Thank you for sharing your story Maria. I am very proud of you! Congrats on your VBAC and your baby! HERE is the link to her story. I’m also reposting it below.

My Baby Boy! Born By VBAC

Mariposa has a brother
This second pregnancy wasnt a surprise. After the painful experience of a c-section, I try to heal my mind and my body, wait two years to give me a second chance. I Leave nothing to the chance. If the minimum time between pregnancies had to be a year, I wait two.
When I was pregnant I was convinced that in no way I could return with the same doctor. So even before I began an exhaustive search of the doctors or clinics that supported a vaginal birth after cesarean.
On the blogs, I realized that even though some doctors seemed pro VBAC, actually end their policies betrayed and ended in Elective c-section. So I had to be very careful. I found several references to a Dr. Regina C, who attended in a clinic, but the deliveries took them within a hospital, with everything needed to help a natural birth. She also had a team of midwives who came to know well before delivery.
I made an appointment. Knowing my history told me that my c-section had been totally unnecessary and that this induction was doomed to failure because of the way it was done. Do not weigh myself. She ask me if I wanted an ultrasound, still without impositions. I left there completely optimistic.
Afther three months of  pregnancy, we had to change our country for work purposes. Now in addition to seeking a home and school, had to find a doctor and a hospital. The first two months I went in looking for a house, my daughter adjust and adapt to change. moving home, close accounts, open other, etc.
I was 7 months pregnant and just going to have my first consultation with social security. The private part was saturated for my dates. The doctor who could assist me perhaps these days would be holidays. I realized I want to have my baby in the private wing meant fewer possibilities for a natural birth by clipping services.
Social security was not bad. They took the blood and urine tests were in the same query. Never made me an ecographie. In England they make just one or two. And I was already late for that. You do not see doctors, midwives comes and touch your belly and know the baby’s position, size, if the liquid is fine, etc.
At first the spelling I have no echo was little security, but then I realized that you must thrust your body until you have real reason to think that things go wrong.
So I spent a very peaceful pregnancy. Walking a lot. Very busy with my new life. Without fear of anything. Trusting in my body.
In the public hospital they put me in contact with two midwives in charge of VBAC, vaginal birth after cesarean. I love meeting and talking with them, gave me confidence by saying that it was possible, which would let me get to 42 weeks, or a day before, did not have to be lying when I was in labor. That could take a shower. And wouldnt put time limits, but be very careful with the baby’s heart monitor my pulse etc. .. When asked if they were there they said only if the birth was Tuesday.
Finally I had an appointment with the obstetrician, but midwives canceled it because it was thought that if he would want to schedule a cesarean, so I saw it through week 39. Talk to him and see how everything was an imposition made me realize that everything was shaping up for a new caesarean. Luckily from the 36th week my husband and I had a visit to the birth center.Somewhere between home and hospital.
I did not want to give birth at home, I looked much risk, but the birth center was literally in the corner of a hospital. From the first visit one of the midwives was very interested in my case asking me questions, they said they had 80% of VBAC. I knew my chances in the hospital were 40%!
A week later, after much thought, talk with two doulas that  I contact via the Internet, we make the decision to try delivering in the birth center. So we started to have consultations with them about twice a week to make sure to meet as many of them. (they were 6 in my team)
During the 39 weeks I began to feel more flow than normal, and I thought it was broken or cracked the bag. The options were to do a test that increased the chances of an infection in case if it were broken or wait. The hospital would not let me and I would expect nothing touches.So I decided to do nothing and wait for nature to take its course.
Not expected to give birth before 42 weeks. 40 week walk a lot. I had a lot of energy. But after the damage of c-section that, I did not really believe being able to get birth alone and in my head I was thinking about the options I had if I  would have 42 weeks and not put me in labor.
I heard so many stories. Women who have never broken bag and contractions. Women who start labor but never expand enough. In order that my head was full of negative stories. Attempts impossible.
I read a lot. I wanted to convince my body that was possible. I could not understand that in God’s creation could be so imperfect. I had to let nature take its course. No inductions. I had to relax, I knew the adrenaline in my body could not let act natural oxytocin.
Week 40 +3. On Friday morning I went to get my daughter to the park, I sat in the sand to play with it. we went to the house of some friends. I went to make last minute purchases. When we got home noticed a little blood. I thought it was a bad sign, but to call the midwives told me it was the mucus plug. After two hours the contractions started. every 5 min lasting 1 min. Still it was a good pattern was not very intense so we hope to see what happened and try to sleep.At 4 am the contractions became less continuous. 1 every 10 min. So all morning. On Saturday night were more intense but every 7 min. Domingo. The contractions were up but they were more continuous. It was difficult to walk and talk at the same time. At 4pm try going to the park for a walk but it was impossible. We returned home. Contractions every 5 minutes with duration of 1 min. We call the birth center and 6pm and we were there.
We left our things. We were alone. I got into the tub immediately, with relaxing music and candles. The contractions had a good case. After it became difficult to carry them, all I could do was walk.
3 am, I thought it became increasingly more frequent, but the midwife looked at me and told me that they had no specific pattern. 6:00 a.m. and could no longer walk, I had strange feelings in my body was exhausted. I was beginning to give up. It seemed that there was extensive enough yet, (I had made no touch) but the pain was impossible to endure the fatigue I had.
I thought about the power of the mind. I thought my mind was able to do everything I wanted.The only thing left was trying to rest and find strength. I asked her to make me a “tacto” for what to expect, but the midwife who was with me that night told me to wait for the nex midwife who was to be with me the full next day.
Spend the whole morning in bed, having contractions every 5 or 4 min, very painful, which made me get all my body, I had to shake hands with my husband too hard to endure a little longer.
My mom was really worried, the contractions were very strong. The midwife kept saying they were not really a case to make a touch if I had spent the morning in bed was difficult to progress.

She said that the  option  still available was caesarean section, in the hospital inductions are not allowed to  who have had c above. So we decided to wait a little longer and see what happens.
At 3 pm we ask her to do a  tacto. She said that the bag is intact. She looks at me and tells me I have 8cm and can feel the baby’s head. I suddenly comes an energy, I do not know where. I get up, take a shower. I go out and get into the tub (birth pool) request music, candles.Contractions are becoming increasingly strong. Very intense. I try to breathe and relax. I feel the need to expel something, and had that feeling since Saturday.
During the entire time they are checking my pulse and heart of the baby and going well.
She says  to bid when you feel you need it. I try, not works, is a feeling that I had not felt before. I think in all women who undergo a cesarean innecesarea, and put even more strength to try. Water breaks and water is clean. But attempts nothing happens. Suddenly I feel the baby’s head. that gives me the strength to keep trying I keep seeing even impossible.Suddenly comes the head and the body is triggered by itself. The midwife takes it in his hands and passes it to me immediately, I put on my chest. I feel a joy indescriptible. I kiss him. He was born when he wanted., I cry.. I could not believe my God. We did it!

Postpartum Experience

After the baby was born he was put to my breast. The cord stop beating, and we left the tub. The placenta has not come out. I slept with my baby at the breast and a contraction come the midwife came pull the cord and the placenta.
The midwife was concerned that had not yet gone to the bathroom so she asked me to get up and when I did I began to feel dizzy, and when we got to the bathroom try to sit down and only heard a popping sound. I passed out. I was injected to stop the bleeding. I get to the ambulance. We went to the hospital. They saw my platelets. Apparently I lost fourth is blood in the body. Do not let me leave until the next day at night with a promise not to move in the next two weeks.
Apparently was the result of fatigue from many days of contractions, combined with oxytocin put me not to expel the placenta, which prevents bleeding. Nothing that I knew so far.
Now I’m in my room, my skin is green. I have to eat well and take a million of pills. But Im not depressed, I’m happy. Afraid of what might have happened. But now I can separate the two experiences. The happiness of having my son as I dreamed in not going to be remove for anyone.
The postpartum shock either. I think what happened makes the two births of my children fairer.It would have been hard to tell always the tragedy of my c-section and the happiness of my VBAC. Both experiences have taught me a lot. The most important thing is:  I have my two loves with me and they are fine. With the two and the two I have learned.
My butterfly is the nicest girl in the world, God has given me in my children a great blessing with which I can only be grateful for them and for the oportunity to be here to enjoy them.

Graham was what most people would refer to as colicky. He screamed from about 6pm to 10pm every night (that’s sounding pretty good right this moment though!) and when he was awake during the day he was generally fussy and unhappy. This went on until about 10-12 weeks old and then he gradually began to relax a little. I’m pretty sure he needed crania-sacral therapy due to his birth trauma and that might have helped him a lot.

