Of all the things I learned from my struggle with infertility, advocating for myself was the biggest takeaway.
At my first OB appointment during my second pregnancy, the doctor told me that I was a great candidate for a VBAC—or vaginal birth after C-section. My first daughter had been born via C-section because she was in the frank breech position and stubbornly refused to turn head down.
The thought of going through labor and a vaginal delivery completely freaked me out, but the doctor assured me that I had plenty of time to decide whether I wanted to try for a VBAC.
I was raised with the understanding that once you had a C-section, you always had to have one. However, in 2010, the American College of Obstetricians and Gynecologists (ACOG) changed their restrictions, allowing women to attempt labor and vaginal birth. So, I decided to try for a VBAC. I wanted the experience of labor and delivery. As the weeks passed, I became more determined to achieve a VBAC.
Much to my shock, more than halfway through my pregnancy, one of the doctors in my practice told me that in order to attempt labor and delivery, I would have to go into labor on my own by 40 weeks. I would also have to schedule a C-section in case labor did not happen. However, most women do not go into labor with their first pregnancy right at 40 weeks.
I couldn’t believe that after encouraging my VBAC attempts, the practice suddenly wanted to attach all of these stipulations to the process. I left that appointment feeling defeated.
Fortunately, I was able to find support elsewhere. I joined my local International Cesarean Awareness Network (ICAN) Facebook group to learn how I could maximize my chances at a VBAC. ICAN’s goal is to prevent C-sections by educating parents on maternal-child health. They also support cesarean recovery and advocate for VBACs. The group pointed me in the direction of the current ACOG guidelines, which state that VBACs are “safe and appropriate for most women.”
According to ACOG, there are several benefits to a VBAC, including avoiding major surgery and the risks that come along with multiple C-sections and less risk of hemorrhage and infection. The biggest risk of a VBAC is uterine rupture. However, I learned that the risk is actually far lower than I initially thought. If it does happen, the situation becomes an emergency because rupture can lead to serious injury for both mother and baby.
Armed with this information, I went to my next appointment prepared to fight. The doctor I saw dismissed all the evidence I presented her with. She refused to consider letting me go past 40 weeks or allow me to get induced. I was running into the classic issue with VBACs: despite the ACOG’s guidelines and all of the evidence to support VBACs, many doctors still do not believe in inducing women or allowing them to attempt labor after a C-section.
After everything I went through trying to have my first daughter, I had finally learned to trust my gut and speak up.
I went back to my original practice two more times. I requested to meet with a different doctor. He spent time really listening to me. He adjusted my due date based on ovulation, not my period, which set my due date five days later. He reviewed the evidence I presented to him and understood my deep disappointment in the other doctors I had seen.
The next time I saw him, he told me that he spoke with all the doctors to make sure everyone was on the same page. They would allow me to go to 41 weeks and 6 days so while I still had to schedule a C-section, I had more time. If I did go into labor and was not progressing, they would do a gentle induction, using a Foley balloon. However, he informed me that I had no control over who my doctor was on the day I had my baby. While he was completely supportive of my attempts, he told me another doctor might push me towards a C-section anyway.
This helped me decide what to do. At 33 weeks, I switched to a solo practitioner who was completely supportive of a VBAC. He did not make me schedule a C-section. He would allow me to go a full 42 weeks. He would allow for the use of Pitocin to induce labor if I reached 42 weeks and decided to still try to VBAC. I also hired a doula to help prepare me for birth and advocate for my husband and myself during the labor process. On April 26, my water broke.
Going through labor was the most physically difficult experience of my life.
I needed Pitocin to start contractions and was constantly connected to monitors to watch for uterine rupture. My doctor had to give me a small cut to help get my second daughter out. I pushed for two and a half hours. None of that was what I had hoped for when I fought for my VBAC.
In the end, I was able to successfully labor and deliver my baby. I felt that I was truly given a chance to succeed. Unfortunately, many women are pushed into repeat C-sections because doctors are unwilling to allow them to attempt a VBAC.
If a VBAC is your goal, take time to educate yourself. Find a supportive practitioner. Finally, accept that the ultimate goal is a healthy baby, regardless of how they arrive in the world.
I am so grateful for the opportunity to have experienced labor and delivery, even though I wear my C-section scar from my first daughter’s birth as a badge of honor. They might have entered the world in very different ways, but the end result was the same: a happy, healthy baby girl. I could not be happier with either experience.