Cutting Versus Healing (Not just for VBACs)

It only takes five minutes to perform a C-section.  Five minutes to cut a woman open, and pull her baby out of her body.  Of course that’s not counting the prep time, or the delivery of the afterbirth and suturing up afterwards- that’s another 30-45 minutes.   The physical healing of that incision will then take weeks, and for some women, months.

It takes five minutes to put a permanent scar on a woman she will carry for the rest of her life, both physically and emotionally.  It may have been necessary.  It may not have been.  But the scar is the same.  It doesn’t take much time to mark a woman with something she will always have with her, inside and out.

In contrast, consider the process of a woman deciding to try for a VBAC, a vaginal birth after cesarean.  When the woman who has had a C-section gets pregnant again, she may not want to accept the outdated “once a C-section, always a C-section” saying, which more and more people are realizing isn’t true or always the safest choice.  She will do research, read studies, and find out that the American Congress of Obstetricians and Gynecologists (ACOG) now states that it is acceptable for women to have a trial of labor after a C-section and many will be able to give birth vaginally.

That statement does not make it automatic however.  The woman now has to find a health care provider who can support her in this goal of laboring and delivering naturally, in spite of her scar.  Many providers are not interested.  It is, after all, much easier to schedule a repeat C-Section that will be a convenient date on the calendar and take five minutes.  So women may turn to midwife based care to meet this goal, and here is often the place she finds a safe supportive environment.

This is where I come in.  Several times a year I get to walk alongside special women in their journey of attempting a VBAC.  My role is to assist the healing, the “do-it-right-this-time”, the “try-again-for-what-I-want.”  I provide the same high quality prenatal care for VBAC moms as I do for all my pregnant ladies, but the VBAC mamas have special needs. 

As their due date approaches, they will have more anxiety.  Will their bodies work?  Will they go into spontaneous labor without being induced?  What if they don’t?  What if they get stuck again, at whatever point they got stuck at before?

Unfortunately they not only have to deal with their own internal questions, but the external ones coming at them from friends and relatives and even strangers. What does your doctor say?  Is your midwife trained to handle this?  You mean she won’t induce you?  What if you don’t go into labor on your own? Isn’t that dangerous to go so far past your due date?

At this point I become a life coach as much as a midwife.  I expect daily texts and phone calls.  I expect my VBAC clients to go past their due dates, and to have to discuss each day how we will manage that.  There will be extra sonograms to make sure baby is doing well, extra chiropractic adjustments to make sure mama is doing well, extra supplements to buy, extra office visits to evaluate contractions that will be happening on and off for days before “real” labor sets in. 

Then, at last, labor.  It may be her very first attempt, or just her first attempt since her surgery, but either way, a big FIRST.   I will be there with plenty of encouragement, extra mama and baby monitoring, reassuring family when needed, and with constant presence.  There will be physical and emotional hurdles and much need for patience and endurance.  We will all invest many hours and much sweat and probably some tears in reaching the final goal.  

All this effort to get past something that took five minutes to do.  

Years of waiting and thinking and reliving the past experience, months of research, days of interviewing providers, more months of pregnancy care, weeks of nail-biting, days and hours of early labor, more hours of active painful labor…to achieve natural birth.  

Past the scar. 

That scar that took someone five minutes to make.

But that’s how it is in life.  It is easy to cause pain.  It only takes a minute to cut someone deep, to speak words or behave in a way that makes a permanent scar on a person's soul. It is much harder to be a part of healing the scars the pain leaves behind.  And it takes many times longer to heal than it did to get hurt in the first place.

It’s one of the things I enjoy about being a midwife.  I like being on the healing team. As someone who has many scars myself (not the C-Section kind) – I know how important it is, how necessary if we are to go on living, and go on living well. 

And all the time, all the “inconvenience”, all the lost sleep and personal time on my part as a midwife is worth it in exchange for being a part of a woman’s healthy healing redemptive experience that will also stay with her, for the rest of her life.

To me, that's the more valuable skill to offer a woman. 

This skill is not exclusive to midwives with VBAC clients, but what people need all areas of life. Everyone needs someone to be patient with them when they are anxious, to be longsuffering with them when they are needy, to speak words of encouragement when they are discouraged, and to offer hope of a better outcome in the future.

Particularly those people who are trying to push past their scars.

It's a skill all of us can develop.  It's a choice to build up instead of tear down, to heal instead of hurt, to fix instead of break, to be patient instead of impatient, to stop and listen instead of being in a hurry.  

Because everyone has scars and everyone needs healing. 

And most people can push past them, if they just have the right support.