Awhile ago, I wrote a post called “Choosing a VBAC care provider.” Obviously I am now pregnant and am planning not only a VBAC, but an HBAC (homebirth after cesarean) and am choosing a midwife.
Almost 2 months ago, I received a late comment on that post. It has been sitting in my email inbox since then… I knew I wanted to address it, but wasn’t ready. Here it is:
I am an Ob/Gyn resident and I have delivered 2 of my 3 children naturally with a midwife. I defiinitely recommend CNMs! However, I felt compelled when reading this to encourage you to deliver in a hospital setting. Although the risk of uterine rupture after 1 prior cesarean is low, the results are catastrophic. I think you can get everything you want out of the birth experience without compromising the safety of your unborn child or your own safety – find a CNM, be open about your hopes, and then remain flexible because labor/delivery is often unpredictable. Any provider who offers to deliver you at home is not invested in your best interests – a home birth can be amazing, but should be reserved for a very carefully selected patient without risk factors for complications. A 1% chance of uterine rupture doesn’t sound like much, but what a tragedy that would be for you and your famliy if it happened at home. Best of luck to you in this wonderful endeavor!
First–I appreciate that the comment was kind and friendly. Most that have a differing opinion on birth, VBACs, midwives, etc. are not so nice. So I read this comment about 5 times. And thought about it for days.
And I came to this conclusion: the part where her comment goes wrong is where it says “I think you can get everything you want out of the birth experience without compromising the safety of your unborn child or your own safety.”
One of the biggest things I struggled with when choosing a homebirth was the question–am I being selfish? Am I putting myself and our baby at risk to get this birth experience?
And the answer is no.
A repeat c-section is more dangerous to both me and the baby. The best thing possible for both of us is a VBAC. Now, you have to understand where I live. My city is birth-backwards. It’s completely birth-unfriendly. We have 3 major hospitals. Only 1 clinic of CNMs/OBs “allows” VBAC patients and there’s a strict time limit put on those patients–labor must start spontaneously by 39 weeks (yes, I have personally spoken with them). Seeing how Ryan came after 41 weeks (9 days late), I can’t even fathom this baby will want to come at 39 weeks. And then what? I’m screwed. Repeat c-section. Yes, there are some CNMs I could see at the hospital, but as a VBAC patient, they are not “allowed” to see me alone. I’d be paired with an OB who would have to present the whole time as well. I might as well just be seeing the OB. I explained it in my previous post:
…even classified as a low-risk birth, I would have a nearly 90% chance of having a repeat cesarean section. That’s just based on the national averages. My city and state are statistically and legislatively more anti-VBAC, anti-homebirth and anti-midwife than most.
I am nearly positive that if I go to a hospital, I will end up with a repeat c-section and most likely an unnecessary one. That is more dangerous for myself and for our baby. Not to mention it will probably land me in the nut house. Labor and birth should not be a fight.
Obviously if it comes down to it, I will not be selfish, and will transfer to a hospital if needed. In that case, it would be a necessary cesarean and that is something I can prepare myself for and be okay with. I read Pam England’s book “Birthing from Within” (AMAZING, empowering book) and she made a great point that I’m going to stick with. She said if you’re feeling any reservations about a homebirth, just make a plan to labor at home. If everything is going well and fine, it will come time to push and a baby will be born. At home. However, if things aren’t going as planned and issues arise, you are free to transfer to the hospital for more assistance. In most all cases, there is plenty of time and it is not an emergency.
I’ve done my research and I know my stuff. I’m sure there will be more posts throughout this pregnancy with stats and more info for others who are interested in planning a VBAC. You can do it!!!
Have you had a VBAC? A homebirth? Any wonderful words of wisdom?