Vaginal Birth After TWO Cesareans (VBA2C)...in Saudi!

Bismillah al-Rahman al-Rahim

Beautiful Baby Boy

Born Vaginally After Two Cesareans! 

It is a blessing to share this story on my blog.  What makes it amazing is not only the rarity of having vaginal delivery after TWO cesareans, but that she did it in Saudi Arabia, masha'Allah!

Although I wish she had gotten educated sooner, avoided medical interference from the get go, and tried non-medicated natural bith...I am still very proud of this mama!  I'm also thankful to her for sharing the many links she researched when pursuing her VBA2C (listed at the end of the article).  Due to copyright, I cannot post the ACOG (American College of Gynecologists) report that she showed her doctor, but I do have it on file and would be happy to email it to anyone who requests a copy.

I hope you enjoy reading this inspirational birth story.  Please let me know if you'd like to share yours.  Now on to the story...Vaginal Birth After TWO Cesareans (VBA2C)...in Saudi!...



Salam Alaikum,

I would like to share my birth story so that other women will know that vaginal birth is possible after two or more cesareans. I will start with a little history about my first two births and finish with my VBA2C (vaginal birth after 2 cesareans). My first two births were in the United States and my VBA2C was in Saudi Arabia.

My first child was born in 1999. My pregnancy went well with no issues whatsoever. I did gain a lot of weight, 60 pounds, but all of my tests came back fine. As my due date came and went I was ready to get the show on the road. My midwife talked to me about induction. I agreed and scheduled an appointment at the hospital a few days later.

Early on the morning of my appointment, I went into labor. I was contracting for a few hours before I arrived at the hospital. The midwife-on-duty checked me and told me I was 1 cm dilated. We started the Pitocin (medication given to start or speed labor) around 8 or 9 am. Around noon I was asking for pain medicine. The nurse gave me a shot in my IV. It helped a little but after a few more hours I was in so much pain. I asked for and received an epidural (around 2 or 3 pm).

I wasn’t progressing fast enough for the midwife so she broke my water. After that I reached 10 cm and it was time to push. I think that was around 6pm. I pushed for about 30 minutes but could not feel my contractions so the staff shut off my epidural. I felt everything after that. I pushed and pushed for 2 hours with no progress. The midwife called the doctor-on-duty to my room and he checked me. He told me I could push all night or have a c-section because the baby was lying funny. I agreed and signed the consent form.

Right after I signed, my baby’s heart rate started to drop, so they had to rush me to the operating room. The c-section went as good as it could have. I got to see my little boy for a minute after his birth, then he was taken to the nursery to be cleaned up and whatever else they had to do. He was born at 10:45 pm weighing 8 pounds 1 ounce. I was in recovery for about 2 hours and then moved to my room. I was in the hospital for 3 days.

In 2007 I embraced Islam, Al-hamdolillah. I celebrated my first Ramadan and on Eid I found out I was pregnant again. I found a great Muslim doctor, Amal, who was VBAC (vaginal birth after cesarean) friendly. My pregnancy went well. I only gained 25 pounds this time and all my tests went well.

My husband was encouraging me to have natural birth. I was open to natural but I was also considering pain medication because I do not handle pain well. My due date came and I was very nervous. I really did not educate myself about VBAC and was just going with the flow.

Again I was tired of being pregnant. I called my doctor 2 days after my due date and talked about a RCS (repeat cesarean section) and made the appointment for the next morning. I knew my husband was disappointed in me, but he supported my decision.

My husband and I went to the hospital where I got prepped for my RCS. The nurse was great. My husband was able to go into the operating room with me and hold my hand through the entire operation. My little girl was born at 10:43 am weighing 8 pounds 4 ounces. I got to see my little girl for a minute then they cleaned her, wrapped her and gave her to my husband to take to the recovery area.

When I was moved to the recovery room I was able to hold her and nurse her right away. She breastfed like a pro and roomed in with me during my entire stay. I should also add that my husband was able to stay with me for the 3 days also. The hospital allows that and has a reclining chair in the room. The RCS recovery was better than the first one I had.

We moved to Saudi Arabia in 2009. Shortly after we arrived I got pregnant a third time. I ended up having a miscarriage at 12 weeks. The baby stopped growing at 8 weeks but I could not tell. I went to the hospital because I started to bleed. They did an ultrasound and found that the baby had no heart rate.

