Episode 334 Susana’s VBA5C Story

We have received so many messages and emails from you requesting more VBAMC stories and today, we are giving you just that. Susana joins us from Mexico sharing her VBAC story after five Cesareans!Each of Susana’s Cesarean experiences was unique in their own way, but the dream of a vaginal birth never left her heart. When she found a supportive midwife and doctor during her VBA5C pregnancy, Susana knew this was her chance to finally achieve that goal. With her husband by her side encouraging and supporting her, Susana powerfully pushed her baby out. The hospital staff and community buzzed with shock and amazement over what she had achieved!“That moment was unlike any other moment in my life.”ACOG Article: Dr. Angelica GloverEvidence-Based Birth: The Evidence on VBACNeeded WebsiteHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details Meagan: Women of Strength, this is the moment so many of you have been waiting for. We have a VBA5C so for anyone who doesn’t know what that means, it is a VBAC after 5 Cesarean story for you today. This has been requested so much. We received emails in our personal email. We have gotten it on social media saying, “Please, can we get some stories that have VBAC after more than 3 Cesareans?” We know so many people out there don’t know that this is an option or they know it’s an option but they don’t find the support or they can’t find the support. They are few and far between but we have our friend Susana today who is going to be sharing her VBA5C story. Welcome, Susana. How are you?Susana: Hi. Thank you so much for inviting me. I’m so excited. Meagan: Oh my gosh. I am so excited. Yes. I am so excited and you are in Mexico, correct? Is that where your VBAC was? Susana: I’m sorry? Meagan: Was your VBAC in Mexico?Susana: Yeah, but it was a very, very hard way. I’m going to share what I did. First of all, I can’t separate this way from my faith because I prayed so much for this and I trusted so much and also, I trusted so much in the process and in the body and those things But okay, I’m going to tell you what happened with me and why I had five C-sections. First of all, I got pregnant in 2009. My pregnancy went very healthily with no problems at all. I was 41+5 weeks and I had a doctor who was– well, he said he was for natural birth. I don’t know how to say it. He was pro-birth. Meagan: Yeah, that he’s pro. He’s supportive. Susana: Supportive. Yeah, that’s the word. But in reality, he was more C-section-supportive. While we were passing a very difficult part of our life because my father-in-law passed away exactly on my due date. We were very emotional and very sensitive. Labor wasn’t starting so the doctor said, “No, baby is not engaged. You are only 3 centimeters. I can say that baby is not going to birth naturally. I say that it is better for you to go directly to the C-section.” I was disappointed because I was walking so much every day, but for the situation for my husband and all of the family, I accepted. We went to the C-section. I got pregnant again in 2010 8 months later and I was very excited to now get a VBAC. The doctor said he wasn’t going to support me but in the end, I had a TOLAC, a trial. I was progressing well. I was 5 centimeters when I went to the hospital and the doctor was a little bit nervous because the C-section that I had before was one year and five months before so he was like, “You have to be fast because we have the risk of uterine rupture.” He started to make an impression on me and I was starting to be stressed. After 5 hours I think, he said, “Baby is not getting down. You are still at 5 and we are going to the C-section again.” I cried a lot and my husband said, “We tried and we can’t do this anymore. It can be dangerous. Go to the C-section.” It was very traumatic because they put in the epidural and it only worked in half of my body. I started to scream, “No, please. No. I can feel everything.” They put the epidural in again. It was difficult. Then I got pregnant again in 2012 but I didn’t fight anymore. I decided for a repeat C-section. The good part is that it was peaceful because I was accepting the situation. Everything went well. Then I got pregnant in 2013. Also, we were going to opt for a C-section because I didn’t have any other chance but the doctor started saying, “No more babies. Four C-sections is a thing,” and things like that but my husband and I were talking about it and we thought that it wasn’t an option for us to have– I don’t remember the word. Tying the tubes. Meagan: Oh yeah, a tubal. Susana: Yes. The sterilization. So we went to a repeat C-section. It wasn’t as smooth as the one before because my baby was 37.5 weeks so we had a little problem with maturity. Is that the word? She was very small. Meagan: She was technically preterm. Susana: Yeah. Preterm. She