CW: Traumatic C-Section is part of the narrative.
Disclaimer: All information and resources in this article are based on my personal research and opinions unless otherwise noted. I wish to contribute to the VBAC conversation from a patient point of view; I am not a doctor. My educational background is in English-Creative Writing. Please consult health care professionals before making decisions about your health.
When I tell friends that Ceci , our second child, was my VBAC baby, I usually find a confused expression on their face or they ask me point-blank, “What is that?” to which I answer, “Vaginal Birth After Caesarian Section” in an even tone. I’ve had practice saying “vaginal” now for eleven years. At first, it felt a little embarrassing or like I was supplying information the questioner wasn’t prepared for. Then, I got over it. It’s part of being a positive force in the world of women’s health and it’s why I write articles about subjects I wish were discussed more, like maternal incontinence.
If you’re reading this, I’m guessing you’ve either had a VBAC, are considering having a VBAC, or know someone who has had one. Now that I have thirteen plus years spaced between my traumatic and unplanned C-Section and my emotionally healing VBAC I feel I can finally share my experience with people who are interested in possibly pursuing this option. Let’s dive into my backstory and then I’ll give some details about what you can do to further research your options if VBAC is something you’re considering.
My VBAC Story Starts With a Traumatic C-Section Story
Close to Christmas, I went into labor. I was terrified and denied I was in labor until my water broke many hours after labor started. At that point, David helped me waddle into the car and go to the hospital. I was at almost 8cm (out of 10cm) dilated and our son’s head was stuck in the brow position, meaning he was looking skyward instead of chin tucked in. My doctor was on vacation and a very pregnant doctor came in to introduce herself and break the news that we should consider a C-Section. Otherwise, we risked breaking our baby’s neck during vaginal birth.
Neck Breaking. That’s all she had to say. We agreed and looking back, I do believe this was the right decision. After our son was born, I second-guessed myself, but the fact of the matter is either way he’d have been born, there would’ve been trauma to both my body and his.
When we got to the hospital, I was in so much pain that I screamed for drugs. I let loose like they do on TV. And, the nurses shushed me for making such a scene. I got doses of pain medication and my thinking became blurry as the pain receded. David got suited up in scrubs and they wheeled me to the OR. I was not restrained. An anesthetist hooked me up to an epidural and rubbed a piece of ice across my huge belly. “Can you feel that?” he asked. “I’m not sure,” I replied, “Can you do it again?” At least that’s how I remember it. But, he shushed me as the nurses had. “If you don’t know, then you didn’t feel it.”
The thing was, I did feel the ice. And, my drug-blurred brain wasn’t doing me any favors. The doctor started making the incision. I could feel the scalpel cutting into my flesh. I imagined people enduring torture and told myself if they could do it, so could I. It felt like forever before my brain caught up and sent me the signal that we were in an OR, this wasn’t torture to be endured, and I should speak up. I don’t remember what I said but I do remember reaching under the curtain trying to grab the scalpel and make it stop.
David saw what was happening and got the doctor’s attention. She was shocked and sternly told the anesthetist to fix his mistake. As he upped the dose, it worked, but I was in another world, one of PTSD, terror, torture, and knowing I was about to have to take care of a baby who caused this pain, followed by guilt because it wasn’t our baby who caused the pain. And, was it my fault for taking medication during pregnancy, for going to the hospital too late in labor? My brain spun as the doctor made precise incisions. My scar is barely there — she did an excellent job.
And, then it was time for our son to be born out of this slice in my abdomen that I couldn’t see. The doctor tugged to free him and he stayed firmly inside me. Another tug. And, the third, he was free. She’d had to dig her heels into the ground and pull with all her strength. She seemed to also be suffering a case of trauma — after all, she too was pregnant.
Our son scored well enough on the Apgar test and they wheeled him off and David left and I was all alone in a room full of steel — wounded, weak, and scared.