With Stella, I’m at a loss. She isn’t colicky. She is demanding. She wants to be held constantly, which I don’t mind at all and she spends a lot of  time in the Moby wrap. The Moby is where she is happiest and I love to wear my babies so it’s perfect. However, at night it is a big problem.

Take tonight for instance. She slept from about 7pm to 11pm which is a great stretch of sleep for a newborn. Unfortunately, I could not sleep then since I have a two year old and a kitchen to clean. I did get to sleep from 9pm til 11pm though. When she woke up my husband brought her to me and from 11pm until 1:30am, the only way she would not scream was if she was in the Moby and I was walking. That is VERY exhausting but I have to do it because I don’t want to wake up Josh and Graham. At about 1:30am I kicked Josh out of our room and sent him to the couch and told Stella we were done walking. She did not appreciate that very much and has pretty much been crying (screaming) ever since. I alternate holding her and laying her down and she alternates between crying and not crying. I’m hoping she will drift off to sleep soon since it’s almost 2:30am now.

The newborn days are hard but they do go by quickly. I will miss her as a newborn and I know it. I do want to enjoy this time and I am, mostly, but I’m also tired and really over being up so much at night. I don’t mind waking up several times a night for feedings and diaper changes but I have a really hard time with being up  (and walking!!!)  for 3-4 hours straight. My two year old tends to get up really early too.

I am pretty good about napping and thankfully I can. During the week Graham goes to school for three hours in the morning and most days I can nap with Stella, if she will go down. My two year old also takes a three hour afternoon nap so Stella and I get in a nap there too. I’m not well rested but I’m not a zombie so I’m functioning. Of course, I’ve had an ajuma (Korean cleaning lady who also cooked) for five days a week.. Her last full week ended Friday so I’m on my own now. She will come on Mondays to clean but day to day I’m back to doing the housework and cooking. At least I’ll have something to do while doing all this walking with Stella!

Hopefully Stella will calm down soon. I’m trying to remain peaceful and calm and ride it out. I don’t expect her to sleep through the night and don’t mind night feeding but I do wish she’d learn to go back to sleep after she eats. A two or tree hour stretch would be just fine!

EDIT: I just wanted to add that after I posted this, Stella did finally drift of to sleep just before 3am. We slept until after 8am. I’ve been saying quite a bit that it’s not the sleeping that’s the problem, she sleeps great once she gets there. It’s that she wants to be walked around for several hours in the middle of the night that’s the problem. I have to figure out how to get her resettled when she wakes, that’s the main issue.

Karen began ECing her daughter around 7.5 months old which was right around the time we met in person (we had an internet friendship for months prior to this). I thought it was so cool that her daughter was sitting on the potty and actually using it at such an early age and that Karen could read her cues and know when she had to go. I saw it working and realized the value of it even more as I was potty training my toddler who at the time was 18 months old. Graham was a potty expert as long as he was naked and this is still actually true, 10 months later. If he is naked he will go pee or poop with only the rare accident but with clothes on he has a harder time. He is more relaxed about it with clothes on and will pee or poop in his clothes. At 27 months, he is no longer ok with peeing or pooping in his clothes (we’ve made huge progress the last month) but for the longest time he would only poop if wearing a diaper. That was his comfort zone and what he was used to and the only way he could relax enough to go.

When I read the EC book Diaper Free Baby I realized why Graham was having a hard time letting go of pooping in his clothes. The idea behind EC is that as humans do not want to soil themselves. It’s a survival mechanism. A wet and dirty baby is more likely to get cold and sick so human babies instinctively do not want to go on themselves. It’s why newborns always seem to pee or poop when their diaper is removed. We, in modern diaper wearing times, train our babies to go in their diapers for our convenience. This is also why babies eventually stop peeing and pooping when the diaper is removed, they have become programmed to go the diaper. Then once they are at the age when we think they should start learning to use the toilet, which in the US is average 2-3 years old, we retrain them not to go in the diaper. Graham was having a hard time with the retraining part. It was a bit frustrating for us so both my husband and I read the book and it made perfect sense to us. My husband was completely on board with it and would even tell anyone who would listen about it.

We decided that with Stella, we would give EC a try. If we could preserve the natural instinct of not wanting to go on herself, surely it would make potty time easier. Perhaps she wouldn’t be so conditioned to go in her diaper that she preferred it. Maybe she would actually care about sitting in a poop diaper. We talked about how we wanted to approach it and formulated a plan and waited for her to be born so we could get started.

Stella is one day shy of three weeks old while I am writing this post. The first two weeks were spent observing her and learning her cues. We learned that when she had to poop she would squirm and grunt then get really still for a butt explosion. Poops are very obvious with her. Pees are much more relaxed. She actually goes a bit limp when she pees. Every time we saw her poop or pee we made the PSSSSS sound so that she could have something to associate with going. At every diaper change we would lay her on a clean pre-fold and give her a couple of minutes to go before putting a clean diaper on her. We would make our PSSSS sounds. During the second week she caught on and began to pee on command if she needed to go. The first time she did it, I went PSSSS, and she turned her head to look at me then she began to pee. I knew she understood and it was so exciting.

On the beginning of the third week, we started holding her over a potty bowl. We were ready since she recognized the cue to go. Holding a newborn over a potty bowl is pretty simple. I put her back against my belly and held her legs in the cups of my hands so that  she is in a seated position. The very first time I did it and went PSSSS she immediately peed. I was so excited I took a picture and called my husband at work to tell him. That night was kind of rough for us. Stella was up for several hours in the middle of the night and I was so tired the next day that I didn’t give her an opportunity to go outside of her diaper. I also didn’t notice that she hadn’t pooped or that her butt crack was red and had a raw spot on it. She was pretty cranky the whole day. When my husband got home he held her and walked around with her and when he went to change her diaper he did put her over the potty bowl. When he PSSSSd, she had a major poop in the bowl, probably the biggest I have seen her do since her meconium poop when she was two days old. She had been holding her poop in. She was either doing it because she didn’t want to go on herself or because she knew that it would burn the raw spot. She had some ‘sharts’ (we are so mature in this house) throughout the day that irritated her so I think she was holding it because she knew it would hurt. Once the poop was out, she relaxed and went back to her normal non-cranky self. It was an amazing immediate difference. Either way, I’m so glad we are doing EC because it saved her some pain by not going in her diaper.

We are approaching EC in a relaxed way. We aren’t going to let it become a stress factor or let it rule our lives. We are going to take an extra few minutes at diaper changes and when we notice she needs to go to give her an opportunity to use the potty bowl. I’m excited about  it and seeing how aware my newborn is of her body functions is quite amazing. I do believe in the value of it and if it helps reduce a little bit of laundry from diapers that I don’t have to wash then that’s an added bonus. Mostly I hope that it helps us to learn to use the potty more easily and effectively and earlier. Karen’s daughter is 17 months old and is nearly potty trained. They have done a great job with it and I hope to follow in their footsteps.

The first most obvious difference is physical. I physically feel so much better.  Major abdominal surgery is a much longer recovery than an uncomplicated vaginal birth. I had pain from my c section for over a year. I did have a first degree perineal tear after my VBAC but it wasn’t bleeding so I opted not to have stitches and to instead rest and keep my legs together. The tear took a few days to close, I think about five, but it was only mildly uncomfortable. The worst part of it was that is would sting on occasion if I did too much. Regular cleaning with a peri bottle and limited activity took care of it and it seems to have healed up just fine at two weeks postpartum. Two weeks postpartum after my c section, I could still barely get out of bed unassisted and had to move slowly to avoid pain. It probably didn’t help that I didn’t take the prescribed pain medication but I had a much harder time getting around. I’m really amazed at how good I feel. I knew I’d feel better but the difference is almost indescribable.

Another physical difference is the way my body looks. Part of this is due to the fact that I only gained 30lbs this pregnancy as opposed to the 60lbs I gained when I was pregnant the first time. As of right nowI am only about 10lbs from my pre-pregnancy weight (at two weeks postpartum) and I feel really good about it. My stomach still has the c section flap but I’m strangely ok with it after this pregnancy. A lot of it is a sense of acceptance on my own part. I accept that I’ve had two babies in just over two years. I accept that my first one was a surgical birth and it changed the way I look. After my c section, I felt deformed and disfigured because I developed a flap of fat that now hangs over my underwear. I wouldn’t even let my husband see me completely naked, not once in the more two years that has passed since my c section. After my VBAC I feel like i have given myself permission to stop hating my body. I’m certainly never going to wear a bikini again and I don’t openly walk around naked but I’m done hiding. I don’t feel like I need to any more. My VBAC has given me the confidence to let go and be grateful that I have carried two healthy babies to term and birthed two healthy babies in two very different ways.  My body did some pretty amazing things when it birthed Stella and I can’t be so hard on it anymore. I appreciate that it works and I also appreciate the fact that the flap is a result of my son’s birth. Had he not have been born by c section I would not have the same perspective that I now have.

