The Decision Regarding How to Bring Baby Gale #3 Into the World

Have you ever made a decision, thinking you knew what you wanted, only to question your original decision? Well, I got myself into a situation like that.

First, a quick bit of history for those who don't know or don't remember my two previous birth stories. Allie was breech, didn't want to turn despite a painful attempted version, and was a scheduled c-section at 39 weeks. We moved to Stillwater, Oklahoma, where they did not allow women to try for a Vaginal Birth After Cesarean (VBAC). I wanted the opportunity to try for a VBAC, so we went to a doctor in Oklahoma City, which was approximately one hour and 15 minutes away (+/usually - , depending on traffic and who was driving). I had been progressing a little each week, starting around 36 weeks. I went into labor on my own four days after Rachel's due date, and we started heading for Oklahoma City. We were only five miles or so out of Stillwater when a deer jumped out in front of us. Our car was totaled, and I had to be taken to the nearest hospital by ambulance. Everyone was okay; I just happened to be in transition, though I didn't really realize it at the time. The ambulance had to take me to the nearest hospital, which was Stillwater Medical Center. Upon arrival, the nurse checked me and she was surprised to find that I was dilated to a 9 and was fully effaced. But they did not allow VBACs, so I had to have another c-section.

Despite the crazy circumstances surrounding Rachel's birth, I felt that it happened that way for a reason. I was at peace with having another c-section. I was just happy to have my healthy baby girl in my arms in the end.

Soon after Rachel's birth, some people asked me if I thought I'd try for a VBAC the next time. I honestly hadn't researched it much and didn't know. I figured I probably would if it was an option, but I didn't really know if doctors would allow it. Then when we moved to Arkansas, I either read or heard somewhere that no hospitals near us would allow VBACs. I wasn't heartbroken; I just figured that was how it was supposed to happen for me. Then when I took Rachel into a well-check, the pediatrician told me that there were a few hospitals that just recently started allowing VBACs again. I was glad to know that, yet still didn't know if my medical history would even make me a good candidate. I wasn't pregnant, yet, so I didn't dwell on it too much.

When I wanted to get my IUD out, I asked women at church for recommendations for OB-Gyns. A few gave the same name, so I decided I would go to her. However, she was affiliated with a hospital that did not allow VBACs. Since I hadn't even realized that having a VBAC could even be an option here in Northwest Arkansas, I sort of just thought, "Well, I didn't think I would get to have one anyway."

Time passed, and a friend of mine got pregnant. She was in a tight financial situation, so she was wanting recommendations for multiple clinics. I again asked ladies at church for recommendations. And from that, I heard some people share negative experiences that they'd had with the doctor that took out my IUD. It wasn't just the fact that the doctor had some critics, because most do (and others had raved about her), but one of them was specifically related to the doctor's attitude toward how many babies a woman should have via c-section. The doctor told a friend that she would have only let her have three, though she already had her fourth (and ended up having a fifth, all by c-section). Jared and I have never had a specific number of kids in mind. We take it one at a time, but I didn't really like the idea of going to a doctor who would probably pressure me into not trying again. Another lady at church spoke highly of her doctor, whom she had had a VBAC with, and then another friend spoke highly of the same clinic. So I decided to switch to a different doctor when I got pregnant.

I chose to go to Dr. Schmitz, largely because of the one lady's recommendation, and I decided that I would like the option of having a VBAC. I didn't necessarily feel that I was deciding that a VBAC was right, but I liked having the option, whereas I had no option with the other doctor and at the other hospital.

When I went to my first appointment with the new clinic, I saw the nurse practitioner. She was pretty certain that the doctor would allow me to attempt a VBAC if I wanted to. Then when I saw the doctor and he heard my history, he agreed that I would be a good candidate for a VBAC since I had progressed on my own with the last one. He stated that the risk of uterine rupture was 3% and that such a rupture could result in death for me and/or baby. I already knew these things. They were essentially the same risks as when I planned on attempting a VBAC with Rachel. At this point I figured I would try for a VBAC. Three percent is not a very high risk, and they should be prepared for the worst case scenario.

However, the following thought lingered in my mind, "I truly believe that the last one happened the way it did for a reason. But I don't know the reason. Maybe I'm not supposed to try for a VBAC."

Early in the pregnancy, these thoughts existed; however, around 23 or 24 weeks, I couldn't stop thinking about and questioning what was the right decision. I knew it wasn't a decision that needed to be made right then, but it would not leave me alone.

General Conference, the conference in which the Prophet and Apostles speak to us, happened when I was 25 weeks pregnant. I decided that I would pray to receive my answer during the conference. I've had several experiences in the past in which I've prayed for specific answers and then received them during General Conference. I know that the Lord hears our prayers and can answer them for us through others. This time, however, I just felt that my answer was that I needed to study it out more and pray about it more. I would receive my answer, but I needed to work for it a little more. And honestly, my prayers up until then had mostly been, "Help me to know which decision is correct." For whatever reason, I sort of feared asking point-blank whether one way was the correct decision or not.

