By Janet Fraser

VBAC is an endangered species. This is not really surprising since vaginal births of all kinds are endangered and it only makes sense that having created a birthing monster of cuts and scars, Dr Frankenstein would be unwilling to let the monster go use it's body in some way that silly old evolution intended.

But surely, I hear you cry, surely MY surgeon is different!** She supports my vbac hopes! Her secretary said  she was great for VBAC so I had no need to ask further! No doubt someone whose wages are paid by Dr Frankenstein would be utterly objective and truthful in their comments to me, the potential paying client!

So yes, she supports me to birth vaginally so long as we're both healthy.
Well gee that's a relief! Here was me thinking you hoping for a VBAC would mean your surgeon would refuse to slice and dice if you got genuinely ill. Phew.

She supports me to VBAC so long as I go into labour before 38 weeks.
Oh nice. So long as you  gestate shorter than about 95% of women, you'll get a bit of a go at labour! Yay! Send out for pizza! Oh but not in labour, because you're not allowed to eat in case you need surgery.

She supports me to VBAC if this baby is smaller because the last one didn't fit through my pelvis.
Ah excellent. Of course she's forgotten to say size estimates are a crock, and she's totally forgotten that your pelvis works perfectly. I didn't see you come in with a wheelchair, or on crutches, or with a pelvis so misshapen you can barely walk and your nearest relatives lived in London's East End prior to WWI.

I was hoping for a vbac but at 36 weeks my surgeon tells me my baby is too small.
Hang on, I thought small was good? And you know, at 36 weeks most babies are small because they haven't finished growing. Your baby may have another six weeks in it's growth plan, do you know otherwise?

My surgeon supports me to VBAC, I just have to have a little more monitoring in labour.
Are you aware that "a little more monitoring" is actually going to be you with a bed strapped to your back, monitors wrapped around your belly, probably a scalp monitor shoved through your vagina and screwed into your baby's head thus preventing you from moving around and actually birthing? Are you aware that evidence does not support this? You will also have a cannula stuck in your vein making it impossible for you to use one hand. Good thing you're strapped down and don't need to hold onto anything, hey? At least there won't be much difficulty moving you about when it comes time to wheel you into theatre for your life saving surgery! What a comfort...

My surgeon said I gave it my best shot, I laboured for X hours and I was tired so I would never have been able to push my baby out anyway.
Ah yes. It's a good thing birth normally lasts about 30 minutes so no one's ever tired by it. You know, no one rushes up to marathon runners and says, "Hey you look really tired, just grab a cab to then end. It's ok, you gave it your best shot, don't worry about it!" And I often see footballers being carried off the field so they don't get too exhausted, poor things. And of course your surgeon's trusty crystal ball would have told them exactly how long your labour was going to be, so that was easy to predict. And since you never get to sleep again in your whole life, you would never have caught up on any sleep. One could argue that we have lots of time to sleep, but only one chance to birth a baby but one wouldn't want to upset anyone with logic, hey?

My surgeon said that my scar was hanging on by a thread so I should never attempt to VBAC again!
Golly gosh, Batwoman! Hey how come there was no sign of imminent rupture with all that monitoring? How come your baby has Apgars of 9 and 9? Although it's gut has been irretrievably altered, but let's not mention that.

And sadly, my surgeon informed me that my uterus was paper thin so that's another reason I will have to have "elective" surgery next time!
It's the simple things which say the most, isn't it? Get a normal household type balloon for kiddie parties and the like. Study it closely. See how thick it is at this resting state? Now blow it up, watch it change colour and get thinner as the same amount of rubber stretches to take on a large amount of air. See that? It gets thinner. Now see what else? Look down, look at your amazing body with all it's muscles, tendons, bones and ligaments and remember that pregnancy is a normal use of your body and all those things are keeping your uterus firmly in place. They've held your baby through a long gestation, constant workings of the muscle as it tones for labour. If you don't doubt your lungs can breathe and your gut can digest, give your amazing uterus some credit too.


** Far be it for me to point this out, but there's a basic contradiction in going to a surgeon to avoid surgery, isn't there? Do I go to a plumber and hope she won't fix my pipes? Do I go to a mechanic and ask her to look at my car but not recommend any mechanical alterations?

Do you really want a VBAC, or are you pretending so you can humour those boring people around you who have all those "facts" about how it's better for you?

You know, it's ok to have fear, but you're not going to avoid a hole in your uterus by having surgery. In fact, you're going to guarantee your uterus has more than a hole, it will have a big slice that someone will put their hands in and rip open. If you want to keep your uterus intact, you will stop hoping, start planning and make some better decisions about models of care.

Pick a surgeon, don't be surprised when you get surgery.