At week 24, I finally made up my mind that I wanted to try VBAC (vaginal birth after c section). My first pregnancy had ended in a c section but the baby didn’t live past day five (a story for a whole different day).
I did an extensive study on VBAC to see if it was possible for me; it was. It had been 5 years since my procedure, the cut was transverse, and I didn’t have any medical conditions that caused the first csection. I shared my decision with my doctor and he was on board with it as well. The only challenge was by week 24, I had already gained too much weight. Notwithstanding, I was determined to try labour. So, throughout the remainder of my pregnancy, I continued to exercise and eat healthy. At 36 weeks, we checked the fetus weight and did an estimation for the next four weeks. she was within the weight limit. Everything was on course for the VBAC.
Conditions for VBAC
You stand a better chance of VBAC success if :
- Your previous C-section was performed for the baby’s health, not because of the actual labor process. For example, a breech baby or abnormal fetal heart rate tracing.
- You’ve had a previous vaginal delivery: This includes if you’ve already had a successful VBAC.
- You are younger than 35: A 2007 study found that women younger than 35 were more successful and had fewer complications during a VBAC.
- Your incision is a low-transverse (horizontal) uterine incision.
- there is at least a 3-5 years space between your previous c-section and the current one.
- The fetus is no more than 3.5kg
By week 39, I began to do more squats, yoga and meditation, as well as walking. At week 39 day 6, my labor started with mild contractions. I called my doctor and told him. We stayed at home relaxing and monitoring the contractions. By the next morning I had bloody show and the contractions had gotten more consistent.
We drove to the hospital around 9am. I continued to walk and do all the pelvic opening exercises to help baby descend. By 8 am the following day, my cervix was effaced but there was no dilation. Doctor asked for my consent to rupture the membrane. Once the membrane was ruptured, cervix was dilated at 6 cm, so we estimated the opening at 1 cm every hour. This would put delivery at around 1pm. By 12 midday, I was still dilated at 6 cm even after a small dose of pitocin was administered (with a vbac, administering any kind of medication to induce labour is risky because the force of the contractions could rupture the uterus scar).
The contractions remained mild coming 2-3 every 10 minutes. I asked the doctor to go with plan B because I didn’t want to stall any longer and risk an emergency c section. Hospitals in Liberia are not equipped to perform emergency surgeries. So I got a repeat c section.
Though I didn’t get to experience natural birth, I still consider this birth beautiful and successful because I was informed and in control of my body every step of the way. The doctors, midwives and nurses were very supportive throughout and allowed me to make my own decisions.
Why opt for VBAC? (from the Mayo Clinic)
Once a c section does not equate to always a c section, especially if you satisfy all the conditions listed above. There are many positive reasons why you should try vbac. Compared with having another C-section, a vaginal delivery involves no surgery, none of the possible complications of surgery, a shorter hospital stay and a quicker return to normal daily activities. Trust me, I know. If you’re considering VBAC, discuss the option, your concerns and expectations with your health care provider early in pregnancy. Make sure he or she has your complete medical history, including records of your previous C-section and any other uterine procedures. Your health care provider might calculate the likelihood that you’ll have a successful VBAC. It’s important to continue discussing the risks and benefits of VBAC throughout pregnancy, especially if certain risk factors arise.
The woman’s body was made to birth babies. Therefore, women should be supported with information and care to experience vaginal childbirth if she so desires. Doctors and nurses, stop telling women that “once a c section, always a c section”. If your facility cannot bear the risks of vbac, just be upfront about it. And ladies, arm yourself with information don’t just take their words for it. The internet is loaded with information that can be useful in any given situation. Make use of it.