So, I did more research. Most of what I found was exactly what the doctor had already told me. The risk of uterine rupture, having had two c-sections, was between two and three percent, and the results of said rupture could be catastrophic for mother and/or child. Yet, I did learn something that I wasn't aware of. I had always assumed that the higher risk would be for the mother. However, I learned that in most cases they could sustain the mother through blood transfusions and other measures. On the other hand, the baby would need to be delivered via emergency c-section within 10-26 minutes (Give or take a few minutes. I can't remember exactly right now.) in order to prevent death or other serious conditions. So I really started questioning whether I would want to be in that situation. Yes, the risk of rupture is only 3%, but would I really want to put the baby at such risk? I didn't think so. So I started thinking that a c-section might be the best option for me.

I had done more research and had a decision in mind (c-section), yet was still afraid to pray and ask, "Is having a c-section the right decision?" I talked to different friends about it. Some favored c-section, while others sided with attempting a VBAC. I knew that other's opinions really didn't matter, though, and I truly started analyzing why I was struggling with this decision so much.

I spoke with the doctor at one of my appointments, telling him I was praying about the decision and mentioning the different thoughts I'd had on the matter. He was really supportive and open about it. We discussed the options a little. A few of the things that I remember him stating are: 1) My history would suggest that I'd fall into the successful VBAC category, though it isn't a guarantee; 2) Some women just really feel the need to have the experience of having a vaginal delivery, and for them, he will support them as long as he feels it is safe; and 3) Ultimately, I need to follow my heart.

The first item wasn't new. The third item was what I sort of knew already, though I still liked hearing him say it that way. The second item made me question myself, "Why would I want a VBAC?" After having Rachel, despite not having been allowed to push her out, I felt like Heavenly Father had let me "have the experience." I had wondered whether I could do it naturally, and having got to a 9 without drugs, and handling it relatively well (the nurse actually asked me if I thought I was a 9 because I seemed to be handling it really well), I figured I could have done it. I felt contractions, got really close to pushing and delivery, but Heavenly Father had another plan for me. So this time around, I really do not feel like I "need" the experience. Really, the one reason I would prefer a VBAC is for the possibility of having a quicker recovery. And more than likely it would be a quicker recovery, but that isn't a guarantee either. One of my friends shared how she had a really traumatic vaginal delivery that took months to recover from. I know, there is surely a greater chance of having a faster recovery with a VBAC, so again, that would be my reason for choosing to try for one.

Jared and I discussed the option several times, and he would support either decision. During one of our discussions, I asked him in which situation he would be more comfortable. He now knows what to expect with a c-section, so would he be more comfortable with that? He said that he really wasn't sure and threw the question right back at me. Would I be comfortable during an attempted VBAC? Not "comfortable" in the physical sense, because contractions are definitely far from comfortable, but comfortable in the emotional and mental sense. And I realized that I didn't think I would. With as much as I've wrestled with this decision, I don't think I could be at ease during labor. While in labor with Rachel, the thought, "I could rupture... Am I going to rupture?" never entered my mind. But I don't think I could go through labor without having those thoughts this time. I think that I would question my decision for an attempted VBAC the whole time. Some women choose epidurals because it allows them to "enjoy" the experience and be more comfortable. I've never judged them, and I hope no woman would judge me for choosing a repeat c-section partly because I believed that I would be more at ease during the process.

And those thoughts made me reflect on the societal pressures. So many people spout out opinions regarding what they believe is best for all - home vs hospital births, epidurals vs natural, etc. And because of the information that is available, we, as women, often put unnecessary pressure on ourselves. I think about the stress relating to breastfeeding with Allie. We had several problems. We worked through them, but it was STRESSFUL, and mostly because of the pressure I put on myself. I ended up using a nipple shield for the entire 11 months that I breastfed her. Literature stated that that wasn't best. I'd heard others talk about the evils of nipple shields, so I would try to hide it when I'd feed Allie in the mother's lounge. Now, I think, "How crazy!" I did not need to worry about what others thought, and I did not need to put so much pressure on myself. I just needed to do what I felt was right for me and my baby.

So now, I tell myself the same thing but in a different situation. I feel that most of the world would say, "Why wouldn't you try for a VBAC?" Or, "Elective c-sections are evil." Or... whatever. But, I need to do what I FEEL is best for me and my baby.

And I had already felt that a decision was correct. I just needed to pray about it. I spoke with Jared again. I spoke with my mom. And I prayed about it. I asked to receive the confirmation that I needed, to know that having a c-section was the right decision, no matter the reason. And I can tell you that I have received the confirmation I need. Since making the decision and praying about it, I have had peace of mind. The debate doesn't continually occupy my mind. I feel that it is right.

It is still somewhat uncomfortable telling those who thought trying for a VBAC was the obvious choice that I'm going to have a c-section, but I know it is right and that I don't need to worry about what others may think.

I have a doctor's appointment tomorrow, and I'm hoping that I'll get to schedule the c-section. One true convenience of c-sections is the ability to plan. Of course, baby could still come early, and if she does, we'll proceed as we feel is right, but for now the plan is to schedule a planned c-section.