Vaginal, cesarean, and VBAC. Those are the most common forms of birth. VBAC stands for vaginal birth after cesarean. Attempting VBAC or TOLAC, which means trial of labor after cesarean, is no small feat in a birth community with a high cesarean rate. In order to do so you really have to be determined, advocate for yourself, be educated, and be strong. Now, when you add two prior cesareans to that, it’s called a VBA2C and it’s a little more uncommon.

February 15th, 2022, I attempted and succeeded in having a VBA2C and it is one of the proudest moments of my life. One of the beautiful midwives referred to it as my “birth justice” and that couldn’t be more true. I want to share some of my story for anyone hoping and wishing for their own birth justice, too. 

Background

A little background, in May of 2007 I had an emergency cesarean when I was 19 with my first child. My labor was long and intense, at 22 hours and I labored all the way up to 8 cm before being told that I was what providers call “failure to progress.” 10 years later, I was pregnant with my second child and knew immediately that I wanted to try for a VBAC. I went to the same OB out of familiarity and was completely ignorant of this practice’s cesarean rate and aversion to VBACs. A long 9 months of VBAC intolerant comments at our appointments and I ended up with a scheduled cesarean. 

While my son was born without as much commotion and trauma as my daughter and the recovery was easier than the first, I still felt robbed of something. I grieved the birth that was taken away from me which spiraled into a bout of postpartum mood disorder that greatly affected my life for the better part of a year after my son was born. I thought that my son was my last baby and so I accepted the births I had and worked on healing. This catapulted my doula journey as well because I wanted to support other women during birth to do my part to lessen birth traumas like mine. 

Summer of 2021 and to my husband and I’s surprise, we were expecting a little girl. This time I refused to accept anything less than I desired (read: deserved). I explained how important this was for me to my husband and told him that if I was going to be successful, I needed him to be by my side and fully support me. I called the local hospitals and providers and asked questions. None of them answered in a hopeful way and I knew I wouldn’t find what I was looking for locally. I searched online for options and came across a practice of Midwives over an hour away that would be willing to discuss the possibility of a VBA2C with me. After an extensive review process, they decided that I was not what is called, “risked out.” 

From the moment I walked in, I knew it was different there. They left no stone unturned. They sent me to MFM (Maternal-Fetal Medicine) to have extensive imaging done to see the full picture of what we were working with regarding my scar tissue and rupture possibilities. They also had me consult with the hospital system’s OB team to have them sign off. All of these measures were taken for my safety and all while speaking of my vaginal birth as a fact, not a possibility. 

How I Got My VBA2C

Outside of having a supportive partner and a VBAC-friendly provider, you have some work to do yourself. You have to let go of any fear you might have. You have to truly believe that your body is capable and you’re going to be safe. You cannot lie to yourself. Be educated but choosey. Don’t unnecessarily read horror stories of births that will sway your choice but also know what the risks are. Being informed is key. You have to be willing to speak up and stand up for yourself because this is YOUR birth experience. No one else’s; not your husbands, not your doulas, not your moms, and not your medical providers. And lastly, you have to be patient. It is hard. It’s probably the hardest part of the whole process. I was contracting for weeks before I went into labor. In the last 2 weeks, my body started and stopped the labor process several times. Each visit with a cervical check that showed my cervix was still completely closed was disheartening. 

February 14th at 11:45 pm I started feeling contractions that I knew were different than every other time. I just knew deep down that this was it. I told my husband, we better get some sleep, and mostly for him. I woke up several times through the night, still feeling the same contractions even while laying on my side. I couldn’t sleep through them anymore at 5 am. I got up, started the coffee, sat in the silence, and swayed on the ball while I let my husband sleep as long as I could. Around 5:30, I had to wake him up and tell him that he was not going to be making it to work that day and that he might want to get ready. I started timing contractions and we were at 5 minutes apart for over an hour. We called the babysitter, got all the things, and got in the car. 

We drove the hour and a half to my birthing hospital and imagine our surprise when we got there at 9:00 am and the OB on call said “your cervix is still closed, so you’re not in active labor.” I had been contracting for close to 10 hours at 40+3 and they wanted to send me home. This time I stood up for myself and said no. Thankfully, one of the midwives I had previously seen was there. She checked me and said you’re not leaving here without a baby one way or the other. However, being a TOLAC, they gave me a timeline of two hours to see a change in my cervix before we had to discuss our options. For legal reasons, they had to consent me for a cesarean as a precaution and let me tell you, this is where some serious mental strength comes in. Hearing the list of possible worst-case scenarios, consenting for blood transfusions, etc is very taxing on your mental state when you’ve been in pain for hours.

My doula arrived, we got moved to a room, and I got into my zone. I turn inward heavily with pain. I had my eyes closed for 75% of the labor, probably. My doula reassured me, used some essential oils I requested to help me stay calm, and was there for anything I may have needed. I rested, changed some positions, and when they came to check my cervix after 2 hours, I was at 3 cm. Things started moving really quickly at this point and after some time on the toilet (ask your doula about this trick) my water broke. When we got to the bed to check my cervix again, I was between 9 and 10 centimeters dilated. It was time to push. After 1 hr and 15 minutes of pushing, I had successfully and safely accomplished my natural, epidural free, VBA2C. 

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