My labor with Graham was long but not nearly as tiresome or as hard as my labor with Stella. It was long though and I didn’t get much sleep leading into the c section. After the c section, I was so shell shocked by the whole experience that I didn’t get much sleep in the following days. I was absolutely and completely exhausted. I was also so disturbed by the experience that I craved normalcy to the point of going home from the hospital and  cleaning my house. I didn’t allow myself to rest or recover. I felt the need to constantly do something and I didn’t sleep well. Add to that a baby that wanted to nurse every two hours or less round the clock for the first four months of his life and the results are not that great. Since my VBAC, I have been able to get so much more rest. I attribute a portion of this to my body adjusting more easily to the natural changes that occur after a normal birth. The hormonal processes that normally happen during and after a natural vaginal birth happen to help ease both mother and baby from pregnancy to postpartum. I believe my milk coming in just over two days after the VBAC versus six days after my c section are proof of that. I think that the body generally adjusts better when the normal processes happen. It also makes it more real that the baby in front of me is the baby I birthed rather than having my baby brought to me three hours after being lifted out and having a hard to associating him as the same baby that was in me.

Psychologically it all makes sense to me. I birthed Stella. No one delivered her. My husband caught her and passed her to me and I was the first thing she saw. We were not separated and we had an immediate bond. With Graham, the bonding took more time. I feel bad that he didn’t get what Stella has gotten but I do know that he is ok and we are bonded. He is my first born and very special in a different way but Stella’s birth has given me a sense of empowerment that I never had. After this VBAC, I feel like I can do anything.

*Please note, this is a lengthy post to try and convey our breastfeeding experience

Background

I was due to give birth with our first child toward the end of January 2009 and I currently live in South Korea because my husband is in the military. Since I was living “outside of my comfort zone” I didn’t feel prepared to give birth and wanted a little more reinforcement. I was put in touch with a doula that a friend of mine used during her delivery about 5 months prior. After meeting with our doula, Amy, I realized that she was going to aid in my ability to have my baby naturally. I had never even thought about having a baby without the use of pain medication until I reached a certain point in my pregnancy and I thought about how I didn’t even want to take over-the-counter medication that was approved, why did I want to take “a cocktail” of drugs to just give birth.

Short summary of labor and delivery

I was 41 weeks and 1 day when I finally went into labor. I did not want to be induced and I had been monitored on a regular basis to make sure my baby was not under any stress. I spent several hours in a place set-up for expecting mothers that do not live on the army installation where I was going to give birth. I had my husband, Amy, and a doula-in-training, Karen, with me to help me achieve the birth plan that my husband and I set-up. I spent approximately 12 to 14 hours in the alternate location working through my labor before we decided as a group that it was time for me to be admitted to the hospital. I then spent another 14 to 16 hours working through contractions in the hospital. After a total of 30 hours of being in labor, the current doctor came in and told me that I had been in labor for too long and I was not progressing on my own and they had to intervene medically. At that point, I had been through a tough labor because my baby had flipped and was in an OP position several hours prior. My doula’s, husband, and I were all getting exhausted after my lengthy laboring process and once the doctor came into the room and made her statement that I wasn’t going to be able to do it on my own terms, my concentration was broken and I broke down in my husband’s arms. I remember stating to him, “get this baby out of me if she is not going to come out the way I want…NOW!!! I didn’t want to feel another contraction if it wasn’t going to result in the birth that I had discussed and worked for over the past 2 days. I would like to note that if the doctor would not have stopped us I would have probably continued for several more hours because I didn’t want to have drugs or a c-section. Would the outcome changed, I don’t really know. I do know that at the time both the baby and I were still medically okay. I then felt required to allow them to give me an epidural, what other choice did I have, and pitocin to help regulate my contractions and to allow them to “break my water.” I was then allowed to rest for about an hour while the “medical intervention” took effect. I had finally dilated and began to push for a few hours, but my baby stayed at 0 station and was not descending. My husband and I were then faced with the question of if we wanted them to use forceps or a vacuum. Thankfully I was semi-educated, due to my own research and my doula, and I didn’t want something attached to my unborn child’s head, if preventable. We opted for a c-section because it was the safest choice for our baby. In hindsight I wish I would have asked to push for longer since we were both still medically fine. However, I don’t know if I would have been allowed.

Recovery

The recovery following a c-section is very difficult and changes what you anticipate following birth. I was very firm when I told the nursing staff I did not want my baby to have formula or a pacifier after birth, unless medically there was a reason and my husband and I needed to be consulted first. After birth I was separated from my little girl, Sierra, for a little over an hour, but began to “try” my hand at breastfeeding almost the minute I was given her. She latched right on and I was elated to say the least.

This was only the second item on our birth plan that was accomplished. The first was my husband announcing the gender of our baby.

1st Breastfeeding hurdle

Our attending pediatrician came into our room on one occasion to discuss with us his concern because Sierra had not began urinating and it was now a day after her birth. He told us if she didn’t urinate within the next 12 hours she would be transferred to a Korean hospital for additional care and treatment. My mind went into immediate overdrive. I knew that my body was providing Sierra colostrum and it should have been adequate, so I wasn’t worried about her getting the correct nutrition because I knew she was. Amy had helped with the education and I also read a couple of baby books and searched the internet. However, we now had another hurdle. I asked what can we/I do to help this along. I told the pediatrician that I really wanted to continue breastfeeding, but if she needs more liquid in her diet that my body isn’t producing at this point to help her urinate that I was willing to do what she needed so that she didn’t have to leave me. At that point, it was a double-edged sword because if she left she would be given formula anyways because I couldn’t be released yet. He suggested that I nurse Sierra for five minutes and then I let my husband give her formula. We did this every hour for the next three hours and Sierra probably consumed less than 2 ounces of formula the entire time. However, she peed on the nurse while she was being examined 3.5 hours later. A huge relief!!! We were in the clear.

Incision

7 days after the birth of Sierra a portion of my c-section incision opened up. This is one aspect of a c-section that is not publicized and is fairly common. My husband and I were very concerned for my safety because we didn’t know what had just happened. I didn’t feel any pain, but I had a substantial amount of fluid on my clothes, fluid on the seat where I was sitting, and it was still minimally coming out of my incision. We called our medical care provider in our area and were advised that I would be fine and to come in the morning. Just what every new, paranoid mother wants to hear. After seeing the medical team in our area they called my attending OB doctor and we had an appointment with her the following day. We were told this is fairly common, and that we should begin packing it with gauze and changing it twice a day. I also started having medical appointments twice a week at the hospital I delivered at which is over an hour away, one-way. My husband was now my primary provider of the dressing changes. I was still recovering from a c-section, now had an open incision, and was still nursing Sierra exclusively. I did not even let the idea of a bottle and formula into my mind. She was too young and I wanted to prevent the likelihood of nipple confusion. There would be times in the early days of breastfeeding that I would be feeding Sierra and my husband would literally be feeding me food because there was so much going on around us. My husband could not have been a better provider to Sierra or me and still takes care of a lot of my medical issues. I couldn’t have done any of this without him because he took care of her in the early days of her life and my only function in the beginning was to breastfeed.

Over 4 months later we were still changing my dressing and my incision was still not healing. However, I was able to maintain my ability to breastfeed Sierra. In hindsight, it sounds like we didn’t ask enough questions, but we had complete confidence in our current OB. He has been an OB doctor for over 35 years and I am the only case he has EVER seen where the patient did not heal. I also need to note that I was in the United States for a month during this time and I also went to a doctor there and he told us the same things. I just needed more time because a wound takes time to heal. After the OB doctor consulted with many other doctors in his field and in surgery, I was being referred out of the OB area to a surgeon.

Surgery

I had exploratory surgery on my abdomen on June 4. My CT scan did not show anything that was alarming so he had to get in there and see what the problem was. My surgeon removed a rind of tissue that was not allowing me to heal. Prior to my surgery I couldn’t get an answer on the type of anesthetic that was going to be used so that I could continue to breastfeed. Because of this I had to stop breastfeeding Sierra for 24 hours and this broke my heart. I hadn’t stored any milk for her because she refused to take a bottle. She just couldn’t figure it out and my husband tried on numerous occasions with milk that I had pumped. This is when our breastfeeding journey begins to get very difficult for me, Sierra, and my husband. My husband had to take care of our baby who had been nursing on her mom for the past 4 months and try a bottle. At that point we had tried almost every nipple known to man to see if she would take one and my husband had to feed her with a syringe the first few days. Then we began getting nipples that are used for newborns in the hospital because she could figure those out. Throughout my 22 day hospital stay there were many instances when I had to pump out milk that Sierra should not have because of the medication that I was given. She began to take the formula from my husband, Kevin, and it broke my heart, but I was happy she adjusted so quickly. My milk supply was no longer what it used to be, but my baby stayed loyal. She still latched on right away every morning when she can to my room. This was a very difficult time for me because this was a bond with my daughter that I wasn’t ready to give up yet, but I didn’t know what else to do. It still brings tears to my eyes to even think about my time in the hospital. After 22 days in the hospital I no longer had a sufficient milk supply for Sierra and we even started her on vegetables a little over a month earlier than I wanted. Sierra still wasn’t a huge fan of formula and I thought at least she is getting nourishment from me, formula, and vegetables.

