The Bestest VBAC of All

So I got an epidural for my VBAC.  Get over it.”  What a great title!  You know exactly what kind of story you’re going to read and can even take a guess at the spectrum of responses to such a post.

I think this is an important post to read.  A VBAC doesn’t have to be a fully unmedicated waterbirth at home to be a ‘success.’  Yet, we run the risk of presenting a set of demands on VBAC mamas, and for many if not most this might be obstructive.

My sense of this woman’s story is that she got the epidural knowing what risks and benefits are involved.  If not, then yeah, maybe she got lucky.  My sense of other women’s stories who have had epidurals, is that even though in most women, the risks may outweigh the benefits . . . some women just don’t dilate or labor well without them.  Perhaps we can hindsight quarterback their birth preparation process, but I think that’s a fruitless discussion.

I agree with Andrea’s point that fighting about the best way to VBAC isn’t constructive.  Ideally, we wouldn’t even need to address the “best way to VBAC” if we had a medically-appropriate cesarean rate in this country.  And if “normal birth” (and I do mean natural) has a high degree of variability, so much so that we insist women be left to labor in peace without clock pressure, then we must be willing to accept variability in the way women pursue their VBACs.

Most of us, I would assume, who consider ourselves to be VBACtivists, are working so hard to re-educate women about patient autonomy, patient choice, informed consent, and participating in health care choices, that we start from the position that a woman who requests an intervention such as an epidural during a VBAC labor doesn’t know the risks.  And this is probably how the squabbles begin.

Further, plenty of “die hard” VBAC gals make “natural choices” that I find potentially risky.  I’m pretty specifically talking about the use of EPO for home induction and tonics such as 5w or PN6.  And some women say NO to induction but YES to augmentation.  And some women agree to AROM (having their waters broken).  Some women have their membranes stripped.  And I get it . . . because as soon as you get to 40 weeks, you’re treated as a ticking time bomb.

What will I do this time?  Only time will tell.  But you bet your butt that if I get exhausted laboring at home but think an epidural will help me regain the strength to birth this child vaginally, we’ll hop in the car and accept the the bad with the good.

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5 responses to “The Bestest VBAC of All

  1. I think it is all about making the best choices for you and your baby along the way. That may be an epidural for one mom, that may mean a home birth for another. There is not ONE RIGHT choice. There are too many variables and only Mom can make the best choice.

  2. I totally agree! I plan to use EPO and explore some of the other “natural” induction choices as I approach my EDD with our next baby. I am aware of all the potential arguments against interfering with the process at all, but based on my own personal experiences, I would prefer to go sooner than later. And you bet your butt if we transferred, I would choose an epi VBAC over a RCS if that were a possibility, although my goal is a HWBA2C. I would do so fully informed of the risks and the benefits, which I think is the most important thing.

  3. Hold on here…what is the problem with PN6 or 5w or Gentle Birth tincture? They do NOT induce labor – they only tone your uterus and enhance cervical ripening. But even though they enhance cervical ripening, they in no way shape or form are prostaglandins…not even close. What exactly is your problem with these herbs for vbac?

    The levels of herbs in these preparations are gentle enough that they are not risky, particularly in comparison to the known risk of higher uterine rupture when any induction or augmentation agent is involved. The point of these herbs is to get your body primed to have a great labor, not to bring on labor sooner than the baby ‘throws the switch’ for. I think the problem is that we’re taught that pitocin is fine because its sanctioned by the medical community (even though it’s not), and that herbs are automatically risky and unsafe because there is ‘not enough research’ blah blah…..

    I think it’s way better to start labor with a ripe cervix, and minimize your chances of intervention that way. It’s the mom with the ripe cervix and efficient uterous that is the most likely to need the least pitocin, if augmentation becomes necessary. And the longer a woman’s vbac labor is, the more likely people are to start suggesting she needs a ton of intervention or even a RCS.

    How can these birth preparations be seen as a risk, when they’re only trying to improve the natural function of your body? I think they function more like exercise to tone and strengthen your body, rather than drugs that get your body all bulked up to force it to produce effects it doesn’t naturally have the capacity to achieve in that short time period.

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