My Decision to have a Repeat C-Section Rather than a VBAC
Faced with a Birthing Choice
I am a certified Usui and Lightarian Reiki Master which is a form of hands on energy healing. I am more likely to treat a cold with vitamins and tea than antibiotics. I practice meditation and attachment parenting. In short, I am an intelligent and pragmatic sort of person who prefers a natural way of life and healing over artificial and invasive techniques whenever possible.
When I became pregnant with my third child, I was faced with a very difficult decision. Should I have a repeat c-section or attempt a “vaginal birth after cesarean” (VBAC)? I don't have any regrets about my first C-section. I don't have any doubt that my daughter was truly stuck and that an emergency c-section was medically necessary. The choice of a planned C-section with my second daughter was much more difficult.
The First, Second, Third and Fourth VBAC Opinion
I started out researching online. There is a lot of material out there and it can be very difficult to sort fact from fiction and personal bias. If I have learned anything from my experience, it is that there is no one right answer. It is my hope that by sharing my story, maybe it will help other women on a similar journey to find the answer that is right for them.
I spoke to one of the doctors at my OBGYN and they basically told me that they don't do VBACs and that was that. They were not very helpful. I did not want the rote answer given to everyone. I wanted a well reasoned medical opinion about my personal situation and what was medically right for me and my child. I heard that my nearest local hospital does not allow them but four other local hospitals do. The question was why? I had a consultation with a doctor that works out of one of these community hospitals that allow VBACs. Unfortunately, they had the other extreme attitude and essentially said that they would let me do whatever I wanted. If wanted to try a VBAC, I could. If I wanted a c-section, I could have one. I am all for a patient oriented approach to health care that helps a patient to understand their situation and the options that available to them and helps to guide them to a choice that is right for them. But patient free for all? Why attend so many years of medical training if the patient is always right? This isn’t the hospitality industry, this my health! Needless to say, I did not find this consultation very helpful either. I still wanted a well reasoned medical opinion about my personal situation and what was medically right for me and my child. Was there one to be found?
My next doctor appointment was already scheduled. They rotate you through each doctor, so I went and figured I'd ask the next doctor and see what they had to say. It just so happens that the next doctor was head of gynecology at the hospital. In addition, this was not his first high ranking position. He had a pretty impressive resume of other high positions at area hospitals and other organizations. He finally gave me a great medical explanation. He said that while the serious complication of a uterine rupture were rare with a VBAC, when they did occur, they were catastrophic with loss of the mother and the baby's life, likely. Even an attempt at saving their lives required a fully staffed and supplied trauma center with blood, equipment and surgeons on site and ready. Two of our area hospitals are trauma centers. My doctor explained that when he worked at a trauma center hospital, he had a lot of patients who gave birth via VBAC. The hospital where he delivers now is a community hospital and is not equipped to handle that kind of emergency. Because of that, they refuse to allow VBACs. If they had a VBAC go bad, the chances that they could save the mother's life was slim to none. Each community hospital has the discretion to determine their own VBAC policy, but just because a hospital allows them does not mean they are fully equipped to save your life from a uterine rupture. He recommended that if I chose to pursue a VBAC that I go to a trauma center hospital to deliver, not a community hospital. Armed with all of that information, I agreed with his recommendation that I only pursue a VBAC at a fully equipped hospital.
Repeat C-Section or VBAC - A Very Personal Decision
Next however, came my concern about distance. The nearest trauma center was an hour away, more in bad traffic. Getting to a hospital that was an hour or more away would be frightening and uncomfortable. Add to that, the need to make sure that my other two children were cared for and I became really concerned about what would happen if labor progressed quickly. My husband’s cousin was crowning by the time she made it to the hospital with her second child. Since then, I've personally known two more women who gave birth within twenty minutes of arriving at the local hospital.
Finally I had to consider my business. I had an employee when my first daughter was born. They were trained and prepared to handle my business when I went into labor and had back up resources to call on for help for at least the few days that I would be in the hospital. When I was pregnant with my second daughter, it was only me. From a business planning standpoint, scheduling real estate closings and then going into labor and not being able to follow through and accommodate that closing - especially if it is a purchase, would be catastrophic for my customers, my company and my reputation. Getting colleagues to help out was a possibility, but it would be very difficult and expensive. By choosing to schedule my c-section, I would be able to schedule closings around that date and notify my clients in advance which days I would be in the hospital and closed for business, keeping the impact to a minimum. It is terrible to think that something so mundane as business factored into the birth plans for my daughter, but a fact of life is that a small business owner does not get the luxury of paid leave, sick days and other similar benefits that are available in the corporate world and my daughter will be more interested in having a home and food to eat than she will about the manner in which she entered the world.
From distance, to childcare, to business, and more it all added up. The risks and inconveniences of a possible VBAC delivery at a distance trauma center hospital just did not make sense. For me, a scheduled c-section was the best choice for me.
I wish I had been in a position where a VBAC made the most sense. I think I could have birthed my daughter without incident and would have been proud and happy doing so. But I also feel that given my particular circumstances, I made the choice that was best. I made a choice based on reason rather than emotion.
In conclusion, I am about as whole and healthy as any mother of three could possible hope for and so are my kids. Nothing else matters more than that.