A Risk Analysis' Review of Her Own Births

This is a mamas review of her own birth experiences, cesarean and two VBACs. Thanks for sharing mama C! 

To those whose c-sections were for "failure to descend" (stuck baby) who are seeking a VBAC but having doubts about your ability to push out a baby, I hope my story (and data) will encourage you.

My first OB said she'd support my first TOLAC but she didn't see why I bothered trying as I probably just have a "small/heart-shaped" pelvis and probably can't push out babies. Which is funny because she didn't even attend my first birth that ended in c/s (she had an ear infection). So how would she know anything about my pelvis? Luckily by then I had read enough to know the necessity for my c/s was probably caused by position (baby's and mine) and preparation (mine). So I fired her. Clearly not supportive. I interviewed 6 OBs and finally hired another, much more supportive, OB who delivered both of my VBAC babies.

Some data which may interest you, in order of birth (c/s, VBAC, VBAC):
Birth weight - 7 lbs 2.3 oz, 7 lbs 0.2 oz, 7 lbs 0.8 oz
Birth length - 20.5", 19.8", 20"
Head circumference - 32.5 cm, 34.5 cm, 33 cm
(So, clearly it wasn't a size issue...)

Baby's position - stubbornly OP and asynclitic, OA, OA
(Figured out first was OP due to 24 hrs back labor, slow dilation, contraction pattern, head shape post-partum, and ultimately OB had to reach in and turn her for a final pushing attempt - she then flipped back to OP prior to surgical delivery)

My position - flat on my back, seated squat, flat on my back
(Delivering my 3rd on my back was unplanned and probably only successful due to SPD during pregnancy and/or my pelvis having opened before and/or preparation (see below))

Preparation -

For my first delivery I took the hospital childbirth and child care class which taught Lamaze. I did not however practice the Lamaze on my own between classes or after the classes were complete. I assumed I had learned it, and would use it when the time came. I didn't understand that when your body is under stress the only response you can count on is one that is INGRAINED in your psyche, not one that is simply understood by your brain. So it didn't work when I went to try and remember it during my birthing time. In addition I didn't prepare well when it came to my birth team - I had my husband, who had no birth experience, and my 3 best friends, who had no birth experience. I have no local family, and we all tried real hard, but no one knew how to recognize poor baby positioning, no one could advise on how to reduce discomfort, no one had a clue about how to calm me down and get me to release and let my body do what it needed to. I saw 4 shifts of L&D nurses of varying quality, and the least helpful was unfortunately who I had at the most critical time. The OB wasn't there much at all but was very encouraging when she was (again this was not the OB I had prenatally but the on call I met when I was admitted).

For my second delivery I took Hypnobabies (HB) and I practiced between classes and practiced after the classes were over right up until delivery. I wasn't perfect, I didn't practice every day, but I did it enough because I made it through delivery using those tools. For me HB was essential in preventing panic, which is what locks me up, in response to discomfort. My husband took the class with me and became a great L&D coach, more confident in how to support me, how to help me get through it. And I hired a doula, (Cole), who supported me through both shifts of L&D nurses (yay for consistently great support no matter who's on shift!!), and also specifically used her tools to help move labor along and help move baby down, in addition to taking the time to learn all my HB cues to help me use it successfully. My second birth was a GENTLY induced VBAC - yes it can be done when medically necessary and still end with a vaginal delivery!!

My third birth I credit HB for allowing me to be in denial about being in my birthing time most of the day. I practiced HB from week 30 up until birth, most nights, just listening to my tracks and practicing finger-drop. The day I entered my birthing time I was just uncomfortable and felt crappy. So I took the opportunity to "practice" HB for some relief but never believed I was actually in my birthing time. Suddenly late that night I knew we had to go to the hospital. I gave birth 42 minutes after arriving at the hospital, using HB the whole time. Everything happened so fast that my OB didn't make it in time, but my doula (Cole) did and she and my husband again gave me exactly the support I needed. Even with birthing flat on my back I pushed her out in under 15 minutes.

My point with all of this, ladies, is that POSITION and PREPARATION are far more important than perceived body capability and baby size to achieve the birth you want. Body capability and pelvis size CANNOT be determined by an OB by any method of examination, just educated guess! Baby's size doesn't matter as much as you'd think because FAT SQUISHES! Baby's position on the other hand can be encouraged (see SpinningBabies), your own birthing position can be controlled (particularly if you have a trusting relationship built with your care provider), and your preparation is entirely in your control as well. Find a childbirth class/method that you can COMMIT to and PRACTICE, and build your birth team based on your birthing NEEDS, not necessarily the PEOPLE you simply love.

You CAN do this, and don't let anyone - including well-meaning family, friends, or care providers - tell you otherwise!!!

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