showed signs of preterm. She was whimpering and something like that. We had to go to the neurospecialist. Everything was going well and there was no problem at all, but we were careful for another pregnancy. We waited a lot and we got pregnant again in 2017. I spent the half of my pregnancy with the same doctor, but at half of the pregnancy when I was 20 weeks, some friend told me, “Oh, you know what? There is a mom in Brazil who had a VBAC after four C-sections.” I was like, “What?” I didn’t know that existed. I started to inform myself and I found a supportive midwife but she said, “We aren’t going to chance it to go to the hospital. We have to have the birth in your house.” We prepared everything for the home birth and the bad thing is that I was anxious at 39 weeks and had prodromal labor. I passed the due date. I was 41 and 42 and then 42.5 weeks so stress started to play a role here. I started labor but I passed three days in labor so that was really, really hard. I passed two days at 5 centimeters dilation. Then my midwife said, “I don’t know what has happened. I think we can’t wait anymore. You have to go to the hospital. Baby is good.” The heart rate was optimal but I didn’t know what to do anymore. We went to the hospital. It was the only public hospital. Oh, the doctors were freaking out like, “What are you doing? Come on. You have to get the C-section 2 weeks before.” I suffered very, very much obstetric violence. It was very traumatic. Baby was very low. I was at 8 centimeters when I got to the hospital. I was begging for them to let me try and let me push but they said, “No. You are crazy. We have to go to the C-section right, right now.” When they pulled baby out, they broke the uterine artery and I lost a lot of blood. I was very weak and it was very painful. That was a disaster. We were like, “No more babies I think”, but by the grace of God, I got pregnant again in 2021. Sadly, I had a miscarriage on Christmas actually. It was very sad. But I don’t know. That miscarriage let me know that my body works and that I would be able to have good contractions and my body was able to give birth. I prayed, “God, if you want, I want another baby.” In November of 2022, I got pregnant again and that time, I was totally strong to fight for another try to have a vaginal birth. My husband was totally against the trying. He was so scared. Also, I was a little bit scared, but I was trusting at that time. I was trusting so hard. I was praying so hard. I decided to not go to the doctor because I was so scared of the doctor. I was hesitant. I don’t know why I didn’t want to hear, “You are in danger. No. This is so dangerous. You can’t try. You have to go directly at 38 weeks to the C-section and you have to have a blood transfusion and you are of advanced maternal age,” because I am 41 years old, but I don’t know. I said, “I don’t want that in my pregnancy.” Actually, I had a friend who had seven C-sections and then had four home births. She was telling me, “No. Trust God. You have to know when they talk from fear and when they talk from the truth.” I could tell that a lot of people were speaking to me from the fear they felt, not from the truth. I stayed with that doctor until 28 weeks. I found a doctor who wasn’t judging me and who was open but he didn’t have experience with VBAC after multiple C-sections so he said, “I can check you and support you but not in the birth. I can’t do that. I have no experience.” Well, for me, it was like, “Oh, I’m at the beginning of the way.” Okay, so I kept praying and when I was 34 or 35 weeks in the pregnancy, I had a doula who gave me a contact of a midwife that she was supporting VBAC after three C-sections in a hospital with a doctor. I said, “Maybe there’s a chance for me.” I contacted her. I talked to her and she was very optimistic. She said, “Yeah. Of course. I can support you. We can prepare a home birth. I can support you. I can be your attendant.” I don’t know the word. Meagan: Maybe advocate? Susana: Not advocate. I mean, she was the one who received the baby. Meagan: Oh, like catching. Yeah, attending. Susana: Yeah, attending the birth. But my husband was like, “No, not a chance.” Because for my husband and also for me, it was very difficult and not secure. We were scared. We thought about what if something happened. That midwife told me, “I can speak with the doctor and maybe we can have a plan.” I said, “Okay.” I was 36 weeks so it could be difficult that he started to attend me in these late weeks. But I still had trust and confidence in God. I kept praying all of the time. One day, she called me and said, “Susana, good news. The doctor said yes. I told him all of the truths. I didn’t hide anything and he said, ‘Okay. If you are with me, I can attend this birth. But I need to watch her in the next days.’” So we went to the