I started my second pregnancy thinking I would have a scheduled repeat c-section. It was not because I wanted to. I have a tainted record in the world of medical obstetrics. Scarlet letters on my operative report that read "should be advised not to attempt vaginal birth."
My story is best explained with a little background about my first birth experience.
My first child was born by an unplanned cesarean section in 2010. This was due to complications resulting from her un-diagnosed double footling breech presentation. By the time I was prepped for surgery, I had delivered her up to her shoulders but due to the lack of training of the hospital staff, her head became trapped and I was rushed to the OR. She was so stuck in my birth canal the doctor extended my incision vertically (resulting in what's called an inverted-T incision). I recall the surgeon telling me after the surgery "you can have as many babies as you want but they will always have to be delivered by c-section". He also wrote in my report that my incision was "large". He explained to me it was larger than normal because he had such difficulty getting my daughter out. I was so relieved my baby was ok that I didn't let what he said sink in until years later when I began to plan another pregnancy. I just nodded and accepted what he said without question. The first two years of my daughter's life were dark and difficult for me. I suffered from thyroid disease and postpartum depression and anxiety.
After healing myself through counselling, my husband and decided to expand our family. I found out I was pregnant with my second baby in August 2014. It had been almost 5 years since my traumatic c-section. Within the first week I started searching for midwives and I hired a doula, Julie. I'd heard of the many benefits of having a doula and knew if I had to have another c-section I wanted a postpartum doula to help me in those first few weeks. I didn't think a vbac was out of the question at this point but I knew it would be a long road and a fight to find a supportive care provider. It was important for me to have a doula during the postpartum period but especially if I was attempting a vbac.
I began chiropractic adjustments with a Webster certified chiropractor at 7 weeks pregnant and continued seeing her throughout my pregnancy (highly recommend!). I called around a few places and got accepted into a midwife group that was close to home (I didn't mention my special scar over the phone). I figured surely I'd have better luck with midwives than an OB. My very first appointment, I presented them with my surgical report and my desire to vbac. The midwife left the room to talk to her superiors and when she came back she told me that a vbac was too risky, because of an increased risk of rupture, and while they couldn't force me to have a c-section they wouldn't recommend a vbac and sternly advised me against attempting one. She referred the ACOG guidelines and said that I was not a candidate for vbac. I haphazardly agreed to the surgery because I didn't want to lose midwife care. I had yet to discover that all midwives in Ontario are regulated by the government. There are no "home birth only" midwives in Canada. They are as I now like to call them "MEDwives" (medical midwives). I was so happy to be in the care of midwives I didn't realize I was not being supported in MY choice to vbac. I already knew it was possible and had spent hours researching the risks but felt powerless to fight against the force that is technocratic birth in this country. Every time I sat down to write a c-section birth plan, something didn't feel right. Tears would well up just thinking about walking into an OR, being injected with drugs and strapped to the table. No immediate skin to skin. The weeks of recovery and pain afterwards. The risks from complications and impact on my baby and any future pregnancies. How was I supposed to take care of a newborn and a 5 year old and recover from medically unnecessary surgery? How could I willingly do that to myself? Don't get me wrong, I realize that c-sections save lives and if it was medically necessary for me to have one, I would! But I knew VBAC after a special scar was possible thanks to the Special Scars ~ Special Women community. I just had to fight through my fear of the unknowns. I found the best way to do that is empowering myself with knowledge. My husband had heard what the midwives were saying and he was unsure of me attempting a vbac at first and it was important to me that he felt comfortable with this decision. I needed him to have confidence in me and the more we talked about it, he came to agree that I should at least try to have a vaginal birth. He became my biggest supporter. We learned to educate ourselves, do our own research and question everything. He came with me to my prenatal appointments when he could and didn't hesitate to call them out when they didn't have answers to our questions. The small study available (Landon Study, 2004) did nothing to gain support of my midwives who tried their best to convince us a vbac was not a good option for me. One midwife told me that me and my baby could die, right in front of my 5 year old daughter, without any regard as to how that might affect her. This was extremely unprofessional. What that midwife fails to understand is there is no such thing as a risk-free birth. Women without a scarred uterus can rupture. There are no guarantees. I remember emailing Julie and admitting to her that I felt selfish for wanting a vbac. I was so glad when she assured me that I wasn't being selfish and she happily listened while I vented all my frustrations. She got in touch with her contacts and recommended some midwives closer to Toronto that might support me. I did find young midwife who wanted to help me. She pleaded my case to her superiors but was ultimately unsuccessful in gaining their support. These midwifery practices have huge insurance premiums and they don't want to take any risks no matter how small. I returned to my original midwives for a prenatal appointment. They tried to appease me by referring me to a local OB for a consult. When I met with him the first thing he said was "you cannot have a vaginal birth". He then told me some scary stories (scare tactics) and I walked out of his office feeling angry but not defeated. I would not let him or any provider make me cry no matter what horrible things they said. On the bright side at least he wasn't a bait and switch! There was something he said that disturbed me. He said that if I showed up to the hospital in labour they could do a c-section with or without my consent. I was horrified at the thought of this. It was at this time I started researching unassisted childbirth. I felt backed into a corner and it seemed like a better option that being forcefully cut open for no valid medical reason. I love everything UC stands for but it's not for everyone. Ultimately, I couldn't take the responsibility for my own birth, which makes me sad but it was the best decision at the time.
