By Jen Kaplan

Other than a strange affinity for blueberries, my first pregnancy was a very mainstream and very typical. I was the perfect picture of a stereotypical expectant mother in our country today. And the outcome was also a very typical story in today’s birthing environment. One medical intervention after another started a downward, unstoppable spiral. A 40 week ultrasound showed that my baby was “very big,” much too large for “any woman” to birth.

A pathetic attempt to labor was quickly called off since I was making no progress, proving that this baby was not meant to be born vaginally, and so I walked myself into the operating room, since that was what was “best for the baby”. Within minutes my son was born and being resuscitated while I was being given massive amounts of morphine.

My son was whisked away with my husband in hot pursuit of all those first moment pictures. I was alone with the nurses and doctors. The next 4 days were a blur of pain, pills, and recovery. However, I went home feeling fine, healing well and successfully breastfeeding my son. We were inseparable. I had no major complications from the surgery, my son was healthy, and all was fine.

Fast forward to three years later when I became pregnant again, and I was not the same person I was from my previous birth. Becoming a mother changed me. I am not the mother portrayed in the popular baby books or magazines. I became a mother who nursed on demand, co-slept, and wore my baby. But to find other mothers like me, I had to look beyond mainstream media. And I found them: families committed to a natural, attached, conscientious way of life. These mothers spoke about how important, special, magical, amazing their births were.

They were in charge of their bodies, listened to their instincts, and strived to birth their babies naturally. I was led to a world of doulas and midwives and Ina May Gaskin. It was eye opening and transformative. I began to realize how sad and pathetic my birth story was.

I researched C-sections and felt like I had lucked out. The list of possible complications for mother and baby are long. Don’t get me wrong: when a cesarean is medically necessary, it can be a lifesaving technique for both mother and baby, and worth the risks involved. However the potential risks to babies from cesareans can be deadly.

Knowing all this pushed me into the direction of wanting–no needing–to have a vaginal birth after cesarean (VBAC). I was determined to find out all I could about having a VBAC. My search was relatively easy. Online the information is everywhere.

I found an organization called International Cesarean Awareness Network (ICAN) which helps educate and support women by promoting birthing choices in the community, advocacy for VBACs, and prevention against unnecessary C-sections.

Through that organization, I found that SLO has a local chapter and I soon found myself at the first monthly meeting of ICAN-SLO. There I found a world of information provided by our leader, a doula, midwifery student and mother of 2 C-sections and 2 VBACs.

At these meetings I met other mothers who were determined to not be forced into a routine C-section and were also seeking out VBAC information. I learned that According to the World Health Organization, “There is no justification for any region to have a cesarean rate higher than 10-15 percent.”

And yet in our country one in three births is a cesarean. This cesarean rate increase has not led to an improvement in the infant mortality and morbidity rates, but instead has put mothers and babies at greater risk. I also learned that VBACs are safer for both mother and infant, in most cases, than is routine repeat cesarean, which is major surgery.

I have heard labor and delivery nurses speak from both local hospitals. They all come to the same conclusion as to why so many births wind up in C-sections: inductions and epidurals. Mothers lose touch with their instincts, bodies, and choices. Once an induction is begun, there is a series of events that have to take place. An IV and Electronic Fetal Monitoring must be used. When an epidural is requested the mother from that point on must labor in bed, lying down. These are all contraindicative to birthing normally and naturally.

Women who birth naturally are in a comfortable environment, unrestricted, allowed to eat, drink, bathe, and move. There must be movement for the babies to descend into the birthing canal. Preferred pushing positions are squatting or standing. When there are unnecessary medical interventions, that then lead to more medical interventions, this whole process is broken down. She now must birth in the certain parameters and restrictions that have been laid out before her.

But if you leave a mother alone to birth her baby and to trust the birthing process, we may not have so many unnecessary C-sections. C-sections rate across the world should be in the 10-15 percent rate. Why are we at 33 percent?

According to a recent press release by ICAN, “Every pregnant woman in the U.S. should be alarmed by this rate. Half or more of cesareans are avoidable and over using major surgery on otherwise healthy women and babies is taking a toll.” A major driver of cesarean overuse is underuse of vaginal birth after cesarean (VBAC). The VBAC rate currently hovers around 8 percent, far lower than the Healthy People 2010 goal of 37 percent. Driving this decline is the growing practice of hospitals banning VBAC, due to unattainable guidelines that hospitals have to follow.

Thankfully here on the Central Coast, there are doctors and midwives that know and believe in the safety of VBACs. These doctors know that it is almost always safer to let a woman deliver vaginally. The very small (less than 1%) risk of uterine rupture outweighs the risks associated with a C-section.

One of the precautionary guidelines for a VBAC birth is that there must an anesthesiologist in the hospital. The doctor must also be with the patient during the whole delivery. These are in place in case of a uterine rupture. The laboring mother and fetus must be able to have an emergency C-section quickly. Because of these limitations, the only place locally to attempt a VBAC delivery is at Sierra Vista Regional Center with a handful of doctors or at home with a licensed midwife.

From numerous recommendations I found a doctor that would take me as a VBAC patient; he assured me that all labors and all births are different. And this time I would need to do some things differently. He highly suggested that I labor at home for as long as possible. He was happy that I had hired a doula, was a member of ICAN, and was educated on the importance of a non-intervention birth, and that I had tools to guide me through my labor this time. I learned that failure to progress is a relative term and that all births have their own timeline. I learned to trust my instincts, calm my fears, and to visualize a normal, vaginal delivery.

I had a very uneventful pregnancy. No complications. Felt great. My doctor was a calm, experienced man who had delivered thousands of babies and who believes in the safety and practice of
VBACs. My doula was a peaceful, strong, intelligent, loving presence who guided, taught, and supported me.

Finally, 12 days past my due date, my labor started very slowly. After 2 days of laboring at home, we went to the hospital. We were greeted with an excited, encouraging, and supportive staff of nurses who were just as thrilled as I was to have a successful VBAC. All through the night and next day I labored on, slow and off the normal labor curve, but still progressing. We were calm and capable and knowledgeable. We knew that this was not an emergency or a crisis. This was just me, slowly having a baby.

Finally, after 36 hours of prodromal labor and 20 hours of active labor, I pushed my baby out into the world and into the hands of a doctor who held faith in the body’s ability to birth, surrounded by cheering nurses and a proud husband, and my doula who was with me every step of the way. When the baby was placed on my chest and was nursing shortly thereafter, I looked around calmly and knew that if I could do it, anyone could.

Our own government wants to reduce the amount of C-sections being performed in our country. Our statistics are appalling and an embarrassment. Avoiding unnecessary C-sections needs to be a priority in his county. More accessibility and fewer restrictions to VBACs need to happen. Women should not be forced into repeat C-sections. Women can–and have the right–to say NO to an unnecessary surgery. Women need to demand their right to a trial of labor. Midwives are also an invaluable gift to our society.

They are the original catchers of babies. They are the most knowledgeable when it comes to birthing and mothering. We need to seek out and utilize their wisdom and services. We are women. We can birth our babies.