The following article was written by Andrea Codega and printed in Kindred Magazine, Issue 26, June to Aug 2008, page 22

My Path to Successful VBAC

The journey of Vaginal Birth After Caesarean (VBAC) is often long and involved, with twists and turns along the way. With lots of deep, black lows but then lots of shimmery highs as well. VBAC is certainly not all about "the day of the birth" and that is something that many people who make unwelcome comments, have not quite grasped. It is a story of growth. Of reclaiming your birth rite. Of rediscovering who you really are. Of discovering who your true friends are. What your limits are. What your strengths are. How to work together as a couple to reach your goals. Of discovering spirituality and your own personality. It is about using up all your strength, all your energy, all your sanity, and then discovering this amazing, beautiful, powerful birthing woman that everyone said did not exist.

I was quite prepared to accept that a third caesarean may become necessary during the birth of my third child. I knew that was a possibility and I certainly would not have risked my child's life, for the sake of "saving face". What people didn't understand, was that I had already become a stronger woman during the time leading up to the birth. Sure, I would have been bitterly disappointed had I not been successful. But I believe that disappointment would not have lasted as long, or been as heavy, or damaging, as the disappointment in myself of my previous births.

During VBAC, I went into the birth as a fully participating decision maker, with an essence of control over my decisions. My midwife provided me with the pros and cons of each decision required and I steered my family in the direction that I thought was best. In contrast to this, during my first two births, I see myself as merely an observer. I gave over complete control for all decision making, thinking that "they know best". I didn't question the fact that I was not provided with all the information required in order to make an informed decision. And in the end, decisions were made that were not quite in line with the needs, hopes, desires and values of me or my family.

I think this is where the anger and confusion and terrifying memories of a violent birth become very bitter and twisted. I am so thankful that I found Birthtalk.org so I could try and bring all those emotions to the surface, rather than keep squashing them down and pretending nothing was wrong. I knew there was something wrong. I knew I changed after the birth. But I also knew I had perfectly healthy babies and I should have been satisfied with that. Birthtalk.org helped me to unravel all those feelings and helped them make sense to me and my partner so that we could actually begin the repair process, individually, and as a family.

A number of studies are currently underway across Australia, evaluating the effectiveness of counselling following traumatic births and /or forceps, vacuum or caesarean births. Other studies are looking at hospital and community-based prenatal VBAC education and support programs. One large study from Canada found that "women with high motivation for vaginal birth were much more likely to be successful, irrespective of the type of educational program they received". I liken this to Henry Ford's famous quote: "Whether you believe you can or you believe you can't - you're right either way". Perhaps counselling sessions are the key to success. It certainly would increase feelings of support for women on the path to VBAC. I know they made a difference for me. But there was still more to it than that.

I was surrounded by negativity and had to be very selective during my pregnancy of who I would associate with. It's amazing how quickly someone's negative comments can drive a stake of fear through your very being. The only way I managed to claw my way back on top of things after negative comments were passed, was to have 24 hour access to up to date information and support for my decisions. This came in the form of my husband's support, but also through the support and knowledge of my private midwife. I had 24 hour phone contact with her and was able to check any misinformed comments from others, with her. Also, the internet, particularly childbirthconnection.com was a valuable source of quality information and support at a time when you are being forced to prove yourself right. I think, because of my increased knowledge of the natural process of birth, I managing to increase trust in my birthing body and release fear from my thoughts of birth.

As they say, "knowledge is power". This time, I was provided with all the information required to make fully informed decisions. This allowed me to negotiate with hospital medical staff on their policies and guidelines for VBAC. This time, I knew which routine procedures would increase my sense of trust in my body and I knew which routine procedures would increase my fears of birth. All along though, I trusted that had there been a problem, my midwife (the specialist in normal birth) would have enlisted the expertise of an obstetrician - as complications are their speciality. I just wasn't prepared to be cared for under blanket policies. Because I was special. This was a special birth and I needed individualised care. Something that many women are denied.

I continued to become more attracted to the idea of birthing at home due to the lack of support I continued to find in the hospital. At the time (2006), it was uncommon in most hospitals for a woman to be supported during a vaginal birth following two previous caesarean sections. I felt my chance of success and support was better at home. And I knew that care for complications was only 15 minutes away. I felt I would have arrived there and they'd still be setting up for a caesar - so I didn't think the trip to hospital was particularly long. I had studied uterine rupture in depth. I knew the figures given to me by most health care professionals were distorted and exaggerated. So I felt confident that my risk for uterine rupture at home was lower in comparison to other risks that I felt were present for me in a hospital setting. I knew that being at home increased my Oxytocin levels; "the hormone of love" which research states, can lead to a higher likelihood of normal birth.

The night my third child entered the world was an intense, raw experience. I completely gave myself over to the process of birth. I had knowledge. I had power. I had a sense of control. I had built a support network around me and I felt cocooned in my birthing space with my partner, my birth support person, and my midwife by my side. I birthed without fear, trusting my birthing body and my instincts. I was equipped with enough knowledge to make decisions that were right for me, and I trusted that my midwife knew my values well enough to help me make decisions that were in my best interests.

I felt this time I truly had that second set of footprints in the sand, next to mine. I had that guide to the summit. I knew there was a chance something could go wrong. But the alternative of lying down under the knife, being an observer in the holiness of my child's own birth, was more horrifying and soul destroying for me than trying VBAC and "failing". I can see now that the actual journey of VBAC built me up to be the person I am today. I can see the self discovery, self awareness and empowerment that became apparent along the way. That, regardless of the outcome of my VBAC, I was a stronger woman. My family was a stronger unit. I had a stronger support base around me in order to cope with a possible third caesarean section. And I could sense that I was now able to tap into my own self determination if another of life's problems arose, in which I felt I had no control over.

Along my VBAC journey, I found a new respect for birth. I found that birth is perfect the way it is and that any unnecessary interference in the process of birth, leads to more and more interference and ultimately, you run the risk of stuffing things up completely. In then end, I found a new respect for me. I feel humbled by the experience. I climbed the mountain. I am thankful that I got to the top. But ultimately, without the journey along the way I think the impact of my success would have been short lived.

By Andrea Codega

Homebirth Midwife and Homebirthing mum