My first pregnancy, in 1995, ended in a C-section. I was young and single, had the support of my parents and at the time, wasn't terribly concerned that my delivery was a surgical one. My baby was born -- he was so warm in that distressingly cold operating room -- and I loved him from the get-go. My recovery was difficult, after all, it is major surgery and the incision isn't a tiny one. I had no trouble establishing breastfeeding and aside from a lingering numbness (seriously, will this ever go away, after nearly 17 years?) suffered no long-term side effects.
The VBAC idea
When I got pregnant with my second child in 1999, I took myself and my new husband to the obstetrician's office, expecting to be told to anticipate a repeat C-section. I was surprised and kind of angry when he strongly recommended attempting a vaginal birth. I thought it was a crazy idea and a bad one to boot. I had heard the adage, "Once a C-section, always a C-section," and ascribed to it completely.
However, I had many months to consider the decision, and decided to go ahead with a VBAC (vaginal birth after cesarean) trial. I went into labor five days after my due date and welcomed my second son with a happy heart. My labor was quick and uneventful (around 11-1/2 hours total) but I tore like crazy, thanks to a mismanaged pushing stage and a big baby. My recovery was just as bad as my C-section recovery, if not worse.
Baby number three
When I got pregnant with my third, I knew I was going to VBAC it again, even though my last birth hadn't had the quick recovery I had hoped for. My obstetrician, this time, was more ambivalent about VBACs, as the tide had turned in his profession (from the outright encouragement of the '90s) to: "Hey, maybe this isn't such a good idea," in the next decade. More doctors were hesitant to recommend VBACs due to what I believe was a fear of malpractice lawsuits, in the event of a failure that resulted in uterine rupture. Uterine ruptures are a catastrophic complication that can end in the death of baby or mother.
However, the rates for uterine rupture are low. A recent study found an overall incidence of pregnancy-related uterine rupture of 1 per 1,416 pregnancies (which translates to 0.07 percent). This includes rupture of an unscarred uterus, as well as those who had a scar from a C-section or other surgical procedure. According to VBAC.com, "Medical experts state that the risk of a uterine rupture with one prior low-horizontal incision is not higher than any other unforeseen complication that can occur in labor such as fetal distress, maternal hemorrhage from a premature separation of the placenta or a prolapsed umbilical cord."
I decided on a trial of labor, and this one went very quickly -- she was born less than six hours after my contractions got regular. And it was amazing. This was what I thought birth should be like. Her exit from my body was surreal. I felt an absurd, instantaneous and overwhelming joy when I saw her for the first time. I experienced little trauma and had a quick and amazing recovery -- the goal I was searching for when I had agreed to my first VBAC nearly four years prior.
I never considered a C-section with my fourth pregnancy, even though my OB yet again told me I had the choice. He said that studies haven't shown whether a third VBAC would further test a prior C-section scar or that it meant that I had healed very well. But I knew that the hospital I delivered at had a full-time operating room on standby and an on-call anesthesiologist, in case an emergency would arise.
Her birth took a bit longer but was no less magical than my third. She was born during a blizzard on Christmas Eve and everything was simply incredible. I was able to hold her right away and I was in awe from the moment she was born. Recovery was awesome and I was full of energy and was so happy I was able to, yet again, have a vaginal birth.
The decision to VBAC or not isn't an easy one. Complications from C-sections aren't unheard of and may even be more common than complications from a VBAC, but many moms feel safer with a scheduled surgical delivery. I'm so glad, however, that my second baby was born in the '90s when VBACs were strongly encouraged. I'm honestly not sure I would have considered one otherwise.