I am a midwife, childbirth educator, lecturer, doula, and natural mother of eight children. This is not a medical reference; I do not proclaim to give medical advice. Anything stated here is from personal experience, research, study, and opinion. Each woman has the responsibility to do her own research, consult with her own medical team, and make her own decisions about pregnancy and birth.

Thursday, November 11, 2010

Hoping for a VBAC!

Bismillah al-Rahman al-Rahim
Khadijah, New Born

Many mothers who end up with a cesaraen are left with the question, "Can I attempt a vaginal birth next time?"  This mother is no exception.  I really enjoyed reading her story and am happy to post it here.

The good news is that over 80% of women who attempt vaginal birth after cesarean (VBAC) are successful at doing so.  At the end of her story, I have added my advice about preparing for VBAC next time.

I hope you enjoy reading these birth stories.  Please let me know if you'd like to share yours. Now on to the story...Hoping for a VBAC!...

Since it was my first pregnancy (and delivery), I had so many assumptions as to how the delivery itself might go.  In the end, however, it was nothing like what I expected. 

Throughout my pregnancy, we were going to a very renowned (and expensive) doctor in Alexandria, Egypt.  Alhamdoulillah, it was smooth sailing throught. I only had the typical stuff, alhamdoulillah:  heartburn, constipation, running to the toilet every 5 minutes, etc. 

But around the sixth month I had some bleeding and sharp pain around my kidney area.  It turned out to be due to me not drinking enough liquids, so some sand appeared in my bladder.  (It's a good reminder to expecting mommies out there-DRINK LOTS OF WATER!)  It was also due to cultural change/shock that I was experiencing at that time.  I was not able to get used to so many things in Egypt, the horrible, rusted,/rotten taste of water being one of them, but alhamdoulillah.
I was told we would attempt natural delivery (of course no classes or advice on breathing, pushing, exercises etc. was offered to me as a mother, nor my husband and I as a couple).  As a matter a fact, it was expected that my mother-in-law would follow my pregnancy, instead of my husband (yeah, I know)!
Khadijah was a very hyperactive baby, even while still being stuck inside my tummy, masha'Allah.  She would rotate and one week stay heads down, other legs down, till about the end of seventhth month when she assumed the strangest position of sleeping horizontallish-with her head under my right rib! :)
After about 2-3 weeks of that, the doctor told me we might have to have C-section if she stayed in the same position or with her legs downwards.  Right about that time (I was about half way throught my 8th month), one evening she was extraordinary hyper and in a dancing mood or whatnot.  I had tried calming her down throughout my pregnancy with ipods headset stuck on my belly playing Qoran all the time, but subhanaAllah. :))

As I was saying, that evening her acrobatics were causing me extra hearburn.  I finally slept around 11 pm.  Around 1 am, the strangest feeling woke me up; I thought to myself in horror, "I didn't make it to the toilet !!!"  (I had been running every 5 minutes at that point of pregnancy! LOL)  I was completely wet from waist downward.  I was fighting the feeling of embarrasment as I tried to wake up my husband and tell him what had happened.. After he finally came to and put the lights on, we realized the whole matress was wet and actually my water had broke.

I felt the wave of panic come over me.  Suddenly, I felt that I didn't want to deliver; I didn't want to go to the hospital; I just wanted things to stay the way they were. (Chicken, I know!)
I feel, in a way, there's a blessing and mercy from Allah to first-time mothers in the "not knowing" what is exactly waiting for you ahead.  I think this makes less panic and thinking of all the things that could go wrong.  We called our doctor and left to the hospital immediately.

By the time we got there, I started feeling contractions (painful!!!).  After doing an ultrasound I was told to go to my room and wait for the delivery to start.  After about an hour of contractions that were coming close to 4-3.5 minutes apart, I had to go to the toilet.  To my shock, I felt Khadijah's foot was coming out (just the toes-but that was more then enough to freak me out)!

