Tuesday, 9 August 2011

Cesarean Awareness and VBAC Support

A few months back I met a lovely mother at the YMCA where I take the boys for active tots.  Her son was the same age as my older boy, and she was about 37wks pregnant with her second son.  After speaking with her I learned that her first son was born by c-section after a long and gruelling labour, but that she was going to try for a VBAC this time around.  I was happy to hear this of course, and I think she was pleasantly relieved to hear that I had a successful VBAC.  Finding a woman to talk to who has had a VBAC seems to be a difficult task for many other women.

I bumped into her yesterday and her gorgeous new baby, not even a month old.  Of course I was curious how it went, and had even been thinking of her over the last few months.  I was disappointed but not at all surprised to hear that she ended up having a repeat c-section.

Obviously only having spoken to this lady a few times, I wasn't about to go pressing for intimate details about her birth, but I gathered the gist of it was she went into labour on her own (yay!) 10 days overdue, but soon into it decided to have the c-section (boo!) to avoid the same situation she had last time which was a long labour ending in surgery.  I wondered to myself, was she informed?  Was she supported?  Not only by her careprovider, but by those around her.

Why is it so hard to find successful VBAC stories?  This is not the first instance where I have encountered someone who mentioned they were thinking of trying for a VBAC but opted for a c-section instead.  Granted this lady actually went into labour first at least, in most cases the mother just goes ahead and books the surgery ahead of time.

It is not my place to judge individual situations.  But a small part of me cringes every time I hear someone in a possible VBAC situation say they aren't going to go for it, or even if they were but they changed their mind at the last minute.  I don't want this to be taken the wrong way by anyone as I do know many fantastic ladies who ended up in these types of situations, and I'm not going to go unfriending people or making enemies over their choices.  Not to mention the fact that what's done is done, I won't lose sleep over someone else's decision.  But naturally I do wonder, why?  Why did they choose another c-section when a VBAC would have been better for them and their baby?

VBAC aside for a moment, I will never understand why a woman would book a c-section (ok wait, we had booked our first one so I guess I do understand from a certain point, but now that I am the wiser I would not do it).  Like with breastfeeding, I will respect that women have the choice, but in most cases I won't understand why they would choose surgery over at least trying for a natural birth.  The only thing I can come up with is, they were not properly informed.  I know that if I had been, and done my homework, I would not have booked an elective c-section for my first son's birth.

When I was pregnant with our first son, my husband had a client who swore up and down that booking a cesarean was the only way to do childbirth.  Her reasoning?  It was more convenient for her.  She almost had him sold on the idea.

In a VBAC situation, I realize that a lot of women are scared.  Particularly if they laboured the first time and ended up with a c-section, they are afraid of the same situation happening again.  I had the fortune to not have this fear, never having gone into labour my first time around.  I can appreciate that fear is a very strong emotion and driving force when making decisions, especially one where the health of your baby is concerned. 

Of course then there are all other things I hear - the doctor said there isn't a chance at successful VBAC, it's too dangerous with the risk of uterine rupture, first labour was failure to progress and the mom's pelvis was too small so no point in trying again because the same will happen.  I cannot stress how there is so much information out there about these topics that is not being shared, and what women aren't being told is that medical intervention is often what led to their cesarean in the first place. 

I feel that it is a woman's job to be informed when making these decisions, and unfortunately most of them are not being given the proper information and support.  In the case of the lady I spoke to yesterday, I suspect she was under OB care and the doctor said to her "sure you can try if you like" but didn't give her the support or the resources she needed to be successful.  With a proper support team in place, the chances of having a successful VBAC are great.

I think I just have such a hard time wrapping my head around two things:  One is why there are so many cesareans in the first place, and two is why more women aren't offered support for attempting VBACs when it is a known fact that vaginal births are healthier and safer for mothers and babies in almost every instance.  I will not dispute that in rare cases a cesarean birth is necessary, but in the vast majority of situations it could have been avoided with proper knowledge and support.

There is a great organization called the International Cesarean Awareness Network (ICAN) which offers information and support for women planning VBAC, as well as providing awareness about unnecessary surgical births.  I am currently in contact with the Simcoe County branch and am going to become a member and volunteer, so I can help educate and support others about these important and often overlooked topics.

I wonder how many cesareans could be avoided, or how many women would go on to have successful VBACs, if only the right information were being shared.

It is easy for me to sit here and preach about VBAC after having had a successful one.  But I can honestly say that it did not come without research or effort.  If you want it, then learn and do all that you can to make it happen.  If you are indifferent and decide to see what happens, or want to just go ahead book a c-section, make sure you are making an informed choice.  You might find your attitude changes when you realize not only how much better a vaginal birth is for you and your baby, but that you have a great chance of success and are at no greater risk for complications than in any other birth situation.

Back to the topic of my own planned cesarean.  Of course at the time, being far less educated than I am now, I was made to believe that it was the safest thing for my baby.  I now know that it would have been better to at least have let us go into labour naturally before making the decision to have surgery.  I do feel a little guilty for having taken that decision out of my son's hands, and again feel fortunate that we had a positive experience because it could have been worse.  He might not have been ready to be born and as a result had suffered complications.

I feel like I have so much knowledge to give other women planning their births, not just in VBAC situations but even for first time pregnancies.  There is so much information that gets overlooked which could mean the difference between an unnecessary surgical birth, and the natural birth that is healthier for the mother and child.  This was a hard post to write, simply because there is so much information to share, and because I feel so strongly about these topics.  It was hard to organize my thoughts, hopefully I have made some shred of sense in all my jabber.

I found this article really interesting on the topic of risks associated with VBACs:  VBAC: making a mountain out of a molehill (be sure to watch the video at the end, it is so heartwarming and empowering, and I cried all the way through it)

The bottom line, the choice is personal, but make sure it is an informed choice.  The natural start of labour and a vaginal birth is how nature intended babies to be born, and it is a healthy and safe choice even in a VBAC situation.

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