Many months later, the doctor who delivered Jaden and I found ourselves at a restaurant unexpectedly attending the same dinner party and discussing our deliveries. Mine had traumatized her as I’d thought. She ended up also having to have a C-Section. It was cathartic to have this unexpected conversation.
Recovery took weeks, months, years. There was emotional trauma beyond the physical toll of the unplanned C-Section. I share this backstory with you to illustrate why it was that I was so adamant about birthing our second child by VBAC. I didn’t want to endure unnecessary suffering and pain and didn’t want to put our baby through any trauma either.
It Wasn’t Easy Finding a VBAC Doctor, But it Was Worth It
Jaden was born in late December of 2007. David was ready to talk about having another child long before I was prepared for entertaining the thought of it. I needed to first find a way to heal.
After the C-Section, I’d been unable to breastfeed. In my mind, this meant I failed at the most basic task of mothering. I no longer believe that and wish there wasn’t so much judgment of parent’s choices around breastfeeding. I also began having intrusive thoughts, which is part of Postpartum OCD (PPOCD) but was something I didn’t know about then and is only really coming into the postpartum discussion more prominently in the 2020s. Aymes Sarah has written a book about this subject, which is forthcoming. It took many years for me to finally obtain an OCD diagnosis to go with my Generalized Anxiety Disorder and Depression diagnoses. Medication, therapy, writing, and other modes of healing have helped me navigate the mental illness aspects of my life.
I knew I wanted another child as much as David did, but I was terrified of going through C-Section trauma again. Very few doctors had the insurance to practice VBACs where we lived (Oklahoma, US) in 2010:
“From 2005 to 2015, the main malpractice insurance company in Oklahoma, PLICO (Physician’s Insurance Company of Oklahoma), refused to cover care-providers who allowed their patients to have a trial of labor after a previous cesarean.” — Bethanie Verduzco, Tulsa Kids
The restrictions were lifted in Oklahoma in 2015, allowing many more doctors to offer VBAC services. From what I understand, this varies from state to state and country to country. Finding a local resource group is a good place to start if you are interested in pursuing a VBAC.
Some VBAC Basics
I don’t remember how I even learned about VBACs, to be honest. I’d guess it was either from a local mom’s group or from a source like Babycenter. I do remember that I was led to the online resources that ICAN (International Cesarean Awareness Network) provides. ICAN describes its mission:
The International Cesarean Awareness Network is a non-profit organization whose mission is to improve maternal-child health by reducing preventable cesareans through education, supporting cesarean recovery, and advocating for vaginal birth after cesarean (VBAC). — ICAN
All the warnings against VBAC mentioned the risk of uterine rupture:
“A possible rupture: A rupture of the cesarean scar on the abdomen or the uterus itself is rare. If a rupture does occur, most often there are no significant complications for you or your baby. Very rarely, however, a rupture can result in serious harm to both you and your baby. Your obstetrician will inform you if you are at a high risk for a rupture. If you are at risk, it is not recommended that you have a VBAC delivery.” — Brighamandwomens.org
The Brigham and Women’s Hospital has very good basic information on the risks and benefits of VBAC. One of the reasons I wanted a VBAC was the shorter recovery period. I still deal with emotional trauma in my C-Section scarring area, though it is much diminished now. And, they were right — my vaginal birth recovery was a breeze compared to the recovery from a C-Section, which is, after all, abdominal surgery.
Once you have decided that you want to pursue a VBAC, you will need to do some homework:
- Find doctors who perform VBACs in your town with a high rate of success. You can call and request the success rate.
- Figure out which of these doctors accept your insurance.
- Call insurance to confirm that they’d cover a VBAC birth.
Catharsis Through Delivery
I don’t remember how I found the details for Dr. John R. Thompson, but I do remember finding that his rate of success with VBACs was very high. Because I desperately wanted a successful VBAC, I decided to go with Dr. Thompson and take all of his advice. He had a proven record. He did some things differently than other VBAC doctors, namely that he induced a week early, which is generally recommended against because it slightly increases the chance of uterine rupture. His argument was having a smaller birth weight baby would increase the rate of success.
