#84 | Lynne's Last Minute Home Birth After Two C-Sections

It just got me wondering if I had any options for this third pregnancy even though I have had two Cesareans so and she said something so interesting, she said that with an OB, you have to prove you can give birth. And with midwives, you have to prove that you can.

I'm Cynthia Overgard, owner of HypnoBirthing of Connecticut, childbirth advocate and postpartum support specialist. And I'm Trisha Ludwig, certified nurse midwife and international board certified lactation consultant. And this is the Down To Birth Podcast. Childbirth is something we're made to do. But how do we have our safest and most satisfying experience in today's medical culture? Let's dispel the myths and get down to birth.

My name is Lynn, I am 40 years old. I have been married to my husband Jamie for just about 15 years and we have three children ages 13, 10 and 9 and I'm a high school guidance counselor.

Alright, so I am I'm here to share with you my VBAC after two Cesareans story. But in order to do that, I sort of have to back up and start with my, my first two Cesareans. So my first pregnancy ended in a Syrian, after about 24 hours of labor and two hours of pushing where the baby just didn't budge. I had been induced for no good reason, really, I was just at my due date. And I had been nervous that the baby would get to be too big for me to even have the option to birth badly, I'm very petite. So in my head, I just, you know, was afraid that at some point, the baby would would get too big. And then my only option would be a Cesarean. I know now that that's not how this works. But at the time being a first time pregnant woman, I had my unfounded concerns. And I did have a doctor say well, you know, based on your size, you could handle about a seven and a half pound baby. So again, I know now that that's not how this works. But at the time I took that as bible so and I had I think I must have had a late ultrasound. So we had an idea of the fact that the baby was you know, a little over seven pounds. So this seven and a half pound number was stuck in my head. And as I was approaching my due date, with no signs of, of labor starting I was really getting anxious. So again, I was right at my due date. And my doctor, my appointment suggested induction when I was expressing my concerns, and I was like, great, sign me up. I'll be there. You know, I didn't do any research on induction. I didn't ask about the pros and cons. My doctor certainly didn't go into the pros and cons with me. So I just I showed up for my my induction, which again was for no good reason other than I was I was getting anxious because labor had no indication that it was starting soon. So I was induced with him again, 24 hours of laboring, I pushed for two, he wasn't budging, I was having a lot of back labor. So that would indicate a posterior presentation, which I know is you know, certainly more more challenging. So my epidural was wearing off. And so I was really uncomfortable in labor, and they kept having to reduce it. And toward the end after pushing for two hours, and the anesthesiologist was called in again to reduce me. He's actually the one who said, what are we doing here? Are we going to continue? Or are we thinking about C sections. So then the doctor was called in and we started to talk about C section at that point I was, I was toast I was done. I was you know, they suggested doing the C section, I was fine with it. At that point. I had the I had the surgery. But afterwards, I was just I was so disappointed that that's how my my birth had gone. That's how my son had come into the world. You know, it was a very difficult recovery, or at least what I perceive to be a difficult recovery I was in pain for for several weeks. I certainly did not understand or appreciate the fact that a C section is a major abdominal surgery and your body goes through quite a bit. You know, especially I think the long labor the pushing going into surgery went into it completely depleted, which no doubt contributed to again what I perceive as a challenging recovery, a lot of pain for several weeks. I just it really took me a long time to feel back to myself, my energy level and all that and you know, again, just having this disappointment in not having the birth that I would have liked my mother who's petite like I am had Three natural vaginal birth. So birth to me was never really something that that I thought I couldn't do. So I just had it in my head that I could and so when I didn't, I was really disappointed. I didn't view it as actually giving birth. My son was delivered by surgery, I didn't feel like I had experienced giving birth. So I did ask about VBAC. And I think my six week appointment after having my son and the doctor said to me that, you know, with VBAC, if something goes wrong, it becomes an emergency situation, and they have to get the baby out within minutes. And as a new mother, who's now responsible for another human being the thought of anything, God forbid, happening to me, or of course, the baby was more than I could handle. So at that point, I said, You know what, maybe this just isn't worth it. And I just really didn't think much about it again, plus, you know, having been through a long labor pushing and going into this area and so depleted, I was a little bit fearful that that would happen again, and then I would have another, you know, difficult and challenging c section recovery and now two children to care for. So I really didn't think much about it past that initial, you know, asking of my doctor at my six week checkup. We just did a VBAC episode in November, Lynn and one of the women said something that really stuck with me, she said, when she was planning her VBAC, what she realized was like the last thought she could tolerate, and I never would have been able to finish her sentence if she had stopped there. This surprised me was to labor again for a long time only to result in another c section. And that's what you just said, right?