Back Home

By the time we were released from the hospital we had finally found a nipple that she could figure out. By figuring out I mean she could still use her breastfeeding latch and the formula would still come out. I continued to breastfeed Sierra and I wanted my milk supply back and was even given information from Amy on how to make this happen, but after I thought about it, I couldn’t let myself stress about the formula anymore. Our days were still very stressful because I had/have doctor appointments that are an hour drive one way from where we live two to three times a week. Plus, I am still attached to a wound VAC that I have to carry around because it is attached via cords to my open wound. I needed to make peace with myself that she was still getting some breastmilk and I needed to come to terms with the fact that she may wean herself off breastfeeding before I wanted because of our circumstances. I was also being faced with the good possibility that I may have to undergo another surgery and I couldn’t put Sierra or my husband through that painful transition again from breastfeeding to formula because I wasn’t ready. As of today, August 4th, I am still recovering and Sierra is a little over 6 months old. I still have an open wound and a slight possibility of another surgery, but Sierra is back to breastfeeding exclusively and formula is not a part of her nutrition as of yesterday, but she still enjoys her veggies daily. When I began to realize the little amount of formula she was actually taking I began to get really excited. The one thing I did do to help increase my milk supply was to keep her at my breast for longer to help with stimulation if she was nursing/sleeping on me.

If my story can influence anyone to push pass the physical pain that you may feel in the first few weeks or adversity you might be facing, I am happy to share.

Stella latched on soon after birth while we were still in the pool. She wasn’t really interested in nursing but she did make contact. After we got out of the pool, we realized I was bleeding a little too much, Danica the midwife, held Stella and my breast and latched her on and helped her feed while Dr. Chung and Rosa worked on me. The contractions and fundal massage where incredibly painful and my placenta had not passed so i was really not able to hold her and nurse her myself, especially while lying flat on my back. I was glad to have an extra set of arms so that Stella didn’t miss out on that very important after birth skin to skin contact.

Over the next two days, nursing continued to go well. I knew I had colostrum and on day two after birth Stella began peeing in her diaper. She had not, however, passed meconium. Generally newborns pass meconium before they pee but pee is also a sign that baby is getting plenty of colostrum to stay hydrated. I wasn’t worried about her getting enough to eat but I was concerned about the lack of poop. Most healthy newborns will pass meconium by 48 hours. Stella didn’t have any symptoms of an intestinal blockage like a painful or distended belly or spitting up bile or bilirubin but I did worry that if she didn’t pass the mec soon that she would become jaundiced.

I talked to Karen about it and we called the pediatrician who said to insert a q-tip just a bit to see if it would stimulate a poop. We tried it and it didn’t work and really it just seemed mean even though we were really gentle about it. I knew that if we took her in that they would do it again but more aggressively and that they’d poke and prod the rest of her. I figured that a little extra fluid would be enough to push the poop right out but my milk hadn’t come in yet. I didn’t get milk until six days postpartum with Graham so I was a little worried about waiting because I didn’t know how long it would take this time. Karen and I had already discussed her nursing Stella if i had a repeat c/s or surgery for the retained placenta so I knew she was ok nursing Stella if I wanted her to. I really wanted to avoid formula and bottles at all costs and Karen had no hangups about nursing someone elses baby. We decided once we hit the 48 hour mark after birth without a poop that we’d give it a shot.

Karen nursed Stella for about a half hour and the baby was quite content. I didn’t feel the least bit weird about it, I was really grateful to not only have a friend close enough to do this but also to have a much more gentle approach to stimulating a poop. This just seemed like the natural course of action and even Karen’s kids didn’t seem phased by it. Of course, her 16 month old wanted in on the action but that’s to be expected. Once Stella was finished, Karen brought her back to me in a milk coma. She did stir and want to nurse from me some more which was great because she knew she was back to mama. While I was nursing her she began to pass some rather loud and very smelly gas. I pumped her legs, pushing her knees up to her belly and held them with a little pressure, then released and repeated. After a couple of minutes Stella emptied out for a good five minutes. I gave her time to finish before I began to change her but she was still pooping when I opened the diaper so I just swapped it out for a clean one and let her lay on it while she finished. It was thick black tarry meconium and a lot of it. She pretty much cleaned herself out with that one poop. The next one she made, a few hours later, had only a little black mec and the rest was the yellow seedy breast milk fed baby poop. That was the last of the meconium.

I was so excited. It was nice to have an instinct and be right and take care of her in a gentle peaceful way. And what better friend could a new mom ask for than one who will nurse your baby without a moments hesitation or thought about it? The funny thing is that almost immediately after all of this took place, i felt the tingling in my breast that signaled the beginning of engorgement. I knew my milk was on the way. By the next morning, I had a nice big full supply.

Karen’s side

Stella was latching well and nursing frequently, but with the exception of the meconium she passed on the inside, she hadn’t had a good meconium poop on the outside by the second day. Since she was peeing and nursing well, the plan was to go see the pediatrician in the morning if she still hadn’t pooped. Amy called the pediatrician who suggested a butt-probe. I put some petroleum jelly on a q-tip and gently twisted it around. There was a bit of mec on it when we took it out, so we knew something was in there, but hours later at the 48 hours mark, it still hadn’t passed.

Since I have full-on milk because I am still nursing, Amy asked me to nurse Stella. We had already planned to have me nurse and pump for Stella if Amy had to have a c-section or surgery for retained placenta. We felt that nursing would be a much more pleasant remedy than a more aggressive butt probe by the pediatrician or messing with finger feeding formula.

Stella is the first baby that I have nursed other than my own children. It was very natural. It seemed just the right thing to do. In fact, after she was born and I held her in the Moby as we were getting ready to go to the hospital, I had an instinct to nurse her. I didn’t do it at that point because she had already been nursing from her mom and I was able to get her to sleep in the Moby.

She latched perfectly and nursed for about 30 minutes. Ian and Eva (my children) were very interested. I was surprised that Ian (who is almost 4) didn’t find it strange at all that I was nursing another baby. Eva (16 months) is fascinated by Stella and just kept saying,”Baby! Baby!” She eventually did get jealous, though. I attempted tandem nursing, but couldn’t get into a good position for both of them. Eva patted Stella as they nursed together.

When Stella finished nursing on one side, she let go, flashed a peace sign and relaxed into the milk-drunk happy state that babies get to when they have full bellies. I offered the second side, but she just played, so I took her back to Amy.

When Amy held her, she recognized mom and wanted to nurse again. Shortly after that she had a MASSIVE butt-plosion. Amy waited through several blasts before attempting to change her and even then, more was coming out. I felt strangely proud of myself for being able to clear her out like that. In fact, it worked so well that her next poop had only a little meconium and actual poop!

After having a c/s with an inverted t cut, I was nervous to get pregnant again. I knew that I didn’t want another c/s but finding a doctor to attend me would be really hard. I did find the perfect team right here in Korea, which saved me from having to split up my family and going back to the States. My birth team was so much more than convenience though, each person was there for a specific reason and each person was there in their own perfect capacity. I truly did have the best birth team possible in Korea and most likely Stateside as well. I am very sure of this.

Graham and I were already in Seoul at my friend/doula’s apartment, where I planned to birth. We live two hours from Seoul and the nearest hospital is about 45 minutes away and my OB and I agreed that was too far away in the event of transfer since I was planning to have a(n) HBAC (home birth after cesarean). We came into the city on the 15th, my estimated due date to await baby Fuller’s arrival. My husband was out in the field for an exercise and waiting to get the call to join us. He was 2.5 hours away minimum which made me nervous. In hindsight that is really really funny.

On Thursday, July 22nd I began having prodromal labor: start and go labor, regular then irregular contractions, no contractions, ‘false’ labor, etc. I also began losing my mucous plug. I called Josh to let him know and he decided to go ahead and make the trip to Seoul. Even though we weren’t sure when labor would really kick in, we knew it would be soon, especially since I was 41+ weeks at that point. He got in that evening and Josh, Graham and I checked into the hotel on post to get some private time as our last few days of a family of three. The next two days were spent hanging out, playing with Graham and doing lots of walking. I continued to have the prodromal labor until Friday night.

