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To VBAC or not to VBAC, that is the question...

For those of you who have read my blog posts on my first pregnancy and birth you would understand why I feel so anxious as my due date nears again this time around.

I’ve really struggled this pregnancy with reminders of my first birth and how it didn’t go at all the way I’d planned. As I've previously spoken about, I had a really difficult time coming to terms with the way it played out and it took me a long time to try and accept that it wasn’t my fault - I didn’t do anything "wrong", and I didn’t fail just because I ended up having a c-section.

I’m unfortunately certainly not ‘cured’ and feeling fabulous about how things worked out the first time - I think if you tear up every time you start describing how your previous birth panned out it's a pretty good sign there is still quite a bit of healing to do. The combination of my previous pregnancy and birth experience was part of the reason we waited almost 4 years to try for a second child.

Caesarean birth emergency c-section

An emergency c-section definitely wasn't part of my birth plan!

When we decided to try again, I had already decided that I wanted to schedule a repeat cesarean this time around to take the anxiety out of it, and to have a set date and understanding of how my birth was going to go. I felt like this would give me more control, and by having more control I would be more accepting and less anxious about the birth.

Once we found out we were actually pregnant however, my thought process started to shift slightly. Everyone kept asking me what my ‘plan’ was this time around - and I found myself struggling to answer. For four years straight I swore I would definitely book in a repeat cesarean if we ever had another child, and now I was pregnant I was second guessing myself - and finding it really difficult to put into words why I was hesitating.

I think if i’m honest a part of me second guessing myself was the hope that I could potentially have a VBAC (Vaginal Birth After Cesarean) and feel ‘healed’ from my first birth - that if it went to plan this time around, I would feel like I have succeeded in something that I’d not been able to achieve the first time around.

At the same time, I continued to get more and more anxious as the weeks went by - I still hadn’t made a decision, and this was giving me even more stress, as I couldn't articulate what I wanted or why.

My midwife has been amazing, and they will support whatever decision I make. I decided to attend a VBAC information class, to talk with other mums about their previous experiences and their reasons for wanting to try a VBAC this time around.

I also spent time learning about the pros and cons of both a scheduled RCS (Repeat Cesarean Section) vs a VBAC - just some of which include the risk of uterine rupture with a VBAC, and the recovery and general surgery risks that come with a RCS.

I found out the process of both options at my hospital - with a RCS, your surgery date is normally scheduled for around 39 weeks if you have no other pregnancy complications. You go into the hospital at your booked time, have major surgery and go through all the normal c-section processes - unlikely to get immediate skin to skin, being separated from your baby for a time whilst in recovery, and the chance of needing to be anaesthetised and being asleep for the birth, however (for me) also could mean less anxiety and stress about the unknown of my potential birth journey.

For a VBAC, at my hospital they prefer not to induce and instead let the mother go into labour naturally, however they will reassess at 40 weeks as they don’t like the mother going too far overdue. Once in labour naturally (if it does occur), they prefer women having VBACs to go to the hospital a bit sooner than normal (say, when contractions are every 5 minutes apart instead of every 3 as an example). The reason for this is they like to put on fetal monitoring to track the baby and their heart rate throughout labour due to the increased risk of uterine rupture and potential fetal distress. This is highly recommended, however my midwife explained it is still the mothers choice if she accepts this or not - as a mother, you still have the final say on all decisions happening to your body and your baby.

Attending the VBAC group session and also talking to my midwife and OB about the different options has been really helpful. It didn’t instantly make me feel one was a better decision for me, however it gave me the tools to really think things through and start trying to come to an outcome. I would recommend anyone unsure of how they want their next birth to go to do both of these things to help their thought process. Neither the class, my midwife or the OB leaned me towards one way or another - they were all very neutral giving facts about both options and making sure I knew it was my decision and they would support me either way without judgement, which I'm so grateful for.

My poor midwife has had to deal with me crying at every appointment when she asks if I've decided which way I want to go yet. At one of my more recent appointments around 36 weeks, when I said I still hadn't decided for sure - she said something that stuck with me, which was ‘you know no decision is a decision right?’ with a smile on her face - and she was right. By not deciding to book in a RCS, it meant I was deciding to let my body do it’s thing and see how it goes. No decision meant there would be no scheduled date booked, and subconsciously I think I was avoiding putting it into words not because I didn't know what I wanted to do, but because I’m so scared of trying for a VBAC and feeling like my birth was a failure all over again if it doesn’t go to plan.

It’s funny, because every other birth story I hear that ended similarly to mine I don’t think they failed at all. I think they are strong, amazing, and their bodies did just what needed to happen to get their baby here as safely as possible, no matter which way that was. I understand the strength needed to get through a c-section and subsequent recovery, and feel like everyone no matter which way they have given birth are warriors - however when I think of myself and my experience I can't help but to have this huge range of emotions come out.

Beautiful pregnant woman 39 weeks pregnant
39 weeks pregnant and I've finally made my decision!

It only took almost the whole 9 months, but at 39 weeks pregnant, I can finally say out loud that I am attempting a VBAC. Now that I have decided on a VBAC, it doesn’t mean my anxiety has magically disappeared - I still feel just as anxious, but also a tiny bit empowered too. I feel like I’ve made this decision and although it is scary, it is MY decision and no one has decided it for me. I am hoping with everything that I can have a successful VBAC - however if it doesn’t go to plan I think I will be more okay with the outcome this time around, as I am more prepared mentally for the possible ways my birth might end up.

I’ll be sure to update everyone on my birth journey the second time round and how it ended up - the countdown is on, and I feel like I can do this!


Nikki x


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