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Opinion

Are VBACs worth the risk?

Nadine tells her second birth story and wonders if trying for VBAC is worth the risk

By Nadine Silverthorne
Are VBACs worth the risk?

I had originally started writing about this crazy contest one radio station is having where you can win a fertility treatment. Win a baby! How polarizing! How provocative! But being hyper-fertile (not an exaggeration. Don't hate me -- it has its huge downsides too), I didn't feel I was the best person to weigh in on that story.

So while surfing on Babble.com, I came across one American woman's tale of choosing a VBAC (Vaginal-Birth-After-Cesarean) against her doctor's wishes. Now, this is something I can speak my mind about!

Like the author, Jana Llewellyn, I also had a scary epidural/emergency C-section experience with my first child. Failure to dilate they said -- a supremely insulting term IMO. Afterward, I felt angry; I grieved the birth experience I didn't have. I had been so scared of the pain of childbirth that I didn't fully research or pay attention to the risks of epidurals. Now for most people, epidurals are a modern miracle. But not for everyone, and this is an important message. As our beloved Teresa Pitman states in this article called "Do epidurals have side effects?"

"...it’s worth noting that much of the research on epidurals has been inconclusive or even contradictory, making it hard to know for sure what the risks are."

I should state that I'm not anti-C-section. The end goal of birth is always a healthy baby. But I'll spare you the details of my first birth story right now, though I promise to share one day. When I had the good fortune of conceiving another child two years later, I was determined to see my labour through, fully aware of what was happening to my body. I wanted Baby #2's story to be a different one. And perhaps a bit selfishly, I wanted to prove to myself that I KNEW my own body and what it was capable of doing. I wanted to try for a VBAC. Without drugs.

As my due date of August is apparently the busiest month in Canada to have a baby (did you know that? Thanks SweetMama!), I wasn't able to secure a midwife, which I felt was crucial to the success of this plan. I ended up with a kind and dynamic OB, and while he accepted my VBAC decision, he didn't necessarily agree with it. On more than one occasion he tried to sway me towards making a c-section appointment. And sure, it would have been easier in some respects. I could have scheduled grandparents to watch my eldest, popped into the hospital and my doctor could have been back with his own family or playing golf by day's end.

Eventually he accepted it, because hey, chances of getting your actual OB on your actual birth date are pretty slim. "I'm in on Sunday," he joked, "Try to have your baby then." The caveat? Hospital policy dictates that women attempting a VBAC must have an epidural in the rare case of a rupture of the original incision. But with two and a half years between births and my relatively young age (I was 33), plus an ultrasound to look at the incision scar and determine the viability of my uterus, I preferred to go drug-free.

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I knew what would likely happen to me should I have the epidural: I'd probably be on the OR table, having my baby cut out of me. With no midwife, we decided to have our friend and homeopath attend as a labour coach. She's pretty bossy and we needed someone to help us navigate busy doctors and nurses, an advocate of sorts. She also gave me homeopathic remedies throughout, based on my symptoms, to help manage the pain and encourage labour.

It should be noted that the efficacy of homeopathic remedies is not proven or lauded by the traditional medical community, and while I'm often mocked for "buying into the concept of expensive sugar pills," my family's experiences with homeopathy would prove otherwise. As my labour progressed in hospital, I asked the nurses to hold off on the epidural. "Just a bit longer? Until I'm more dilated?" Fortunately they acquiesced and by the time I was in the holy-mother-of-curse-words pain of the Transition phase and begging for relief, everyone was too busy performing C-sections to insert a giant needle in my spine.

I took a shot of Demerol, which the nurse was able to administer and I immediately wished I hadn't. I was stoned, but I felt everything. So now I was just dozy and could care less about the pain. I felt outside of my body, something I was trying to avoid. I was 9.5 cms dilated when they came back with the offer of an epidural. I said no. Why they broke hospital policy and allowed me to have control of my body, I don't know, but I'm so glad they did. I'd survived the worst of it and was ready to push shortly after.

They offered me a mirror -- which I promptly refused. But when my husband said he could see the head, I changed my mind. I wanted to be present for my child's entry to the world. I did not want to repeat my sanitized, TLC version of birth from behind a blue sheet . The mirror helped with the pain too. It was like I could transfer what was happening to that woman in the mirror (the one who should have considered a bikini wax more carefully). I saw my baby's head (which I falsely assumed was her whole body), then shoulders, legs, feet... OMG! A baby! One that wasn't being taken away by worried looking doctors.

By the time they announced "It's a girl!" I was in already in love. The girl part (my eldest is a boy) was icing on the cake. I'd done it. And it was single-handedly the most visceral, cathartic, alive moment of my life. The best part? Being able to WALK with my baby to the visiting room to introduce her to her big brother and the rest of our family.

So should you have a VBAC? Is it worth the risk? I can only speak to my own experience. I have absolutely no regrets. If you're thinking about it, consider a midwife or find an OB that will support your decision and be there for you. If that doesn't work, look into a doula or birth coach. We forget that for the most part, we were designed to do this. And if a wimp like me could do it, so can you.

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Did you have a VBAC? What was it like for you?

This article was originally published on Sep 30, 2011

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