My Path to a Home VBAC


Warning Label: This story contains all kinds of foul language that I’m usually careful about excluding from my articles. But my VBAC story just wouldn’t be the same without it.  Also, this post will, for sure, be my longest post on Attachment Mama as it compares the c-section birth experience with the H-BAC. So grab your tea and a comfy chair and settle in for this one!

My story begins in song. Please sing aloud to the tune of the Brady Bunch theme song:

Here’s the story,

Of a rockin’ home birth

Sometimes I can’t believe that it’s my own

I went to hell and back in 6 long hours

And then my babe was born

A home V-BAC, A home V-BAC

Here’s the story of my ass-kicking V-BAC.

How did I come to decide that I wanted a vaginal birth after a Caesarean in the first place — when so many people assume it’s not possible?  And beyond pursuing that somewhat unusual path, how did I decide that I wanted to do this at home?

I wanted a homebirth with my first baby.

Waiting until my mid-thirties to have children, I had many years to think about how I wanted to experience childbirth, how I wanted to parent my babies, what I wanted them to experience, etc.

I read a number of books that guided my view that natural birth at home was the best option for me:  Ina May’s Guide to Childbirth, Spiritual Midwifery, Gentle Birth Choices, and Birthing From Within.  I was surprised to learn that so much that I had grown up believing about childbirth simply wasn’t true — including that hospitals are always the safest place to have a baby, that drugs for pain relief during labor won’t hurt the baby, and that babies must be observed in newborn nurseries separate from their mothers.

I also became aware of statistics about the increasing rate of C-sections in the United States – in just the last ten years they’ve increased by 50 percent nationwide and now occur in nearly one out of three births.

It was only when reading Wendy Ponte’s article, “Cesarean Birth in a Culture of Fear,” in Mothering Magazine, that I learned all the reasons a woman might want to avoid having a C-section unnecessarily.  The following reasons were listed in this article.  In the U.S.:

1. A woman is five to seven times more likely to die from a cesarean delivery than from a vaginal delivery.

2. A woman having a repeat C-section is twice as likely to die during delivery.

3. Twice as many women require re-hospitalization after a C-section than after a vaginal birth.

4. Having a C-section means higher rates of infertility, ectopic pregnancy, and potentially severe placental problems in future pregnancies.

5. Babies born after an elective cesarean delivery (i.e., when labor has not yet begun) are four times more likely to develop persistent pulmonary hypertension, a potentially life-threatening condition.

6. Between one and two babies of every hundred delivered by C-section will be accidentally cut during the surgery.

7. The US is tied for second-to-last place with Hungary, Malta, Poland, and Slovakia for neonatal mortality in the industrialized world.

8. Babies born via C-section are at high risk for not receiving the benefits of breastfeeding.

9. The risk of death to a newborn delivered by C-section to a low-risk woman is 1.77 deaths to 1,000 live births. The risk of death to a newborn delivered vaginally to a low-risk woman is only 0.62 per 1,000 live births.

(References for these stats listed in linked article.)

In planning a home birth, my primary focus was not actually avoiding a C-section so much because of the above reasons (I wasn’t aware of these at the time). Keenly important to me was the spiritual and emotional experience of the baby.  I really wanted my babies to enter the world in the most beautiful way possible.

At home I could control the environment – low, soft lighting; a limited number of people present and people that I trusted intimately; the opportunity to drink and eat if I needed sustenance for the work at hand; labor strategies that supported a natural birth like movement, water and meditation. I would have dedicated attention and care from midwives who would coach me through the birthing process as something my body was designed to do – a completely natural act of nature versus a medical emergency that required medication. And my sweet angel baby would be with me, skin-to-skin, after her birth.

I could avoid the bright lights of a hospital room, the intermittent care of nurses that I didn’t know, an OBGYN busy juggling multiple women’s needs, and I would have a significantly lower chance of a caesarean birth.

Now – as fate would have it – my first attempt at a home birth didn’t work out. I labored for 18 arduous hours at home with our midwife with contractions that overlapped one another so that together they would last 15 or 20 minutes. I was unable to pee the entire time and was ultimately given a catheter. Good times. And then I became dehydrated and got hooked up with a home I.V. Also enormously fun.

