My VBAC Birth Plan
When I was pregnant with Caity I ended going into labor and delivery a few times for various issues. Each time they completed an intake form and asked the question, “What was my delivery method with Parker?” followed by, “Why was a c-section needed?” By the end, I had my answer down pat, “because I had an impatient knife happy doctor who wanted to get home on a Friday night.” Of course I don’t know if that is the real reason but it is the one I am sticking to because I simply cannot provide another one. The doctor claimed that my pelvis wasn’t big enough to birth a child but I later found out that is a common excuse for c-sections. Not to mention I proved that reasoning false with Caity’s birth.
Even before I got pregnant with Caity I knew I wanted to try for a VBAC (vaginal birth after c-section). I just wasn’t satisfied with my birth experience with Parker and to this day don’t feel a c-section had been necessary. Don’t get me wrong, I don’t regret a thing because Parker is a happy, healthy, thriving toddler. Never the less, I wasn’t going to just concede to a repeat c-section “just because”. When I saw that BFP (big fat positive) pregnancy test I knew it was time to step into gear. While people typically think about a birth plan starting when labor begins, I think my birth plan really started when I saw that BFP.
Here are a few things I focused on throughout my pregnancy, labor and after Caity was born.
Choosing A Midwife/OB Practice
I wanted to find a joint midwife/obstetrician practice where my primary contact during check-ups and initial contact at the hospital would be with a midwife. I also wanted to find a practice where a midwife and doctor were on call at the hospital 24-7. That way they would have no where else to be and would hopefully be more patient during the course of my labor. Baring any complications, I was adamant about laboring for at least 18 hours before any talks of a c-section were to happen. It took a little while but I eventually found a practice with about 15 midwives and 8 doctors that rotated between three different offices. Although they delivered at a hospital a little farther away but I was okay with that.
Hiring A Doula
I also wanted to hire a doula again. I had one for Parker’s birth but looking back she was not much help at all. I was a little more specific this time around and actually interviewed a few. A doula is a great resource and advocate for any birth, even scheduled c-sections. They often have a large library of books you can borrow and packages may include private birthing classes before hand. This time around I was looking for a doula who could also take birth photos and encapsulate my placenta (more on that later this week). I wanted to find someone who would support but also challenge me during labor. I wanted someone would was willing to speak up to me when the midwife/doctor walked out if she thought I should make a decision about something. I also wanted to find someone I connected with who had a good amount of experience, especially with VBACs. I was so lucky to find Jen who was absolutely amazing. The total package cost $1,850 which included a natural childbirth session, doula services, photography of the birth, placenta encapsulation, and a postnatal visit.
Weekly Appointments With A Chiropractor
One of the reasons my old doctor said a c-section was necessary was because my pelvis was too small. How she could tell that is beyond me. I had intended to start seeing a chiropractor before getting pregnant again to get an x-ray but it happened sooner than we anticipated. During my initial visit with the chiropractor he noticed that one leg was a little longer than the other which may indicate a tilted pelvis. We spent the next 7 months adjusting that weekly. I also found out that our insurance covered up to 40 massages a year from their in house masseuse. You better believe I cashed in on that at saw her two times a month for most of my pregnancy. I strongly recommend you look into your insurance to see if they will cover visits to a chiropractor and possibly massages as well. Pregnancy is rough on the body and it’s important to take care of it for an easier birth and postpartum recovery.
Diet & Exercise
Throughout my pregnancy I tried to gain as little as possible and stay as active as possible. Having a toddler around made it a little easier especially when Rob was deployed. I struggled towards the end but was pleased with how flexible and limber I was able to stay. I started to swell near the end but nowhere close to when I was pregnant with Parker. I am sure I could have controlled my diet a little more but I wasn’t about to ignore all those pregnancy cravings! After a few inaccurate glucose tests I decided to test my blood sugar and follow a gestational diabetic diet. I will say it’s a fabulous diet while pregnant and one I will most likely automatically follow in the future.
Natural Induction Techniques
When my due date got closer I started taking Evening Primrose Oil, eating spices foods, walking as much as possible, and even went to a Acupuncturist. I wanted baby girl to come when she was ready but wanted her to know she was good to go anytime! She was measuring a little on the large size, just like her brother, so the earlier she came the better.
During our pre-assessment session with our doula, Rob and I reviewed my wishes once labor started. I was important for her to know them as she would be the most educated advocate in the room during labor and birth. I also mentioned them in several of my appointments with the midwives. Once I was admitted I again mentioned them to the nurse(s) and midwife oncall. There was a shift change during my labor so Rob and Jen, our doula, explained those wishes to the new staff. There are many books you can purchase to help write your birth plan and some like to have it all written out for the staff. In my experience while it is helpful to write out during your research and brainstorming, it isn’t helpful to hand to a nurse or doctor at the hospital a document to review. It cant hurt to try, but in many cases they won’t have time to actually sit down and read it.