After my first c section, I remember saying to my husband the second day, how do women recover from these, it just felt like I would never be able to move without pain. And there, you know, especially from the epidural and being reduced so many times, my face, I could barely even move my facial muscles, I just didn't want to have to go through that again. And I had heard from, from some friends or people I knew who had had c sections that when it's scheduled, the recovery is very, very different, or it's easier. And so that was you know, sort of in the back of my mind too, because again, I had a really hard time recovering after after the first one. And I really do attribute that to the long labor the pushing and just not having it in, or, or had, you know, much of anything to drink. When my son was about two years old. I got pregnant, pregnant again. Um, and throughout their pregnancy, I did ask a few of the doctors when I would go in for my appointments about VBAC think I asked maybe two different doctors, and both of them could just tell from their responses that they were not for it. They were not supportive. They really, I don't want to say they actively dissuaded me. But they made it clear that it was not something that they that they were for. And so I just kind of left it at that, again, I had heard that the second c section one that scheduled isn't as bad the recovery. And so I went ahead and just scheduled my Syrian, my second one, the recovery was a lot easier. I knew what to expect, for one I knew, you know, to stay on top of my pain meds and get moving, even though you don't want to be moving when you're in pain. So the recovery was definitely easier the second time around when it was, you know, not one that I went into after laboring for a long time. But at the same time, I was still so disappointed for, again, not having experienced giving birth to me, and I knew everyone is different. But to me having a subsidiary and did not feel like I was giving birth my children were delivered. And so I just had that disappointment, every time a friend would have a natural delivery, of course, I was so happy for them. And yet it just kind of touched this, this part of me that was just, you know, unfulfilled or just so disappointed that that's how my children came into the world when I was strapped to a table. And I couldn't touch them. They were just, you know, brought to my my face. That's that's how I greeted, you know, my two children. So that disappointment just was always always there. So after I think my second was about eight months old, when I found out I was pregnant again, with our third, we always planned to have three children. But, you know, we thought they'd be spaced out a little bit longer. It's not always for us to decide. So when my my second was eight months old, I was pregnant again. And VBAC didn't enter my mind at all. I just knew I would have a third scenario and I didn't ask I didn't think about it. I didn't look into it at all. So it was about I think I was just starting my third trimester with my third pregnancy. When I went to lunch with a friend and at lunch that friend told me all about The home birth that she was planning, she was pregnant as well. This was a friend that I worked with. And now I had never known anyone who had had a home birth. And then I don't even know if I knew that was really a thing that was done. But this friend explained, you know, how she and her husband came to decide on having a home birth, all the planning that went into it all the research that they had done, but she was so, so content in her decision and so confident that this birth was going to play out the way they had planned. And it struck me that she felt that way. Because she had informed herself she had done the research, she and her husband had staff to reflect on what kind of birth they wanted. And they put the work in to put that plan in place, something I had never done. I never looked into induction. Again, pros and cons when that was suggested, I never looked into having multiple Syrians and you know, again, the pros and cons of that. And again, of course, the doctors are not are not sharing those with their patients, or at least they didn't with me. So several weeks later, she ended up having her beautiful home birth. And she shared her story and one of the things she did was on Facebook, she shared her testimonial that that went up on your HypnoBirthing of Connecticut website, Cynthia. So I read her testimonial on your website. And then I started scrolling through all the other testimonials that were on your website. And what I was so surprised about was that many of them were VBAC births. Based on the maybe five minutes I spent on Web MD researching VBAC. I didn't realize that this was really something that women did I thought it was something that was so risky and and not recommended. So the fact that I saw many of them be VBAC birth stories and and beautiful birth stories that that just got me wondering if I had any options for this third pregnancy even though I had had to Syrian so one of the things I came across on your website at that time, because I think I clicked around on really every piece of information that was was on your site at the time was Nancy Wainer's blog. And as you know, as you know, Nancy Wainer is a home birth midwife up in Massachusetts she coined the term VBAC. So I was reading through her blog, and I ended up emailing her really just to ask if I had any options, I explained my situation to her and just wanted to know if I had any options, even though I had had these two Syrians, and I kid you not within about 45 minutes, she responded with a five to six paragraph email, explained to me that of course, you have options and I felt so hopeful and encouraged by her response. So after I had gotten that, then, you know, in doing some more research, finally, with my third pregnancy, actually researching, you know, what kind of birthday I might be able to have. I reached out to you, Cynthia, about your HypnoBirthing class, because I knew from the information I had had come across that if I was going to have a successful VBAC, or at least I should say, maybe the best shot at having a successful VBAC would be to have as few interventions as possible, so enrolled in your HypnoBirthing class. And I also knew that I would need to change providers since mine clearly was not supportive of a VBAC after one Cesarean there is no way they're going to consider allowing a trial of labor after after two, I want to say was maybe 32 weeks pregnant at this time. So I know it was, it was late, I think was around 32 weeks when I was starting your class, Cynthia, and also looking for a new provider. So I had reached out to a number of different practices in the area, just asking if they allowed a trial of labor after cesarean. Some said no, some said they do under certain conditions. So you know, I did a lot of consults. I went to a lot of different practices to figure out which one would be the best for me, I did actually go up and meet with Nancy Wainer. My husband and I just didn't, you know, find out more about, you know, whether our situation was one that that, you know, would make a VBAC after two Cesareans possible so we ended meeting with her for about two hours, she's so great, she'll, you know, make all the time in the world for whoever is reaching out to her. And she said something so interesting, she said that with an OB, you have to prove you can give birth. And with midwives, you have to prove that you can't. And that just that struck me so much, and I found that to certainly be the case in my in my experience with be true.