My main foggy memory of my first experience with labor was that I was completely checked out mentally. I was moaning loudly throughout and recall GB, my midwife, telling me that my vocalizing had a quality of despair and suggesting I consider trying not to make any noise for a while or to shift it.  There was a stretch of time when I accomplished the silence and the shift to something different, but ultimately I never snapped into becoming present and purposeful.

We made the decision to transport to the hospital because the lack of progress was proving risky. After an epidural which I happily welcomed and Pitocin, I labored in the hospital for another eight hours. Dilation continued to stall. When they clocked 20 hours since my water broke and I was still only 6 cm,  the attending physician recommended a C-section and our midwife, who had accompanied us to the hospital agreed. With her blessing, I knew it must be necessary.

Afterward we learned she couldn’t make her way through the birth canal due to unusual cock-eyed positioning of her head.

My precious baby entered the world in a room with bright lights, surgical masks, rubber gloves, and immediate separation from me.  I remember hearing Tori Amos singing on the surgeons’ CD player while they drugged me up and prepared to cut me open.

Sadly, I didn’t retain what song was playing — which might be a good thing even though Tori is an old favorite of mine. I have this strange intuitive sense that the song was “Cornflake Girl” which I’ve always liked but never fully understood all the  metaphors. Whatever song it was, I kind of doubt the lyrics offered any kind of “life is wonderful, welcome to the world” sentiment.

So with the C-section, I wasn’t able to be skin-to-skin with my baby after she was pulled from my uterus. My husband, Mark brought her to me after she was briefly examined, washed and wrapped in a hospital blanket and hat. Because I was still somewhat constrained with I.V., etc., I was not able to fully hold or hug her.

Mark rested her on my shoulder where I could touch her head and relish staring at her precious face. My entire being oozed in pure wonderment at her existence and then she was whisked away for another hour while I was sewn up and brought into a recovery room.

Thankfully once we were reunited, we had no trouble with nursing and we have been bonding ever since.

Fast-forward two years later to Birth #2, or Baby Dos as I called her during my pregnancy.

***********************************************************

I disregarded the surgeon’s recommendation that I remain in a hospital if I wanted to try for a vaginal birth with subsequent babies. As soon as I learned I was pregnant again I signed up for prenatal care with my beloved midwife, GB.

In the subsequent months and weeks as I made plans with her and my husband for birthing at home, I maintained a fairly solid poker face of confidence while inside doubt and fear of the choice permeated my being.

Even though I had survived many hours of drug-free labor at home previously, and I knew in my heart that I was perfectly capable of doing that again – I was petrified of pushing a baby out and I kept wondering about uterine ruptures.

I scoured the Internet for data and stories on VBACs, other women’s success or failure stories of doing them at home, and what the risk of uterine rupture was all about.  Once again, I gravitated toward Mothering Magazine’s web site, a publication I love for its promotion of natural birth and attachment parenting principals.

Of course the majority of the articles were in full support of women like myself who were pursuing a VBAC at home. But, perhaps with an unconscious desire to find something that would support my fear, I focused my attention on one tiny article from 1998 that said:

Sometimes women who give birth at home or in birth centers erroneously believe they can’t have a rupture because they are not using Pitocin or prostaglandin gel. Although a rupture is more likely after labor is induced with one of these products (or speeded up with Pitocin), some ruptures have developed without the use of either. In Arizona, California, Colorado, and probably elsewhere, babies have died in homebirths because of uterine ruptures.

(“Nonhospital VBAC and the Risk of Uterine Rupture,” by Diana Korte, Mothering Magazine, Issue 89, July/August 1998)

This article didn’t change my mind, but it did succeed in leaving me in a somewhat anxious state that I only reconciled three days before going into labor.

The mental and emotional reconciliation occurred all thanks to GB Khalsa. She came to the house for a prenatal appointment and shared that she heard through one of my girlfriends that she was also caring for that I had some fears about the safety of having the baby at home.

She didn’t remind me of her 20+ years of experience attending more than 1000 births, all the success she has had as a midwife, how conservative she is about choosing to transport to the hospital if needed, etc. She didn’t make it about my need to trust her.  She directed the conversation around my needs.

