I myself am an HBAC mama and births like the one told here are very rare.
Most women seeking these options have very successful outcomes.
DONA International trains their doulas to understand the importance of a woman’s choice during labor.
If the mother feels she is not heard, it can create negative memories that remain with her for the rest of her life.
The doula’s role is to ensure that the mother knows her options and feels she can make her own choices throughout the labor process.
While I was taught this in my training, I was still surprised when I discovered it to be true during an experience with one of my clients.
Out of respect of privacy, in telling her story I’ll change the name of my client. We will call her Meredith.
Meredith’s Birth Story
This was Meredith’s third baby and her first two births had not gone the way she wanted.
With her first baby, she developed HELLP syndrome and had an early scheduled C-section. With her second pregnancy she was promised a VBAC, but in the last week was tricked into having another C-section.
This time around, Meredith was determined to have a different experience. Her plan was to have a natural home birth with a midwife.
Labor began on a Tuesday evening and almost right from the start contractions were roughly 10 minutes apart and painful.
After a full day of mostly steady contractions, Meredith called the midwife and I to come. It was evening when we arrived and Meredith was tired and uncomfortable.
She went through a second night with very little sleep and very little progress. In addition, every time she got out of bed her blood pressure rose significantly, so the midwife wanted her laying down most of the time.
By lunchtime the next day, we all discussed options. After a lot of talking, Meredith and her husband decided they would continue to labor alone so the midwife and I went home.
The steady, painful contractions continued yet another day without much change. And Meredith was now going on three nights with very little sleep. She was exhausted, to say the least.
On Friday afternoon they decided their best option was to transfer to a hospital so Meredith could get an epidural and hopefully rest before finishing labor. I met them at the hospital and within a few hours she had the epidural.
But things weren’t smooth sailing at that point. The epidural only worked briefly before Meredith could feel pain again.
The anesthesiologist kept trying to make adjustments so her pain would be more tolerable, but nothing seemed to help. Throughout the night, she was able to get a little more sleep, but contractions were still quite difficult.
Dilation was slow going too. But what had already been an exhausting, trying experience was about to get worse.
Just before dawn, Meredith complained of pain in her lower abdomen. The nurse came in to check her and immediately the baby’s heart rate dropped.
The nurses were frantically rushing around, and within minutes they were wheeling her out of the room for an emergency C-section. There was unexplained bleeding as well.
Since her epidural wasn’t working, they had to give Meredith general anesthesia. During the surgery, they discovered that the bleeding was caused by a uterine rupture.
The good news was that both Meredith and the baby were healthy and fine.
Anticipating the Aftermath
After the experience, I spent time reflecting on everything that had happened. I worried about her emotional state.
After all, she had desired a vaginal, unmedicated home birth and ended with a hospital birth, uterine rupture, and general anesthesia.
She didn’t get to see the moment her son was born (by the way, the sex was a surprise). Absolutely nothing went the way she hoped.
So when I met with Meredith and her family at our postpartum visit, I was anticipating her to be an emotional wreck. But I was wrong! In fact, she was doing just fine and was beautifully healing both physically and emotionally.
During our meeting, I asked how she compared this experience with her first two births.
And this is where I was floored and everything I had learned during training really resonated. She confessed that this had indeed been her best birth experience!
I was pleasantly surprised and wanted to know why! She explained the reason was due to her ability to make choices.
She didn’t have a voice in the first two deliveries. But this time she had the opportunity to make decisions all 3 1/2 days of her labor. She was heard and respected, and that meant more to her than anything.
Choice is a powerful thing. And I now see that first-hand with Meredith’s birth story. Besides the health of mom and baby, the outcome of a birth experience is not as important as the way a mother feels during and after the experience.
This is an important factor to consider when a mother is thinking about to what she wants from her labor experience.
In determining where she’ll deliver, whether or not she’ll have an epidural, if she wants delayed cord clamping, etc., she should also note the importance and power of choice.
Many items on a birth plan may be altered, but a woman’s power of choice should be engraved in stone and treated with the utmost respect.