough and this was no exception.
I had horrible back labor with my previous two births that resulted in home to hospital transfers. Back labor really is the worst kind of labor you can have. My first baby came out vaginally after 24 hours of labor, twelve of which were after an epidural. With my second baby, we transferred to the hospital at 31 hours of labor. Unfortunately, that epidural made my blood pressure plummet which made the baby's heart rate go down resulting in a C-section.
I knew with my third, I wanted to have another vaginal delivery. I also knew choosing my care provider would be one of the most important predictors of success. With my history of back labors, I made a decision to birth in the hospital. I would have access to pain relief if I needed it again and wouldn't need to ride in a car while having contractions. I chose a VBAC-friendly OB and VBAC-friendly hospital.
Flash forward to nine days past my due date and I was still pregnant. Even though I knew a risk of induction was having a C-section I chose to be induced since I was so far past my due date. I had a good Bishop score and a positive history of a vaginal birth so I had a good liklihood of success (a great example of informed decision making). I had an awesome team: a doula who was familiar with baby positioning, a wife who supported me in all of my decisions, an OB who was not just VBAC-tolerant but actually advocated for VBACs, and a nurse who was familiar with Spinning Babies and the Miles Circuit! I was set! We started the induction early in the morning. Neither the foley bulb nor pitocin did anything to get labor going. This baby was going to be stubborn. My OB finally broke my water and that's when things really kicked in. After a few hours, I was having back labor. Again. I decided to get an epidural because I just could not cope. My epidural was not without complications though. I had breakthrough pain. The baby's heart rate kept dipping. But my team was on my side. They literally and figuratively held me up when I didn't think I could do it any longer.
Even though I had an epidural, my doula kept me moving. Turn to this side, turn to that side, squat. When I finally got to start pushing, my doula still kept me moving. Squatting, hands and knees, on my back, on my side. It's what I hired her for. And just when I was trying to negotiate to have another C-section (I didn't really want it, I just wanted to be done), we started seeing her head. It was only a few more pushes and she was out! My wife got to help catch her and she went directly to my chest. We got to do delayed cord clamping and nobody took her off my chest until I was ready. I asked them to do all of their checking of her right there and they did.
Without the knowledge that I had as a midwife and the right team by my side, I don't know that my VBAC would have happened. This is why I push so hard for people to make well-informed choices. Do your research. Find your team. Your birth may not turn out the way you dreamed but you can still find your voice and your power.