doctor. The doctor was in another city 40 minutes to an hour away from here. My husband couldn’t be with me so my parents went with me. My parents were so scared. Meagan: I bet. Meagan: They were very against trying. My husband wasn’t completely confident about it. All of my environment was against the VBAC. When we went to the doctor, the doctor was so supportive and so humane and so good and so kind. He said, “We are going to try. We are going to make our best. We are a good team. The midwife and I work together very good and very successfully but I’m going to keep all of the team here if we need the C-section in the last moment.” We agreed on that. My parents were so relieved. We talked with my husband and he was relieved also but he also had doubts. But in the environment of a hospital and– oh, I don’t know the word. The place where they make the C-section? Meagan: The operating room? Susana: Yeah, the operating room. In the side of the room, if everything was good, we trusted. He was supportive for the first time. He said, “Okay.” Two weeks passed after this visit and there was the moment when I started getting excited with things with labor. It was on the 11th of August last year in 2023 when I saw my mucus plug and the bloody show. I said, “Oh. I think things can be starting at any moment.” But in my last experience when I had the bloody show, it was two or three days before the labor really started. I patiently waited and the contractions started to be hardest but there was a half hour in between them. It was very manageable and still manageable. I passed the day with my normal activities. I had lunch with my parents and my five kids. I went to gymnastics class with my daughters and actually at night, we went to mass with friends and families that we know. A friend of ours invited us to dinner and I said, “No. I want to go home.” My husband was like, “What? You don’t want to go anywhere.” My husband started to sense that something was wrong. We returned to home and contractions started to be closer and intense. I wrote to my midwife and she said, “Okay. You have to count how many contractions happen in one hour,” so I started counting and from 10:00 PM to 11:00 PM, I had nine contractions. I wrote her and she said, “Okay, you are starting. I’m going to go to your home.” By the way, she lives 2 hours from my city so she came to my place at 2:30 AM and checked me. I was only 3 centimeters and 60% effaced. She went and she said, “Oh, congratulations. You are a 3. We only have to wait 7 more.” She was so positive and so kind and so lovely. But for me, it was like, What? 3 centimeters. There’s a long way to go. I was so disappointed and I started to have a crisis thinking, Okay. This is going to be three days of labor. It’s starting to be unbearable. I don’t know what I’m going to do. My husband told me, “You have to know that this is not going to be easy.” I was like, “Oh my god. What is going to happen?” I wrote a friend and she told me, “Maybe you were wrong. Maybe you are not in labor yet. Maybe it is prodromal labor so calm yourself and keep making your activities as normal.” I said, “Yeah, maybe that’s true. Maybe I’m not in labor yet.” One of the things is that my contractions don’t hurt in the uterus or in the belly. They hurt in the legs. Meagan: Oh. It radiates down. Susana: Exactly. I felt like it started in the hips and ran into the legs but I felt like– I don’t know how to say– but a burning. Yeah. It was burning pain. It was very, very intense. My friend told me, “Put one leg on the chair and one leg on the floor and balance side to side while a contraction comes.” I made that and that was really, really helpful. I could have a contraction very easily that way. I was telling myself, “My pelvis can open. My baby can know how to birth. Everything is okay. God is with me,” and things like that. That affirmation worked very, very good because it calmed myself and that’s how I passed the contractions all day long. Not the day, only the morning. My daughter, that morning, had a science fair so we decided it was at 8:00 AM so we went. It was the worst time for me having those contractions every seven minutes and very painful. All of the parents were like, “What is happening to her?” Meagan: That’s amazing that you went. Susana: It was because I thought, I’m going to have three days in labor. My midwife had told me that when there’s a labor after so many C-sections, there’s a lot of times that it lasts three, four, or even five days so in my mind, that was my expectation. While I was at the science fair, I said to my husband, “Please take me home. Let’s go home. I am in a lot of pain.” I called my midwife again and she came. She checked me and I was 6 centimeters so for me, I was like, “What? Whoa!” Yeah. She said, “We have to go to the hospital.” Oh, before that, we