I wanted to use natural techniques to help ease the pain including moving around the room and sitting on an exercise ball. This was huge for me because I was not allowed to do either during my labor with Parker since my water had broken. My doctor was very old school and required you to stay in bed. One thing that was very helpful with a tennis ball inside a sock. The pressure against my back really helped.
I knew I did not want any IV pain medications regardless of the circumstances. I was hoping for a completely medication free birth but ended up requesting an epidural after a few hours of active labor. This was a little risky because an epidural meant I had to finish laboring in bed and it can often stall labor. I discussed it with Jenna, the midwife, who didn’t believe my labor would stall at which I gave the go ahead. I had previously discussed this with my Doula and Rob who knew that I would make it known when I wanted one. Even then they asked me a few more times before requesting questioned me quite a few times to make sure I did want one.
Watching The Birth
Prior to her birth, I had wanted access to a mirror so I could watch. When it was time, Jenna asked if I wanted one. I was so emotional because the chance of a VBAC was becoming a reality I didn’t want to lose focus and declined. I didn’t know it at the time but when I said that Rob and my mom looked at each other, pulled out their phones, and starting taking videos. I am really glad I didn’t know what they were doing because I would have most likely asked them to stop. The videos is absolutely amazing, personal, emotional and empowering, something I will cherish forever.
Delayed Cord Cutting
During my research of birth plans I came across the practice of delayed cord cutting. Once Caity was born, even after she took her first breath, the placenta was still transferring blood and iron through the umbilical cord to her. By delaying cutting the cord until it finishes pulsating, it allowed her to receive that last bit. Having Jenna and Jen present at the birth made my request a little easier as it is more common practice of holistic birth methods. Although it is less common during c-sections, some doctors will slightly delay at the mothers request baring no complications. It is certainly worth a conversation with your doctor if it is something you would like.
Skin To Skin
This was by far one of the biggest reasons I wanted a VBAC, aside for the health benefits. You better believe I wanted to be the first person to hold her. Parker was held by doctors, nurses, and Rob before I even got to hold him. Even then I was so out of it I don’t remember the first time out skin touched. As soon as Caity was out she was on my chest. Well actually, she was on my stomach because she ended up having an extremely short umbilical cord. Once the cord was cut she was on my chest. The nurses were able to do her APGAR screening and clean her off a bit right on me and within about 15 minutes she was nursing. About an hour later they took her measurements and finished cleaning her off while I had some breakfast.
Did you know that humans are the only land mammals that do not automatically eat their placenta after birth? There are many benefits and methods to receiving those benefits based on your comfort level. I chose to have my doula dehydrate, grind, and mix with other herbs into capsules to take.
For the moment, I want to just explain the process I had to go through in order for this to happen. Later this week I will be talking more specifics about the health benefits and why I chose to do it. While this isn’t yet a common practice it certainly is gaining popularity. Luckily, that makes the process a little easier. I knew that some doctors and hospitals push back a little when mothers ask so I did my research and made my calls ahead of time. I would recommend calling L&D and asking to speak to the head nurse on call. Talking to anyone else will probably be a waste of time because they will have no idea what you are talking about. I am talking from experience after I tried to explain what I wanted to about 10 different people. For my hospital, if I had a normal vaginal delivery I just needed to have in the room a cooler and some ziplock bags. There was also a form I needed to sign indicating I was taking it with me. If I ended up with a c-section the process is a little trickier. In many cases your placenta is sent down to pathology for evaluation. If that is the case, there is a form you need to fill out and sometimes a fee to get it back. Going down to pathology also runs the risk of contamination. If this is something you plan on having done I would definitely talk with your midwife, doctor, and call the hospital to learn their policies ahead of time.
If you are brave enough I would ask the midwife/doctor to show you your placenta after it is delivered. It was amazing to see what had been keeping Caity healthy and growing for nine long months.
No hepB Shot
Similar with Parker’s birth, we opted out of the hepB shot in the hospital. One of the common side effects of vaccines is a fever. In most hospitals, it is protocol to transport an infant to the NICU for additional testing and observation when a newborn develops a fever. We felt the low risk of contracting hepB outweighed the risk of them being sent to the NICU and undergo additional testing and a longer hospital stay.
While there are many other things you can choose to do or not do during labor, birth, and postpartum these were the main things I focused on. Labor doesn’t always go as planned but all that matters in that moment is both you and baby(ies) are healthy. It’s important to go into labor as educated as possible and with advocates in the room that will honor your wishes even if they don’t agree. This is especially true with your midwife or doctor. It maybe stressful during pregnancy to switch practices but if you don’t feel a connection or they don’t seem to respect your wishes it will only cause more stress during labor.
Even though my labors were extremely different I am so thankful I have two beautiful, healthy, and amazing children. I am proud of the research and time I put in before Caity’s birth and luckily it resulted in my goal of a VBAC.