Friday night at 1am, I was woken up by a contraction that was not like the prodromal ones. It was ‘real.’ I layed there thinking I should ignore it and go back to sleep. Three and a half minutes later, I had another one. Then another one the same interval. I went to the bathroom and realized they weren’t stopping. Graham and Josh were both sleeping so I got on Facebook and started what would end up being a live feed of the birth until the end. I never planned on doing that but it helped me cope for many hours of the labor and once I couldn’t do it anymore, my husband and Karen (friend/doula) took over.

For the next 2.5 hours, I had contractions 3.5 minutes apart. I started to get the shakes and decided to text Karen and let her know I was thinking about coming back to her apartment. I also woke Josh up. It took about an hour and a half to get ourselves back to Karen’s and thankfully, Graham went back to sleep for a few more hours. I continued to labor all morning. I also had bloody show and knew it was the real deal.

Around lunch time or so my labor seems to space out. The contractions went down to 7-8 minutes apart and I was mildly annoyed. I knew it was because the baby was trying to get into a better position and just went with it. I made sure to eat and drink and I took a nap between the contractions. After that, Karen did a maneuver on me called a hip lift that we learned from the Pink Kit and I had immediate results. When she did it, I felt my pelvis open and there was an obvious shift in the baby’s position. Karen felt the movement too and she was only touching bony pelvis. As soon as I stood up, my contractions kicked back in stronger than ever. They were very intense compared to my labor with Graham. I had no back or hip pain but had intense cervical and lower uterine pressure, so much so that it caught me off guard and I found it overwhelming at times. I listened to my Hypnobabies tracks the entire time and it really helped me focus if I began to struggle at all. A few hours later I was able to nap between contractions some more and it really helped since I had only had four hours of sleep the night before.

Karen and I had discussed when to call Dr. C and I just felt like that even though I was definitely in active labor, it wasn’t very progressive and I didn’t want to have the pressure of a bunch of people there just yet. Little did I know that my med team (Dr. C and MW1 and MW2) would be the least pressure I’d encounter! We did call them around 7pm to let them know we were ready for them but that they didn’t have to be in a hurry. They arrived around 9pm. They checked the baby with a portable contraction/fetal heart tone monitor for about a half and hour and she was doing perfectly. My vitals were great as well. Everyone retreated to the kitchen and living room and gave me my space to continue to labor. Karen and Josh alternated helping me and keeping me company. At some point before the med team arrived, Karen and Rachel (another doula friend of ours that came by to help out evening #1) got the pool filled and I got in. I love it.

Around midnight I decided that I wanted a vaginal exam. I am not a fan of routine exams and my team knew that if I wanted one that I’d ask so no one ever offered. Rosa (MW1) checked me and said I was complete, 10cm and 100% effaced. I was floored that I was complete and excited too because I just knew that I’d be pushing soon and would be done! Then Rosa said that the baby was still a -2 station which is high in the pelvis still.

Because of the work I did with the Pink Kit and and the time I had spent discussing my birth history and pelvic shape issues with Gail Tully, the midwife that runs www.spinningbabies.com , I knew that I had some things to contend with and work through. I knew the entire labor that these things were why the labor had been somewhat funky with the spacings and with the baby being high. I also knew that if I could get the baby to descend into my pelvis that there was a very strong possibility that I’d push her out. The trick to this would definitely be getting the baby to descend.

Rosa began working me in different positions to aid descension. The first was walking while doing abdominal lifting in between contractions. I did this for 30 minutes. The she had me swaying my hips between contractions for 30 minutes. Then she had my so a side lying position in the bed for an hour. This was nearly torture. The rest of the birth team slept except Karen and Josh. My contractions were at the strongest intensity that they had been the entire labor at this point and laying down in bed on my side but while also squishing the left side of my belly into the bed (to force the baby out of a left occiput transverse position) was torture. Karen and Josh had to talk me through every moment of it and the last 20 minutes made me want to scream at both of them. And I did along with many choice cuss words that would embarrass some people but I managed to do the hour because of those two and it did help the baby move so it was worth it in the long run.

That said, that hour was so incredibly difficult that I lost my control and focus. Josh went to take a nap while Karen stayed with me. I got back into the birth pool and tried to refocus and get my control but I struggled. I told Karen I was done and I ready to go to the hospital and I didn’t care about a VBAC any more. I wanted an epidural and some sleep and if that didn’t work, fine. She looked at me as if to say ‘everyone else is asleep’ and I glared back ‘then go wake them up!’ But what I said out loud was “I’m so tired and I need to sleep” and she responded with “so sleep then.” She didn’t pity me or baby me which is what I wanted. She was blunt and she wouldn’t let me jump of the ledge I was so desperately trying to escape from. It pissed me off but I do mad way better than I do upset or pity so it worked and I went to sleep. For two and a half hours I slept in the pool. My contractions had spaced a bit, maybe 6-7 minutes apart and I did wake up to work through them and then I went back to sleep. Karen slept on the bed next to the pool.

When we woke up the sun was coming up and I puked and ate, in that order. Rosa did another exam and said that the baby was still at -2 but that her head had moved to an OA (occiput anterior, optimal for birth) position so we were all encouraged that things would start moving. My water had not broken either and the bag was bulging out in front of the baby’s head. I wondered then if they would want to break it and analyzed how I felt about it. I didn’t like the idea but felt like something needed to happen. No one said anything about it.

Because of the nap and the food, I felt much better. I was still worried that I didn’t have the stamina to continue when my labor kicked back into high gear but I was beginning to believe that maybe I could do it. I had more energy, now I just had to find a rhythm. Karen and Josh rewarmed the pool and I got back to work. I labored in positions that made my pelvis feel open. Mostly I stayed on my knees while holding onto the side of the pool. Around lunch time, Dr. C told me they were going to go eat in shifts and that when they were all back that we’d discuss rupturing my bag of water. I had been at 10cm for about 12 hours that we knew of at that point and since the baby still was’t descending it seemed like something worth exploring.

They (med team) were all back by 2pm. They discussed what they though amongst themselves then Dr. C came to talk to me about it. Since the head was in a better position he thought that if he broke my water that the more intense contractions that would create would push the baby down farther into my pelvis. He was blunt and honest and said that he didn’t know if it would work but if it did hopefully I’d have the baby soon (music to my ears since I was 36 hours into it at that point) or it wouldn’t work and we would go to the hospital to explore other options. I agreed with him and gave him the go ahead.

They wanted to do a half our of monitoring first so we did and baby looked great. It was about 4pm when we were all ready to rupture the membranes. He wanted to break the water during a contraction so that the force of the contraction would bring the baby’s head down and prevent cord prolapse since the baby was still high in my pelvis. Rosa did the job and wow did i ever have some water! It just poured out. The baby’s heart rate jumped up to 180-190 for a bit so they gave me oxygen and had me lay on my left side. I had a contraction and more water poured out and then I had another contraction and my body pushed with all it’s might in the most uncontrollable way that I have no words to describe it. I looked at Dr. C and said, “I pushed!” and he said “I see that!”. They had me side lie for about 20 minutes longer and continued monitoring and the baby looked great so I was given the go ahead to get back into the pool.