They gave me the option to wait and let my body cleanse itself, or they could give me medicine on my cervix to induce and expel the embryo. I was so sad and just wanted to get it done so I could go home with my family. I was in the hospital for 4 days. All in all, Everything went well, Al-hamdolillah.

About 4 or 5 months later I was ready to try for another baby. I took folic acid for a month before we tried to get pregnant again. When I found out I was going to have another baby, I was so happy!

I asked my doctor about VBAC (Vaginal Birth After Cesarean). She looked at my history and said no because I already had two Cesarean Sections. I was upset. I came home and started to search online to see if it was possible or even safe to have a VBA2C (Vaginal Birth After Two Cesareans). I found so much information, Al-hamdolillah. I joined a VBAC community online and asked tons of questions. I made a friend online who was getting her doula certificate. She was a blessing. She sent me so much information and helped answer my questions.

Come to find out, her 4^th baby was a VBA3C with an inverted T scar (Cesarean incision in which the uterus is cut both vertically and horizontally resulting in a T shaped scar). How amazing!

I kept researching and educating myself and knew VBA2C was my goal. At 7 months pregnant I transferred to a new doctor and asked her about VBA2C. She told me she would not recommend it. She said that RCS are safe and since I am married to a Saudi, I will have lots of kids.  Shockingly, she told me that having 7 Cesarean Sections is okay.

I was upset at the thought of it. At every appointment I would ask about VBA2C. She finally told me that she cannot tell me I have to have major surgery and it was my choice. My husband was, again, very encouraging and supportive.  He went with me to my appointments and even talked to the doctor.

When I was 8 months pregnant the ACOG (American College of Gynecologists) released their new VBAC guidelines. The new guidelines stated that women with 2 previous low transverse scars on the uterus should be encouraged to have a TOL (trial of labor) for a VBA2C. I was so happy! I printed the report and showed my doctor. She said she had read over it. I asked her if I could try and she said YES!! She told me that the hospital has never had a women try for VBA2C so as soon as I go into labor I should come to the labor and delivery unit because I will need an IV and will be hooked up to monitors to make sure the baby is handling the contractions.

I asked the doctor about a guess of the baby’s size. She felt my stomach and told me the baby feels on the biggish side. Again my due date came and went. I was due 2 days before Ramadan. I was starting to lose hope for my VBA2C attempt. At my appointment my doctor said I can go 1 week past the due date and after that we would need to talk about other options.

I knew the other options were a RCS because she already told me she will not induce me. I had a non-stress test appointment for 9pm, six days past my due date. That same morning, well, afternoon, I woke up with cramps. I was asking myself, “Is this labor?”

Now it was Ramadan and I was fasting. It was 1 pm and I was home alone with my daughter because my husband was working. I knew I had to keep moving so contractions wouldn’t stall or stop. After about 2 hours I went to the bathroom and had lost my mucus plug.

Now I knew things were moving along.! I sent my husband a text message saying today was the day. He called me and asked if he should come home. I told him no because I knew it was still early labor. I finished cooking and getting things ready for Iftar (evening meal to break the Ramadan fast).

When my husband came home, we broke our fasting and I timed contractions. They were varying from every 6 to 15 minutes. We went to my test at 9pm and I told the nurse about my contractions. She hooked me up to the monitor for half an hour. The doctor came in to check me. I was only at 2 cm and leaking fluid. After she checked me for dilation, my water broke. She admitted me to the hospital because of my water breaking.

I had wanted to labor at home as long as I could so I would not have to be hooked up to monitors. I was moved to my room and my daughter and husband came in to say bye. My husband had to eat Suhoor and get my daughter to sleep because he was working in the morning.

My nurses were great and trying to get me to rest but I was too excited to sleep. The doctor put me on restrictions of no food or water past midnight in case I needed a RCS. Around 2 am the doctor came in to check me and I was at 4 cm. I was in active labor and I knew the pain was going to get worse. After a little while I asked the nurse if there was anything for pain. She gave me a shot and I don’t know if I blacked out from pain or if the shot knocked me out, but I don’t remember anything until 5 am.

