Attempting a VBAC: Pregnancy Update

I went to see my midwife this morning for our 36-week look-see. Baby Benjamin is doing well, hanging out upside-down just the way he ought to be, and kicking like a mule! You’d think I’d be extremely happy, wouldn’t you? But I’m not. I’m so mad I could spit.

I love my midwife. She has been there for all three of my previous deliveries, even though two of them required a doctor to step in. (Birth stories will posted eventually, I’m sure.) She is, by all accounts, one of the most competent, caring people you can find in women’s health care. I have no doubt that the High Country has a ridiculously large number of little girls named “Carrington” running around, thanks to her influence in the community. Her reassuring presence has sustained me through the three most awesome days of my life–the 3 times I became “Mommy”.

And that’s why I’m angry. She can’t deliver my baby this time. Out-dated hospital policies and (I think) malpractice insurance rules are forcing me to drive an hour farther down the road to give birth to my next son. Our local hospital doesn’t allow VBACs.

Many thanks to The Common Room for the link to this article: Women Need Chance to Avoid 2nd C-section, which includes the disturbing statistic that “Among 19 states that track VBAC, 92 percent of women had a repeat cesarean for their next delivery in 2006.” This is despite the fact that 60-80% of these women could successfully give birth vaginally, saving them weeks of difficult recovery, thousands of dollars, and (most important to me) giving them a better chance at carrying subsequent babies to term.

My last delivery was via c-section. My little girl decided it would be polite to shake hands before presenting herself to the world, and stuck her precious little arm out just a little early (all the way up to her elbow, by the feel of it). The doctor attempted to stuff the little hand back in so her head could get out, but she just wouldn’t pull it back. (Sorry for the mental image that must bring up, but “stuffing” is precisely what he was doing. Can’t say I enjoyed that.) So off to the operating room we went. I hated it, of course, and would like to avoid doing that ever again.

My midwife and I agree that I’m a good candidate for a VBAC, and that it would be foolish to schedule a c-section without at least attempting to labor on my own first. So down the mountain I go, to a hospital that will allow a trial of labor. It’s a great place to have a baby, and I love the doctor who is going to be taking care of us, but I’ve shed a few tears over losing my midwife.

I don’t entirely blame the hospital, since malpractice lawyers have made it nearly impossible for doctors and hospitals to have any confidence at all that they can do what’s best for everyone involved without becoming the target of a lawsuit the minute something goes wrong–and things do go wrong! I do, however, blame them for not having more flexible policies that allow them to waive these rules when a woman can be shown to be fully informed about the risks and benefits of VBAC.

I’m not a lawyer, but I have a hunch if they’d get some of their legal people to put their minds to it, they could come up with a waiver that states that the mother accepts that that VBAC comes with some risks, and agrees not to sue the hospital or doctor should something go wrong. When are doctors going to start treating women like adults who are capable of making their own decisions? I don’t need to go to medical school to understand that I could lose my uterus or die, OK? I’ve weighed the risks of VBAC (uterine rupture, having to have an emergency c-section) against the certainties of C-section (scarring, pain, long recovery, more difficult breastfeeding, expense, and on and on). I’ve decided to trust God and my body to get this baby out in the usual way.

My midwife, God bless her, is the kind of woman who moves mountains. She’s still hoping to someday convince the decision-makers at this hospital to loosen up their policies. Hopefully, by the time our next baby arrives, there will be a more up-to-date policy in place for women like me, who have a good chance of delivering their babies naturally after c-section.

I didn’t cry or hug Carrington or anything when I left the office this morning. That’s just not how I do things, but I felt like bawling. I am really, really frustrated with my lack of choice in this situation.