The pool made everything better. I was ready to do it. I pushed when my body said push. I was loud and I roared and grunted and made noises that I never imagined. I remember Karen saying to be a lion and thought it was funny even though I ignored her. I pushed spontaneously for about two hours before I asked Rosa to check the baby’s station. The baby was at zero which was improvement but I knew I still had a ways to go. Rosa made sure I was swaying my hips and changing pushing positions at interval. I also got very serious about pushing and began bearing down as hard as I could on top of what my body was doing. It just seemed like I should. I was exhausted and had been pushing forever and was so ready to be done with birthing! After a bit, I could feel the baby’s head just inside and that gave me a lot of strength. I was oblivious to the world around me. I knew Graham was in the room and he seemed ok with my roaring. Josh said that he said ‘ow mama’ a few times and ‘oh shit’ more than a few times as that was my cuss phrase of choice. After the three hour mark of pushing I knew the baby was really on it’s way out. I felt fierce and determined. Everyone was focused on me and I didn’t care, I was happy and loved every single person present and so grateful that each of them were there for that moment. I soon realized that the baby’s head was crowning and I yelled “OH ring of fire, that’s sucks!” and I thought about how many times I told a client that ‘you can do anything for a minute!” and it made me want to slap myself and hug myself at the same time! In the next push, Dr. Chung reach down to help slow down the baby’s head and I really felt the stretching then. The next push I bent over on hands and knees and Josh got prepared to catch the baby from behind from outside the pool (I didn’t want him to get in). Dr. C and Rosa moved to the backside with Josh and I pushed what felt like a huge rock. Dr. C told me when to push and when to breath through it and not push. He has a 70% no tear rate so I told him I would listen and do exactly as he said. In fact, when I realized the baby was crowning, I asked him if it was time to listen to him which got some laughs. The next push brought the head all the way out and that was the hardest thing I think I have ever done. I waited until the next contraction for push again and Josh said that she opened her eyes and mouth and moved her head under the water. The next push brought her shoulders out one at a time which I felt every bit of then her body just squished out which kind of felt like a reverse vomit or something equally strange. I looked over my should in that moment and saw Dr. C and Josh both with outstretched arms and the next thing I knew they were trying to pass the baby back under my legs to me. I sat back in the pool and was somewhere between “OH MY GOD I JUST HAD A VBAC” and “OH MY GOD, I’M DONE!”. The very first thing I did when they handed me the baby was lift her leg and then say “I knew you were a girl!” It was an amazing moment. Karen was crying and saying “you did it! you did it!” and Josh was tending to Graham because as soon as the baby popped out he lost it. I sat back in the pool and stared at my baby girl and just couldn’t believe what had just happened! I had a perineal tear that wasn’t bleeding so we decided not to bother with stitching and opted for resting with my legs closed for a week or so instead.

The amazing thing about my birth is that Dr. C was so incredibly comfortable and confident. He was confident but not cocky. He listened to Rosa, who is more experienced than he is but he still made the call when it came down to what he felt was best. He discussed everything with both me and my husband and Karen and I ultimately had the final say in every aspect. There were no time limits, no unwanted interventions, lots of privacy. They did monitor regularly but were not over bearing and were unintrusive. Rosa is probably one of the most experienced home birth midwives in Korea. She is a CNM who worked in a hospital for 10 years before doing home birth. She also runs a birthing center. Dr. C respects her and listened to her and she did exactly what I wanted her to do when I asked her to join the birth team which was help me deal with positioning issues. I knew going into my birth that I have pelvic shape issues that would made birth more difficult and that lended a hand in what was Graham’s c/s birth. I wanted the best and she brought it. Dr C told me later that adding her to the team was the perfect choice.

I was 10cm dilated with an intact water bag for 20 hours or so before any intervention. Dr. C told me today that he didn’t feel intuitively about doing anything earlier than what we did. There was a chance it could have cause more harm than good and by waiting we were able to increase the chance for best case scenario. I agree wholeheartedly and adore him for his patience and do not know of another care provider that would have been comfortable doing that. He said that the baby was fine and I was ok so waiting was what was needed. When we did break the water, it worked exactly as it should have. I am in awe.

After the birth, I had some heavy bleeding. It wasn’t to the point of hemorrhage but it was concerning. The placenta did not detach either. Afte two hours and still bleeding and still no placenta birth, Dr. C told me he wanted to take me to the hospital. He felt like everything was ok but he wanted me monitored over night and wanted blood work done. Josh and Karen got us together and Karen took the baby. I was weak and needed a lot of assistance getting out so Dr. C and Danica (MW2 who was also great but more of a Dr. C/Rosa support person than so much for me). We got checked in to the hospital and I ate some food that Karen packed up for me and Josh took care of baby Stella. Once settled in, i was able to sleep for about 5 hours until Stella was ready to nurse. She nursed like a champ and slept all morning on my chest. Josh go to sleep for 5-6 hours in the morning.

Once morning came, Dr. C dropped by and checked me out. The bleeding was at a normal level and my labs were fine and other than being weak I was ok. The placenta was still attached but in the absense of any indication to do so (such as infection or bleeding), Dr. C is comfortable with waiting to see if it will come out on it’s own. He doesn’t want to have to do a manual or surgical extraction. So orders are bed rest and daily check ups and blood work and infection monitoring and we will reevaluate the situation daily until either it comes out or he takes it out.

None of the after birth stuff has affected my birth though. It was exactly the birth I was supposed to have and I would do it again five times over if it meant not having to recover from another c/s. I am still in shock and awe and amazement and I can’t believe I did it! It was the hardest thing I have ever done and I’m so grateful to my team, they were perfect. I know I’ve left out important details and that this hasn’t been proofread but I had to get it out. Enjoy! I’ll edit later.

EDIT: The placenta came out a few hours after I posted this birth story. I went to the bathroom and couldn’t pee much but could tell my bladder was full. I stood up and felt a very heavy weight on my bottom and I looked in the mirror and saw the placenta bulging out. I didn’t push but when I spread my legs it plopped out onto the floor all at once. My bladder immediately released and for a second I couldn’t tell what was going on and was afraid that I was bleeding. I realized what happened and calmed myself before yelling for Josh. I told him what happened and he was super excited then I told him how bad it smelled. It was TERRIBLE and like meat that had been left out for a few days. He peaked in to look at it on the floor. I had him go wake up Karen (who of course, took a picture) and she called Dr. C. Since I wasn’t bleeding he decided to wait until our planned check up for the next morning. My bleeding has been a bit heavy but still normal, so I’m not concerned and I’m sure he won’t be either.

I feel SO much better physically. I immediately felt different when it came out. I did get weak and woozy and had hot flashed but the pain I was having in my bottom was gone. I’m still sore but i can actually move around with little assistance now. My body knew that the placenta didn’t belong in there any more but I guess it just needed time to release it. I’m so glad Dr. C was patient and didn’t force manual extraction. Again, everything about this birth was exactly as it should be and I’m so happy there was not a surgical ending to my beautiful VBAC. The placenta was born 29.5 hours after my baby was. Dr. C told Karen “Time. She needs more time. With Amy, everything takes more time.” He knows me so well!

Our baby girl’s name is Stella Rose. I didn’t know Stella meant “Star” when we chose it but it’s so appropriate because for our VBAC the stars had to align on so many levels. We chose Rose as her middle name to honor our Korean birth team. MW1′s Korean name is Kim Oak Jin (Oak Jin is her first name) and there is no English translation for that name so she chose Rosa as her English name. We thought that by choosing Rose for Stella’s middle name that we were acknowledging our medical attendants and their dedication, hard work, patience and confidence in our birth. Plus, Hwan Wook (Dr. C’s first name) didn’t flow very well with Stella!

Stella Rose
9lbs 2 oz
21.5 inches
15 inch head

The seven steps include…

1. Give your baby a healthy womb environment.
2. Do not allow smoke around your baby – pre or postnatally.
3. Put your baby to sleep on his back or side, not on his stomach.
4. Breastfeed your baby
5. Give your baby a safe sleeping environment.
6. Avoid overheating your baby during sleep.
7. Practice the “high-touch” style of attachment parenting.

I am picking out a few major points. The article is long but well worth the read.

Most of these seem pretty obvious to me. They are biologically sound. SIDS used to be a mysterious tragedy but researchers have since found that the number one way to reduce SIDS is to put babies on their backs. The Dr. Sears article says…

Between 1989 and 1993 SIDS researchers in cooperation with the British government launched a “Back to Sleep” campaign, advising parents to put their babies to sleep on their backs rather than their stomachs. A few years after this risk-reduction campaign was launched in England, SIDS rates plummeted throughout the United Kingdom by as much as seventy percent. A similar “Back to Sleep” SIDS-reduction campaign occurred in New Zealand and Australia followed by a fifty percent decrease in national SIDS rates in these two countries. The Netherlands, Sweden, Denmark, Germany, and Ireland saw a similar decrease in SIDS rates following “Back to Sleep” campaigns in these countries. Eight countries doing similar risk-reduction campaigns and all getting similar results. This had to be more than a coincidence. These findings were a breakthrough in SIDS-prevention research – and in SIDS-prevention attitude. Instead of the previous belief – that SIDS was a mysterious and hopeless tragedy – the changing sleep-position advice was finally something practical that professionals could agree upon and parents could do.

In 1994, the U.S. Public Health Service organized a national “Back to Sleep” campaign, and it paid off. In the past few years, SIDS rates have dropped around 30 to 40 percent in the United States.

I do find it interesting that later in the article a few points are made about babies who may be better off tummy sleeping…

BABIES WHO SHOULD SLEEP TUMMY DOWN

Be sure to check with your doctor to see if your baby has any medical conditions that necessitate front sleeping. Babies who should sleep prone are the following:

• Premature babies with respiratory problems still in the hospital; sleeping on the tummy increases breathing efficiency in prematures with compromised breathing, but not necessarily when their lungs are normal

• Babies with small jawbones or other structural abnormalities that may compromise the airway when sleeping on their fronts• Babies who have mucous-producing respiratory infections or profuse drooling associated with teething – if so advised by your doctor

• Babies who are extremely restless and settle poorly unless sleeping prone

• Babies who suffer from gastroesophageal reflux (GER).

