The Business of Being Born Message Board

Q: I had to have an emergancy cesarian in October 2007. My baby’s heart rate dropped dangeriously low, I believe because of the pitocin and the epidural. Both times they were administered his heart rate plumited. I would love to have an at-home natural child birth next time. I am not pregnant now but I am reserching my options for next time. Would it be possible for me to have an at-home child birth since I had a cesarean? Thank you.

A: Essentially your question is about VBAC and HBAC (Home Birth After Cesarean). I am so glad that you are asking these questions. I think they are good ones. According to your story, it seems like you can avoid some problems by attempting a natural childbirth.

For many women, VBAC is possible with the right support team. I always encourage my VBAC candidates to do a lot of extras to increase their chances of having a successful VBAC. Here is what I suggest:

1) See a chiropractor to make sure your pelvis is in alignment.

2) See an acupuncturist throughout the pregnancy to make sure that “all channels” are open and that your hormonal system is functioning well.

3) See a hypnotherapist to revisit your Cesarean section and try to resolve some issues around that birth. Look at your fears and try to put things in place that will help you overcome your fears. Look at this birth as a fresh start.

4) Eat well and exercise throughout your pregnancy. Avoid excess sugar and junk food. Everything you eat needs to be quality food.

5) Make sure your partner is on board with your VBAC plans. Talk about natural childbirth and how you will achieve that.

6) Make sure you have a supportive care giver and a supportive environment to birth in.

Finally, go to the ICAN website for inspiration and encouragement. Their address is www.ican-online.org. This site may help you find a midwife in your area.

But you are also asking about HBAC. That is a political question that will have many answers according to where you live. I live in California where we are very committed to keeping VBAC and HBAC available to women. We were able to set special regulations that allow us to do VBACs at home. The special regulations require all licensed midwives to inform their clients of the additional risks incurred with attempting a VBAC at home (1% theoretical risk of uterine rupture) and to supply additional educational materials. The mother needs to supply copies of her previous operative report for the C-section and to sign an additional consent form. We are using a model of informed consent to allow women to make their own choices around VBAC at home. So, ask your local midwife what the standard of care is in your area around VBAC at home. Unfortunately, I have heard of many stories of women having to cross state lines to have a VBAC out of the hospital. Ask lots of questions and do your research. HBAC is possible!

Maria Iorillo, CPM