At 28 weeks pregnant, I fired my midwives. I couldn't put up with the bullying anymore. It was too stressful. I wanted to enjoy being pregnant. I contacted my local ICAN chapter. I was referred to another midwife group that had supported a mama who wanted a home birth after 2 c-sections. I thought they might give me a chance. When I met with them, they still refused me as a patient and said if I chose to schedule a c-section they would be happy to have me as a patient. Uh, no thanks! Before I left, the midwife made sure to tell me 3 different horror stories (scare tactics again!) about uterine rupture. I was glad they didn't accept me into care, I didn't want MEDwives again anyway.
Thankfully another member of ICAN, and coincidentally a mama with a special scar herself, referred me to an OB who had supported her desire to vbac. I tried to remain optimistic but thought it wasn't likely he would support me because my incision extends into the upper segment of my uterus, which is a slightly higher risk. After doing a background check I discovered this OB was leading a task force to lower the c-section rate at his hospital and had a great reputation, I walked into the appointment cautiously optimistic. I told myself if this OB wouldn't support me with a vbac, then I would just book the c-section and be done with it. I didn't have any fight left at this point and just wanted to stop worrying about it. I was so nervous walking into the appointment. I was afraid of more rejection, I considered not even telling this OB about my T-incision but my husband convinced me that wouldn't be a good idea and I eventually agreed. After the initial paperwork and routine check up we started talking about a vbac. He saw it had been 5 years since my c-section and it was for a breech baby so he thought I was a GREAT candidate for a vbac. "but...I have a T incision" I admitted to him. He shrugged and said "in that situation they would've had to T it up". Like it was no big deal. I will never forget that moment. I was shocked/relieved/nervous/excited all rolled up into one. I was so elated leaving that appointment!
I threw myself into preparing for a natural vaginal birth. I let Julie know right away and we started planning for a vbac! About a week before my due date, pre-labour started. I had mild contractions during the day about 10 minutes apart but they would stop at night and they weren't painful. I continued about my normal routine and hit the gym every other day or so just walking the track or bouncing on an exercise ball. I did yoga, swimming and weight training all throughout my pregnancy. I wanted to be as healthy as possible and do everything in my power to ensure a good outcome. The day I gave birth I was at the gym, which makes most people laugh or think I'm crazy but when I tell them about my labour/delivery, its easy to see the benefits of a healthy and active lifestyle. I had sent my husband to work that morning and my mother-in-law picked me up for our usual class at 8:30 am. I decided just to bounce on an exercise ball during the class and I also walked the track. After about an hour on the track, my contractions picked up and were about 5-7 mins apart. I texted my husband and told him to come home. Once I got home from the gym my contractions slowed down to about 10-15 mins apart so I took a nap and told my husband there was no rush but he came home anyway. About 3pm my husband left to pick my daughter up from the bus stop and I was folding a load of laundry when I felt a pop and a gush. My water broke! I sat on the toilet and more fluid came out, nice and clear. My husband returned with our daughter and I told him what happened. I wanted to think I had lots of time before active labour would kick in but the contractions picked up almost immediately. I had a shower while my husband loaded up the car and called my mother-in-law to come pick up our daughter. Julie arrived and she asked me what I wanted to do. My plan had been to stay at home as long as possible but I felt like I needed to get to the hospital. I felt like once I was there I could relax and focus on birthing my baby. I told Julie "I just want to go to the hospital and have the baby." So we left. On the way there my contractions were only about 2-3 minutes apart but I was still talking through them and returning to normal in between. It was about a 35 minute drive. Finally we got to the childbirth centre. I went into triage and