My son probably would have benefited from tummy sleeping earlier on. He was a terrible sleeper. At six weeks old he was only sleeping about 8 hours out of 24. He did sleep well on his tummy but I was so bent on following ‘the rules’ that I didn’t go with my instinct. Later in the article Dr. Sears says…

What if my baby prefers sleeping on her tummy?Unless advised to the contrary by your doctor, it is best to let your baby sleep in a position she prefers. If baby doesn’t settle well, or stay on her back or side, front sleeping is all right. Also, you may find that your baby prefers different sleep positions at different ages. After all, there is a meaningful wisdom of the body, even in a baby. If a baby repeatedly doesn’t settle in a certain sleeping position, this may be a clue that this position may not be the safest for this individual baby. This is just one example of how babies often try to tell us what is in their best interest. Parents should not be afraid to listen.

He does go on to say to try to teach back sleeping if possible. My son ended up rolling from back to front at about three months old so it was pointless for me anyway as I would put him on his back asleep and he would just roll himself right over. I guess he knew what he wanted!

I also like that Dr. Sears gives 8 reasons why breastfeeding reduces SIDS…

THE MILK
There are hundreds of substances in human milk that aren’t in artificial milk. These cannot be manufactured or bought; they can only be made by mother. Each year researchers discover new factors in human milk that are beneficial to baby. I suspect that researchers have only scratched the surface of what amazing factors exist in human milk. The following is what we know. What is even more intriguing is what we do not yet know about how human milk benefits human babies in general and how it lowers the risk of SIDS in particular.

1. Breastmilk fights against infection

2. Breastmilk builds better brains.

. Breastmilk is kinder to tiny airways.

4. Breastfeeding reduces reflux.

5. Breastfeeding promotes safer sleep.

6. Breastfeeding organizes baby.

7. Breastfeeding increases mother’s awareness

8. Breastmilk improves breathing/swallowing coordination.

Check out the article to get more details on the 8 reasons why breastfeeding reduces SIDS.

The last point Dr. Sears makes is…

Ever since parenting books found their way into the nursery, sleep trainers have touted magic formulas promising to get babies to sleep through the night. Most are just the old cry-it-out method in disguise, and technology has also provided us with a variety of sleep-inducing gadgets designed to lull baby off to sleep alone in his crib. Oscillating cradles, crib vibrators that mimic a car ride, and teddy bears that “breathe” all promise to fill in for parents on night duty.

While sleep-training may be necessary for some babies, for others it may be unrealistic, even risky. Be discerning about using someone else’s technique to get your baby to sleep. Weigh these schemes on your inner-sensitivity scale before trying them with your baby.

Especially in the first six months, avoid sleep trainers who advise you to let your baby “cry it out.” Only you know what “it” is and how to respond appropriately to your baby. The first SIDS baby in my practice awakened frequently. Her mother responded intuitively to her and nursed her back to sleep. When that baby was four months of age, a friend warned this mother that she was “spoiling that baby and that she should let her cry it out.” That night her cries went unanswered – permanently. While there is no scientific evidence that sleep-training causes SIDS, the memory of my first SIDS patients has made me wary of the hard-line approach to getting babies to sleep through the night.

I believe that training babies to sleep too deeply, too long, too soon, while convenient to parents, is not in a baby’s best biological interest. Sleep- training done before their cardiopulmonary control mechanisms are mature enough to handle prolonged deep sleep could be risky. Training a baby to fall asleep and stay asleep alone in his own room in his own crib may be the “modern” way, but for some infants sleeping lighter and for shorter stretches may be the safer way.

We co-slept with my son until about 5 months old. Once he started sleeping 5-6 hour stretches I put him in his crib in his own room. I will admit at 6 months I did do a little cry it out with 5 minute intervals. I would put him down and if he cried I would let him cry for 5 minutes (I would stand outside his door and time it!) then go back in and help settle him. It did teach him to fall asleep on his on. It worked for us but I would never do it before 6 months old and I would never let a baby cry for more than 5 minutes.

I think this is a great article though. It’s good a lot of good tips and sound parenting advice.

Here’s a link to the page, which is also on the tabs across the home page of the site.

I know I am certainly one of those women that it would be easier for. It would probably be easier to go ahead and schedule my ERCS now. I was told after Graham was born that due to the inverted t incision scar on my uterus that there was an up to 15% chance of uterine rupture and that it would be best to schedule an ERCS at 36 weeks to avoid any labor. At first, even though I was devastated, it didn’t sound too bad. I didn’t have Graham until 41 weeks 1 day. Having my next baby at 36 weeks kind of sounded great compared to going past 41 weeks. Plus, we had a really hard long labor, 52 hours total, so the thought of skipping all that and just having the baby sounded pretty tempting. That’s how I rationalized it all in my head, to make myself feel better about having had the first c section and about having to have the inverted t incision. I thought, ‘well, at least I don’t have to be pregnant forever and I don’t have to labor just to end up with another c section and I can plan everything.’ But it never really set in and it never really felt right to me. So I started researching.

I already knew that VBAC was a safe and healthy option for moms with bikini cut scars so I didn’t really start out researching VBAC safety as a whole. I started with the inverted t incision because that put me in a whole different category of risk according to the doctors. I looked for the studies that backed up the 15% claim of rate of uterine rupture in a subsequent trial of labor (TOL) and couldn’t find anything. I did find the most commonly quoted rates of 4-9%. So I started thinking that at least that meant there was a 91-96% chance that no rupture would occur. That was motivating. The I found my friend Jessica, another inverted t incision mom. She had started a Yahoo group, Life After Inv T, on her own webiste, Jessica’s Haven, she shared her birth story of a VBAC after inverted t incision. It was the first I had ever heard of this and I was so excited. I didn’t even know it was possible then I realized, she had two other moms stories on her site too. This gave me confidence to start really looking at VBAC as a viable option for me.

One reference that Jessica made as far as determining the safety of VBAC after an inverted t incision was the Landon Study 2004. The Landon Study found a rupture rate of 1.9% for inverted t incision type scars. I was floored. This was the largest VBAC study ever done and the rate was more than half to almost four times less than the smallest rate quotes I had found previously. At this point I got angry. I got angry at all the information I was given after my first c section. I was angry at the suggestion that I purposely deliver a preterm baby when I have always known that it is better for babies to initiate labor, letting us know they are ready to be born. I was angry at the thought of having to endure another c section, not just for my own sake but my baby’s sake.  I realized that ERCS tend to be easier on both mom and baby but what if I want a third child? A fourth? Each c section a woman has increases risks of complications. And what about the issues that area associated with babies that are born by c section? They weren’t risk free either were they? My brain was racing and I was again on a quest to learn more.

I have read the Landon Study many many times. I gave my Korean OB a copy of it the first time I met him, in case he had never heard of it. I highlighted all the parts that pertained to me and any other information I thought should be discussed. He was very welcoming of that information and asked me to be sure to bring him anything else I come across that my help me have a better birth or for him to be a better doctor. I really appreciated that support.  I found a post on a message board the other day that kind of breaks the Landon Study down a little bit. I am including that information here because there are several points that I want to touch on that really define why I want to VBAC. I am going to bold these points and I am going to italicize any of my own commentary.

The 2004 Landon study in the NEJM (12/2004) is a very good source for UR information. It included nearly 18,000 that had a TOL (trial of labor which may or may not lead to a successful VBAC). The overall rate of UR was 0.7% which translates into 124 uterine ruptures in that group of nearly 18,000. Only 2 of the babies died following a uterine rupture. Keep in mind, the group included women having a TOL after 1, 2, 3 and 4 c-sections. It also included women who classical, invert T and J incision as well as the low tranverse incision (which is most common and considered the safest for a TOL). About 25% of the women in the TOL group had their labors induced (with prostoglandins or pitocin) and/or augmented with pitocin which also increases risk of uterine rupture. About 25% of the women in the TOL group were less than 2 years from their previous c-section. Clearly, there were many other potential risk factors that could come into play here with the risk of UR.

According to this study :

The absolute risk of neontal death is 0.08% with a TOL vs 0.05% in an ERCS; stated otherwise, the risk of neonatal death is 1 in 1250 babies with a TOL vs 1 in 2000 with an ERCS . Babies can die in both a TOL and an ERCS. The difference between the two is very very small as you can see. TOL and ERCS both have risks. There are risks associated with vaginal birth in an unscarred uterus. There are risks associated with getting in a car and driving to work and leaving your house with the oven on and with pretty much everything else we choose to do in life. At least these are calculated risks with firm data to give us an idea of what we are dealing with.