It really goes along with the philosophy of the midwifery model of care versus the obstetric model of care which the midwifery model of care believes that birth is normal and will go right the vast majority of time, whereas the obstetric model of care is that birth is something that needs to be managed and monitored and won't go right the vast majority of the time.

Right? Exactly. So luckily, I did end up reaching out to a group of men, midwives to birth at a local hospital. And they had actually just recently had a successful VBAC after two Cesareans. So they were, you know, happy to take me on as a patient. So they're the group that I ended up switching to. And again, I think it was about 32 weeks at this point. So I had switched my care over to them, I'd started to the HypnoBirthing class, I was really hopeful and encouraged by a lot of the information that I was gathering. But at the same time, there just seemed to be a lot of obstacles to or you know, hoops to jump to jump through. One of the things that in order to be approved by the hospital to do a trial of labor after two seconds, I had to meet with their maternal fetal medicine doctor, like the head ob that the midwife group ultimately reports to, so I had to meet with with them. And when I met with them, they had my have my medical records, but they were still waiting for the surgical report for my second Cesarean. So our conversation was sort of tentative and all all waiting for the surgical report, the surgical report would have had information like how much scar tissue there was, whether there were any adhesions windows in the scar, and then also, if they had done a double layer, suture or a single layer suture, the preference for a VBAC is certainly if there was a double layer suture done. So why that's not the standard with Cesareans, I don't know. But it certainly wasn't at the time, but they really didn't necessarily apply to the back after two Cesareans. One of the sticking points was at the time they were recommending 18 months between deliveries for a VBAC. And I was due 17 months from my last delivery. And that was a sticking point, which was very frustrating because it was only only four weeks. And yet that was a real sticking point. Honestly, I think they're looking for any reason to to not make a recommendation, it covers them more. But those four weeks were a sticking point. But they also pulled up this VBAC calculator in my appointment, which I had come across in my research. And so I just sort of internally rolled my eyes. They asked before us how many c sections they asked about race age, I'm not much else to be honest. But I remember seeing at the bottom of at least the one instrument that I had come across that it specifically says it's not to be used for women who have had more than one c sections. So the fact that the maternal fetal medicine doctor was bringing this up to be used in determining whether I can be offered or at least you know, approved for this trial of labor just blew my mind.