the nurse checked my cervix. "You are 2-3 cms dilated and 80% effaced. Unfortunately we don't have any rooms or doctors available so I want you to walk around the hallway for an hour and then come back and reassess. If anything changes before then come back." So we set off down the hallway. At this point my contractions were very intense and coming fast. I was getting tired and just wanted to sit down. So we sat in the hallway and I laboured while people walked by. It was weird because I'm a private person but luckily it wasn't too busy. I stayed calm and composed (Julie later told me she couldn't believe I went through transition so composed) I tried my best to relax through the contractions and not fight them. It was pain with a purpose. It had been about 45 minutes when I felt the contractions change. I was no longer comfortable sitting and when I stood up I grabbed onto my husband I said "the baby's coming out! I feel pressure." Julie ran to triage to tell the nurse we were coming back now. I had another contraction on the way in and I knew the baby was coming because I felt like pushing and started making those grunting sounds everyone talks about. "Don't push!" someone told me but I couldn't help it my body was taking over. They got me onto the stretcher and checked my cervix. "The head's right there!" The nurse said. She ran out of the room and called the OB. My husband heard her say I was fully dilated and before I knew it they were running with me on the stretcher from triage into a birthing suite. This is when I realized, the hard part was over. All I had to do was push my baby out. I was so happy. "I'm going to do it!" I remember saying. Once we got into the birthing suite, I crawled onto the bed while all the nurses gave each other high fives. "We didn't have a baby in the hallway!" one nurse laughed. They couldn't believe how fast I went from 2-10 cms. The OB on-call came in and her cell phone rang. She picked it up and said "I'm going to have to call you back in 15 minutes." My husband looked at me and said "were going to have a baby in less than 15 minutes!" The OB then told me on my next contraction to hold my breath and push and while it was weird at first (as I was used to breathing through the contractions and not holding my breath) by the second contraction I pushed again and my baby was born. "It's a boy!" My husband told me. "It's really a boy?" I was shocked...I thought for sure he was going to be a girl! "Yes! Look!" someone lifted his leg and yep he was a boy. I was elated!! "That was awesome!" I said, and everyone was laughing. "Did she just say that was awesome?" I heard a nurse say. "I've never heard anyone say that!" Then another nurse asked if she could take Bryce to weigh him while I delivered the placenta and got my one stitch from a small tear I had. They brought him back for skin to skin and he latched on to my breast right away. My husband was amazed that a baby only a few minutes old had such a good sucking reflex.
And so, I rocked my un-medicated VBAssC with Inverted T (vaginal birth after special scar). Just like that. Active labour was less than an hour and my 7lb 6oz son was out in 2 pushes. I'm proud of myself that I didn't give up and that I pushed through all of the opposition I faced. I questioned myself many times but I conquered my fear with knowledge and committed myself to doing everything I could to ensure a good outcome. I kept up my fitness regimen and incorporated spinning babies techniques into my daily routine to help ensure optimal fetal positioning (this is so so so important!!!). I believe the regular chiropractic adjustments helped immensely to correct misalignment's in my pelvis, and allowed my baby enough space to rotate into an optimal position. I also owe my success to my supportive birth team. Julie was a great friend, resource and support. My husband, who advocated for me and had my back and my OB who treated me like a normal patient without a scar. We all worked together and I was able to achieve something I once thought was impossible. I'm so thankful to have had a healing birth experience and I will continue to support, educate and inspire women who are fighting for their right to give birth how they want.
"Whenever and wherever you give birth your experience will impact your emotions, your mind, your body for the rest of your life." - Ina May Gaskin
A special thank you to Renee for writing and sharing her birth story!