How to pull off a VBAC (vaginal birth after cesarean) like a pro

Guest post by Nancy Cavillones

Loyal OBMists may remember the birth story of Nancy’s first daughter, Alice, which can be found here.

Stella Frances was born on Sunday, April 18th at 12:43 AM. She was eight pounds and seven ounces, exactly two pounds heavier than her big sister.

Stella was breech from weeks 34 to 37, and for those three weeks, I prepared myself, mentally and emotionally, for another c-section. Though I chose not to do an External Cephalic Version (ECV) with my first daughter, Alice, I decided to do it this time around. It didn’t work (and it hurt like a bitch). The next day, we took our ironing board, propped it on the couch and I lay down on it, upside down, for 15 minutes. Then came an ultrasound showing that Stella had decided head-down was best, after all.

My labor started on Friday night, three days before Stella’s due date. I was in a bit of denial for a long time–I couldn’t believe that I was really in labor. I was excited and anxious and felt like I was holding the biggest secret in the world. The next morning, I was prepared for the possibility that absolutely nothing could happen, or everything could happen. I had the morning to myself, as Henry had taken Alice out for a few hours. By the time Henry and Alice returned, my contractions were heavier and more regular, to the point where I had stop what I was doing to focus on the contraction. Even then, I had a hard time voicing out loud to Henry that I was in labor. Maybe. I was still saying “maybe” at this point.

I started a batch of oatmeal raisin cookies, for the nurses at the hospital. By this point, it was late afternoon and I found myself leaning on the kitchen counter when I felt a contraction coming on, my face resting on my crossed arms. I was also looking for relief for the relentless back pain. Around 5pm, we decided to call my mother and tell her to come over. We put in a call to my father to let him know that I was in labor. When Henry described my condition to my father, who has six children, he was skeptical and suggested that we should be at the hospital at this point. Sure enough–we ended up meeting my mother at the hospital around 7pm.

Once at the hospital, I was checked and told that I was only one centimeter. We had to decide whether to stay or leave, which we were doing when my mother arrived. We decided to leave, and get dinner at our favorite restaurant. On our way there, I suddenly realized that I didn’t want to be in public, that I wanted to labor at home and not have to be uncomfortable at a restaurant. I think I knew, deep down, that I was progressing quickly, that birth was imminent. So, we headed back to the apartment and ordered take-out from instead. I was encouraged to eat and I took a few bites of my salad, like a good girl, but promptly threw everything up. I continued to throw up for the next hour or so. In hindsight, I was going through transition, though none of us realized it at the time. Everyone wanted me to lie down and rest, and conserve my energy but I couldn’t lie in bed. The pain of the contractions and my back (my god, my back!!) was too much.

My mother, who was watching the ballgame, and also observing me, began to suggest that we go back to the hospital. It was 11 or 11:30 at this point, and I was in a lot of pain. Later, my mother would say that it was the cursing that tipped her off, that when I started cursing , it was definitely time to go to the hospital! (Note: I do not remember cursing at all!)

Henry and I left for the short drive to the hospital. The bumpy ride was a relief to my poor back, short-lived as it was–both the ride and the pain relief, that is. As soon as we arrived, I forced myself out of the car and threw up in the parking lot. We made our way up to L&D. I was moaning and carrying on and hollering about my back pain. The nurses had me lie down in the bed, so they could put on the monitors and check the baby’s heart rate. It was the most uncomfortable part of my labor thus far, having to be in that bed and I started hollering to be allowed to stand up–I believe my exact words were, “MAKE IT GO AWAY!” The nurses relented and helped me off the bed.

As they were adjusting my monitors after I got out of bed, my water broke. This made me yell “MY WATER BROKE.” One of the nurses said “what did she say?” I yelled again, “MY WATER BROKE.” With that, they all looked down at the floor, where, indeed, I was standing in a puddle of amniotic fluid. This sent everyone into a frenzy. All the while, I had been begging to be allowed to go to the bathroom and finally, at this point, I was escorted to the bathroom. My sweatpants, soaking wet, came off and I sat on the toilet. For what, I don’t know. I really don’t. I just really wanted to sit on the toilet. Women in labor are weird, what can I tell you?

The midwife wanted to check me at this point, and asked if she could. I agreed, a little worried that I would only be 2 centimeters or something like that. I couldn’t believe my ears when the midwife said that I was at 9. It had only been four hours since I was checked last and found to be at 1! Well, that explained the intense and unbearable pain. I didn’t have to be told to push! I was ready to go. I don’t remember when Katherine showed up but she was there as I propped myself up on all fours on the hospital bed, facing the mattress and gripping the top of it, willing this baby to GET OUT OF ME. I sent telepathic messages to Stella, strongly urging her to get the hell out. For 30 minutes, I pushed and screamed and grunted and generally behaved like an animal, pissed off that her head kept going in and out, which I could feel. Henry and Katherine were a tag-team, relaying information to me from the midwife and nurses, since I wasn’t facing them and didn’t know what they were saying to me.

