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VBAC No More!

June 10, 2011

VBAC No More!

Genny White

The surgeon snapped her sterile gloves off, that only moments before were glistening with my blood crystallized by the bright surgical lamps.  She pulled down her mask and looked at me, as she said “You will be an excellent candidate for a VBAC in future pregnancies.”  I heard a loud thud and a baby crying, yes a baby crying a nurse was walking by carrying a crying baby.  I was shocked I was stunned who was this person who walked in and opened a door carrying a baby in the middle of my surgery?  I was so full of shock that I did not even realize that this crying child was my own baby.  Those words “an excellent candidate for a VBAC in subsequent pregnancies,” I had heard!  Not, here is your baby, you are a Mother, but I now was a candidate, and what was I running for?  I was a candidate and those words would haunt me would beckon to me for 3 more years to come.

Let us back up though, shall we, a few hours earlier on that fateful evening.  I cannot tell you much about the obstetrician attending this labor and delivery.  I remember that she was a short woman with dark hair and that she wore glasses.  I also remember that she had a cold and each time she spoke with my husband and I she did so through muffled breath as her hand was pressed up next to her lips as she stifled out a cough.  I was not supposed to be here.  I was supposed to be at the birth center with the midwives, but there were complications, so here I was, I had been transferred lock, stock and barrel.  The Nurse Midwives care was alarmingly removed from me from this point onward.  After hours of long arduous unproductive labor, a declaration was made that I should have surgery.  I, not quite wanting to hear these words, drew upon the last bit of resolve I had I knew something about requesting a fetal scalp blood sample to confirm whether or not an infant was truly in distress before consenting for surgery and so I asked for this test to be performed.  The sample was taken from my little princess’s head and hurried off to the lab.  The report came back to Phillip and me that the test was bad, it was indeed bad.  So, this is a true Emergency, it was said, and a wail of hysteria swallowed me alive as they draped and shaved me, and rushed me to OR.  Now I am a Mother left with the label candidate for VBAC.

I am against the term VBAC.  I am for a woman with a previous cesarean, moving forward on other pregnancies, toward the journey that is before her.  But each pregnant woman is on a journey toward the birth that lies before them, but only mothers who have had a section are labeled with terms as VBAC and trial of labor.  Labeling someone as a candidate for a VBAC is counter productive to her achieving a satisfying birth experience in subsequent pregnancies.  The term candidate by nature is a term of condition and is not a firm platform, a trial demands the proving of something, or more candidly that a doubt exists.

The ideology that women who have had previous cesarean sections are more likely to have their uterus rupture is abundantly flawed.  If truth be known all uteri have the potential to rupture during the course of labor and delivery, but not all women are presented with consent forms to attempt a vaginal birth only those who have had previous cesareans whose care providers deem it necessary. I believe that from the perspective of the care provider that the care women should receive who have had a previous caesarean is that their care should be no different from the care of other mothers to be who have not had a caesarean experience.  I am not understating that there are emotional hurdles a woman expecting after a previous caesarean will experience, what I am saying however is let us not make those hurdles any greater than necessary by stigmatizing with verbology that would communicate any less than that they are:  Mothers on a journey toward birth.

Read the Labels

Other Mothers face other hurdles but have no special labels, and I guess that the medical establishment currently has not figured out a way to cash in on these other bumps in the road, that some women have faced.  What if women who had bouts of vomiting in previous labors were stigmatized with declarations Woman attempting Birth Without Throwing Up or Woman with Previous history of Runny Stools before Labor.  Just because certain issues presented themselves in one pregnancy is not a statement that they will manifest in subsequent pregnancies.

The culture and indoctrination of VBAC is not only counter intuitive it is counter productive.  What women who are experiencing pregnancies after a previous caesarean need is truth, balanced truth, and if they are fortunate enough as I was to hear that truth from someone who has personally had a caesarean experience in a pregnancy and has gone on to other more satisfying journeys.  Patty Brumbaugh, CNM and herself a Mother whose first birth experience was a caesarean childbirth and had gone on to give birth vaginally sat across from me now 4 months pregnant with our second child and said.  You are my client in my practice.  I have a c/sec rate of 4%.  I see you no differently than any of my other clients.  I reckon that you have a 96% chance of giving birth vaginally this time.  Patty sat there; she knew what I had been through, she knew what I was going through, and she knew the truth and stood by it.  Yes 96% of her births were NEVB  (Non eventful vaginal births).  Don’t you just love that as if any birth was non eventful.  Patty delivered! And so did I, vaginally. Patty Brumbaugh’s statistics however are not that uncommon for practicing midwives.  Choose a Midwife for your Maternity care to get the very best.

Some weeks later I sat in the waiting room of Patty’s Nurse Midwifery Practice.  I had to wait, I had time to spare.  So I asked the receptionist if my surgical report had arrived from back east.

“Yes, Mrs.  White,” she said.

“May I take a look at I asked?”  She said yes and handed it to me.  I sat back down and read moving through the labor and the stations and the dilation up to 7. I read the progress notes and then I read the lab slip report said insufficient sample to process: Bad Test.  The test was bad because it was an insufficient sample not because my child was in distress.  The surgery, the guilt, the stigmatization and all the rest were now contingent upon this test.  Insufficient  sample, the test was bad, not that the test had delivered bad results.  If we had brought a doula, maybe we would have entered another course of action, as the presence of a Doula could have disseminates the information correctly to us.

So I am against VBAC.  I will not stand for it. VBAC no more! I am for Yes, Yes to your body, yes to this journey that lies before you I am for Yes You Can.  I am for ICANICAN and I did.  Finding the right supportive birth team is critical to achieving safe and satisfying births, and I believe that this is through a midwives very capable hands.  Choose a Midwife for your Maternity Care.

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3 Comments leave one →
  1. Tammy permalink
    April 9, 2013 9:44 pm

    this is lovely! Thank you.
    It’s a sad shame that CDM’s in Alaska are not allowed to attend VBACs. We are very limited here.

  2. May 6, 2013 9:37 pm

    Many women having a subsequent baby have ‘labels’ on them from what happened in their first labour most a result of questionable care for example PPH (haemmorrhage) after an induction or many other disturbances to her natural flow of birth hormones, so she is told she needs even more’management ‘ during this labour………..Women and care givers are need to become more informed of the true physiology of birth by reading Michel Odent’s “The function of the Orgasms’
    .

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