VBAC homebirth after 4 c/sections

 Posted by on November 25, 2012
Nov 252012
 

Mama Jacqueline, Big Sister Tory holding baby Travis, and Daddy Travis at postpartum home visit

VBAC as Women’s rights issue

 Jacqueline called me about 3 months ago looking for someone to help her birth her baby without having to have another c/section.  She did not seem to be a particularly strong homebirth advocate, but she was scared to have another surgery and she knew she could get her baby out vaginally.  This was her 5th pregnancy, her first baby was born via “emergency” c/section when late in her pregnancy it was discovered that he had spina bifida.  Jacqueline asked about a VBAC with her second pregnancy, but was told very firmly, NO, absolutely not.  When she showed up at the hospital thinking she was in early labor, her cervix was checked.  Even though she was 6cm, she was whisked quickly away for a repeat c/section.  She went into labor between 37and 39 weeks with her second, third, and fourth births, and each baby weighed less than 7 pounds.

When Jacqueline called me with this pregnancy, she was about 30 weeks along.  She had been seeing an OB who did not seem to be hearing her concerns about having another repeat c/section.  She had called many OBs and several midwives and no one felt comfortable helping her.  She told me recently that she had only found four cases of VBAC after 4 cesareans when she googled it.  When she first called me, I told her I would be happy to talk to her, hear her story and see how it “felt”.  I can’t say I wasn’t nervous, but I feel very strongly that women should have the right and choice to birth how they want.  I also thought if I don’t help her, no one else will.  Having had a home VBAC myself, I know how powerful and life changing the experience can be.

Jacqueline and I met several times over the few months until she was due.  I asked her to get the surgery reports from each of her previous c/sections.  The first one, from her son’s birth, 11 years ago, was not available.  Each of the other reports stated they were repeat low transverse c/sections.  We also knew that her placenta was not near the incision based on several ultrasounds she had early in this pregnancy.

As Jacqueline’s due date approached, I had mixed feelings.  I was not worried about her ability to get her baby out or that her uterus would rupture. I know uterine rupture is extremely unlikely, even though there is very little research about vaginal birth after 2 or 3 c/sections, much less four.  What I was worried about was what it would look like to my peer group, other midwives and birth professionals, both from Austin and around the US.  What if something happened? What if??

Still, my desire to support this woman’s well-researched and informed choice to have a vaginal birth out-weighed my fear of what others would think.

Jacqueline had many days of warm-up labor starting around 38 weeks.  I was encouraged by these contractions and kept reassuring her that this practice labor was important for the uterus to get strong for the actual birth.  Her baby continued to move well, she was not in pain, and she was determined.  She called me the day before her due date with regular contractions that she was not sure was labor, but she was having some bleeding.  It was not much, it was red, it was not dripping, but it was not mucusy.  I wanted to go check out what was going on.

When I arrived at their home, Jacqueline was happy and walking about, and the bleeding really was minimal and looked like regular bloody show from the cervix opening.  She was about 4 cm dilated, 90% effaced, and the baby’s little round head was low.  Jacqueline did not like sitting still, or sitting at all, for that matter.  I said, well, don’t sit.  At some point she realized she had to take an online school exam before midnight.  That’s when labor really got going….she would answer a question, have a contraction, leak fluid, answer a question, have a contraction, leak fluid….this went on for about 45 min, she finished the test and we discovered her cervix was 8cm, very stretchy.  With this exam, there was more bloody show.  More than usual, but not more than I would have been worried about in a non-VBAC birth, about ½ cup total, on the chux pad.  I suggested she get up and sit on the toilet for a few contractions.  The baby’s heart tones continued to be stable, decreasing a bit with the contractions, increasing again after.  The bleeding that I as concerned about did not continue on the toilet.  She started bearing down some and then pushing more.  I suddenly got a glimpse of her vulva and there was shiny black head just inside.  We moved back to the bed and she pushed the baby out all in one contraction, from seeing little peep of baby’s head to toes out in a millisecond.  All of us were a little stunned I think.  She was so happy she had done it.  Travis, her husband, was thrilled and surprised.  The placenta came out easily, with very little bleeding from the uterus.  Six-ish hours of labor, 10 minutes of pushing, 10 minute wait for the placenta, routine postpartum time, leaves me wondering why?  Why did Jacqueline have to go through all of those other surgeries when they were so unnecessary???

I don’t know the full answer to this, nor will we ever.  What path each person’s life takes can be changed at any given moment, but had this one women’s choice been honored long ago, it would have saved her a lot of pain, money and heartache.  It raises so many questions for me, questions about birth and beyond:

Why is there so much fear around VBAC?

Why are more people not scared about c/sections?

Why do other people think they know what is best for everyone else?

Why is choice not honored more in our culture?

Why do women’s rights consistently get pushed aside?

Why do we think we can control birth?

I am grateful to Jacqueline for trusting me to hold the space for her to have her baby, and for allowing me to write about it so that others will know and be encouraged.  Stories are the best educators. My hope is that more and more stories of women who dare, will overcome the stories of women who fear.

This one story of VBAC homebirth seems so small compared with all of the other women’s rights issues around the world, but for one woman, her family and a midwife it feels like a grand accomplishment.

Thank you to Brielle, Paula and Jenni for helping me be there for Jacqueline.

