What Does It Take?by Katie Perez
When planning my VBA3C (with inverted T), I knew there was a huge road with lots of obstacles and mountains ahead. I began with research, reading everything I could. I wanted to know what people did who had successful VBACs, knowing I would need to do everything I could to set myself up for the very best chance of success. This was my last shot at this, and I didn't want to have any regrets! This leads to my personal list of recommendations.
#1. Choose a *truly* supportive provider. Someone who will “support” your VBAC, and work with you to see that it happens, not just “tolerate” the idea or give you a TOL (trial of labor) as long as all the stars align and your labor follows the picture perfect textbook bell curve, which is completely unrealistic for most.
I was blessed enough to find a supportive OB that was just 25 minutes north of me! Many Special Scars moms are not that lucky though, and drive several hours, or even relocate their families around the time of delivery to get the chance to birth with supportive providers. I have never heard one say they regret it!
While birthing with an unsupportive provider is possible, it really should be a last option. No one wants to fight in labor! We are vulnerable and can't possibly think clearly, site our statistics and research, and have an educational argument while birthing at the same time! We have women in the Special Scars support group who have managed to VBAC on their Special Scar without supportive providers, (many not by choice) but wow what a beating!
#2. Get chiropractic care. During my research and reading I kept coming across stories of malpositioned babies being the culprit of cesareans. A misaligned pelvis *greatly* increases the chance of a malpositioned baby. Baby just can't seem to get into that ideal birthing position!
I read so many stories of this sabotaging VBAC's and natural childbirths alike. There was no way I was going to do all this work to prepare for my VBAC and have it blown because baby was malpositioned and labor took so long I exhausted myself, or baby got stuck, or the pain from back labor was so bad I caved and got the epidural which started the cycle of interventions that lead to another repeat cesarean, etc.
Its amazing how much easier and faster labor can be if baby is aligned correctly in the pelvis! The labor for my first vaginal birth was only 5 hours and 25 minutes. I attribute this to the chiropractic care I received my last trimester! I love my chiropractors!
#3. Hire a doula! I should have made this one my #1, haha! (I'm a birth doula.) I could not have made it without my fantastic doula. Study after study affirms that having a doula reduces the chances the birth ends in cesarean, the need for drugs during labor, increases the involvement of dads during labor, and increases the chances of breastfeeding success, just to name a few! I needed that extra person in the room believing in me, her wisdom and ideas when I couldn't. The support is invaluable, especially for Special Scar mamas, and if finances are tight, find one still in the certification process who offers a discounted rate. You won't regret it!
#4. Take a childbirth education class. Labor is such a mental thing and being prepared makes such a huge difference. Couples who take childbirth education classes learn valuable tools to cope during labor, know the in's and out's of natural labor, can make informed choices on suggested interventions and know how to smell out and avoid the unnecessary ones.
I needed my husband to be as prepared as possible too, so taking a Bradley class together was a great way to prepare both of us to know what to expect. And learning the importance of relaxing and going with the birthing process was invaluable.
#5. Diet and exercise. This is not to be downplayed! Keeping yourself as low-risk as possible does so much for getting you to that finish line! I personally followed the Brewer pregnancy diet. I'm a huge believer in high protein for pregnant mamas, at least 80-100 grams a day, and a LOT of water! My doctor had me drinking a gallon of water a day, and it helped my irritable uterus SO much! These 2 things, coupled with chiropractic care, I greatly credit for getting me my first full-term baby (after 3 preemies!). Inadequate nutrition is also linked to toxemia and pre-ecclampsia, and with a Special Scar, induction is not an option (and even without, induction increases our risk of cesarean by up to 250%). So get your protein, drink up that water, and eat a healthy diet of nutrient-dense foods with as little processed foods as possible!
And for the exercise, just keep moving! A walk, a swim, a little time in the gym, do something active every day that raises your heart rate and gets your blood circulating! It will keep you feeling good, help with energy, and has so many other benefits. My VBAC baby was due in early September and we live in Texas. It was crazy hot and the pool was oh so wonderful, so I swam a few laps a few times a week. The extra cardio helped a ton on birth day too!
#6. Deal with emotional and psychological barriers. This one is SO important. Especially if you had a traumatic experience the first time around, felt like a failure from your cesarean, or were told you "couldn't" for whatever reason birth naturally. This is unfortunately so many of us. We need to cast off these lies, look these fears in the face, and conquer these mountains! Our bodies were created to grow and birth babies! Sure, things sometimes can go wrong in the process, but that doesn't mean it’s going to happen that way again. WE AREN'T BROKEN.
For me this meant joining the Special Scars support group and my local ICAN chapter. Hearing the stories of other women who had been through what I had, who understood where I was and what I was facing, brought so much comfort. Hearing success stories gave such a boost of strength and encouragement that I could do the same!
The road to healing was a long one for me, and most of the hard work took place during the pregnancy of my VBAC baby, because I never properly processed the hurt I experienced the 7-10 years earlier with my other births. As a Christian, I wrote out birth affirmations backed with scriptures and read them to myself almost daily for a long time, to renew my mind, to cast out the fear I was feeling, and was afraid of feeling during my labor, to dissect the lies I had been told that I would "certainly rupture, bleed out, and die" if I ever attempted a VBAC, and really addressed the anger I had at my prior providers for the way my care was handled (honestly I'm still working on this part.) On birth day, I had one fast-fleeting thought of rupture when I first started pushing, but dismissed it easily, and it was all peace and joy and wonder and awe.
#7. Read, Read, Read. I don't put this last because it's least important. The more knowledge you have, the more ammunition you carry into the battle. Join forums and read others' stories. Read blogs. Read research and the latest studies. Read books that portray the normality of birth, study the evidence, and as the Executive Director of Special Scars, Jessica Tiderman, has said, “make your decisions based on truth, not fear!”
All these things really help to set us up for the greatest chance of success. I did them all because I did not want to have any regrets. And I concede there are times that things go wonky, and a cesarean or repeat cesarean becomes necessary to get a healthy mama and baby. If my VBAC attempt ended in another cesarean, I wanted to be sure it was not because I should have done so-and-so or such-and-such. I wanted to be able to rest in the fact that I had done everything I could!
I am amazed time and time again by the stories of women in our group. They are truly inspirational! Aside from having Special Scars, many of our mamas have been diagnosed with CPD and FTP, or have been told because of their histories, medical conditions etc., that they will never carry a baby to term, or they will never go into labor on their own, and most have had successful VBAC's anyway! I see them work hard and set themselves up for success because their births and their babies are worth it. We are worth it! And our bodies are amazing!