by Heleena Claire Pasumbal-Espina
PART 3: I WORKED HARD FOR MY DREAM BIRTH
I worked hard for my VBAC. I wouldn’t have been successful if I came less prepared. Here is the summarized list of the most critical factors (in no particular order and importance) of my successful vaginal birth after cesarean (VBAC).
1. Lots and lots of prayers
I believe in the power of prayers. I would have not surpassed everything I had gone through if not for the Lord’s protection and guidance. I remembered praying every night pleading that my baby will be delivered safely and healthy through vaginal birth.
I also will not forget the powerful prayer circle of five or six people composed of members of my family and doula Velvet Roxas, led by my OB-Gyne Dra. Menefrida Reyes, when I was already in severe pain and exhaustion after hours of labor. That prayer kept me going for a few more hours and it gave me unexplainable strength.
I also recall my husband singing Hail Mary while I was clinging onto him when strong contractions hit me. It uplifted my spirit. There was one point when I got irritated with him because he suddenly stopped singing while I was contracting. He continued with the hymn and I was quickly okay again.
The Lord is the source of my strength, I tell myself everyday. He is always there with me when I need Him the most. He was definitely with me and my family during my birth.
2. A loving and supportive husband
My husband supported me in my decision for a VBAC. He was first apprehensive of the idea because VBAC is unpopular. He was still trapped in the idea that “once a caesarean, always a caesarean.” When I explained to him that I needed and wanted a VBAC because I don’t want to suffer from the consequences of cesarean, he ultimately agreed. Why would he not? He was also affected by my postpartum depression and rants on “unsuccessful breastfeeding.” I was able to convince him to take the necessary steps to prepare for a VBAC and he was with me all the way – from birthing classes, to hiring a doula, to looking for a VBAC OB, up to the challenging labor and delivery.
If the Lord is the source of my strength, my husband Jobman IS my strength. He was the wall who endured the weight when I needed to rest my heavy and tired body. I was 157 lbs. before giving birth. He carried me, literally and figuratively, when I could no longer stand on my own feet. He braved my every clasp when I had to share a portion of my pain so I will somehow feel relief.
I remember that time when my doula told us to rest because we were all tired due to the long labor. I was already groggy and trying to doze off but couldn’t sleep because of continuous contractions. My husband then lay down on the sofa nearby. Maybe I was able to take a quick sleep but when I realized that he was not beside me, I panicked and ordered everyone in the room to look for him and tell him to stay by my side. Everybody was laughing because he had just reclined for a few seconds. Still, I heard no complaint from him.
He held my hand throughout my VBAC journey and continues to be there for me.
3. A caring family
Just like my husband, the members of my family and family-in-law were apprehensive about my VBAC but were still there for us. I explained my decision and they backed me. Without the members of my family, it would have been very difficult for me and my husband. My sisters were there when my husband brought me to the hospital as I started active labor. My siblings, together with my siblings-in-law, held my hand when I was in pain and helped my husband with all the things that we needed – from buying buko juice, to wiping the blood on the floor, to accompanying me to the restroom. All those things would have been difficult if they were not there.
Of course, my parents and parents-in-law were always present to assist us. I think that is the unconditional duty of each parent – to constantly be by their children’s side in any circumstance, no matter what.
I asked my mother how she felt each time I am about to give birth, and she said “ambivalent”. She was happy, excited, worried, all at the same time. In the midst of her ambivalence, she said that she “did not want to lose the chance of documenting such moments”.
4. A VBAC-believer Obstetrician and a breastfeeding-friendly birthing facility
My heart is overflowing with thankfulness to Dra. Menefrida Reyes of St. Luke’s Medical Center. Dra. Menie, as I’ve told her, was the OB-Gyne I have been praying for. I have searched everywhere to find someone like her. Thanks to Gentle Birth Philippines (GBP), I found this highly commendable doctor.
