Facing your fears: planning for cesarean when you are preparing for VBAC

July 22, 2015

I’m 35 weeks pregnant today. Last night, we attended the 2nd week of our two-week “childbirth refresher” course at the hospital where we will be having Little Brother.

Another mom asked a question about catheter procedure during epidurals and spinals, and I almost gasped. Just like that I remembered that the night before I had a dream about having a catheter…more the catheter bag that was attached to me for the first day or so postpartum. A big latex pouch filled with my own urine and blood.

I shuddered at the recollection…both of the scant details of the nightmare from the previous evening, and the actual occurrence after Ezra was born.

They went on to talk about c-sections…and not just talk. Role play. They asked a father to lie down on a makeshift operating table and walked through the procedure. I had to remind myself to keep taking deep breaths because the whole thing was so unsettling – seeing his hands stretched out, hearing them explain about the drape, and watching the role play of having a room filled with people.

Russ whispered to me, “Yeah, I can’t handle being in there with you for that.” He was obviously very disturbed too.

We talked a lot in hushed whispers. We talked while we toured the halls of the maternity ward. We talked with the instructor after class.

Neither of us remember much. But what we do remember stands out.

“I remember walking in and it looking like a scene from ER. There was blood all over the floor,” he tells me for the first time in five years.

All the other couples have left. I’m recounting this to our instructor, and I find myself overcome with tears. I can’t speak. I’m embarrassed and I try to laugh it off as hormones, but I’m deeply upset.

The memories. The bright lights. The shaking arms tied down. The oxygen mask. It’s all still there.

A cesarean is a big deal. Because you are lying there and you. are. being. cut. open. 

I ask her if we can see an operating room. She says no. I am disappointed – not because I want to see an operating room, but because I feel like I need to see it – need to face it.

Russ assures me that it’s okay. We won’t need it.

But that’s what I thought last time.

As the tour ends and I enter the elevator, I have to close my eyes to keep the hot tears from falling. Deep breathing. Just trying to maintain composure.

I had no idea this dumb childbirth class would be so hard. I had no idea that walking through the halls of the hospital would give me so much anxiety and bring back so many negative feelings and emotions.

The instructor seems to understand, and is just with me as I cry. She takes down our information and promises to track down the appropriate people so that we can come up with a plan to make any cesarean “as family-centered as possible” while still giving Russ the space to not be present during the procedure. We talk through possibilities and our most frightening concerns.

The biggest comfort of all is when she tells me that after the baby is checked by the NICU team, he is put on my chest for the duration of the procedure.

“I don’t think I know how to explain to you what a relief that is. How hard it was that I didn’t get to hold Ezra for 45 minutes. Even if I have to have another c-section, I think that alone will redeem the experience for me.”

As we drive away, I am drained yet somehow comforted. We have done the hard things. We have faced our biggest fears. As hard as it was, it needed to happen this way.

Going into Little Brother’s pregnancy, I wondered how to balance this dichotomy:

How do I think positively and believe that I can do this, while still being honest with myself and prepare for the worst so that I’m not devastated by a cesarean outcome?

I wondered if planning for cesarean would work against me – as if thinking about it would make it happen.

What I’ve realized is that you have to face your worst nightmare. You have to prepare yourself for what to do if it happens all over again. Having a plan for your cesarean will actually help alleviate anxiety in the long run.

1. Talk with your spouse about your memories of your cesarean.

It can be healing and help you process the emotions that you need to clear before attempting a VBAC. It can also help either diffuse anxiety or give you an idea what your and his triggers are so that you can work to avoid them.

2. Make a plan.

Talk with your care providers, your doula, and ****especially**** the hospital staff (if you can) about exactly what you can expect as far as hospital cesarean policies and what can be changed or different if possible.

3. Allow yourself to feel ALL THE FEELINGS.

I had a lot of nightmares about having another cesarean. I had to talk through those sometimes, with my husband, with my doula. As I mentioned above, I had a breakdown during childbirth class. There were tears. There was fear. There were times I struggled to remember to breathe.

But it was all so necessary, and so healing.

4. Find a cesarean or ICAN support group.

I went to two cesarean support group meetings before I had Little Brother. I felt very silly attending as a mom five years post-cesarean. But the first meeting, I was able to tell Ezra’s birth story. And even just telling it one more time after the multiple times I’ve told it over the years, it was incredibly healing and freeing. Because these women around me understood. They told their stories too. They made me feel validated in the pain that I was still carrying. And it helped.

_____

Having a TOLAC that ended in RCS, I now believe that coming up with a good cesarean birth plan is one of the MOST important things you can do to prepare for VBAC.

Nothing is lost if you don’t end up needing it. But everything is gained if you do. 

In the weeks preceding Little Brother’s birth, I talked with our hospital class instructor on the phone, as well as the director of birthing suites at the hospital. They worked together to make sure that everyone on the OR team was informed about our previous experience and my husband’s anxiety. They knew, ahead of time, that my husband didn’t want to be present for the surgery and that my doula would be taking his place. The birthing suites director, the anesthesiologist, and the nurse who was assigned to relay information to my husband during surgery all came by our room when I was in labor to introduce themselves to us. So when we got to surgery, their faces were familiar.

While there were a few things different (I wasn’t shaking, I didn’t have to have both arms strapped down or wear oxygen, and I got skin-to-skin time with him in the OR), the biggest difference in the two births was that I was prepared for Little Brother’s surgery. We had a plan and it unfolded just as it should have.

Little Brother’s cesarean birth was beautiful. And, if it comes to that, yours can be too.