She said, “This is your body and your baby. You get to decide what feels best to you and where you will feel the most safe having your baby.”  And she gave me her genuine support in choosing not to give birth at home if that felt better to me.

She then suggested a way that I could meditate on the question, “Where will I feel most safe to have my baby?” that would help me to get out of my head and get more connected to my body to find the answer.

The next day I tried it out and the answer I got was very clear: The baby is meant to be born at home and any problem that may arise would be resolved.

My labor started around 7:45 in the morning on Friday, October 3 – two days after completing this meditation.  I was busy helping my almost 2-year old daughter, Sadie, get ready for preschool and mentioned to my husband that I was having what I thought was another pre-labor contraction.

“Ah, here they go again,” I said and took a brief time-out from helping Sadie with her socks and shoes.

Mark and Sadie left the house at 8:15 and my teenage step-daughter, Audrey, left some time within the next half hour for high school.

During that hour the contractions seemed to be every 20 minutes or so.  I tried calling GB and wasn’t able to reach her. I then tried her pager which didn’t work. (I learned later that I had the wrong pager number).  I then called her assistant Julia whom I knew from my first birth and who conveniently lived 2 blocks away. I let her know that I thought labor was starting but was still relatively slow; I was doing dishes, sweeping, etc. She suggested I go for a walk or a swim and call her in a few hours.

But over the next half hour, things accelerated fast.

I called my husband 3 times during this period of time and in the last call said, “It’s definitely on, please come home.”

Mark said he needed to wrap up a few things and then would be home as soon as possible.  This translated in my mind to mean he might not be home for another hour, so when I called McClain, my BFF of 20+ years, to let her know things were starting and that I was alone, I happily accepted her offer to come to the house.

By the time she got there (10 am I think) I was unable to be conversational any more. I became fixated on the kitchen sink. I was leaning over it, moaning, thinking I might throw-up.

I remember McClain holding my hand and letting me death-grip it during contractions and then one-by-one, the rest of the team arriving: Mark, Julia, another midwife that often joins GB for births, and a midwife who came with Julia that I didn’t know until they were able to reach GB, and then GB. I just remember faces popping in and out of my view while I stood hunched over the sink all saying sweet, encouraging things to me. And Mark hugging me and giving me a kiss on the back of my neck.

I knew it was early and I was hating that it hurt so much already. “Holy shit,” I kept thinking – “How the hell am I going to do this?”

After Mark got the bed made with cheap sheets I had set aside and GB and Julia got set up with everything they needed upstairs, Mark encouraged me to leave the kitchen and head up to our room.

Sometime later, GB suggested I get out of my clothes and take a shower. I remember looking at GB through the shower glass and crying, “GB, it really hurts,” “OOOOOOOW GB!”

Once out of the shower, GB asked to check me to see how I was progressing.

I was devastated and horrified to hear her say that I was only TWO CENTIMETERS!  Oh my God, I couldn’t believe it was hurting so much and I had progressed so little.

Mark and I then made our way to the bath-tub where my biggest mental freak-out took place.  Simply put, despite knowing better from birthing classes and books and the Carl Yung adage, “whatever you resist persists” — I was totally focused on the pain and hating it, absolutely writhing in it.

At one point – which Mark refers to as the moment he fell in love with GB – I yelled, “Fuuuuuuck!!!”

GB said to me in her sweet soft-spoken voice, “Yes, fuck. Sometimes I think they need to invent a new word for what this feels like because ‘fuck’ really doesn’t quite cover it, does it?”

Mark sat behind me in the tub with his swimsuit on and wrapped his arms around me. My body contorted and my arms flailed around with every contraction and I was getting louder with my vocalizing protests.

The fact is, I wasn’t taking advantage of the breaks.  I should have been celebrating their existence since I didn’t get very many during my first experience with labor!  Instead of breathing and relaxing and saving up energy for the next round of contractions, I was tense throughout as I anticipated the next wave.

GB told me that I needed to get connected with the baby, to focus on her and remember what this was all about. They found a newborn picture of Sadie that I had framed on my dresser and brought it to me in the tub to look at. GB suggested to Mark that he help me by placing my hand on my belly.

This really pissed me off.  I didn’t want to put my hand on the pain I was feeling!  All I wanted to do was death grip his hand and it was aggravating me to no end that every time I grabbed for his hand that would take my hand and re-direct it.