When I learned that I was pregnant the second time, I went back to the OB-Gyne who assisted me in my first cesarean birth. She’s an excellent doctor and stitched me perfectly. I told her of my situation and asked if it’s possible for me to have a VBAC. She told me it could be a possibility but chances are lean. I never came back to her again. Then I visited two more doctors who gave me the same answer.
Again, I prayed and God answered me because mothers of GBP recommended Dra. Menie. They were right. The first time I visited her, I knew that she’s the one I had been looking for. When I asked her about it, she did not tell me straight that I can be a candidate but asked for the history of my previous cesarean. She told me that if I had low-transverse incision (bikini cut in popular terms), there is a higher possibility for a VBAC than if I had a classical incision (vertical cut). She also addressed the common question of my family about tearing. She told me that there’s a possibility but based on records, it is a rare situation. She also said that if ever it happens, there could be adverse effects on the mother and the child but it is not a sudden event which can cause immediate death. That’s another thing I like about her, she thoroughly and untiringly answered all my questions. I even told her that I’m jotting down notes and she’s okay with it. Some doctors might even find it absurd. She, on the other hand, laid out all the information and options for me.
Given the way she entertains her patients, you must be aware that if you are number five in her clinic schedule’s list, then you have enough time to take your meal and visit the hospital’s maternity wing. Make sure to call her Secretary first, Ate Mildred at 723-0101 local 6224 because consultation is by appointment only.
After looking for your OB Gyne, at this point, I want to emphasize the importance of giving birth in a facility which is truly an advocate of breastfeeding. St. Luke’s Medical Center Quezon City is a great example. It is strict in implementing Unang Yakap, rooming-in the baby, and breastfeeding. It even provides lactation visits in your room. I know most people think that St. Luke’s is an expensive hospital. In my opinion though, the price you pay for the hospital is relatively reasonable with the high-quality services you get.
We occupied the birthing suite at St. Luke’s QC. I know it sounds luxurious because of the word “suite” but the cost of this room is equal to the summed up cost of the labor room, delivery room and recovery room. Yes, you get to be transferred three times but if you’re in the birthing suite, you can stay there while undergoing the three phases. However, if you go beyond 24 hours, you will incur additional costs. (I was advised by my OB-Gyne and doula to monitor contractions and go to the hospital when the frequency is between 2-5 minutes with a duration of 1-2 minutes, that’s when I’ll know it’s active labor.)
5. A doula (professional female birth and labor support)
“What is a doula?” asked my parents. I told them in brief words; she’s a birth support system who will tell me I still can when I’m in the brink of giving up my VBAC. She’s Ms. Velvet!!!
Doula Velvet is that person but more. I first met her during my first breastfeeding support meeting in Trinoma Mall and she’s the one who mentioned VBAC while lecturing on breastfeeding. You will be amazed with the facts coming out of her mouth because she knows breastfeeding and natural birthing like a genius. When I was researching about VBAC, I also attended the mother support group meeting by Pinay Doulas Collective. That’s when I asked her if she could be my doula.
Why is it important to have a doula? Is it necessary? Those are the questions I have to answer when I explained to anyone about VBAC. In my opinion, having a doula is not always necessary especially if you are considering financial matters. Hiring a doula to assist you and support you has its costs. Think of it this way: when you hire an expert you pay for their services.
But knowing myself and my situation, I felt a doula was a necessity. My reasons? First, nobody in my family or closest friends know VBAC. Who can I turn to when I need expert answers to my questions? My family can also cheer me up when I’m already in labor but they are more vulnerable because of extreme emotional attachment. Their love for me could mean that they could give in to the thought of another cesarean just so I could be saved from the agony. On the contrary, your doula could protect your decision for a VBAC.
Second, I was so desperate to give birth vaginally because I don’t want another C-section. Thus, I exhausted all the means to get what I wanted. Third, I prepared for it financially. I knew that VBAC would cost us but not as much as another cesarean. So I summed up the expenses of having a VBAC with a doula versus another cesarean and VBAC with a doula won! Doulas in scientific journals are repetitively cited for helping achieve a positive birthing experience and of course I wanted that.
