In my last update, I forgot to mention a dream I had recently that pretty much sums up this whole journey to VBAC experience so far. I had a dream that I was sent to the hospital for "observation." I wasn't in labor yet though. For some reason, my Doctor was not available to see me, so who did they put in his place? My old OB who did all 3 of my c-sections!! I kept saying over and over again, "But I'm not in labor, I need to go home!" She kept insisting that I stay and be monitored. She strapped me down and kept saying that I needed to have a c-section! I was sweating bullets trying to figure a way out of that hospital!! Somehow I escaped... but I woke up seriously freaking out!
I think that really does sum up what many women in my position are feeling when they start this journey of attempting a VBAC. I think we feel like there are so many obstacles to overcome, the biggest one being the medical community. I am NOT anti-hospital or Doctors... I plan to birth in a hospital with a Doctor. But I do feel that the medical community as a whole needs to wake up to the reality of what is going on around them. The c-section rate is climbing every day, and it is not out of necessity, it is out of convenience! The World Health Organization says that there should be no more than 15% c-sections if all c-sections were done out of absolute medical necessity... yet the numbers have climbed well over 30% in many hospitals, some reaching as high as 50-60%! That number is astronomical to me! Unfortunately, the hospital I delivered my first three children in had a very high c-section rate. I wish I had been armed with that information before heading into my first pregnancy. There is so much I wish I had known when I first started out! This is why I feel so strongly about sharing my experiences in hopes that it will help someone out there to make wise choices for themselves instead of Doctors making those choices for them.
So here are some of the things that I am doing to make sure I have the best possible chance of having a successful VBAC:
1. Find a supportive Doctor. I truly believe this is the most important thing you can possibly do! If this is your first time pregnant, you have to be diligent about researching Doctors, asking around for recommendations and ask tons of questions when you first meet that Doctor! Don't be afraid to ask questions! Find out what their induction and c-section rate is.. if they are hesitant to answer, run as far as you can!! If you are at all interested in having a natural birth, choose a hospital and Doctor that are known for being more "pro-natural." I think if I had to do this all over again, I would've also considered using a Midwife. I think either a Doctor or Midwife is a great choice, as long as they are not known for pushing inductions and c-sections. If you are pregnant after one or more c-sections, you MUST have a Doctor or Midwife that is pro-VBAC. Don't just take their word for it if they say "Oh yeah, I'll let you have a trial of labor and TRY for a VBAC." There is a good chance, they won't in the end. Sorry to be cynical, but this is just the plain truth. Find out from your local ICAN chapter which Doctors are pro-VBAC, and choose wisely. For me, I didn't have a choice. My Doctor is the ONLY Doctor in all of Texas and really all of most of the U.S. who will do a VBAC after 3 c-sections. He is only one of TWO Doctors in the U.S. who will do a VBAC after 4 c-sections. The other one is in the Atlanta area. We are blessed in the DFW area to have such a Doctor who believes in the woman's ability to birth naturally. So no, I didn't have a choice, but I couldn't be happier with that choice!
2. Hire a doula! I have already mentioned before about hiring a doula, but I can not stress enough how invaluable it is to have a doula! I haven't even been through the birthing process with her yet, but she has already well exceeded my expectations! She has just such a wealth of information available to give me anytime I have questions and is there anytime I have one either by email or phone. Having a doula can help to reduce the mother's request for an epidural or pain medication as well as reduces the need for pitocin or cesareans. (Read up about doulas on the website: http://www.dona.org/) My doula, Katie, has become a friend to me and I know that she will be even more invaluable to me once it comes time for the birthing process! I am SO thankful I found her!
3. Take birthing classes. Steve and I are currently taking Bradley classes and just started this week. It was pretty funny that we were the only couple that had children already, since most couples who take birthing classes are first time parents! I just feel so strongly that I need to be armed with as much information as possible in order to achieve a natural birth. The Bradley classes teach different exercises and relaxation techniques to help manage the pain of childbirth. I will be the first to admit that I am SCARED of the pain that I will experience during labor and delivery. But I feel that the Bradley techniques as well of the help of my doula (and husband!!) will get me through that pain. There are other birthing classes out there of course. Many doulas will offer shorter classes to give you an overview of some techniques to use. The standard Bradley class is 12 weeks long (ours is condensed into 8 weeks) and many people just don't have the time to put into that many weeks of classes. There are other options out there!
4. Brewer's diet. One of the things that Katie and my Bradley instructor have introduced me to is something called the Brewer's diet. It is a high protein diet for pregnant women which is supposed to significantly reduce the risk of pre-eclampsia, which is one of the biggest reasons for needing a c-section. You can learn more about the diet here: http://www.drbrewerpregnancydiet.com/index.html
5. Go see a Chiropractor who is Webster certified. I am still learning about this and am sold on the need for it, but am figuring out now if it is in the budget! I'm not sure if my insurance will cover it, so it may all depend on that. If anything, I hope to be able to go a couple of times (hopefully more) during my last trimester. There is something called the Webster technique (which you can read about here: http://www.icpa4kids.com/about/webster_technique.htm) that is done during pregnancy. I am not an expert on this by any means, but from what I understand, this helps facilitate optimal fetal positioning for birth. If you have a breech baby especially, this would be very helpful! According to Katie, it also helps to have a much easier delivery. A baby that is malpositioned can cause a much longer and harder delivery and often lead to a c-section. I have also heard from many other Moms that they swear by this as well and highly recommended doing it.
6. Have a birth plan! I think this is absolutely crucial. Even with such a supportive Doctor like mine, there is still the possibility that he will be out of town or unavailable when it comes time to deliver. Most Doctors would not even touch a woman who has had 3 c-sections and would automatically send me to a repeat c-section. Fortunately, my Doctor has several back up Doctors that are willing to go by the birth plan as long as Dr. C has signed off on it. You may have some battles to face, even with the birth plan, such as the hospital staff or an unwilling on-call Doctor. But it is so important to have your desires written down so that there is no question of what you expect to happen that day! If you have a doula, she can help you write a birth plan and let you know of some of the things you should put on it.
Those are just 6 things that I think are pretty important.. I know I have left off many. Unfortunately, as a VBAC hopeful, you have to go the extra mile, but hopefully, worth it in the end. I started with a dream with fears... I hope the end of that dream will be a happy ending with my beautiful baby girl delivered the way I desire it to happen! I do understand that there aren't always happy endings, but it won't be because I didn't try my hardest!