Finally, I felt that “ring of fire,” and felt Stella’s head emerge. I heaved a huge sign of relief. Once her head came out, the pain all but stopped and the rest of her came out with a few more pushes. Another sigh of relief and I collapsed on the bed, my hard work over. She was born just over an hour after arriving at the hospital, so my mother definitely called that one!

When Stella came out, my first question, I think, was “Is the baby okay?,” followed by “Is it a boy or a girl?” I thought all along that I was having a boy, and I was excited but truth be told, when I found out it was a girl, I was a little relieved, as I thought about the mounds and mounds of girls’ clothing that we have packed away under Alice’s crib and our bed. Stella was placed on my belly after Henry cut the cord. I held Stella as we waited for the placenta to be birthed.

My older sister, who also had a vaginal birth after cesarean, had told me that “it hurts and then it’s over.” I was skeptical at the time but it’s true! It hurts, and then it’s over! And you have a baby in your arms to show for it! I will forever be in awe at my own strength and the primal nature of natural, undrugged birth. At this point, 6 weeks later, I’ve forgotten the pain. I’m not kidding you. Somehow, the intense, unbearable pain becomes not even a memory. It ceases to exist in your mind. It’s a great evolutionary ploy and it works!

Comments on How to pull off a VBAC (vaginal birth after cesarean) like a pro

  1. YAY a story about VBAC! i’m kinda pro c section because well i had a pretty good c section experience with my son, but i kinda of wonder about VBAC for the next one and have yet to hear a single VBAC story this one deff. makes me a hell of a lot less scared about a natural birth, BTW: i love your sister’s advice

  2. I had a similar experience with my first, it took 4 hours after the OB broke my water, to push out little Else! It DID hurt but you are so right.. I don’t really remember. I thought to myself, after it was over, that it was like hot molten lead being poured into my womb, and to remember THAT analogy because I would forget the actual feeling. So that is how I describe it to people, and get a good laugh out of the look of horror on their face! But it really wasn’t bad! I am TOTALLY HAPPY that I got to feel what birthing feels like. But I TOTALLY understand why God invented epidurals!!

  3. What does VBAC stand for?….I feel stupid but I don’t see it spelled out anywhere in the article unless I missed something. 🙁
    I’m afraid to google it in case there’s some graphic image….

  4. FABULOUS story! I too, had a c-section with my first child. I am determined to have another child….VBAC!! Your story brought tears to my eyes and makes me want to be pregnant again.

    • I know what you mean it is so true!! Such a wonderful VBAC. I myself had a c-section with my first after 20 hrs of labor and no progression, of which I spent most of my time with my head in one of those pink hospital puke buckets because it was cold and quiet. Every time someone tried to take it I would yell at them “DON’T TAKE MY BUCKET!”

  5. Your birth story is so similar to mine!! Except it was my first.. I totally get the whole sitting on the toilet thing. I sat on there for a good hour (not doing anything other than “coping”) at home before going to the hospital. It’s so true about the pain being there and then it’s gone. I forgot about it an hour after she was born.

    • It’s funny because another friend also had this sitting-on-the-toilet urge when she gave birth (a few days after me!). Someone (my doula, I think?) advanced the theory that maybe women think of the bathroom as a safe, comfortable place or something?

    • My midwife at the birthing center encouraged me to labor on the toilet, which I did for over an hour (pushing!). I was more comfortable there than I was in the tub, on the ball, on the bed, or anywhere! Labor is crazy…and back labor was yikes.

  6. Nancy – do you have any advice on what to do when you live in a backwards rural area where the hospital literally will not LET you have a VBAC? I’m sure I could protest and push legislation and fight, but progress would take a long time. It would certainly help other women, but not me. (Not to be selfish, but it’s discouraging to fight so hard and have to have the c-section, anyway.) I wish I could go somewhere else and have my baby, but it’s just not an option. Anyone else encountered this problem?

    • I guess my first thought would be to try and find a midwife/very supportive OB/family doctor and a freestanding birth center. I would also suggest a homebirth, but A) many midwives will not do homebirth VBACs and B) it depends on your comfort level.
      No one can make you do anything you don’t want to do, so I would seek out your local/regional birth advocacy organization and see what they can offer you by way of advice and support.
      I know of women who have done all their laboring at home, and gone to the hospital at the last possible minute to have the baby–sort of playing “oops!”. No one can force you to have a c-section and if you show up at the hospital in the throes of advanced labor, you can’t be turned be away. Of course, you run the risk of waiting too long and you also will be having a completely natural birth, most likely– no epidural, etc.
      So, that’s my two cents based on my research but I’m no expert!

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