The delivery went smoothly. We arrived early in the morning and began the Pitocin drip. I wasn’t expecting the pain that came with inducing so early in labor. I asked for an epidural when I was only 2cm (out of 10cm) dilated. It was very difficult to deal with labor pain while hooked to an IV and being told to lay on my back in bed. This part was not ideal but I accepted it for what it was.
Dr. Thompson early in my pregnancy said he didn’t understand why women choose natural childbirth when the pain is unnecessary. Although I didn’t agree, I held firm in following his advice, which was to avoid any brain-altering pain interventions and use the epidural. I was clear-headed during the entire labor and delivery and for that I’m very grateful. I’m also grateful I had the epidural since labor was especially painful and movement was so constricted.
When it came time to push, it was difficult to feel what I was doing, which is one of the downfalls of epidural use. Dr. Thompson told me I needed to push or we’d be looking at a C-Section. That, along with an episiotomy, and Dr. Thompson guiding my hand to hold Ceci’s head as she crowned moved things along.
I hadn’t considered holding my baby’s head as I birthed her as an option. Dr. Thompson’s gesture of inviting me to do so was a kindness I will never forget. My body and my baby were able to achieve a successful VBAC. It was an extremely healing experience for me, from the research, reading and self-advocating to the labor and delivery to the postpartum period, in which I successfully nursed for 10 months. At the 10 month mark, intrusive thoughts began creeping in and I made the difficult decision to go back on medication and stop breastfeeding.
Emotional Healing Through VBAC
The pregnancy with our daughter was much easier than the one with our son. I felt supported and excited. I craved healing through this VBAC experience. Intuitively, I felt this would help heal the psychological trauma that I’d undergone with the unplanned C-Section.
I believe it was through ICAN that I discovered a book called Cesarean Voices edited by Martha Basham. I do not recommend this book for women planning C-Section birth or women who have had non-traumatic C-Section births because this book is entirely about traumatic C-Sections. For me, reading the stories of other women who’d had traumatic C-Section birth experiences helped me feel not alone and was a catalyst toward my own healing. The book description on the ICAN website states:
“In a culture where cesarean section is viewed as simply another way to have a baby, we seldom hear the voices of women whose experiences have not been so easy. This groundbreaking book answers the question “What’s so bad about a cesarean?” in a raw, honest, heart-shattering way. If you care for or about women and babies, hear these voices.” — ICAN
I also accepted help after Ceci was born. A breastfeeding friend stayed with us for a week and helped me get the hang of it while also normalizing it for the rest of our family. My mom and mother-in-law and other family members provided support. Where I had felt alone and hurt after having Jaden, I felt supported in my healing after having Ceci.
The Choice Is Yours Whether to Have a VBAC or CBAC
One of the most healing things about having had a VBAC is that moms who are interested in also having a VBAC reach out to me because I’ve been so open about mine. I’ve had coffee shop chats, in-person chats, and online message chats about my positive experience. I’ve gotten to hear when other moms have successful VBACs. Oftentimes, moms didn’t know VBAC was an option until I mentioned it.
Not all moms are candidates for VBACs and this is a personal choice. There’s not a right or wrong answer and I hope there is no judgment for the choices moms make. We are under a lot of pressure to make 100% “right” choices. That’s impossible. We do the best we can with the information we have. ICAN has resources for moms who have CBACs (Cesarean after Cesarean Birth) to help with resources and healing. Although their mission is to decrease the number of unnecessary C-Sections they understand that sometimes C-Sections are the best option.
Whatever you choose, I suggest reaching out to other women who have gone ahead of you with what you are doing. It helps to have the support of knowing you are not alone and of hearing about successful outcomes.
VBAC (Vaginal Birth After Cesarean)
VBACs in Oklahoma: What you need to know – TulsaKids Magazine
Vaginal Birth After Cesarean (VBAC) – Brigham and Women’s Hospital
Vaginal Birth After Cesarean Delivery (VBAC)
VBAC Education Project | International Cesarean Awareness Network