VBAC

By Krista Gray, IBCLC. Last updated April 9, 2013.

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Jack is Born at Heath HospitalThough I went full-term with my firstborn and had a natural delivery in a US hospital, my twins had arrived 7 ½ weeks early by emergency C-section so I was prepared well in advance to go into labor should this baby come early.

Like my first two pregnancies, I spent time planning and preparing for my little one’s birth.  But, this time I was preparing for a Vaginal Birth after Caesarean (VBAC).  I was living in Wales, UK at the time and, as I progressed through my pregnancy and learned about the healthcare system, I was incredibly thankful to live in a place that was so supportive of my desire for a VBAC. In fact, compared to my pregnancy with my first child in America where I had to struggle to find a midwife, midwifery care is the norm in the UK.  It seems they realize pregnancy is a natural, normal state for a woman’s body; since she is not sick she doesn’t need a doctor when a pregnancy and labor progress normally.

Though my pregnancy care was midwifery-led, I did have to sign-off with the lead “midwife-consultant” in order to give birth in the midwifery unit and not the obstetrical unit.  This was important to me; not only did I want the most natural birth possible, but I didn’t want to be in a unit with doctors who may or may not be comfortable with my attempt at a VBAC.  Like my local midwife, the midwife-consultant was also incredibly supportive of my desires.  Everything seemed to be lining up as planned until my little guy decided to become very comfortable in the breech position.  I was really worried; I knew I never wanted to go through a C-section again, but I also doubted I would be allowed to try for a VBAC with a breech baby.  At 32 weeks I finally confided in the lead midwife-consultant that my baby was breech but I still wanted a VBAC.  Without missing a beat she said they would honor my wishes and give me the chance to try!  I cannot tell you how that relieved my stress.  No longer did I fear whether or not my baby would turn; instead I could concentrate on relaxing and having a healthy pregnancy and trust my instincts that I could birth this baby naturally whatever position he was in.  (I did later visit a chiropractor who performed the Webster Technique and I felt very fortunate that my baby moved shortly thereafter.)

Although my pregnancy had gone really well, toward the end I was hobbling around unable to walk well; I was also feeling quite massive.  (Which is quite ironic as a mother of twins to then feel massive with a singleton!) A few days before I was due he changed positions and I was able to walk again.  I decided I was going to walk this baby out and walked five miles for the next two days…and then woke up the third morning with my first non-Braxton-Hixx contractions.  I was SO excited!  Now I knew he was going to come soon and my nine months of waiting to meet my little man was here.  I had contractions like this for the next 12 hours – contractions, but not to the point where I had to stop and only focus on labor.  Throughout the morning I took care of the kids and even walked to town to shop.

By 1:30 p.m. I decided I didn’t want to walk back home, contractions were closer together, and I needed to focus on labor.  Josh came and picked me up about 2 p.m. and I went home to labor.  By 3:00 my contractions had changed- they were intense, painful, and coming quickly.  We decided it was time to go to the birthing center.

We arrived at 3:30 p.m.  By this point I couldn’t even walk without leaning on Josh because contractions were coming so quickly.  The midwife, Kay, came and took me to the room and Josh went to park the car.  I asked for a birth ball to sit on and she asked if I could please let her listen to the heartbeat for a few minutes on the bed and then she’d get me one.  While she was fumbling around with that, I remember looking up and saying, “I feel like I need to push.”  Now realize I have not even had a bloody show, lost my water, or been checked for dilation.  Almost immediately after saying this, my water burst and Kay said to me, “The next contraction you are going to have a strong urge to push.  Let’s push your baby out.”  Wow!  And was she ever right.  I began to push, and it was probably around 3:55 p.m.  I was lying on my side and, on one of the contractions, remember saying, “I can’t do this.”  Honestly, the pain was so intense and not subsiding between contractions I didn’t think I could do it.  Kay was wonderful and the perfect encourager for me.  Gripping Josh’s arm so tightly (he had marks later to prove this!) and screaming I pushed again.

At 4:10 p.m. (just 40 minutes after getting to the birth center) our sweet little Jack Thomas was born via VBAC.  When his head was out the midwife said two things:  that he had a head-full of hair and that he was a big baby.  As soon as I pushed out his body they handed him directly to me.  In the picture above, that was right after he was born, and the umbilical cord was still attached even.  We cuddled, skin-to-skin for the next 40 minutes or so, until I hadn’t yet delivered the placenta and Kay said I had to get it out within an hour or be transferred to the obstetrics floor for a spinal and them remove it.  I gave Jack to Josh and got on my hands and knees and began to really focus [again] on pushing.  Finally, a few minutes later, I delivered the placenta, Jack was back in my arms, and I made sure there was no more pushing for the rest of the day!

It was an absolutely wonderful, perfect experience.  About 1 1/2 hours after he was born they brought in a scale and checked his weight:  9 pounds 6 ounces!  Though I had been happy and thrilled before, I was also quite proud of myself for birthing such a big boy!  The midwives were incredible.  The cord was wrapped around his neck twice and he passed meconium as I was pushing – two things that would’ve caused quite a stir in a hospital setting in the states.  But the midwives were skilled and trained and it was no problem at all.  They had calmly unwrapped the cord when handing him to me initially, and, as for the meconium, rather than immediately using oral suctioning they checked his temperature two hours after birth to make sure he was fine.

This was definitely my favorite birth experience.  It was wonderful to be in a setting where my birth plan was considered “standard care.”  Everyone was supportive of a VBAC, an unmedicated birth, delayed cord clamping, and, most importantly, skin-to-skin contact immediately following birth through the first breastfeed.

This experience was also very healing way to bring closure to the C-section with my twins!


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