What like this calculator to throw us all into this and say, Well, this is how it happens in this country has nothing to do with you your preparation, your body, your focus your provider, which is enormous. In this process. It's enormous. The providers like at least half of it, and the baby's position, the baby's position is everything about whether your baby's born vaginally or not. And that's not even absolutely factored into it. Exactly.

So no big surprise, my score on the VBAC calculator was less than ideal. I don't even remember what it was, I'm sure what they're looking for changes depending on who's sitting in front of them. But you know, my score was less than ideal. So, you know, the four weeks difference in in delivery, you know, span between delivery was strike one and the VBAC calculator was strike two, but again, pending this surgical report. They were you know, they couldn't make a final determination until they got that so a little while after that appointment, I got a call from them saying that their head of maternal fetal medicine had reached out to whoever the head at the hospital I had had my last c section that had let them know there was no surgical report for my second c section. The doctor never wrote one.

So all that is unbelievable. Unbelievable is right. I was major surgery and they took no note you were what notes I was, I was livid. This was not a doctor, I thought very highly of to begin with. I've, you know, talk to you Cynthia about a few different interactions I had had with him. I'm not going to go into those now. But I was I was livid. He didn't speak to me during the Syrian the second Syrian at all. He talked to the resident who was helping him with the surgery, but he didn't speak to me directly. He left the room before the surgery was over the the resident is the one who, who sewed me up and even the resident said to me, he said Have you an aspirin this week, you're really woozy as if this was something that I know could control or, or not. So the fact that he did not bother to write a report for this surgery, and now it was impacting my ability to have the birth I wanted. For my third, I was livid. And I was livid, because So ultimately, because this, this report was not anything they had in hand, they were not recommending that I do a trial of labor. Because, you know, again, they didn't have this information. So they were making their their decision not based on information they had, but just the fact that they didn't have all the information they would have wanted to see. It was furious. So if they, I could still have a trial of labor. But in order to do that, I would have to sign an AMA that to say that I was going against medical advice, which I was more than willing to do, because I was determined to have this birth experience. But the fact that I had to sign that form and and go against medical advice in order to do so, that really, it was like a punch in the gut. It really was. There's just so much up and down to the whole process. It was like one step forward, two steps back. I'm encouraged One moment, I'm devastated. The next was so much of what it took to get to the birth.

And we know that having your provider support you is one of the most important if not the most important factors in having a successful VBAC. So that wasn't lining up to be a very good situation.

Right? Not at all. So throughout this whole process, my husband and I also looked into home birth, just because we were looking into every option that we had. So I reached out to a home birth midwife, and talked with her. My husband never envisioned a home birth for birth. And it really wasn't something that we were able to get on board with. We were just kind of looking into all the options. But when I spoke with this home birth midwife, she said that it sounded actually at the time she was not doing vbacs after two seconds, and I can't remember if it was just something she did not do as a practice, or if, you know, whatever situation she had with her current patients, she wasn't able to take me on. I can't remember what the reason was. But she did say she said that it sounded like I had a good situation, at least with the group of midwives who were providing my care. So what she suggested was that I hire a home birth midwife to be with me at home while I labored to labor for as long as possible at home. Because she was 100 birth midwife, she would be able to check me see how far along I was but also check the baby because if there was anything that might have started to go wrong, the baby's heart rate and other things would be an indication so she'd be able to check the baby. And then when we went to the hospital, she would serve as my doula she would act as a doula once we got to the hospital. So to me and to my husband that sounded like the best of both worlds. So that's what we ended up doing. So week after we hired that home birth midwife, I went into labor. About two weeks before my due date. I had been having a lot of Braxton Hicks that prodromal labor in this pregnancy, especially toward the end, they were tymal seven to 10 minutes apart pretty much all the time. You know, this was around dinnertime, I put the kids to bed, I think I showered and I laid in bed to see if you know they would subside or spread out or just go away once I was laying down and relaxing and drinking lots of water. So I'm gonna say maybe I laid in bed for about an hour or an hour and a half, and they were not going anywhere. They weren't subsiding, they were maybe getting a little bit stronger. So I got out of bed to start putting some things together. This was two weeks before my due date, I didn't have anything packed. So I went into the bathroom to get myself ready a little bit, pack some things. And as soon as I was upright and not laying down, something shifted, because all of a sudden the surges became much more strong, much more intense. So I decided to get back in bed to lay down and see if I could get comfortable again. And I couldn't lay down this was maybe five minutes difference when from when I was more than comfortable laying in bed to when I could not lay down anymore after I had stepped stood up and off the baby had shifted or what my husband called the homebirth midwife that we had hired to come she lived about an hour maybe a little more than an hour away just to let her know what was happening. So I was trying to get comfortable I think I went back into the bathroom because of course I was feeling like I had to go to the bathroom as happens when you know labor is progressing. And then I was back in the bedroom. Then my water started to release with each surge. So we called the midwife back by then I was having trouble talking through the searches so she decided to head down by cuz it was gonna take her a little while to get there. So while we were waiting for her, I got onto the bed I labored for, I want to say maybe an hour, an hour and a half there as we waited for her, like my forearms and my knees, because that was what was most comfortable. And because of that little bit of back labor, I felt like I was having like the first, you know, certainly fearful of that presentation, again, that that resulted in that first c section, I think I had read at some point during pregnancy, that that position can help get the baby into a better position. Plus, yeah,