They sent me to the delivery room and I was placed on the table for normal deliveries.  After five minutes the staff said that I was to have C-section and they would prepare me until the doctor came (who was supposed to be there an hour ago already).
The doctor finally arrived and asked my mother-in-law if she wanted to stay in the room and film the C-section (?!?), afterwhich, both her and my husband left the room.  I was already injected with the anesthesia and was asked to answer some questions.  I don't remember anything after that.
After about 30-35 minutes, the delivery was over.  Khadijah came to us (just in time for fajr actually).  She was a lovely, healthy, baby girl of 2.3 kg (a couple of weeks premature). :)
I remember feeling exhausted and really, really tired.  I had a sore throat and problems swallowing my saliva.  I was told this was normal and it was because of the anesthesia.  I was so happy about Khadijah because she looked like a fairy, as I always pictured a newborn to look (well, pretty much like an orange, and most of the newborns I've seen were just a bunch of squish).
When they brought her into the hospital room, she had pinkish cheeks, pouting lips, curly eyelashes and feathery blonde hair peaking from under her tiny little baby hat.  She also had EARRINGS (!!!). I was told they pierce ears to baby girls immediately.  (I was so shocked that they wouldn't ask the parents first about this!)  But later on I convinced myself this was for the best because babies don't feel any pain in this part of their ears for the first few weeks as the nerve endings are not yet fully developed.
I started breastfeeling her (or attempting to) within 1 hour of her birth.  She was trying to open her eyes and I started to feel that mother-baby bond.  I thought to myself, "This is it; this is one of those life-changing moments where nothing else exists; nothing that used to matter so much to me before will ever feel the same compared to the love I feel for this tiny little creature."  I felt so insignificant and small; thanking Allah for his mercy; thinking of all the things that could've gone wrong (the doctor kept on telling us how we are lucky they proceeded with the C-section immediately, since the cord was wrapped around her neck); thinking how insignificat my pain was compared to the happiness that I had a perfectly healthy baby in my arms, alhamulelah.

For another 7-8 weeks, I continued bleeding and I  felt completely exhausted and nervous at times.  I felt significant pain in the area of my C-cut, but the scar itself healed without any complications, alhamdulelah. 

Now, nearly 3 years after, it's barely noticeable and shrank to about 10 cm in total length.  The constant feeling of being tired eventually wore off as I gradually started moving more and exercising.  But it took a long time!  In retrospect, I wonder, how I would've felt for those 3 months after the delivery, had I delivered her naturally?
My sister-in-law is about to deliver soon.  She was told that since her first delivery was also Cesarean, the next one will probably be the same.  (In translation-they will  not even attempt natural birth.)  This made me wonder, how I cani prepare and educate myself for my next pregnancy, in order to increase the possibility of having a VBAC (vaginal birth after cesarean)?  Or at least, even if it happens to be another caserean, at least I'd be able to say, "I did my best to give myself other options."`

NOTE:  This mother contacted me to ask what she could do to increase her liklihood for a vaginal birth after cesarean for her next pregnancy.  I thought it might be worth pasting my response to her here:

Asalam Alaikum, ya Umm Khadijah,

I pray you are able to conceive when you're ready and are successful at having a vaginal delivery.  The first step is to find a doctor who will let you try!

The exercise I most recommend to prepare yourself is Pelvic Rocking.  It strengthens the abdominal muscles and should be done lifelong.  Below are the steps to doing them:

PELVIC ROCKING:  do as many as you can until you are at 80+ per day...this is done by getting on your hands and knees, be sure your arms and legs are straight under you, not angled...it is done in three steps:  first, let your lower back sag...second, straighten the lower back...third, tuck the hips and butt under (it will feel as if you are pulling your belly up)...be careful to keep this third movement in the hips and try not to use your upper back or shoulders...it takes a little practice to get it right, so have your husband watch and help you...this exercise feels so good and relieves pressure on your lower back...it tones and conditions your lower back and abdomen, increases circulation, and when pregnant, gets your baby out of your pelvis so he/she can get into proper alignment for birth.

Keep in touch with me.  I'd love to know when you're pregnant again.

Best regards,

-Aisha, Natural Mom

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