Insert another variety or two of expletives said by moi that I don’t remember.

Now here’s the magical turning point of the story.  Had I stayed in this mental freak-out state, I’m not sure I would have progressed.

GB coached me that the opening of my cervix would occur during the spaces between the contractions when I relaxed.

She got down eye-to-eye with me in the bath tub and said:

“Monica, you are captain of this ship and you cannot leave your post.  You MUST be present for the sake of your baby.”

Something in that statement clicked for me.  I don’t know why – but it did and in that moment my eyes went from rolling around in the back of my head like a crazy woman to locked dead-on with GB, Mark, Julia – and myself.  The way I experienced or felt pain didn’t change, but the way I worked through it changed dramatically.

I got gritty and determined and for the first time since active labor started I was able to remain quiet during some contractions and simply breathe through them.

We moved from the tub back to our bed some time after 2:00 pm and in a few short hours I had progressed to 8 centimeters. Hallelujah!!

Now I was quite proud and knew in my gut that I would pull it off.

However, things got a bit intense shortly following this news. GB reported that our baby girl’s heart rate was down. She and Julia began giving me oxygen as I progressed further and expressed a desire to start pushing.

And once the pushing started, I was no longer able to be quiet.

I still wonder how many neighbors heard me yelling. I vaguely remember Mark and GB and Julia catching glances at each other while I roared, and mouthing the word, “Wow” to each other.  Maybe they didn’t say it and I just knew they were thinking it by the looks on their faces – I’m not sure.

GB was checking the baby’s heart rate every 15 minutes (perhaps more often?) and at some point let me know that the heart rate had gone down, the baby was in distress, and that I needed to give her a break and quit pushing for a while.

This was a mind-blowing request to me because ever fiber of my being wanted – and physically needed – to push.  She also asked me to walk around our room and to alternate putting each foot up on the bed.  I refused the latter request, but somehow was able to stop pushing and walk around our bedroom – for 10, maybe 15 minutes.

GB said, “Send love to your baby, tell her everything is going to be OK”.  Which freaked me out a little bit I have to say as I wondered just how dangerous a situation we were in – but I rode with it and remained focused on the work at hand.

Their next strategy to help me get the baby out was putting two of our big kitchen pots on the floor and having me squat on them so that one leg was on each and my body was low to the ground.

I tried pushing in this position twice and didn’t like it (or it didn’t work…? I don’t remember.)

At this point GB looked me in the eye and said, “Monica, you need to have this baby in the next three minutes or we’re going to have to go the hospital.  Ask your baby right now if she wants to be born at home or at the hospital.”

I caught a glimpse of myself in our bathroom mirror. Naked, blood dripping down my legs, hair frazzled, experiencing the most intense pain of my life and I thought, “God bless my little angel – I don’t know what she wants, but I sure as hell don’t want to get dressed and drive to the hospital.”  I really couldn’t imagine attempting a transport at that point – AT ALL.

I said something along the lines of, “I want to get this baby out now.”

And the final position that we tried is not at all what I imagined for the “Gentle Home Birth” I had fantasized about.

I was actually on my back on our bed with one foot propped against GB’s chest and the other propped against Mark’s and each knee up at my shoulders.  Julia stood between my legs and held one end of a sheet that she twisted up like a rope so that I could pull the other end.

I roared loudly through one, two, maybe three more pushes and then, with a hasty but necessary episiotomy, out came my sweet Isabel. Blue as can be, but she quickly turned pink while lying on my chest.

I don’t think I’ve ever been more happy to have accomplished something in my life and relieved that it was over at the same time.

I cried with joy, saying things like, “I’m not a wimp! I’m not a wimp! I did it!” and “I’m sooooo happy!  I never have to do that again!”

We love our children dearly and feel completely blessed and complete with the three daughters we have, our little girls and my step-daughter who is now 19.

I discovered that for me the “Gentleness” associated with home birth didn’t come from the birth itself.  The writhing, the moaning, the gritting, the yelling and roaring, the cutting — not so gentle really.  For me, the gentle aspect of this birth was the fact that I could be this raw, this vulnerable, this naked — literally and metaphorically — in the comfort of my home with people I knew and trusted.  And the gentleness for my baby was simply being at home with her parents from her first breath.

