Aisha’s episode is full of wisdom and inspiration! With her first two births, Aisha worked so hard to deliver vaginally, but ultimately had two undesired Cesareans. She was told in the operating room that she had uterine dehiscence, was given a special scar, and should never try to deliver vaginally.
But her intuition was telling her a different story. She dove into research. She found a community and listened to podcasts like The VBAC Link. She knew a VBA2C was possible, and she knew she had to try.
Aisha’s VBA2C journey involved interacting with supportive and very unsupportive providers, hiring a fantastic doula, being proactive with labor comfort measures, planning for the unexpected, staying firm in her desires, asynclitic positioning, and pushing her baby boy out in just 45 minutes with a nuchal hand!
Aisha's Website
The VBAC Link Blog: VBA2C
Needed Website
How to VBAC: The Ultimate Prep Course for Parents
Full Transcript under Episode Details
Meagan: Hello, Women of Strength. It’s The VBAC Link, and we have a VBA2C story coming your way. Have you ever wondered what VBA2C means? If you haven’t noticed, in the VBAC world, there are a lot of acronyms. VBA2C is one of them. That means vaginal birth after two Cesareans, meaning that you have had two Cesareans and want to go for a vaginal birth.
Big question, what are the chances of having a vaginal birth after two Cesareans? Is it possible? The answer is simply, yes. It is totally possible. Myself and Aisha are living proof today that it is possible. In fact, your chances of a successful VBA2C are similar to those of just a VBAC with one Cesarean.
ACOG recommends that VBA2C is a safe option, so today, I want to quickly go over a little bit more instead of a review about some education on vaginal birth after two Cesareans and share a little bit more of our blog.
Like I said, ACOG recommends that vaginal birth after two Cesareans is actually a safe option. They say, “It is reasonable to consider women with two previous low transverse Cesarean deliveries to be candidates for TOLAC.” Now, again, there’s another one of those acronyms. TOLAC- trial of labor after a Cesarean. I know that is triggering for some. It is pretty much just the medical term of saying that you are having a trial of labor after a Cesarean, so try not to let it impact you too much.
But, “for TOLAC and to counsel them based off of the combination of other factors that affect their probability of achieving a VBAC.” There are lots of things that people might go look through to see if you are eligible for a VBAC after two Cesareans.
Now, I’m sure you have probably heard this before, but proven pelvis. If you haven’t had a proven pelvis, meaning that your baby has come out vaginally before you’ve had a vaginal birth or a Cesarean– now when I say this, sometimes we have a vaginal birth, then we will have two Cesareans, and someone wants to go for a VBAC again, so they would be considered a proven pelvis or cervix to a medical staff.
But if you haven’t had a “proven pelvis”, I hope you guys can imagine my air quotes right now, that doesn’t mean that you shouldn’t be considered as someone who should have a VBAC. It says in our blog, “More important to note, there is no mention of a requirement to have had that previous vaginal delivery.” I wanted to point out that it really is not a necessary thing. I hadn’t had a vaginal birth before. My cervix also hadn’t made it to 10 centimeters before, so just know that it is still possible.
Quickly, there are things that you can do to reduce uterine rupture, and there are also things you can do to increase your chances of VBAC. Again, it’s going to be in our blog. I’m going to send you over there after the episode so you can go and read more about it, but some of the things that you can do to minimize the risk of uterine rupture is staying away from induction.
Now, can VBAC be induced? Yes, they can. Yes, yes, yes, yes, you can, so I don’t want you to totally freak out right now. But, staying away from induction for VBAC is better than going to get induced. It does increase our chance of uterine rupture, and it does increase our chances of other things like interventions that are unnecessary.
Unless it’s absolutely necessary or totally desired, try to stay away from induction. Avoid augmentation of labor so things like Pitocin and other drugs to cause the uterus to contract more than it naturally would.
Okay, let’s see. Avoid providers who aggressively intervene or want to manage your labor or come at you with fearmongering tactics. You guys are going to hear some of that here, and honestly, I think it’s a common thing with these stories. We are getting a lot of fearmongering here. Providers, if you are listening, knock it off. Goodness gracious, we do not need to add fear to something that has been looming over us because VBAC has such a bad rap in the world, and it’s so scary.
