Four pregnancies and three babies later, I’ve since learned the power of advocating for myself. Especially during this last pregnancy, where I was able to have a successful trial of labor and a vaginal birth after two c-sections.
I was 27 when I became pregnant with our first child and while I had done the usual research on pregnancy and delivery, it never really occurred to me that I could question what my doctor was telling me during our check-ups. My son ended up being delivered at 34-weeks by emergency c-section when the ultrasound tech noticed what looked like a blockage in his umbilical cord. It all happened so fast. One minute my doctor was telling me I would need to have surgery right then and the next I was in a wheelchair being taken to the operating room. After delivery and further inspection of the cord, it turned out to be a gelatinous section and not a blockage after all, but my doctor was erring on the side of caution. Two kids and two c-sections later — the second one was planned at 39 weeks because my kids are 14 months apart and my new doctor (we had since moved out of state) didn’t want to risk a uterine rupture.
With this past pregnancy I had a lot of anxiety about having a third c-section. The state of maternal healthcare in the United States had been cast into the spotlight for its shockingly high mortality rates, especially for Black and Brown women. Not to mention, there seemed to be a new article circulating every few weeks about another woman (usually Black) dying from preventable complications during childbirth. I’d sometimes start crying at the thought of something fatal happening to me. With each baby, I noticed that the fear of my family losing me prematurely had risen significantly.
It was then that I started researching a VBAC or vaginal birth after c-section, in my case it would be after two cesareans (VBA2C). There are obviously risks, but that is also the case for repeat c-sections. I felt like my body had healed pretty well from the last two surgeries and my incision scar is barely visible. I just knew that I would be a great candidate for a trial of labor, and more than that, I felt it in my heart that I could have this baby vaginally. My doctor this go-around (we’d moved out of state yet again) told me when I mentioned I’d like to have a trial of labor that she wasn’t comfortable with it since I already had two c-sections.
I countered with, “Well, what if I went into labor on my own?”
Her response was that I’d still go directly into surgery upon getting to the hospital. When I asked her what her concerns were, she gave me a list of common risks without telling me exactly how those risks pertained to me as her patient. I was crushed and started crying — those anxious thoughts racing through my mind — and also because, I just wanted the opportunity to try. I was already going to be at the hospital, so if I ended up needing another cesarean I would be in the right place. I sat and thought about everything I’d just been told and realized I had options. I knew there were several doctors at my hospital who allowed for a VBA2C, so I asked for her list of recommendations and set up meetings with the ones I thought would be the best fit.
I ended up switching practices and doctors just over halfway through my pregnancy. I found an OB who was on board with me trying — he objectively told me the risks of both delivery methods and that I would be monitored the whole time. I also hired a doula to be there with my husband and I throughout the process. It was so important to have a supportive team on hand that I felt comfortable with and knew were behind me 100 percent. Looking back now on my experience, I am so thankful that my doula educated me on the questions and procedures to discuss with my doctor beforehand, to know what my rights were, and what I could push back on. I wouldn’t have had the knowledge to stand my ground and push back against unnecessary interventions and surgery — and my birthing experience would have been very different.
We had thought baby girl would come early. She’d been head down for weeks and I was already 1cm dilated and 50 percent effaced, but she was cozy in there. There were a lot of firsts for me this time around. I had never labored before, so kept Googling signs of contractions and what it would feel like. A couple days past her May 5th due date I started feeling regular contractions and called my doctor. He told me to monitor them for two hours then to go to the hospital.
When we checked into labor and delivery, before I was even examined to see how far I was dilated, the hospital doctor on call came to talk to me about inserting an epidural tap. I told her my OB and I discussed this and he said it wasn’t something I needed. Her response was textbook fear mongering, telling me: “Your uterus could rupture at any moment. You’d need to be put under using gas and your husband can’t be in the operating room with you. You’d be alone.”
I held my ground because I felt great, baby’s heart rate and mine were perfect, and I’d been contracting all day and nothing had ruptured yet. Also, none of this had been discussed prior with my doctor. This woman didn’t know me or my situation. The staff decided to keep me overnight for monitoring, since I was having contractions. In the morning, my labor still hadn’t progressed and when the shifts changed and the new intern came to check on me, the first thing she said was: “Okay, we’re going to induce you now.”
I was shocked and asked why? She responded that my labor wasn’t progressing and that “I couldn’t sit in the room all day.” I was LIVID when I heard this and told her that’s exactly what my doctor told me I could do as long as my and baby girl’s heart rates were fine. She was visibly annoyed. After that encounter, I insisted on waiting for my OB to get to the hospital to do his rounds, because no one had discussed inducing me with him.
My doctor gave us the all clear to either go home and wait a few more days for things to progress on its own or to be induced. I told him I wanted to go home. Again the hospital residents and nurse had other plans and tried to keep me there — saying my doctor needed to talk to me about the risks…that he was in a meeting and would come see me right after. Three hours later I was still waiting. I told my nurse I’d be leaving right then when she informed me it would be a few more hours, unless they got my doctor back to my room, because I had already received the okay to be discharged.
When I finally saw my OB, it was clear he was annoyed by the hospital staff. He looked at both baby’s and my heart rate readings again and said everything was perfect and that I was fine to leave — that a woman could have complications at any point in her pregnancy and the safest thing would be to stay in the hospital all 9 months to make sure nothing goes wrong, but we don’t do that. I happily left, because at this point it was almost lunchtime and I hadn’t been allowed to eat since 6pm the night before.
That following Sunday afternoon, on Mother’s Day, I went back to the hospital to be induced. My doctor and I had discussed trying the foley bulb, which is a more natural form of induction, to open up my cervix and see how things progressed from there.
From the moment I checked into the hospital, I had a completely different experience. Everyone we talked to was positive and kind. There was no fear mongering and the pros and cons for everything discussed was told to me in an objective way.
The foley bulb took less than 90 minutes to dilate my cervix to 4cm. I asked the doctor on staff to let me see if my body would keep things progressing on it’s own before we started me on a low dose of pitocin. Six hours later and I was still at 4cm, so we went ahead with the pitocin and getting the epidural lock put in place. My doctor broke my water around 6am the next morning and then we started the pitocin drip.
I labored for a while, but after the pitocin levels reached a seven I was in too much pain and asked for the epidural. And what sweet relief it was! I was finally able to rest after hours of laboring. My OB came back to check on me around 5:30pm and said I was 10cm dilated and that we’d be having baby girl that night! I started pushing at 7pm and at 7:30 Amani Jade made her way into this world. She made the entire room laugh when my doctor tried to use the suction bulb and she immediately knocked it away.
I had done it. After 28 hours, I was exhausted, but my heart was full with happiness and love for this little girl I worked so hard to bring into this world.
Ravelle Worthington is a wife, momma to three, and the founder of Mommy Brain. Follow her on Instagram here.
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Story photos provided by author.