Why I'm choosing a planned c-section and not a VBAC.

I honestly never thought I'd be writing something like this.

With my son, I wanted an unmedicated, natural birth.

(Yes, I still use the term "natural" and don't find it in the slightest bit offensive. It is natural to give birth through your vagina with no medication and not have the baby cut out of you - people are waaaaaay too sensitive about this. From someone who has had a c-section, ain’t nothing natural about that shit, but that’s another blog post)

I even wanted a home birth.

I wanted no interventions and I was completely enamoured by the idea of a totally natural, active birth.

I read all the books, did all the courses, saw all the documentaries and dutifully imbibed the hysteria around how everyone is trying to medicalize birth.

So I never, in my wildest dreams thought I'd be talking about c-sections - least of all an elective one.

But here I am.

Things didn't go to plan. Turns out, my body, for one reason or another, didn't do the things I was told it was "meant to" know how to do.

That I was "born to do".

Here’s a quick low-down of how my first rodeo went:

At 41+5 I was starting to panic. I drank a good dose of castor oil (on my homebirth midwife’s recommendation, and after having drank litres of raspberry leaf tea for months on end, and doing several sessions of acupuncture and reflexology to induce labour “naturally” - as well as sex, long walks, spinning babies, eating dates and spicy foods… you name it…)

My water broke that night, but no contractions (I hadn’t even had a single Braxton Hicks). I wasn’t sure I was feeling movements, went to the hospital, and (VERY) reluctantly got induced.

30 hours later (4 hours of which I had an epidural, and so 26 of which were spent “active”) I still hadn’t dilated even 2cms. I was exhausted and it was time to get him out.

There are still those who will argue that had I done X or had they not done Y, I would, of course, had been able to have a natural birth.

Indeed, I was inundated by such comments from colleagues, friends, my doula and one of the midwives.

I should have tried X position. It’s because I was stressed. It was because of the pitocin. If I had just waited a few more days (or a couple of weeks max?) everything would have been fine.

And maybe that's true.

Maybe it's not. Maybe, without a c-section, me and my son would be dead.

We just can't know.

That uncertainty, that not knowing, that missing certain pieces of the puzzle, has plagued me the past two years.

Slight digression:

Something that has really become a huge concern of mine ever since is how people talk about these topics with absolute unwavering certainty. They don’t say “maybe” “perhaps” “could” “might” - they make out as though it is fact.

Increasingly since my train-wreck of a birth, I have become OBSESSED with how we know what we know, what constitutes as proof, or evidence. I’m intrigued by the logical fallacies that are so rife today.

Like raspberry leaf tea, to give just one example. So many women have told me that it absolutely works, that it induced their labour at 39 weeks.

How are they so certain it was that? How do they know that labour wouldn’t have started on it’s own?

They don’t know. They are confusing correlation with causation - what is known as a post hoc fallacy.

There are endless examples in motherhood: my son is has X problem because of a vaccine or medical intervention. My daughter was a bad sleeper because of a traumatic birth. How do you know it was that? You don’t.

Anyway… let’s get back on track...

I've decided that, all things considered, an elective c-section is the best thing for ME this time.

Because the statistics are not in my favour.

The circumstances of my birth mean that I have a very low chance of succeeding at VBAC - not all women who have had c-sections have the same chance of succeeding at VBAC. If, for example, you had a c-section because your baby was breech, because of placenta previa or some other reason that it was not safe for you to start labour, you have a much higher chance of succeeding with a VBAC next time. If, like me, labour didn’t start by 41+ weeks and you had a failed induction, your chances of VBAC are much, much lower (some statistics suggest as low as 10%)

Because I'm more scared of a VBAC than a c-section.

The idea of going through labour and having a baby come out of my vagina terrifies me. Is this rational? A little bit, because not all vaginal births are wonderful. Many involve cuts, tears, vacuum and sometimes even forceps. Some women heal really well, others suffer from pelvic floor dysfunction and crippling prolapse. I see a lot of this in my work. I’m also terrified of the c-section, and in particular, the recovery. I know how hard it is and how much it hurts. But there’s an element of “better the devil you know”

Because mental health.

I’m not sure that I can deal with the not knowing - not knowing when I’ll go into labour, if at all. Even if I did go into labour, I’m not sure I could handle the whole situation. I’m talking anxiety, panic, fear. It makes me incredibly anxious to even think about it.

One of the sayings that most stuck with me during my postpartum experience is "there's nothing in breastmilk more important than your mental health" - and I feel like "breastmilk" could perfectly be replaced with "having a vaginal birth" here.

Because all I want is a healthy baby this time.

I'm not all that interested in the "birth experience" (which was paramount for me last time). I wanted to give birth in a pool with Indian pipe music in the background, listening to my hypnobirthing track and with my homebirth midwife rubbing my shoulders. I wanted an “empowering” birth experience.

Now, I just want a baby.

Because c-sections aren’t that bad

It’s sometimes made out as though it’s the “worst case scenario” - I certainly thought it was. But it really isn’t that bad. It certainly does not affect your ability to bond with your baby, nor does it impact their health, nor does it need to impact your postpartum experience negatively (apart from the recovery, which admittedly, is HARD the first couple of weeks).

Yes, there is a risk of things going wrong, of infection (but there is with a vaginal birth too). I’ve been through a c-section and I know that a year or two down the line, my body will have recovered and there will be no negative consequences of that c-section. Yes, it’s a hard recovery, but I won’t necessarily be better off long term if I have a vaginal birth.

Because everything “down there” is the same as it was when I was 20

Go ahead and judge me for saying that. But I can’t deny that it’s not a factor. If you’ve had a c-section, you might understand why I don’t want to mess with that. (Maybe you do if you’ve had a vaginal birth too).

Because it's my body (and frankly, none of YOUR business)

I'm starting to learn to do what's right for me, and caring less about what others have to say about it.

…

I realise, as I write all this, that I could possibly go into labour before my scheduled section at 39 weeks - If that’s the case, I’m going to have some difficult decisions to make, and I’m trying to think through that scenario carefully in the meantime (I already have a hospital bag packed!)

I cannot put my hand on my heart and tell you that I don't have doubts. That I'm not scared.

That a part of me doesn’t think that I might be “better off” with a VBAC.

I know that I might not be making the "best" decision.

However.

Here's what motherhood has taught me so far:

You cannot control everything.

You can try your best, and you must, to make the best decisions for you and your family and your child - but nothing is guaranteed. Nothing is certain.

And one thing that is guaranteed: you cannot please everyone, no matter how hard you try.

I am starting to come to terms with all of these things.