Monday, February 1, 2010

So You Want to Have a VBAC...

Isn't pregnancy a miraculous time in a woman's life? To look down and see your belly grow, and grow, and grow! There are moments of panic when you look at your belly and think, "This has to come out of me!" We all do it. It can be frightening and overwhelming.

For the millionth time -- say it with me -- education and a supportive birth team are the keys to a successful, happy, unmedicated birth. Preparing your mind and your body for labor are crucial, but it does no good if you have a doctor who is determined that you need to be induced or are too weak to give birth without his/her assistance. Surrounding youself with positive energy is an absolute must. An unmedicated labor and birth are hard enough under the best circumstances, but nearly impossible with no education and support.

We've talked about American birth and the scenarios that lead to the majority of c-sections. They often begin with an induction, which leads to an epidural, which leads to pitocin to stimulate contractions, which leads to fetal distress and a mom who can't move around to help her baby out. The c-section "saves" the baby. There are lots of variations of this scenario. Maybe this sounds familiar to you.

Let's say this scenario ends in a c-section, which 50% of births do in North TX (33% nationwide), and most women begin that sentence somewhere along these lines: "I had to have a c-section because..." Let's face it -- had she not had the epidural and the cascading interventions that followed, she very likely would NOT have had to have a c-section. Harsh? Perhaps. I think it is crucial that women -- and men -- come to understand their role and their responsibilities when it comes to birthing their child(ren). They need to understand that by interfering with the natural process, they are (almost always) doing more harm than good.

But they can change their next birth.

Here's another harsh statement: If you want a different outcome, you have to do things differently! You have already been labeled by everyone as a VBACer. That previous c-section will follow you forever. Some providers care and others don't. You make most doctors nervous even though your chance of rupture is the same as a women who goes in for a -- in this day and age -- standard pitocin induction.

If the epidural led you down the road to a c-section the first time, why would you do it again? Maybe you aren't even aware that that is why you had the c-section. Think back to your labor. Often, everything is fine until pitocin or pain medication is introduced. If you were told that your hips were too small or or baby was too big, why would you just take that? Your body grew your baby. It is made to birth your baby. Get up. Walk. Give birth. Squat. Take an active role in your labor and your birth. You can do it. If your doctor says no way, he won't do a VBAC, I don't care if he's a "nice guy" (I hear this all the time!), change doctors! Find that supportive birth team. They are out there!

I routinely hear women ask if they can expect their labors to be like their mothers -- slow, fast, c-sections, etc. -- and most doctors will say there is no correlation. And yet, recently I heard of a women who was told that her mother had c-sections, so she probably needed them too. Her sisters have also all had c-sections. The power of suggestion is an amazing thing. How can the need for c-sections run in an entire family?!

One of my Bradley moms gave birth this past Friday (my birthday, too!) and the day before she had been at her chiropractor's office. This woman had been laboring on and off for a couple of days and was exhausted. Her chiropractor told her to talk to her body and her mind. "Tell your body to stop labor for a while so you can sleep." That night she did just that and she slept for a solid hour and woke up to her water breaking and hard labor. She gave birth about 7 hours later. The mind and body work together in labor. Modern medicine discounts this very important fact and only focuses on the body.

My point - the mind is so powerful. If you want a VBAC, go for it. But it will not just magically happen for you. And it is not about luck. It is about preparation and hiring the right care provider who believes in you! Prepare for an unmedicated birth if you really want that VBAC!

It cannot go unmentioned at this point that even if you hire a doctor who is pro-VBAC, it is vital that his/her hospital and OB group also support VBACs. If you read Allison's story a couple of months ago, we learned how important this aspect of your health-care is. Everyone must be on the same page. When I lived in Albuquerque, I was interviewing a group of midwives at one of the local hospitals and they were so proud of their VBAC rate -- an astounding 92.3%! But they all had the same goal. Supporting women. Encouraging them to push their babies out vaginally! If your OB or midwifery group says they support VBACs, ask them for their VBAC rate. According to CIMS' Mother-Friendly guidelines, that rate should not fall below 75%. That means that at least 3 out of every 4 women will achieve a vaginal birth after a cesarean.

Bottom line. You will birth this baby one time. No second chances. Don't let the American way of not "allowing" you to VBAC keep you from this experience. Make the commitment to yourself, your husband, and especially your baby, that you will not have medication to numb this experience. Embrace it. You and your baby deserve to experience labor and a vaginal birth.


TheFeministBreeder said...

Thank you for this. I agree completely. I love how you point out that if you want a different outcome, you must do things differently!

Carlie said...

Hi, was just researching a dr. and a link to your blog came up. You mentioned that Dr. Brian Wolsey was unsupportive of unmedicated birthing options. Well, I am ten weeks pregnant, looking for a Dr. who supports unmedicated birth. I have spoke with several girls who rave about Dr. Wolsey so I am wondering if it is the same Dr. I live in Provo, UT, any ideas?