Another worth mentioning is that Doula Velvet gives flexible payment options depending on your capacity. You can pay her on installment basis without interest. Isn’t it great? And before I forget, Ms. Velvet has her circle of fellow Pinay Doulas who can be her alternate doula in cases like she’s out of the country or the traffic is terrible and she can’t make it to the hospital (mind you, she’s very prompt) when it’s time for me to give birth. All of the mommies of Pinay Doulas Collective are wonderful but I have to choose one. My alternate doula was Ms. Ros Padua who is equally amazing.
True enough, Doula Velvet has given an invaluable contribution to the whole process of my pregnancy, birth and postpartum. Prior to my birth, she gave me free access to her reading selection about birthing. The book VBAC Companion by Diana Korte was my guide. I advice anyo
ne who plans for a VBAC to read it from the beginning up to the end. I also read Birthing from Within by Pam England and lots more.
Another important reason why you would want to hire a doula during your VBAC birth is that she can advise what exercises or positions you can do during labor to minimize your pain. As mentioned, I labored for 19 hours. That was really tough. But with guidance from my doula on the labor positions, I believe it helped me to endure the pain much longer. She knew which labor position can help me when the resident OB diagnosed me with a cervical lip and I had to do lunges. It felt like was at 7cm forever.
After so many spilled blood because of the lunges, I progressed from 7cm to 8cm! Hooray! But then I was stuck again at 8cm. My OB gave an ultimatum that I have to give birth by 1:00 in the afternoon and I remember having only fifteen minutes left!
Deep inside I was panicking but I need to be as relaxed as possible, which is what I’ve learned from my birthing class. Ms. Velvet asked me to be on all fours and sway front to back and vice versa. I gathered all the strength I needed and I did it with all my might. They asked me to slow down but I did not listen because I felt so much relief while doing it.
When my OB checked on me again and it was still 8cm, I thought I lost my chance for a VBAC. They checked the baby and he was strong and perfectly fine. Dra. Menie asked me if I can push. Ms. Velvet gave me assurance that I can do it. When my OB-Gyne instructed me to push, I did push as hard as I can. And she exclaimed, “There you go!”
I felt so giddy and nervous because all of a sudden, all the staff and equipment were gathered inside the birthing room preparing for my delivery. While they were busy, Ms. Velvet gave me honeysticks and buko juice to boost my stamina while delivering. She was there all along cheering and coaching me on what to do. My husband was holding my left hand and Ms. Velvet held my right. Not long after, I had a successful VBAC.
Having a doula may seem like a whim but I could honestly say that I would have not done my unmedicated VBAC without my doula Velvet by my side.
6. Useful Information
Knowledge is power. And I wanted that power of information. If I had not known that there is an option of giving birth vaginally after a caesarean birth, then I would have believed my previous OB. If I did not know that I can walk, navigate through the aisles of St. Luke’s during labor, then I would have stayed in bed enduring the excruciating pain much more because lying back only makes it worse.
You can spare yourself from unnecessary “What Ifs” if you are informed. Here are some of the references which helped me know things. You do not want to be Jon Snow who knows nothing when you want a VBAC. Hehe. (Sorry, I am a GoT fan.)
- VBAC Companion by Diana Korte
- Birthing from Within by Pam England
- Silent Knife by Nancy Wainer Cohen and Lois J. Estner
- Comfort in Labor by Penny Simkin, DONA (she is Ms. Velvet’s mentor)
- Gentle Birth, Gentle Mothering by Dr. Sarah Buckley
- Your Guide to a Natural Induction by Rebecca and Naomi, Red Tent Mums
- Ina May’s Guide to Childbirth by Ina May Gaskin
- The Whole VBAC Module by The VBAC Project (FB Page)
Please note that I did not read all these from beginning to end. I mostly browsed through the Table of Contents and looked for what I think might help me. As said, the only book which I devoured page by page is the VBAC Companion.
