All Akimbo on VBACs

By Kim Blakely

Just so you know, I’m not the kind of pregnant lady who has written up a detailed birth plan, complete with a list of musical accompaniment. I’m uptight and opinionated about some things, and I like to plan, probably more than the next woman, but for some strange reason, giving birth is something I look at completely differently.

I’ve heard from more than a couple of presumably well-meaning folks that I must have been devastated not to be able to have a vaginal birth with Mojo. Really, though? Must I? I can’t say I was. Honestly, I was so happy to meet him, and so ecstatic that he was healthy and in my arms, I couldn’t have cared less how he got there.

So, when I asked my doctor early on if a VBAC would be a good idea for me this time around and she said if she were in my place, she would certainly try for one, I decided I probably would, too. I had done some research and I knew the risks, and though, frankly, a 1 in 100 chance of uterine rupture and the possibility of death for mom and baby sound a little scary, I still thought, OK. I’ll go with it. I know lots of people do it without complications, and though I have my reservations, I feel sure that my doctor will be on top of things.

I had a c-section with Mojo at 37 weeks because I developed mild pre-eclampsia and I couldn’t be induced because he was breech. While I can’t say it was a horrific experience – I didn’t develop an infection or anything horrid – it’s certainly not something I’m anxious to go through again. Recovery was … not fun. I still have some pain in the area of my incision all these four years later, and I wonder if surgery made my endometriosis a bigger problem than it might have been otherwise.

My doctor said that if this baby isn’t breech, and if she isn’t too big, I would be a good candidate for a vaginal birth.

Today, though, I had another regular appointment. After holding my nose and downing the orange Glucola (yuck) and then giving blood for the one-hour glucose tolerance test – my doctor met me in an exam room. She sat down and flipped through my chart … and then she said, “We have a problem.”

My brain raced hither and thither, trying to remember if there were tests I had taken at my last appointment that could indicate that something was wrong with me or my baby, but it was coming up with nothing, so I finally said, “What’s the problem?”

As it turns out, the partners in her clinic have just voted to do no more VBACs because of the risks involved. She’s still willing to do mine, but if I go into labor and she isn’t available, it’s straight to the operating room I go – without so much as a pass at the stirrups. She promised she would come in to deliver my baby if there was any way she could, and although she does have some travel arranged for the end of June, that should be well after I’ve given birth.

I haven’t had a chance to really talk with my husband about this yet, but I could tell immediately that upon hearing the stats in the doctor’s office and finding out that none of the other doctors who work with her would do a VBAC because of the risks, he’s feeling squeamish.

So, at my next appointment (three weeks from now), should I schedule a c-section, or should I stand fast, maintain the status quo and hope for the best?

Really, I’m not dead-set against having a repeat c-section, especially if that seems to be the best course. But who can say, right? From what I’ve read, there are no definitive indicators that point to an increased chance of rupture. But then, I also realize there is no guarantee that a c-section won’t result in some kind of complication.

I’ve never been away from Mojo overnight – much less the three or four nights that I would have to stay in the hospital if I did have another c-section – and that is certainly a factor here. The last thing I want is to worry that he’s sad or upset or that he resents his new sister for keeping his mama away from home.

This is way too much thinking for someone who is trying hard to live in the moment, to savor what I know will be my last pregnancy. If I could only remember where I put my crystal ball, I could put this whole thing to rest.