were planning to rent an AirBnB in the city which is Leon, Mexico to spend with all of the family those days that I was supposed to be in labor. So she said, “Forget about that plan. We will go directly to the hospital.” We called the doctor and the doctor said, “I need to check her with an ultrasound. You need to go to the office with me.” I thought it was useless, but we went to the office. It was the worst travel because I had contractions every 4 minutes and we were traveling in the van, but the good thing was that my midwife was making pressure on my hips and that released the pain. After 1 hour and 20 minutes, we arrived to the doctor. He checked me really fast and he said, “You are 6 centimeters.” Again, I was so disappointed because I thought, “Oh my god. One hour and I’m still a 6.” But my midwife told me, “No, I don’t think so. I think you are maybe a 7 or an 8.”She is very wise. She had a lot of intuition. So we went to the hospital and it was 20 minutes away from the office. We arrived at the hospital at 12:35 PM. When we arrived at the hospital, he wanted to put me in an emergency room, but the doctor arrived immediately and told them, “No. Put her directly in a room because it was going to be a room birth.” I gave birth in a room, not in an operating room, but in a labor and delivery room. Meagan: They had you labor the rest of the way and give birth in the operating room?Susana: Yeah. In Mexico, all of the births happen in the operating room. Actually, it’s not an operating room but it looks like it. It only has that stuff that they put the woman with the legs up. Yeah, I don’t remember the name, sorry. Meagan: Like just the position? Susana: Yeah. Meagan: Okay, gotcha. Susana: So we went to the room. My midwife said, “Do you want to go to the shower?” I said, “Yeah, please.” I went to the shower. At that time, my water broke like a balloon because I felt something really big getting out. It was shocking and I was like, “What? Is that the placenta?” She said, “No, let me see what it is.” It was the amniotic sac almost complete. It was amazing because my midwife told me, “I’ve never seen something like this.” It was amazing. After that, the contractions felt very different with no pain and I started to feel to push. It was very different for me and very scary because I never felt something like that. Meagan: Right. Susana: My midwife told me, “You’re going to birth now. You have to choose your position.” I stayed on my knees on the floor with the arms on the bed and started to push my baby out. I can say I didn’t feel any pain in this moment. I only felt the pressure. I think I had the reflex, the fetal ejection reflex.Meagan: Yeah, mhmm. It’s like where the baby just comes out. Susana: Yeah, because I wasn’t pushing and my body was pushing. It was an amazing feeling but also, I was scared because I didn’t know how to do that. My husband was praying with me and he was very supportive and very loving in that moment. That moment was awesome. I know God was there. I knew all my prayers were answered in this precious moment. I only let my body make its worth. I felt incapable of pushing a baby out. That was an amazing feeling. I don’t know how to say it. It’s like you are here but you are not. Meagan: Yeah. It’s surreal. It’s really– when you realize you’re in that moment of pushing your baby out and I can’t even imagine after five Cesareans, just that moment of, Wait, is this really happening? Susana: Exactly. It was like a dream. My husband was telling me, “Yes. You are so strong. You are telling me the truth. The miracle is done. Come on love. You can do it. You are so close.” I can’t remember exactly but I think it was four or five pushes and baby was out. Baby had two wraps of the cord. Meagan: Double nuchal cord, okay. Susana: Yes. Then the body was out and it was a relieving feeling. It was magical. Everything was done. Every pain, every pressure, and every fear was gone. I felt that very warm and wet body in my arms. It was a magical moment like, I can’t believe this is happening. Praise to God. I was crying. That moment was unlike any other moment in my life. Meagan: I can’t even imagine. Wow. So was everyone very pleased and shocked? That’s not a normal thing. For VBAC after one and two, it’s like, okay. After three, providers are like, “I don’t really know. Risks do go up so we are nervous about this,” so after five, how was your community around you?Susana: Yeah. They were very shocked. Actually, the hospital didn’t allow VBAC after multiple C-sections, but the doctor said because in the lobby, they asked, “How many pregnancies and how many births? All those were natural births?” The doctor said, “Yeah.” Everything was happening very fast. After the baby was born, everyone was screaming, “Vaginal birth after five C-sections here!” The nurses and the