Choosing My VBAC Provider

One year after my VBAC, I think that one of the single most important factors in having a successful VBAC was my choice of provider. When I became pregnant, I was surprised that I needed to go through the process of deciding, once again, if I wanted a hospital birth or home birth. I deeply loved the idea of a home birth and – I’ll just say it – had been jealous of the lovely stories of my home birth friends. Even though I knew there were special factors to consider, given that I was having a VBAC, I did want to seriously consider having a home birth. I sat down with my doula and talked about the pros and cons of home versus hospital. Her words were some of the wisest I’ve ever heard about birth. She told me, “I’ve seen lovely and wonderful home births. I’ve seen lovely and wonderful hospital births. I’ve also seen scary and stressful births happen in both places. The most important thing for you to really do is sit down and figure out where you will feel the safest. Despite the statistics and whatever your rational brain tells you, you need to pick the place you will feel the safest because you will only be able to give birth when you feel safe.”

I knew in my heart that after the traumatic birth of my first child, the hospital was the only place I would feel safe, so I said goodbye to my dream of a home birth. This was a choice I will never regret because I did end up having a lovely and wonderful experience at the hospital.

So, next it was on to choosing the right OB. I knew I didn’t want to use the same provider I had the first time. Although we were on the same page about some things and I appreciated the attention she gave me in our office visits, at the end of the day, she just didn’t seem to trust women’s bodies as much as I really  needed her to. Plus, after carrying around negative emotions about my c-section for over a year I really just wanted to change things up and have a different crew of people present at the birth.

I asked around for recommendations for the best VBAC OB in town. I asked the doulas I knew. Most importantly, I talked to other moms who had had VBACs or who had tried to. I learned the most from attending the VBAC/C-Section support group at BABS (first Wednesday of the month at 6:30pm). From listening to other people’s stories I started to form an opinion of the various OBs who would work with VBAC mamas. I listened closely and started to see that some OBs said they were supportive, but maybe were actually a little on the fence. After making my selection, I set up an appointment and went in with great trepidation.

I left our first appointment feeling conflicted. It was certainly a different atmosphere from my previous provider who had had a posh, spa-like office and had taken a lot of time with me at each appointment. I also felt really annoyed that he gave me a piece of paper with about 20 things I had to read and sign off on before he would allow me to attempt a VBAC. I knew it was probably just an avoid-a-lawsuit thing but, still, I hated the feeling of being set apart from other non-VBAC women. He also said something to me at that first appointment that frustrated me. He said, “I will let you try for a VBAC only if you promise me you won’t be mad at me if it doesn’t work out.” I basically told him I couldn’t’ promise that and we moved on. The thing he did do at that first appointment that made me come back for the second one was this: he asked me about my first birth. He sat down and wanted to know the whole story. He seemed to really care about me – and that’s what made me come back.

At the second appointment, I took my long I-promise-I-won’t-sue-you VBAC sheet back. I asked him questions about the items I didn’t understand or didn’t agree with. I signed it. After that, we rarely spoke about me being a VBAC candidate again, unless I brought it up. The rest of my appointments were incredibly standard. He clearly trusted in my ability to birth my baby and didn’t see me as some special, set-apart category. As the months passed, I occasionally asked him questions, just to get a feel for how he really felt about my upcoming VBAC. I asked him, “So, the hospital policy is that you have to stay in the building while I’m laboring. I had a really long first labor. Does that mean if I’m in labor at the hospital for 30 hours you’re going to put me on some kind of schedule to hurry up and get done?” He laughed and said, “Well, it’s pretty hard to put a laboring woman on a schedule, isn’t it? No. I knew when I signed up to do VBACs that I might be spending a lot of time at the hospital. You should thank my wife for it. It’s hard on our family.” Another time I asked him, “So, what happens if I go to 42 weeks? Automatic c-section, right?” He said, “I sure hope not! I had a woman last week who really wanted a VBAC and she went to 42 weeks. She saw an acupuncturist and I stripped her membranes and she went into labor. I was so happy for her because I know it was really important to her.”

“I was so happy for her.” I truly believe he meant that.

All the questions I threw at him, all the answers he gave me made it perfectly clear that this was a doctor who cared deeply about his patients’ desires. He wasn’t there to push his own agenda. Honestly, he didn’t seem to have much of an agenda besides keeping babies and moms safe and happy. It became clear to me that he trusted deeply in women’s bodies – but that he also had the skills and knowledge to assist if problems really did arise. Through the bitter end, this remained true. There were some things we disagreed about during my labor (when to go to the hospital, whether to break my waters) and he listened to me and made me feel heard. He allowed me to go against his wishes as long as it didn’t put my baby or me in danger. And, in the end, when I successfully birthed a 10 pound, 2 ounce baby I think he truly was happy for me.