I think it's called polar bear.

Yeah, I think that's, I think that's exactly it. But for that was, that was what was most comfortable for me. So I had my rainbow relaxation on from the HypnoBirthing class. And I labored that way until the midwife got to us. And in the meantime, my husband had to call my mom so that she could be with the kids when we had it off. So when the midwife got to us, she checked me and I was 10 centimeters dilated. And that was always our plan to labor as long as possible at home. But I didn't really factor in what being 10 centimeters dilated, actually felt like, and I did not feel like I could move. I did not feel like I could walk down the stairs, get in the car and ride to the hospitals. And I said to her, I said, Is there any possible way this might happen in the car on the way to the hospital? And she said, Well, yeah, it could, you know, it wasn't that it was imminent, but it was a possibility. And I said, well, then I'm not going anywhere. So we stayed put, I started pushing, I think I pushed for about 30 minutes, I pushed on the bed push squatting for for quite a while. So after about 30 minutes, the baby was starting to crown. And as she was crowning, I started to bleed. Because I had torn inside. We didn't know this at the time, but it started to bleed. So remember the midwife saying to me on this neck surge, I need you to get the baby out. Because I was I was bleeding as she was crowning. So on that next surge, I pushed with everything I had an out she came and either I scooped her up or somebody scooped her up and gave her to me I don't recall but I just remember kneeling there holding her as I was drinking the herbs that the midwife had prepared on that could potentially stop or you know, deal with a bleed if there was one. So it did seem to help the bleeding subsides. So I just I remember, kneeling there holding the baby, want to say was five minutes before any one of us thought to check and see whether she was a boy or girl. We hadn't found that out during the pregnancy. And, and I was shocked at how long it took us to even think to do that. But I remember my husband taking a peek and announcing that it was a girl. I was shocked because I thought for sure I was having a boy. So my blood pressure was low after the birth and the bleeding we were trying to get that stabilized a little bit. I was eating a little bit I was drinking, I was really just laying on the floor in my bedroom. I gave birth kneeling on the floor of my bedroom. And so I just kind of lay down where I was. And any time I tried to sit up, I was getting a little bit dizzy. So we were trying to to get that situated. So we were there for a little while just kind of figuring out what our next steps would be. I did have to go to the hospital because I tore during the birth i was i was pushing, not necessarily with the surgeon I was just pushing with all my might. But I did it I had my v back after two Syrians just like I was like I knew I could, even though you know the support wasn't, wasn't there. I knew I could do it. And, and I did.