Little big sister Texie helping change one of baby Travis’ first wet diapers

 

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  13 Responses to “VBAC homebirth after 4 c/sections”

  1. CONGRATULATIONS Jacqueline!!

    And thank you, Christy, for being the best VBAC supporter! If it weren’t for you, women like Jacqueline and I would have NEVER had a chance to bring our babies into the world without bright lights, sharp knives, and chaos.

    Much love,
    Stephanie
    (home-birth after three c-sections in Dec. 2010)

    • I hope you see this reply: congrats on your vbac after 3 sections. Im a nurse and were taught vbac post 2 is not acceptable, that it poses too much of a risk. Hearing all of this for so long makes you actually believe it. Having said that i was also bullied into 3 myself, all because the first one was induced because i was post 42 weeks. Well we just found out #4 is on the way and im such an emotional wreck. My collegues are already telling me how insane it is to even attempt one at home. Months ago i started talking to a midwife because, naturally im fascinated with health related issues and more recently with natural medicine. She says shes never had a problem with hbac and i decided i want to do it. For me, the bigger issue is the emotional scars left behind than the physical healing. I cant take another surgery. So, im interested to know more about your labor and birth. Thank you.

  2. This story just brings me so much hope. I wanted SO BAD to have a VBAC after my 3rd c-section. I got so much opposition and scare tactics. Extremely stressful situation. I got the c-section. Now I’m pregnant again and actually having a hard time finding a clinic willing to take me. My heart again says VBAC. Praying for wisdom.

  3. Amazing. Congrats momma! You should feel very proud.
    I know I wont have another baby unless I have a chance of a VBAC after 3 sections.
    Scares me to death to be cut open again.

  4. This story gives me hope! I’ve had four cesarean and would LOVE for my chance to VBAC! Now to find the road that is set for my journey has a light along the way 🙂 thank you for sharing!

  5. I have been thinking about having a vbac when I get pregnant again I too had 4c-section i just don’t want to go thru that again way to much pain I don’t want to be butchered again!

  6. Awesome, story and so happy that you were able to finally give them the VBAC they desired! I am doing research as my wife has had 2 “emergency” c-sections. I personally am #2 of 3 VBAC’s after 4c-sections. my sister was 1982, me 1984 and little sister 1987. However my mom passed when i was 12, so i unfortunately don’t have that wealth of knowledge to reach out to. My mom was one of the entries in “Silent Knife”. Sad that 30 years later its still so controversial. Thanks for sharing!

  7. Thank you for sharing – just sitting here googling “Successful VBAC after 4 C-sections” and this came up. It brings hope for myself and any women who read it who find themselves in the same situation…. That nagging feeling that our bodies are capable of giving birth and that what we are being told doesn’t quite add up….. but the fear to really step out on a limb (even as you did as a doctor!) to try something that everyone says is risky and irrational is so debilitating! But I am grateful you walked along side this woman and allowed her body to do what is was designed by our Creator to do! With baby #4 I researched and prayed and hunted down people within a few hours of where we lived searching for ANYONE who would come along side me and encourage the woman inside of me to LIVE and thrive and embrace birth… Even if it was only a trial of labor….
    And I met with dead ends and disappointment. “No after 2 C-sections”….. I cried, heart-broken, the night before my scheduled C-section…… Is there no one left who believes in the power within our bodies to give birth to life…?? (I wondered) Am I really unable to deliver these precious babies?

    And now we are on baby #5 and I have read the testimonies of other women who never gave up and have succeeded even after 5 C-sections or more to deliver by VBAC! I draw strength from these stories. Perhaps a C-section is what I must accept again…… but I am hunting for someone, like you, who is willing to take the “risk” and see beyond my C-section scars – to see the emotional scars that a women bears when she feels like her body is “broken”, and I am reminded to keep on trying when I read stories like this. Thank you!

  8. I have had 2 vbacs. I live n tampa am planning on conceiving #3 soon. Do no want another c section once pregnant will u b willing to accept me since n tampa.

  9. Very inspiring for me. I am a mother to 5 children, and I have had 4 c-sections (I had a set of twins). I am pregnant with my 6th child, and I so badly do not want to go thru another c-section. I was 41w5d with my first, and the induction wasn’t done right which led to an emergent c-section. My second, they gave me no choice and did a repeat. I tried going for a VBAC with my twins, not letting the doctor schedule a c-section date, but ended up having one at 37w2d because of preeclampsia. My last one, they did another repeat. My children are 10, 9, 5, 5, and 4. By the time I have this baby, there will be almost 5 1/2 years between my youngest and this baby. Finding a doctor to even deal with me doe this one was so hard since I’ve already have 4 c-sections, which probably lowers my chance of a VBAC, but being this story inspires me, hopefully, I can convince them.

    • I am in the same position. Expecting number 6, 4 previous c-sections, also have twins. First c-section was emergency, had dilated to 10, was pushing but ended up with c because blood pressure and bleeding was out of control due to severe preclampsia. That was in 2003. In 2004 ACOG put out their scare tactic campaign making many hospitals refuse to even consider VBACs. My youngest will be 8 before this one is born and I in just the past week have hopefully finally found an OB that is willing to listen and truly consider a VBAC and will meet him this week. Good luck to you!!

      • Hello i was reading tha you find some body to help you where do you live , i am on my 5th i have 4 c-cection and thinking if it is posible i am from los angeles ca.

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