When I reflect on Izzy’s home birth versus Sadie’s Caesarean birth, do I think that Sadie’s was traumatic in comparison?

I honestly don’t know.

Sadie had bright lights, rubber gloves and an hour of separation where she was poked and prodded. She also came into the world with music and a calm, quiet audience including her parents who were filled with joy and love for her.

The c-section recovery sucked for me. Perhaps more so following a long effort with labor. I was crazy from the narcotics, the lack of sleep leading up to and following the birth, and combine all that with first-time mother fears – I slipped into post-partum anxiety, hyperventilating regularly about my inability to sleep. And I could barely walk for weeks. Enough said.

Izzy had her mama roaring and swearing as she made her transition from womb to earth. We know she was in distress during the last hour of labor but she appeared peaceful as a dove when she came out. She was welcomed into the world with the soft, late afternoon sunlight shining through our bedroom windows and a very relieved foursome that included two midwives and her ecstatic parents.

There was no whisking away to do anything, including cut the cord. We took our time with everything. She was home and that was wonderful. The birth for me hurt like absolute hell.  If I could do it all over again, I’m pretty sure I would not do it any other way – but it truly was the most painful experience I’ve ever had.  Recovery compared to the first?  INFINITELY easier mentally and physically.  I was immediately mentally sharp and present and confident which felt fantastic. And the physical recovery was so much easier – I was astounded at the difference.

I think there is a “traumatic” element to birth anyway you shake it. But I no longer think it’s useful to fret about it. I think the challenges of birth, in whatever form they take, are a rite of passage for both mother and child that include the full spectrum of the human experience: both the darkness and the light.

I choose to focus my ultimate conclusion of my daughters’ vastly different entries into the world as simply what was meant to be for me to prepare for parenting them — and for them.  And if, as they grow up, they are shaped or influenced in some mysterious way by their births, I hope it will be part of what makes their life textured in a rich and positive way and that the over-arching thing that they take with them is a deep knowing that they were each welcomed with immense love from their parents – certainly more love than I ever thought I had inside me.

I wished for both of them before they were conceived; I prayed for their health and their happiness; and I absolutely cherish the opportunity to mother them.

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9 Responses to “My Path to a Home VBAC”

  1. Abby says:

    This made me cry. In a really, really good way. Thanks for sharing.

    Abby

  2. Karen Adamo says:

    I will not soon forget the image of you positioned with both feet in someone’s chest, pulling at a rope of sheet between them. That and the image of you standing before the mirror wild-eyed and dripping. Holy Cow! What a fantastic story.

  3. Thank you soooo much for sharing! Your writing style this such a joy to read! It’s also encouraging, as I also had a c/s w/ my 1st. Thanks again!

  4. Kirsten says:

    How lovey to read Mon. As a mother who attempted vbac only to have a second c-section, I really appreciated reading this! It seems like you experienced some closure from your successful VBAC. And although, my VBAC attempt ended differently, I experienced that too. I still think a homebirth would be ideal, but no sense feeling bad about how my lovely babies came into the world! I am very happy that you had the experience that you wanted. It was so fun to read! Maybe I’ll do the same in the next life! 🙂 love you!

  5. chelsea says:

    Wow. Beautiful and elegant and *honest* — thank you for sharing this story. Much love, chelsea

  6. tinka greenwood says:

    You are a strong and amazing woman, Monica. What an honest, down-to-earth description-you and your sisters of this generation are so much better educated and informed than those of us in my generation, and A LOT more gutsy!!

    Love you,
    Tinka

  7. Lindsay says:

    Beautiful story and very well-written. Amen about the traumatic element of birth- and the full spectrum of human experience. I totally agree. Thanks for putting it into works with such eloquence and poignancy.

    Peace and congratulations 🙂
    -LA

  8. Kami says:

    Brought tears to my eyes! Wonderful to meet you tonight!

  9. vicki mccuistion says:

    GB delivered all three of my girls, now close to 15 years ago. Was missing her, and decided to look for her. She is amazing. We used the sheet trick for my first delivery. All the rest were much easier. Thank you for sharing your story and a memory of GB.

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