The Sun Roof

Like many busy mothers of young children I shower when I can and sometimes I shower like its hot (stolen car hot) and trap my little gremlins in the bathroom with me. My boys are still young and I value the praise for lady curves, so naturally they see me naked now and then. As I was drying off, my oldest son Hudson noticed my c section scar. “Mama, what’s that?!” I thought for a second. A lot came to mind. Pain, ugly, forever, failure. I took his hand in mine and held it to my scar. “Love, that’s the sunroof! That’s were you came out of me!”

He was amazed and a little confused, only because he’s very aware of the anatomy surrounding birth. Since that day he proudly tells anyone who will listen (mainly his little brother) that he came from “the sun roof”. And I also feel a sense of pride. But I didn’t always feel that way. Thats another blog for another day! VBAC! Vaginal birth after cesarian. It’s a hot topic! About as hot as my 3 min showers. After the birth of Hudson I felt robbed of a vaginal birth. I’m thankful for our c section and health but it left me wanting more!

I followed the healing from a section guidelines. I didn’t drive for 6 weeks, I didn’t lift anything over 10 lbs and a didn’t get pregnant again for 18 months. Well almost 18 months. I knew before I even got pregnant again that I wanted a VBAC. At my first prenatal check up I expressed my goals and sadly I didn’t feel respected. Every single apt following that first checkup I was asked if I had booked my section yet. When I told them I wasn’t having one I always received a smirk and a condescending “ok”. As my estimated due date approached I began to look into hiring a doula. I needed extra support on my side as it was very clear the medical field preferred a repeated section. In the end I was evacuated from my hometown of Fort McMurray 38 weeks pregnant due to wildfire. Although it was a extremely stressful time there was a silver lining! A midwife contacted me the very next day and offered to take me on.

At my first check up with the Midwife I told her about my VBAC wishes. She. Was. Supportive?! Huh? She encouraged me to have a VBAC! I was beyond excited and a little shocked. This was the complete opposite of the attitudes I was accustomed to.

May 20th I went into labour naturally, progressed well and had an amazing vaginal birth! I was literally in the McDonald drive through 2 hours after pushing my baby out! This was a very different experience from my section as I was in the hospital for 3 full days, on antibiotics, swollen, unable to cough, sneeze, shit, really anything that involves your core.

I know, I know! There are some mamas reading this and thinking “my vaginal recovery was pain-full and long too!” I 100% understand that not every mama is able to wait in line for a quarter pounder with cheese moments after giving birth. I’m not discrediting how tough some vaginal births can be! Nor do I want to discredit the mamas that healed through c sections like super hero’s from planet krypton. Every experience is different and every mama is different. However statistically, recovery from a section takes longer and puts you at more risk. It’s major surgery! You really don’t realize how much you use your core until you have had it cut open and stitched back up!

There is a very scary image of the risk involved with choosing a VBAC circulating the birthing world. Words like uterine rupture and mortality are very terrifying to a mother. No mother wants to take chances with her baby’s life or her own. So they often hang on the words of health care providers. And dare I ask….. why are health care providers tossing these words out like candy on Halloween and not educating the women in their care of the actual risks and, are you ready for this, the benefits?!

How risky are we talking here? At the “risk” of sounding like Ben stiller in that movie with Jennifer Aniston and the ferret, I know that when I get into my car with my kids every day we run the risk of getting into an accident, 0.20% to be exact. Does that stop me from using my car? Hell No! The benefit of convenient travel far out ways the risk if you ask me. There’s no way Ill sport a horse n buggy in -35 for a grocery run. When looking for a number of potential risk of uterine rupture I discovered a lot of variables need to be considered. But strictly speaking, a woman with a history of one previous transverse c section has a .9-1% chance of uterine rupture. Of that .9-1% only 6% (meaning .0054%) is catastrophic (meaning death). If the numbers interest you here are a few sites that have lots of great info and stats.

https://emedicine.medscape.com/article/272187-overview#a1

https://www.vbac.com/

https://www.ncbi.nlm.nih.gov/m/pubmed/20044789/

Benefits. For some mothers there are significant benefits to having a repeat section and there are definitely emergency situations that warrant a c section. But fear or lack of support is not a good reason! The benefits of delivering your baby vaginally include the probiotic gulp and exposure to your vaginal flora, the movement through the birth canal (important for clearing the lungs and airways of fluids), immediate skin to skin that is uninterrupted, the ability to stay with you baby for the golden hour, natural tearing with faster healing, hormone stimulation from the progression of labour and skin to skin, potentially an unmedicated alert baby, natural and uninterrupted flow of breastfeeding hormones, faster recovery and there’s also research that supports vaginal birth mothers are less likely to experience post partum depression. These are just from the top of my head! I’m sure there are many more.

Let’s talk a bit more about breastfeeding. It can be difficult for anyone, despite how their baby comes into this world. BUT…. from my personal and professional experience your chances of having difficulty increase with c sections. When trying to weigh the pros and cons of VBAC quite often the long term gains and potential risks of not breastfeeding aren’t taken into account. Giving myself and my baby the best possible start to nursing was worth any potential risk of a VBAC. Just to name a few, breastfeeding decreases your future risk of breast cancer. It also decreases your babies chances of developing allergies and asthma.

Does this look bias? Am I painting a picture that favours VBAC? Am I down playing the potential risks? I hope I’m highlighting the huge benefits to having a VBAC! that’s my job here. Decades and decades of healthcare professionals pushing sections and provoking extreme fear of death on mothers has taken the front seat for some time now. It’s our turn. It’s your turn. It’s your birth!!! I’m here to tell you, you have a choice. Am I bias, maybe a little. I’m so grateful my VBAC was successful. If it wasn’t would I feel different? I don’t think so. It was still my choice. I chose to try. And lastly I dont think I’m down playing the potential risk either. I actually gave you those numbers. The facts boil down to this. “Our findings do not support the widely-held belief that neonatal mortality risk is significantly lower for repeat cesarean compared to VBAC delivery.” PMID 20044789 [PubMed – indexed for MEDLINE]. There you have it.

If you have had a section and you feel alone with thoughts of wanting more, your not! However the number of women who actually try for one is sadly low. I put some of this blame on our providers. Sure we need to do our own research but they need to support us!!! VBAC isn’t the best choice for everyone, so I encourage you to do research and ask questions about what qualifies someone for VBAC. The link I posted above clearly outlines the guide lines and actually has put together a VBAC Education project you can access. Some communities, like my own, do not have same floor emergency care. Our hospital does not have an OR on the same level as our maternity unit nor do we have a NICU. So I understand why some doctors feel a little nervous about liability. BUT let’s not forget the actual difference between section mortality and VBAC mortality is fairly small. And you don’t see any OBs fearful of c sections! I actually had my OB tell me “I’m great with a knife” 14 hours before I even had my section! It’s important to remember that obs are surgeons. Their specialty is “worst case scenario” not low intervention labour.

You also need to gather up support! Be very clear to everyone what your goals and wishes are. Think about hiring a doula. Studies show that having one increases your chances of success! Of those who do try to have a VBAC 75-80% of attempts are successful!!! And those numbers increase with good support.

I am in no way ashamed of my sunroof. I’m thankful my son is here to trace my scar with his little hand. But I encourage the mothers out there that also have a sunroof, ask questions and dare to dream of a vaginal birth! It can be your reality but be prepared to fight for your birthing rights. And most of all know you are not alone. Solidarity section mamas!