The absolute risk of the mother’s death was 0.04% with an ERCS cs 0.02% with a TOL; stated otherwise, 1 in 2500 mothers will die due to an ERCS vs 1 in 5000 mothers will die with a TOL)   Again, very small increase in risks here. Even though the risk of maternal death doubles for an ERCS, it is still under a half of a percent. Compared to the risk of fetal death, the mother’s risk is lower so one could say that VBAC is safer for the mom than it is for the baby but I am not sure that is very accurate since again, all of these numbers are under 1% total. And even if I sound cold or strange, I think for me I have to consider Graham, the child that I already have living here now. While the baby growing in my belly is very important to me, I could not imagine dying and leaving Graham to grow up without a mother. If I were basing my decision on the risk of fetal death vs maternal death, I would choose to lower the risk of maternal death. I have not based my decision to VBAC on comparing these two risks, however, and again, since all the risks are so very low, it’s not really important that I compare them that way. Some people may, but I’m not.

This study also separated out the number of women and the number of UR based on incision type:
- Low transverse incision (n=14,483): 105 ruptures (0.7%)
- Low vertical incision (n=102): 2 ruptures (2.0%)
- Unknown type of incision (n=3206): 15 ruptures (0.5%)
- Classical, inverted T or J incision (n=105): 2 ruptures (1.9%) I can’t really say anything. It’s right there to see. It’s not 15% or 4-9%, it’s 1.9% and I believe this.
- Unclassified (n=2)

It also separated out the number of women based on rates/types of induction:
- Spontaneous labor (n=6682): 24 ruptures (0.4%)
- Augmented labor (n=6009): 52 ruptures (0.9%)
- Induced labor (n=4708): 48 ruptures (1.0%)
- With any prostaglandins, with or without oxytocin (n=926): 13 ruptures (1.4%)
- With prostaglandins alone (n=227): 0 ruptures
- With no prostaglandins (n=1691): 15 ruptures (0.9%)
- With oxytocin alone (n=1864): 20 ruptures (1.1%)
- Not classified (n=496): 0 ruptures

Augmenting and inducing does raise UR (uterine rupture) rates. The numbers are still very small but in the absence of a valid medical reason to augment or induce, I would not do it. I feel that way about unscarred uteri though. Elective induction causes problems whether it’s for a first timer, a VBACer or anyone else.

A Breakdown of the number of previous cesareans (obtained from a subsequent study by Landon in Obstetrics and Gynecology 7/2006) (the women who had more than 1 c-section were grouped together and had a UR risk of 0.9% while the women who had 1 VBAC had a risk of 0.7%):
• 16,915 (94.5%) had 1 prior cesarean
• 871 (4.9%) had 2 cesareans
• 84 (0.5) had 3 cesareans
• 20 (0.1%) with 4 cesareans
8 women had an unknown prior # of c-sections

Risks of choosing a a TOL (trial of labor) vs an ERCS (elective repeat c-section):
•More likely to suffer a uterine rupture – the rupture rate in the TOL group was 0.7%; there were no ruptures in the ERCS group, however, women who presented in early labor and did not have a documented intention to labor were excluded so it is possible that women went into labor before their scheduled c-section and ruptured but were excluded from this study’s data
•1.4 times more like to have a uterine dehisence (typically a benign, thin area in the uterus)
•1.7 times more likely to need a tranfusion
•1.6 times more likely to develop endometriosis
•1.3 times more like to have another adverse event such as (broad ligament hematoma, cystotomy, bowel injury, ureteral injury)
•1.6 times more likely for the baby to die (doesn’t sound like that big of a difference right? Remember that babies only die in about 2-10% of uterine ruptures according to many studies AND babies do die after c-sections.

Risks of choosing an ERCS over a TOL:
•1.5 times more likely to need a hysterectomy I could have lost my uterus the first time, it was T’d secondary to difficult delivery of the head and once removed for cleaning and stitching it was found to be extremely large. So large in fact that they couldn’t get it back in. And it wouldn’t contract. I remember the slight panic in the room in those minutes. Luckily with a few shots of pitocin straight into my shoulder, it contracted and they got it back in. I’d kinda like to avoid that drama this time around. I’d like to have another baby, maybe two after this one.
•2.5 times more likely to have a thromboembolic disease (deep venous thrombosis or pulmonary embolism) I have a blood clotting disorder, prothrombin gene mutation. I am already higher risk for developing a DVT or PE. I do not know the stats but factored in with the risks of developing these issues just by having an ERCS, it is very motivating for me to stay off the operating table. PE  is the number one cause of death in pregnant women. So while the data shows a higher rate of death for the ERCS group at 0.04%, mine risk is going to be higher than that, even though I don’t know what the numbers are. It would be pretty hard to find information on risk of death by PE during an ERCS for a woman with PGM. That’s a mouthful.

•2 times more likely for mother to die
Risks of a successful VBAC delivery (remember that TOL can end in repeat c-sections) vs an ERCS:
• 1.2 times more likely to need a transfusion My doc said I could be a little higher risk on this one as my placenta is anterior and if I have any detachment issues after the birth. I am A+ which is an extremely common blood type in Korea and I am delivering at a University hospital in Seoul with plenty of blood in the bank. I feel ok with this.

Risks of an ERCS vs a succcessful VBAC:
•3 times more likely for mother to need a hysterectomy   See above. The above stats were for ERCS vs TOL (VBAC attempt whether successful or not). This stat here is for ERCS vs successful VBAC.
•5 times more likely to have a thromboembolic disease (deep venous thrombosis or pulmonary embolism) See above. The above stats were for ERCS vs TOL (VBAC attempt whether successful or not). This stat here is for ERCS vs successful VBAC.
•1.5 times more likely to develop endometriosis
•4 times more likely for mother to die

2 things this study does not address regarding newborns is the incidence of respiratory distress in babies born by elective repeat cesarean which can be quite serious. It also does not address the number of babies that have brain damage as a result of a UR. I want to say the chance of brain damage is about 10-15% when you have a UR but I’d have to double check that. Obviously, UR is very rare but it does happen. When it does happen, UR rarely results in fetal death or brain damage though that too can happen. Babies are usually okay after UR. As far as the mother goes, it doesn’t address the decrease in hospitals stay, post partum surgical infection, etc.

Overall, I feel as if the medical data on the safety of VBAC, fetal death, maternal death, and other complications assure me that VBAC really is the best option. Medical reasons aside, there are emotional reasons as to why I want to VBAC. HERE is the linkt to a fantastic video of a woman and her three births. The first two were c sections and the third was an HBA2C (homebirth after 2 cesareans). Bring tissues.

I just feel like i owe it to my baby to birth it in a natural and peaceful way. I owe it to the baby to come into the world, straight my arms and not into the hands of rough strangers. I want the experience but mostly I want the baby to have the experience. Graham and I were separated the first three hours of his life, that is heartbreaking!  Part of giving my baby the peaceful birth is to also birth it without drugs as well. I don’t want the baby to be groggy and disoriented at birth or to have latch or suck issues which is very common with c/s babies, including my first baby. I want immediate skin to skin contact with my baby after it’s born, not for it to go to a warming table where it is suctioned and scrubbed and roughed up so it will cry. None of that is necessary, what’s necessary is the skin to skin contact, with me, with my body heat and my scent and my touch.

I truly believe that how we birth matters. I realize there are women who have c sections and they are happy about them and they had no bad outcomes and their babies were fine after them and emotionally they are happy they had their c sections. I also believe that a lot of women who have an unplanned c section the first time do have some emotional baggage as a result. I think that many women who go on to have ERCS rather than VBAC still think about VBAC and ‘what if’ really aren’t that happy that they had c sections and wonder if they really were necessary or not. I am not a woman who escaped my c section unscathed. II did have a lot of emotional baggage as a result. It’s already been proven that c section moms have a higher rate of postpartum depression and I can attest to that one personally. For me, ultimately, I just believe that I can birth. Even though it didn’t quite work out that way the first time, it doesn’t stop me from believing it or believing that birthing the baby myself is the best option for both me and the baby. I know that I could end up with a repeat c section and I am mentally prepared for that outcomes but it won’t be because I didn’t do the work or set myself up for the best possible scenario. It will be because it truly was necessary and that will be enough for me.

I am really looking forward to my labor. I am looking forward to the contractions and finding my rhythm with them, going off to labor land and having a pretty low intervention peaceful birth. I am looking forward to it because at one point in time I thought I’d never get to do that again but I am getting that chance and I am thankful for it. It seems so far away right now but I bet it will all be in here in no time.