Lynne, at any point, at any point, did it feel like the wrong decision? Did you feel scared? Did you worry that you were making the wrong decision for that? Like Did you were you afraid that you were making the decision for the wrong reasons? What about all the doubt that women can face because it's hard enough for VBAC women, but for women who have had two c sections, I have definitely noticed there's an exponential, emotional hurdle and the lack of support that they receive from people around them. So we can't have like 100% resolve and confidence going into these things. Can we? No, we really can't. And I think, you know, it took all of my energy and my time really to inform myself and to do the research and, and get to the point where I knew what I wanted and why I wanted it. So when I didn't get the support from you know, the people who I shared my plan with, I didn't have it in me to try and convince them. So as much as it as it was difficult to not have their support and their doubts, you know, were easy to kind of internalize and and cause myself to doubt. I think I made a conscious effort not to do that because I had done the research. I was confident that this was, you know, not this huge risk to myself or to you know, or to the baby, but anyone else who is not informed When they hear about VBAC, they think of one thing they think of, you know, a devastating outcome. Well, one part of your story that I really love is that when you were 10 centimeters and had to make the choice of whether to stay at home or go to the hospital, as planned, and this midwife who was attending your birth was not planning on attending the actual delivery of the baby.

But in that moment, you just completely surrendered to your body and to your instincts, and your intuition. And that trust that just that was so strong in you to just say, No, this is where I have to be. And ultimately, that was likely the safest choice for you and your baby.

The irony is, sometimes it's the first birth or the first two births that show us how to have our voice, how to make the situation the way we want it to be. And if only you could infuse the determination of a second or third time mom into a first time pregnant woman, it would be such a perfect combination.

Absolutely. Absolutely. Yeah, there's a part of us that just wants to put our trust in somebody else. And then once we do it, we're like, wait a minute.

That's true. And I know, I often hear women who have had vbacs say that, you know, that was so empowering. And I definitely felt empowered by the birth itself. I really felt like I had finally given birth. After, you know, having three kids, it was my third, where I really felt like I had given birth, but empowerment came from the whole process, just you know, informing myself taking the time to do the research, talking to a lot of different people. You know, gathering that information, then making the decision for myself and standing up for myself, when I needed to know when providers were not quite on board with what I was determined to do.

So what you're saying is, even if it had resulted in unnecessary c section, the third time around, you were changed. You were empowered, regardless because of the process he went through.

Absolutely, because I hadn't done that with my other two pregnancies. It wasn't until that third where I felt like I made it happen. I had done the research, I had done the work that's needed.

I think that's an amazing distinction, Lynne, that never crossed my mind, I think you hit the nail on the head. I think that's where the change happens.

It was for me for sure.

How were you received when you arrived at the hospital for the repair.

She was great to me, she really was. And it's a group at the time, it was a group of three midwives. And she was great. I will say she, as as she finished up, and I was I was all stitched up and she was ready to leave. She was very sweet. She came over to me and she sort of gave me a hug. And she said to me, she said, I knew you could do it. And it was so nice to say that. But I thought to myself, why didn't you tell me that? When they do that a lot when I hate to say they do that a lot. They act like they were your cheerleader all along, but they may know, right? And you know what, maybe she can't maybe as a medical provider, she can't tell me that because honestly, she doesn't know if I if I am gonna do it or can do it or not.

She most certainly could have told you that the statistics were in your favor, the odds were in your favor. I'm sure she felt happy for you and all that. But it's like Easy for you to say now. Oh, I knew you could do it. I believed in you all along. It's like I really could have used a hint of that before -- it would have gone a long way. It really it would have made me feel so much more supported so much more validated in my desire to have this birth that, you know, there was a lot of pushback on the unfortunate reality is that they actually probably have very little experience with vbacs after two Cesareans.

But all she had to say all along, she didn't even have to put herself on the line. She could have simply said you know what, Lynne? Do your research. And I have no doubt you're going to make the right decision. What do you just want to say to women out there who might be in the same situation you found yourself in?

You know, what I think I want women to know and to get from this story is just to know that that you have options, but the options are not necessarily going to be presented to you. So you have to do the research. You have to inform yourself you have to talk to as many people as you can. But it's like the tagline of of this podcast here everyone and listen to yourself. I heard a lot of reasons why I shouldn't try for a VBAC. But none of them were good enough for me. None of them were good enough reasons not to at least try so I heard them. But I'm so glad I didn't listen to them because I did it. I had my VBAC after two Cesareans.

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