Donna Ryan said...

Carlie, yes, it is one in the same, Dr. Brian Wolsey. We were there in the mid to late 90s while my husband attended BYU. If you read my posts that included our earliest birthing experiences, you got an earfull!

Drs. Judd and Gordon (also in Provo) have posted a sign in their office -- it's here on the blog too -- that says that if you have a birth plan, a doula, or have taken Bradley Method classes, find another doctor.

Utah Valley Hospital has way too many babies being born to be concerned with your unmedicated labor. Your clock is ticking the minute you walk through that door. They will not let you labor "forever" because your room is needed for the next woman. They will do a c-section and move on.

I would totally recommend going to the midwives in American Fork and birthing at the much smaller, less busy hospital. We had a very good experience there.

Plus, I would also recommend taking a Bradley class. There are lots of instructors up there, I'm sure. If you can't find one, I'd be happy to have you take my Bradley classes by DVD. Good luck!

Donna Ryan said...

Another thing to consider is the kind of births your friends wanted/had. Did they want the epidural? Ask people who are like-minded when it comes to birth, breastfeeding, and parenting. I hope you'll find lots of good info here on my blog.

Carlie said...

Thank you so much! I Really appreciate the advice. I have been wanting to go to the American Fork hospital all along and use their midwives. Unfortunately my insurance isn't accepted, so I wanted to check out my other options. In the end, I would way rather spend the money and be happy with my birth. I was considering a hypno-birthing class, I have previously never heard of the bradley method, have you had experience with both? What made you choose the bradley method in the end?

Donna Ryan said...

I wrote a post about the differences. In the end, for me, two of my closest friends took Bradley classes and had wonderful births. It totally prepared me AND MY HUSBAND for labor and birth. 79% of people that take my class have an unmedicated birth, with a 14% c-section rate. Very few epidurals. Contact your local Bradley instructor and find out which doctors support natural birth. Trust me, they'll know!

The Mama said...

Your blog needs a 'like' button like on facebook. :) Also - support from other resources such as ICAN can really point you in the right direction & encourage you in your vbac journey. They lifted me up & I know that their knowledge & support helped us get our vbac!

海產 said...
This comment has been removed by a blog administrator.
Anonymous said...

I'd just like to point out that sometimes babies are too big to fit through the birth canal. Yes, our bodies did grow our babies, but because things in this world are broken sometimes babies are hurt or die during labor and delivery. And some women need to be induced. For the SAFETY of the baby.

This is the world we live in. We can all hope for the best, but when it comes to deciding what to do during labor and delivery, do what's best for the baby. Please don't orchestrate things around your 'perfect birthing experience'. It's not about us. It's about the babies.

Donna Ryan said...

With a c-section rate as high as it is in this country, "hoping for the best" is not enough. It's NOT a crap-shoot! It's not about luck! You must educate yourself and choose a supportive birth team. With these in place, a c-section will be necessary less than 10% of the time.

Pulling the "you're a bad mom" card is exactly what the doctors do when talking about the baby's "safety." This is a legal issue, not a medical one. A mom is not a bad mom if she wants a "perfect birthing experience" as you mockingly stated. What is good for the mom is typically good for the baby. The safety of the baby goes without saying. No mother is going to choose to put her baby in danger for the "perfect birthing experience" -- it wouldn't be so perfect then, would it? But I learned a long time ago to not believe a everything a doctor says. Many are more concerned about themselves that the health of you or your baby.

If we are so concerned with the baby's safety, let's talk about the narcotics and epidurals that 95% of women (and their babies) receive in labor. Let's talk about how that immobilizes a laboring woman who cannot HELP her baby out. Let's talk about how she is pushing her baby out uphill! Let's talk about fetal distress from the pitocin and pain-relieving drugs!

Birth is inherently safe. The "big baby" has become such a phenomenon is the United States. I suggest you read the post here titled "The Big Baby." While it is the #3 reason in the U.S. for a c-section, only 1 in 2500 women actually have cephalopelvic disproportion (CPD). We are not broken! What a word to use! The system is broken.

Anonymous said...

Okay, seeing that comment from "anonymous" . . . I just HAD to comment.

Anonymous, did you mean to say that some babies are too big to fit through something a little less giving. . . say, the pelvis? Because it seems pretty certain that if all there was to fit through was the birth canal, a baby, no matter how big, with the power of the contracting uterus, would just BLOW through a birth canal that is too small. It is not the birth canal that is in question in the CPD argument.

I'm sorry if this comes off rude. But the first impression I got from this first sentence is that anonymous is just spouting things she (?) has not studied thoroughly. This is one of the reasons the c-sec rate is so high! Women are painfully under-educated about birth!

Okay, I'm done ranting!
(D-you know it's me--Sarah)