But why did you do it at HOME?

The last OB, at Loch’s birth said I should never get pg again. But my regular OB begged me to see a perinatologist, and that Dr said it was totally safe to get pg again. He explained that the lower uterine segment completely regenerates so there isn’t an “internal scar”. The other perinatologist also explained that a woman might come in with her first baby, need an emergency c/s and have a “window” (thin uterus). Then she might have 2 babies by VBAC but #4 might need another c/s and they would NOT see a window that time, so if your uterus stretches paper thin once it doesn’t mean it always will.
As for a VBAC I started googling risks and found that even after multiple c/s the risk of a rupture was still REALLY low and the risk of a catastrophic rupture even lower. The risks of a repeat c/s were MUCH higher, both for baby and for me. But a c/s is more controlled so easier to defend in court, so lawyers prefer them. Even the ACOG now states that a VBAMC is not more dangerous than a VBAC (m for multiple) after just one section so they recommend women try for VBAC, but it takes Drs and hospitals an average of 8 years to adopt policies related to new research, so in 6 years it will be easy to find a VBAC Dr but right now its hard.
I entered the pregnancy EXPECTING a c/s (but dreading it). I did the research to prove to myself once and for all that I NEEDED c/s’s and to find some peace with that knowledge. Nobody was more surprised than me to find that the only sane choice was in fact to try for a VBAC. I lost nothing in the trial and a successful VBAC was WAY safer than a planned c/s for me (and *I* needed to survive the birth since 4 children call me “mom”) and also safer for my baby (and I love these babies before I meet them).
So I was pg with #5. And I needed to have a VBAC. Now what? Now I needed to find a Dr. With all the evidence on my side I never imagined this would be quite the struggle it was. I made 3 calls. Nope they don’t do VBAMC’s. I sent an email to a list I’m on asking if they knew anyone who would want to catch my baby? I asked Google for OB’s and midwives. I sent out emails to midwives, doulas, birth support people, OB’s, and to the nurses at the local labor & delivery wards. I sent letters to those I couldn’t access via email. I invited docs to attend the birth of my 5th child. I presented references to articles backing up my choices and stated my requirements in a birth partner and offered them the opportunity to be present at this birth.
First came the rejections. Then came days of deafening silence. And then, the thoughtful responses. Not knee-jerk NO’s. It took at least 5 days for the “lets talk” replies to start trickling in. I got “yay for you! I support your choice! I have extra research that says you are doing the right thing! But… good luck b/c MY malpractice insurance says I can’t go near you” I got “you can do this! You SHOULD do this! Let me know how it goes” I got “I can’t help you but here are some people who can” I got “send me your medical records and we’ll talk” and I got “thanks for the invitation, call me for an appt!” I even got “you must be an inspiration to the women around you, please call or come in”
And the appts and the calls started. I knew money was an issue, and I was hearing that the hospitals wouldn’t give me a chance. So I was looking for a birth center. Chris preferred a hospital, but was ok with a birth center connected to one. We thought we had this arranged but then that provider fell through. My remaining options were a birth center an hour away, another 90 minutes away, or a home birth. My house is closer to a major hospital than the other birth centers were. I am one mile from a hospital with a NICU.
Still, I hadn’t expected to be approved for a VBAMC so I certainly hadn’t expected the possibility of a home birth. Researching again. Is it safe? Really? It turns out that they bring everything to your home that they have in a birth center. I asked all my hard questions about safety and transport and experience. I narrowed down my choices to one midwife and one Dr. In the end I went with the Dr. The sheer number of deliveries was reassuring to me. Her last baby was a c/s, so she knew when they were REALLY needed. She worked in Africa so she had been forced to learn how to deal with many emergencies. Her personality was one that meshed well with my needs. And I thought Chris would feel better having a “real live Dr” at the birth. Plus being a Dr she says she gets a bit more respect and faster response times if she calls a hospital in a transfer situation. Also, she can legally, and does, bring prescription medications to the birth.
And so here we were, from a 5th c/s to a VBAMC at HOME. None of these choices were made lightly. Each step taken carefully. Hours and hours of research on each issue, followed by soul searching. I didn’t take any of it lightly. I felt each decision was a matter of life and death- for TWO people (me and the baby) and I weighed the future of my entire family in each choice. I needed to make the RIGHT choice for ALL of us. Chris wouldn’t do the research, so he never agreed with me. But I was confident in each decision once it was made. I read the scariest side of each choice. I looked at “worst case” and “tried it on for size” and sometimes it was all about picking “the lesser of 2 evils”. I did not enter any of this blindly following a dream.
Did I WANT to experience a vaginal birth? Yes. Deeply. Did I start this pregnancy thinking I would? No, absolutely not. I just wanted to KNOW really really really KNOW what I was doing this time. I explored my birth options and made choices, educated and informed choices. It was vital to me that I do the safest thing. Believe me, I was as surprised as anyone to discover that the SAFE choice would be to birth in my own home. I never ever expected my research to lead me there.
But the facts were there, they had been weighed and measured and my conclusions drawn.