Here in Brooklyn I am seeing midwives for all of my prenatal care. They are VBAC advocates, and are willing to do as much as they can to ensure that I can at least try to make this happen. The thing is, I'm going to be leaving their care in a couple of months. With baby number two on the way, Brooklyn has finally defeated me. We can't raise a second child in our tiny third floor walk up. I need my family and more support around me. I'm waving a white flag. Second-most-expensive-city-in-the-country - you win. Your struggle isn't fun anymore. We're leaving.
We're heading to Florida - a state that is pretty foreign to me. As luck would have it, my family all relocated to the state that has the third highest C-section rate in the country. This scares me. I'm terrified of having another surgical birth. Not because I am anti-hospital - although they do freak me out a little. Not because I believe my baby will be better off if she's born naturally - even though she probably will. It's simply because being cut open again scares the living shit out of me.
My doctors were great. I didn't have any post-surgery complications. It's just that the whole experience was so scary. Frankly, I knew nothing about C-sections because I never thought I would need one. I honestly never looked into what the whole procedure entailed. I think that worked in my favor. I'm way more terrified of the procedure now than I was when I was being wheeled into the operating room for my emergency procedure.
I hated being still - sweating nervously as they put the epidural in my spine. I hated being in a stark, surgical room for the birth of my child. I hated the feeling of doctor's tugging me open to remove him. My body went into some kind of weird shock after he was born and I was shaking uncontrollably for 10 minutes. I hated that, too. Yes, I delivered a healthy baby and that is the most important detail of the day. But I hated everything else about it. I hate hating everything about the day my beautiful child was born.
In the state of Florida, "less than 1% of women with a previous cesarean deliver vaginally. This downturn is thought to be largely related to the American College of Obstetricians and Gynecologists (ACOG) VBAC guidelines, which mandate that a physician and anesthesiologist be 'immediately available' during a trial of labor." This does not inspire confidence. At to this grim percentage the fact that you are basically rushed into surgery at the very first sign of fetal distress, and I'm kind of feeling like the cards are stacked against me.
The complication that doctors worry about most in regards to VBACs is uterine rupture. This happens to a very small percentage of women. American Pregnancy.org reports that according to the American College of Obstetricians and Gynecologists (ACOG), "if you had a previous cesarean with a low transverse incision, the risk of uterine rupture in a vaginal delivery is .2 to 1.5%, which is approximately 1 chance in 500." This is not a large percentage at all, but apparently the results can be catastrophic enough to risk the life of the baby and mother - as well as the doctor's chance of being insurable. If they detect a fetal heart rate drop, there is essentially no way of knowing if it is something that will safely pass, or if your child is reacting to a ruptured uterus. They obviously err on the side of safety, and rush you into surgery.
A friend of mine just underwent surgery for uterine fibroids. She's from Florida, still has her insurance there, and went back to get the surgery done. She had what is called a myomectomy. This is basically a c-section, minus the baby. It's the same type of incision and healing process. Her doctor flat out told her that when she became pregnant they would be scheduling a c-section for her at 37 weeks, so as not to risk uterine rupture. What? I don't want to be fighting with doctors that think a 1 in 500 chance is reason enough to not let my baby go full term and come out when she's good and ready. My midwives here told me they let VBACs go to 42 weeks before they insist on a c-section.
Trust me, the most important thing to me is that my child and I get through this birth safely. But I don't want to be spooked out of a natural birth and into the operating room by the VBAC boogeyman. I want to at least have a chance.
I'm just not sure that I do.