By Melissa Aberle-Grasse
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I lay on my bed in a square of moonlight, resting. Emma, only seven hours old, slept next to me, her hands folded together as if in meditation. Only my heart's pounding--not with anxiety, but with joy and power--broke the calm. Just hours ago, I had birthed this baby. No outside stimuli or interference, just me: the energy and
knowledge of my body, and several strong assistants.That night stands so bright partly because this second birthing was so different from the first. My first baby was born by cesarean section. My husband and I worked with the same midwives for both births and had desired a natural childbirth with the first. In the first case, I believe that the intervention of surgery was wise. The baby clearly had distress in labor and was born, full term, at only five pounds.
When my second baby was conceived, we again longed for a natural childbirth. Despite discouragement from doctors and medical advertisements, I was able to birth vaginally this second child. Three conditions especially undergirded this birth: supportive assistants, a pregnancy of heart and body, and an active birth.
Supportive Assistants
For a woman interested in vaginal birth after cesarean (VBAC), working with a midwife and a supportive partner is critical. Even though medical research favors VBACs, medical practice generally opposes them. Repeat cesarean section deliveries have increased in the US since 1997, after declining somewhat in the 1990s (ACOG, 1996).
I met this reluctance in the supervising doctor of my midwives. " So, you're planning to use the birthing center?" he said. The tone was clearly dubious. An anesthesiologist friend explained the systemic reluctance about VBACs. " When there's a VBAC, we all have to be on call, ready to go, even though we might not be needed--the anesthesiologist, the neurologist, sometimes other specialists…it's a waste of our time."
Yet medical research favors VBAC for most healthy pregnancies. Of course, there are risks associated with a VBAC. But the facts show that, compared to a cesarean section, a vaginal birth involves less relative risk. In a 1999 study of 500,000 deliveries, the risk of a uterine rupture among those who attempted a VBAC was very low: less than .2 percent (OG, 1999). The American College of Obstetrics and Gynecologists recommends that women who have had a cesarean section consider a vaginal birth, with careful consideration of their individual health and risk factors (ACOG, 1998).
So VBAC is a rational option. Perhaps more important, my husband and I found, was the experience of birthing a baby naturally: my bodies' wisdom and energy, our mutual support, and the miraculous process of growth, pain, and new life.
Every couple entering a pregnancy should weigh the options and choose the birthing plan that works for them. For women considering a VBAC, because of the professional resistance, it is especially important to have supportive assistants. A midwife and a close partner at birth are critical. Knowing and asking for what feels strengthening and calming during birthing is key to a healthy labor. I had two assistants, my husband, John, and a midwife, with me through every minute.
"How about some George Winston to listen to?" John asked. It was about six hours into labor; contractions were about seven minutes apart, and fierce. I was still walking, but groaning or shouting with each step.
"No!" I shouted. "I want the drumbeats!"
I squeezed John's hand like it was rubber. (The next day his fingers bruised fingers showed it!) Having a spouse or partner who can support without fear or judgment is essential. In this, John was a rock. He'd seen my belly cut open for the first baby. He believed in this birthing process and was not afraid of my pain.
With fiery drums sounding in the background, I stamped and leaned over a chair, while a midwife massaged my lower back. I spent time in a Jacuzzi, where the midwife massaged my feet, hard.
I can't imagine pregnancy and delivery without a midwife. (The word comes from Old English, where it means "with woman.") My midwives were licensed and worked in consultation with gynecologists; other midwives may be highly skilled but choose to work outside the medical system. Both kinds are trained to support the natural processes of a baby's fetal growth and birth. They believe that these are mysterious and beautifully designed human processes that usually do not require intervention.
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