As I finally catch my breath from multiple back-to-back births, I cannot but reflect on a wonderful mother at our center who was trying for a VBAC (Vaginal Birth After a Previous Cesarean).
Both parents were wonderfully informed and intent on letting the process of birth occur as naturally as possible. I bring this birth up specifically, as both dad and mom were equally motivated and determined to invest their time and energies in attending our Lamaze sessions, film screenings, and online chats with ICAN (International Cesarean Awareness Network) in order to be well prepared for the birth of their baby.
Needless to say, labor did follow some unexpected paths for them. For one, mom had some bloody show and mucous plug discharge twice in the 2 weeks preceeding the birth of her baby. Each time, we checked her and her baby, and found that all was well, and sent them home to wait for labor to start. Following this, mom had 2 days of pre-labor – contractions every 5-10 minutes, but lasting only for a few seconds each. Again, we monitored and sent them back home since mom and baby were doing well. These contractions stopped completely on day 3, and did not come back until the day of her baby’s birth.
On the day of her baby’s birth, her bag of waters broke around 1 pm, and she came to our birthing center around 4 pm. Initially, she would smile between contractions – a big smile – she was so happy that her contractions had started! During the birth of their first son, she had not been given a chance to start labor – her bag of waters had broken the first time around and her doctor told them that since labor had not started, it would be better to go in for a C-section. So, her relief at starting labor naturally was obviously immense.
As her labor progressed, it became more intense. She did well though, with constant support from us as well as from her husband, who was always there for her. We tried lots of massages, changed positions, and used hydrotherapy. By 7 pm, she was fully dilated, and ready to push, and after some pushing, she birthed her baby, a beautiful baby girl, sitting on the birthing stool. Her baby came into this world in a calm and serene atmosphere with her husband by her side and everyone awestruck at the power of motherhood that nature had just bestowed upon her. Though we have helped many women through pregnancy and birth, the magical moment of her baby’s birth had us all misty eyed and grateful that we played a role in helping this mother fulfill her desire to give birth naturally.
As I reflect upon this and our other VBAC births, I just wonder why and when it got decided that VBAC births are extremely dangerous. Yes, there are risks – the most common one expectant mothers and their families are told is that of uterine scar rupture. While this risk does exist, evidentiary data indicates that it remains small, even for those mothers who have had multiple C-sections. In addition, the scar that has remained intact upto the threshold of labor, is very likely to continue to remain so through the birth. In her literature review, Henci Goer – one of the most reputed voices of evidence based maternity care – found reference to only 46 ruptures in 15,154 labors, a rate of 0.3% (Anne Frye – Holistic Midwifery, Volume 1, Pg 915).
Over the years, research is finding that there is a 1% risk of scar rupture during a VBAC labor; however, what health care providers are forgetting to tell these expectant moms is that, the same 1% risk of scar rupture is also existent during a repeat C-Section! So, while there is a risk when you consider the inherent and multiple risks of a repeat Cesarean surgery, I strongly believe that a trial of labor at every VBAC birth should be the the first standard of care, in otherwise low-risk moms. Personally, being a VBAC mom myself – I know the awesome power of labor and birthing naturally, and I encourage all of you to explore your options of a VBAC birth with you health care provider if you have had a previous cesarean. Do not be intimidated by your hospital or healthcare provider into believing that “once-a-cesarean, always a cesarean”. Feel free to educate and empower yourself – here is wonderful link.
And, feel free to write in your thoughts and comments . I would love to hear from you!
Dr. Vijaya
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dr.fatema poonawala
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Dr_Vijaya
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Dr.Fatima Poonawala
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Dr_Vijaya
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Susmithai
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Poorni Kh
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Nayana