Sorry, friends. J I try to make this a weekly thing. It turns out that when one is too busy to boot up the computer, it’s hard to write more than quarterly!! On to the topic. VBAC and the support of women in hospital. I returned from a VBAC birth last night. I was exhausted…I was there for 29 hours, supporting the couple and particularly Mama while she labored. She actually had the “stereotypical VBAC labor” for the VBAC labors I have seen in the last few years. She presented upon my arrival as if she was deep into active labor. The sounds she was making, the way her contractions were behaving (long, strong, and CLOSE together), the way she was moving, the words she was saying… finally she was burping, she was saying she didn’t want to do this anymore, and she was feeling rectal pressure…so we left for the hospital. To find that she was two centimeters. Now, commonly in this area, this would be the point at which the typical OB would say, “Oh, well, your body must just not know how to do this right. We’ll fix you up in a jiffy--how about just a “whiff” of pitocin?!” Instead, her doc offered her the opportunity to go home, and finish her early labor in a more comfortable environment. She chose to stay and walk in the nice atrium with fountains and plants everywhere, and labor near by for a while, hoping that she would change quickly. Turns out that we were there, at the hospital, for 26 hours before the baby was born. At no point (especially when the woman was “stuck” at the same six she was “stuck” at with her first--induced--labor) did the doctor say, “Well, your body is staying at the same place it was before…it must just not know how to get past this point.” In fact, he kept saying, “You can do this. I believe in you. I trust your body to have this baby. I have seen this before. I wish more women would make the choices you are making, and do such a beautiful job with their birth choices.”
I attended a labor early this spring that was a VBAC. When the OB walked in for the first time, laying eyes on the woman for the first time in that labor, her first words? “Well, I see that you’re at a six! I have to say, looking at your records from your last birth…I highly doubt you’ll get past this six. It’s where you got stuck last time.” Seriously?! Yes, that is what she said. Oh, that and (repeatedly) that she LOVED to be proved wrong. At the end of the birth, when the woman DID get her VBAC, with the baby on her chest nursing away, the mother looked up at me and with a twinkle in her eye, said, “Huh. She didn’t thank me for proving her wrong…” Isn’t it sad that she had to have her baby in that environment?!
I thought of her often, actually, during this birth that I attended yesterday and the day before. The doctor who attended this woman butted heads with staff, bucked protocol, and overall supported this woman in every single way possible. For instance, with the epidural recently turned off and one leg not quite working perfectly yet, the doctor helped me get mom onto her hands and knees, draped over a birth ball, to push her baby out. The nurse in attendance was flabbergasted. The doc encouraged the nursing staff to write a form to sign for the couple to refuse Vit K and eye goop…because it is, after all, their right to do so. He gave her options every single step of the way. He stayed at the hospital and would leave to go home for an hour or two to be with his family, but hurry back, because there were staff there who were trying to make him or the nurses “mess” with this woman and force her to have a more “typical” constantly monitored VBAC that had a great deal more interventions that this birth had. He became not only her OB, but her support and her guardian.
There are two or three docs in our metro area whom I have seen act this way…but one of them is the partner of the woman who walked in and said, “Well you’re at a six, I don’t expect you to get much farther because that’s where you got stuck last time…I love to be proved wrong, but I just don’t see it happening…” How can I expect to send women to HIM to be supported and have their bodies trusted during a VBAC, when he has a partner, who is just as likely to catch, who has completely opposite views!? This doctor, who caught the baby born yesterday, to a mother who fought tooth and nail for this VBAC, and as a care provider, who fought WITH her…he is a Godsend. I look forward to working with him again and again…and to seeing more and more women have a REAL chance at a vaginal birth after cesarean because they are trusted, supported, and given true options when it comes to the birth of their child.
So many docs pay lip service to women who plan VBAC. They say, “Sure you can TRY a VBAC…as long as you meet the criteria when the time comes. I won’t let you go to your due date. I won’t let you move around. I won’t let you have external monitoring (*gasp* intermittent monitoring?! That’s a bad word for VBAC nowadays!). I make the rules, and if you don’t make the requirements, you’ll get cut.” So women expect that their bodies won’t work and that they will have to be cut open again. Why fight and try, when they can schedule it?… and have to recover from major abdominal surgery while caring for their newborn and probably a toddler or preschooler as well. *sigh*
So, Ladies, this is a testament to LOOKING for a TRULY supportive care provider when you are faced with planning a VBAC. It is not only possible, but it is the smart thing to do. You are much more likely to actually have that vaginal birth this time around if you are surrounding yourself with people who care a whole bunch about your getting the birth you want. It might be a hike for you, but I’d be happy to give you this guy’s name. He’s probably the most midwife-y man I’ve ever met. That’s a compliment, by the way. ;) Of course, I’d also be happy to give you the name of a midwife who can catch at home…but if you are planning a hospital birth, he’s the guy to see. Hands down.
So…what’s the difference your spouse or friends might ask? Both of the women I mentioned planned a VBAC, hired a doula, took childbirth ed classes, ate well, exercised, and lo--both got their VBAC. One of them, however, had to fight tooth and nail and be barraged with distrust, a lack of information, a bunch of rules that were useless and non-evidence based, and a doctor who did everything in her power to undermine the woman’s ability to have her vaginal birth…so she could do her fourth cesarean of the day and go HOME, already. The other one fought, too. She worked just as hard physically…but all the other things were a non-issue. Her doula, her doctor, and her nursing staff worked seamlessly together to support her, to make sure that she had all the information she needed, and to be absolutely certain that she had all the faith in her body and her baby to give birth the way God intended. We need more of those care providers out there. The only way we will get them is by customer demand. STOP accepting the Litigator’s rules over your body. Look at the medical evidence and expect that your care provider will follow it too. Your money talks! Go to the providers who don’t have meaningless criteria such as “you can only go to 40 weeks, but if you go before that you are WELCOME to TRY a VBAC…” Every penny that they lose, and I would tell them why you are moving on, makes an impression. Especially if they repeatedly have patients leave for the same reason.
Expect support. Surround yourself with support. PLAN a VBAC, don’t just “try” for one.