Also, look for birthing or birth preparation classes because lectures can be more helpful especially for busy mothers like myself. It is also easier to gain and store information through verbal discussions than reading tons of books.
7. Birth Preparation Class
For my first birth, my husband and I did not attend a childbirth class Why? It is not the norm for both of our families. In the Philippines, generally, birth preparation class seems to be only for high-class society. It is not offered automatically by hospitals. Since we were not informed by the hospital where I first gave birth, then, we did not have an idea that such class existed. Sad right?
However, after so much reading (again, this is the power of information gathering), I’ve learned that there are a few people in this country who offer childbirth preparation classes. Among the top providers who I searched from the internet are Ms. Rome Kanapi, Ms. Chiqui Brosas, Ms. Irina Otmakhova and of course, the group Pinay Doulas Collective led by no other than Ms. Velvet Escario-Roxas.
The birth preparation class called BINHI Childbirth Preparation by the Pinay Doulas is an intensive course packed with informative discussions plus actual application. My husband and I enjoyed this class because it was our first time to attend a same class together and we got to hug each other a lot!
During the birth preparation class, you will know how to handle labor pains, how your partner can help, what to eat and what not to eat before and during labor, options in birthing, birth plans (I was provided with a very colorful and graphic birth plan by my doula), Unang Yakap protocol – the golden hour where you get to hold your baby skin-to-skin right after he/she is birthed, breastfeeding, and so much more.
Having said earlier that birth preparation class is intended for the elite, this class offering proved that birth education is not only for the rich but can also be accessible to the less privileged. It is the most affordable rate by far but the quality of education is not compromised.
8. Prenatal Exercises
I remember, during our birth preparation class, it was said that birthing is like a marathon. You don’t go to a marathon unprepared. Exercise and being fit is crucial for a natural birth. It makes your labor less painful, it may help expedite the labor process, it strengthens your core area which is heavily used throughout the whole course of pregnancy and birth. I believe that exercising helped me endure it physically.
I started my regular exercise in the later weeks of my pregnancy. I was too lazy to move. But when I started it, I got serious about it. I allotted thirty minutes to one hour after office work for my exercise. I watched these particular series of pregnancy videos recommended by my doula because it did not make me catch my already short breath but it was able to make me sweat and stretch. Aside from following the videos, I did the positions taught during our childbirth preparation class.
A word of caution: Before exercising, you need to ask for the permission of your OB first because not everyone is fit to exercise. You may also ask your OB for the appropriate routine for your specific condition. Your doula is also helpful in this situation because she gets to advise you with safe exercise routine.
9. Lots of prayers again
I leave you with a prayer before giving birth. I pray that everyone who reads this be guided with your birthing journey and beyond. I pray for the pregnant mom and the baby. I pray for the supportive husband and father. I pray for the loving family. I pray for your OB-Gyne. I pray for your doula. I pray for your bodily strength. I pray for your mind, soul and heart.
So what now? Did positive things happen after my VBAC? Oh yes! I only had a slight case of the baby blues and it did not last long. My breastmilk was abundant! Until now, after a year, my son is still breastfed. I also tandem feed both my kids. Not only that, I was able to help moms and babies from my breastmilk donations. Because I am not stressed with my milk supply, I have better relationship with my husband and daughter and we are very happy. My children are healthier and they cope with illnesses fast. And one of the best parts is, I get to eat a lot (as in a lot) but I have regained my pre-pregnancy weight!
I owe this story to everyone who supported me in this journey. After a successful VBAC, I vowed to give back by giving inspiration and information to as much women that we have options on how we want to give birth. Don’t be afraid to ask questions. Don’t be afraid to look for the answers. I guess that is why God chose us to give birth; because we are strong, intelligent, and brave beings uniquely crafted by God as instruments of bringing another life into this earth.
Okay, back to my cake! =)