I recently read an article on Navelgazing Midwife about the dangers of breech birth, and while it affirmed my decision that having Charlotte via C-section because of her complete breech presentation was the best choice, it also left me with a lot of lingering questions about my VBAC attempt with Beatrix. Because while I am firmly convinced that Charlotte couldn't have been born without surgical assistance (in my risks-benefits analysis), I still believe that Beatrix could've been a vaginal birth if 1) my OB had been at the hospital when we arrived, and 2) I was allowed to labor longer.
The one thing that really gets me is that I was adamantly told by my OB practice that augmenting with Pitocin was a standard no-no-no in their group. Only to hear this after my section with Bea: "Oh, Dr.---- didn't give you the option of trying a little Pitocin?" I mean, come one, what's that about? I can't help but think about the repercussions of this one action. Did the doctor on hand realize that I'm practically doomed to future Caesareans because of her actions? Or lack thereof? Having a VBAC is difficult enough; having a VBA2C? Practically unheard of.
So, while talking to a friend who is having a homebirth in my area, we began talking about my own birth experiences, and she told me that her midwife just delivered a VBA2C at home. It was like a breath of fresh air, because while I'm extremely nervous about the prospect of having a homebirth, I've decided that if I want to experience a vaginal birth there is no possible way that it will ever happen in a hospital setting. You may have a willing OB, but the logistics of fighting the obstetric group, pushing for non-interventive practices, fighting the "due date" countdown, fighting the hospital staff... it's just too much. I'm a non-confrontational kind of girl, and it was just too much. I couldn't fight that much, against all those obstacles. That , in itself, was an act of labor.
Don't get me wrong. I've never had a bad C-section experience, but even a good experience is not something any woman hopes to go through. I'm not sure that others completely understand, but I still long for that "normal" birth experience. I'd like to be on the secret, you know? I'd like to be the first to hold my own baby, or not be loopy from the Versed they gave to calm me down, or vomiting from the Duramorph. I'd like to be able to change those first baby diapers, instead of holing up in a bed for a week or so, recovering. And dang it, I'd like to be able to drive without waiting the advised three to four weeks.
I get alot of questions about if we regret attempting a VBAC. The answer is definitely not. It was a learning experience, and I'd do it again in a heartbeat. I tell anyone who asks (and many who don't) that'll I'll try for a VBAC with the next baby. The truth is, though, I won't try for a hospital VBAC ever again. The deck's stacked against you. The die are loaded. Go with any analogy you like, it's not going to look good. So, when the time comes, I'll do a lot of praying and seeking. I'll talk to Dave. And if it's possible, if I can find a competent midwife or doctor who will attend a VBA2C with an untried pelvis, I'll attempt a homebirth. I love hospitals; I love all that fancy getting waited on hand-and-foot, and cable television, and maid service. Lord knows, with a whole family of nurses I feel comfortable in a hospital. But it's just not the best place if you want a VBAC. Even having my Mom at the hospital was difficult, because as an RN she kept playing the "what-if" game. So, if it's in the cards, it's a VBA2C for me. Possibly at home.
It's not a guilt thing. I'm done with the guilt-stage of the getting-over-your-bad-labor-experiences. It's almost like the stages of grief. First is denial: "I can't believe this happened to me." Then anger: "My OB was incompetent and wanted to get home to dinner on time." "Who's to blame for this?" After that, bargaining: "If I had just exercised more/waited longer to go to the hospital/refused drugs/gained less weight/used a midwife then this never would've happened." I feel that most bargaining takes place in a past-tense; you go over every detail of your pregnancy and labor meticulously, second guessing, analyzing, and eventually stating that if such-and-such had gone differently, you could've had a vaginal birth. Then depression. This doesn't even need an example, it's so prevalent.
And, finally, blessed acceptance. You (hopefully) make peace with what happened, realized that, although your experience wasn't optimum, you did make it out. Scarred, perhaps in more ways then one, but with a healthy mom and healthy baby.
Well, in my experience.
In conclusion, what would I think it would take to create a positive VBAC? A provider who is more than willing, and who will go the extra mile while keeping the health of both mother and child at the forefront. Someone who is balanced enough to help you in the difficult times, but who's willing to say "Hey, you tried, but it's really necessary to have a section now." AND, a comfortable, positive, and safe environment where you don't feel pressured to progress at a certain speed.
Oh, and in case you were wondering, most research shows that VBACs are just as safe after multiple sections as a vaginal birth. Uterine rupture rates are still under 1% http://ican-online.org/community/users/ican-blog/blog/vba2c-safe-repeat-cesarean-research-finds