Suddenly I snapped out of it and was begging for Cesarean Section so the pain would stop. My doctor came in, checked me and said I was at 6 cm. She asked if I was sure and I told her just make the pain stop. She agreed and had me prepped for a RCS. I sent my husband a text saying I was going for a RCS. He called me and asked why but I was not in the mood to chat.

I was stubborn when the guy wanted to check my throat. I remember he wanted me to lay on the left side because they had the operating room bed on the right side. I would not move because I felt better on my right side. I was all ready to go when it was shift time for the doctors and nurses. I think around 7 am.

At this point a super supportive doctor came in to see me, Al-hamdolillah. She checked me and knew I was in transition. She explained that was why I was giving up. She said, “Honey, please wait a little longer.” I think she was talking to me to take my mind off things. She checked again and announced, “Get that bed out of here were going to be pushing soon!” I had mixed emotions at this point. I was happy, yet sad because of the pain. The nurses broke down the end of the bed and got the stirrups ready.

At this point my husband came and was not allowed in the room. I was 10 cm and ready to push. I pushed for about half an hour when the new doctor said I was not pushing well. She showed me the vacuum and asked if she could help me when I push.

My husband was begging the doctor to give me a little more time to try. She agreed. I was pushing and pushing. The entire team in my room was cheering me on saying things like “Good girl; Push! Push! You can do it!”  I finally asked if they could see the head. When they told me, “Yes!” it was like a new wave of energy went through me. I pushed so hard during every contraction. I felt the head come out, I stopped pushing and they told me “Don’t stop now.” I pushed one more time and my little boy was placed on my stomach.

I said, “Al-hamdolillah, thank God!” I think I even cried. It was amazing how the pain stopped completely right after the birth. My husband was able to see our son and take pictures right after his birth. My son was born on the 5^th of Ramadan at 8:43 am weighing 9 pound 3 ounces, masha’Allah. The staff had him taken to the NICU because he was “so big”. He had to stay there for observation for 24 hours.

The recovery from this birth was by far the best. After I was in my room I was up walking around, using the bathroom by myself and it did not hurt to laugh. I was sore when I sat down but being sore for around a week is a lot better than your stomach being sore for months after giving birth. I was able to go to the NICU anytime I wanted so I could hold my baby and try to breastfeed him. After the 24 hours were up he came to my room to stay with me. He started to breastfeed like a champion. I stayed 2 days in the hospital because the doctors wanted me to rest. I had one doctor check up on me and about freaked out when she realized that I had VBA2C. She went as far as to ask me if I wanted to die. I told her no and that I knew the highest percent of rupture out of all the studies was 3.7% and I felt it was safe to try. Once I said that she did not mention it again and simply said I should stay an extra day to rest. I am so thankful for the new doctor who came on duty while I was in labor. Without her I would have given up and had another CS for sure!

I hope my story will encourage other women to at least try for a vaginal birth. I suggest reading, researching, if possible find a doula, joining a VBAC community and asking tons of questions. I would like to finish my story by saying, “Have faith in your body and remember God made our bodies perfectly to give birth to babies.”

Links I looked at while I did research:

http://www.plus-size-pregnancy.org/CSANDVBAC/VBA2Cstories.htm#Jacki's Story (c/s for failed induction/ftp, ERCS, induced VBA2C)

http://www.plus-size-pregnancy.org/CSANDVBAC/vbac_after_2_cs.htm#VBA2C Studies and Rupture Rates

http://spinningbabies.com/

http://www.plus-size-pregnancy.org/CSANDVBAC/NewestVBAMCresearch.htm#VBAC After More Than Two Cesareans

http://www.plus-size-pregnancy.org/malpositions.htm#Strategies To Correct Malpositions

http://www.babycenter.com/204_vaginal-birth-can-be-okay-after-multiple-c-sections_10327864.bc

http://www.childbirthconnection.org/article.asp?ck=10210#c-section

http://community.babycenter.com/groups/a4095/vbac_support

http://liveyourideallife.blogspot.com/2010/04/caveat-emptor-real-risks-of-cesarean.html

http://www.birthsource.com/scripts/article.asp?articleid=437

http://www.naturalbirthandbabycare.com/natural-birth.html

http://vba2c.webs.com/