Again, air quotes, guys. Just stop with the fearmongering.
Avoid providers who are going to build you up with things– I should say tear you down, but fill you up with things like, “Your baby is looking too big. I don’t know. We should probably induce. I don’t know if your baby is going to be able to come out because you are really small, and that baby is looking really big. Oh my gosh, you have to have an epidural. Oh my gosh, you have to have your baby by 39 weeks.” There are so many things. It’s annoying.
Okay, going back to avoiding rupture. Avoid or delay things like getting an epidural until at least the end if possible because we do know that sometimes when we get an epidural early in labor, it can bring things like interventions, and we are getting Pitocin that is too high and other things like that.
There are so many other things here, you guys. I’m going to make sure that the link is in the show notes. I don’t want to take too much of our time, so we can make sure that Aisha can share her beautiful VBAC after two Cesarean stories and all that she had done to lead up to this experience. You guys, it’s a good one. Something that is very different about this episode is that she actually had a dehiscence with her second which in a lot of the studies and literature for rupture, a dehiscence is often confused or combined with uterine rupture.
I really love that this is a different type of story here, so gear up and enjoy.
All right, Aisha. Thank you again so much for being here. As we were talking about earlier, VBAC after two Cesareans is so highly requested in our community. So without further ado, I want to turn the time over to you.
Aisha: Thank you so much for having me. This is surreal. I feel like this pushed me in some ways. It was a goal of mine. I’m like, “If I make it and do my VBAC after two Cesareans, I’m going to send my story to The VBAC Link.” Yeah. I’ve listened to you guys. It’s been literally almost four years listening to you guys all of the time trying to visualize my birth after hearing other people’s stories. It’s such a blessing, and I’m honored to be here to be honest.
Meagan: Well, thank you so much.
Aisha: Of course. Yeah. I mean, if we start from the beginning with my whole birthing journey, I got pregnant in 2018. I really wanted to try out the whole natural route, so I went with a midwife here in Canada. It’s covered by the government so whether you go to a midwife or OB/GYN, it’s honestly the same thing. It depends on what type of care you want to have.
I chose to go with the midwife, and I chose to give birth at a birthing center for my firstborn.
Labor started. I never ended up giving birth naturally obviously. I ended up having a 60-hour labor. Yeah. After 60 hours, they declared me failure to progress, and I think my cervix was a bit swollen at that point. The baby had made the meconium in my tummy.
Meagan: Oh, yeah. Stressing out is common. Babies poop sometimes, and it doesn’t always mean an emergency or anything like that, but when it’s happening and other things are happening–
Aisha: Exactly. I think I started having a fever and other things like that. At that point, they came to see me. They were like, “Before things turn into an emergency, let’s go and have a simple C-section.” I felt very defeated. I worked very hard for a natural birth. I did 40 of those 60 hours all-natural, but after seeing I wasn’t progressing– when I was with my midwife, I was 2 centimeters after 40 hours, and at that point, I requested to be transferred to the hospital to get an epidural.
When I got the epidural, it worked a little bit on half of my body, but I was having back labor. My baby was posterior, so it did not do much for those pains there. I can say in the moment, I was quite relieved to have the C-section, so everything could be over, but I know afterward, I know womanhood is not defined by how you birth your baby, but I think at that point because that’s what I envisioned, I never envisioned a C-section ever in my life, and it affected me. It affected my self-esteem a little bit.
Right after that, me being me, I’m such a planner and such a researcher. I researched to see if it’s possible to have a vaginal birth after a Cesarean, and I discovered the whole VBAC world. I signed up in all of the Facebook groups that I could find about VBACs all around the world. I was reading stories. I discovered The VBAC Link at that point. I started listening to the podcast.
I also requested, through my midwife, my notes to see what happened.
Meagan: Your op reports. Yes.
Aisha: I’m like, “Okay. I need to know why I had a Cesarean, why a Cesarean was made, etc.” I checked. I sat down with my midwife at six weeks postpartum. Honestly, it wasn’t anything really. They just said it was failure to progress. I had dilated to a 7, and that was that. She was like
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