QUESTION: I had a cesarean for my
first child. I am pregnant again and would love to give birth vaginally,
but I am frightened. I'm very concerned that it might be more difficult
for me emotionally if I try for a VBAC and fail, than if I just schedule
a cesarean. What is the best decision for me and my family?
ANSWER: By all means, try! It is a woman's
right to pursue her dreams and desires and having just the right birth
experience is by no means an exception. Ask yourself if your desire
to give birth vaginally after a cesarean is based on what you want,
rather than a reaction to outside pressures. If it is your true desire,
you are likely to have regrets if you deny yourself the opportunity.
You are right to consider a vaginal birth, since cesarean
birth is surgery, which carries its own medical risk for both mother
and child. A normal, uncomplicated vaginal birth prepares a baby for
breathing when born. Travel through the vaginal canal helps clear
the baby's airway passage, while birth by cesarean holds the risk
of complication when a baby's lungs are not yet ready for breathing.
To avoid respiratory distress, a neonatalogist (newborn specialist)
is prepared to immediately suction and stimulate the baby's first
breath when the womb is opened.
Coming down the vagina, (like a vigorous massage for
the baby!) not only helps squeeze mucous out, readying a newborn for
its first breath, but also brings blood circulation to the skin, warming
your baby to meet the cooler temperatures outside of the womb.
But what about you? Certainly, a normal, vaginal birth
does not require the recovery from surgery afterwards, or the medical
risks involved in cutting through the womb. After a vaginal birth,
you are more mobile and able to hold and care for your baby more readily.
Major surgery may require pain medication at a time when you want
to be alert and bonding with your newborn.
You are not alone in your fear of disappointment,
should you be unable to deliver vaginally. Like anything that you
attempt in life, if you do not reach your desired goal, you will have
some sadness about it. But does this mean that you should not try?
If there is absolutly no medical reason against VBAC in your case,
consider giving yourself a realistic chance to deliver your next baby
vaginally.
The overwhelming majority of women I work with in
my clinical practice, who come to me for help preparing for VBAC,
do so. Their "success" is enhanced by their ability to work with whatever
labor they have, not with the "outcome" of cesarean or vaginal delivery.
We work together to support a woman's courage to give herself a chance!
Within this supportive prenatal counseling model,
women give birth, vaginally or by cesarean, with a sense of accomplishment
and satisfaction. The following tips will help you on your journey
and are critical to my model of birth preparation which promotes women's
growth, rather than focusing on "performance".