doctor and the people in the lobby said, “What?! It’s a miracle.” Everybody was so happy. Everybody was shocked. I don’t know. It was amazing. Meagan: I’m sure they had a lot of feelings. I’m sure they were so happy for you and so shocked and even probably still questioning, “Wait, really did that just happen?” Because even we as a mom pushing in that moment, I think it’s very much for the providers too, “Wait, is this happening?”Susana: Yeah, actually the doctors said the medical community was pretty– I don’t know the word but they were saying, “What did you do? You didn’t do another C-section? What’s wrong with you?” They didn’t do the episiotomy and I didn’t tear at all. Meagan: Amazing. Susana: What else? He said, “It was a perfect birth.” Nothing went wrong. Nothing. So for him, for my doctor, he was very proud. He was not scared of sharing the evidence or the support and my case. Meagan: Right. He wasn’t scared of sharing that he was supportive of you doing that. Susana: Exactly. He put on social media what we did. A lot of people were like, “What?” But he told me, “I only supported you because of your midwife because she is amazing. She is very wise. She has a lot of intuition. She had a good eye to know when it can happen and when not. Meagan: Yeah. Susana: She is awesome. Meagan: I wonder if they work together often now. Susana: Not too often because she usually goes to home births but when a couple wants a hospital or a VBAC, she works with him. Meagan: Oh my gosh. That’s awesome that they can work together and it really truly makes it possible for those who want to. We know that not everybody will and we know that the risk is not acceptable for others. Susana: Right. Right, exactly. Meagan: Something that I love on ACOG, there is a website that is called acog.org so the American College of Obstetricians and Gynecologists so it’s more here in the U.S. but there is a provider called Dr. Angelica Glover. She wrote an article on VBAC and one of the things that I enjoyed about her article was the very end. It says, “One size does not fit all. If you are pregnant and have a previous Cesarean birth, talk through all of these questions with your OB/GYN. Weigh the risks and benefits of each birth option like you would with any important healthcare decision.” I love that. Just like you would with any healthcare decision. It says, “Think of this as an ongoing conversation with your OB that starts early in pregnancy and evolves over time. Your feelings may change and your risk factors could change too. There is no one-size-fits-all answer when it comes to choosing between trying for a VBAC or a repeat Cesarean birth. What matters is that you are comfortable with your decision and you feel supported through your pregnancy and birth.” I love that because really in the end, VBAC after three, four, five, or whatever may not be comfortable for someone else but it may be for someone like you. Then the biggest factor is finding the support and we know that can be really hard so I love hearing that you had two providers who were on board with you, trusted you, and trusted the process. I do love that your midwife talked to you about how it can take time and you made it to 8 centimeters before right? Your body had done it. It just still needed time. It has gone through a lot and there was scar tissue and all of the things. It can take time, but you were allowed that time. You were allowed that time. They trusted you and they trusted themselves even. I am just so happy for you and I appreciate you sharing your story because it is one of those things that is really desired. A lot of people don’t know it’s an option then they find out and they are like, Wait, is this really possible?Yes, it is so it’s really nice to hear a story here and there as they come along to show that yes. Women of Strength, it is possible. Are there risks? Yes. There are risks. Are they more than VBAC after one or two Cesareans? Yeah and honestly, we don’t even know the exact evidence on specifically VBAC after five Cesareans because they are not studied and they are not happening. Susana: No, they are not but I can say that I read a lot. I found very good information from the Royal College of Gynecology and Obstetrics in the United Kingdom and it said that as a provider, you have to let the mom share if they want to try or do the repeat C-section, but always the vaginal birth is less risky than a repeat C-section especially after too many C-sections. Meagan: We do know that there are increased risks with repeat Cesareans as well. We know that is also very much a thing so we want to make sure that we are taking into consideration that as well because we’ve got issues where uterine rupture actually can also happen in a repeat Cesarean and that risk can be there. Bleeding and hysterectomy, there are risks that are sometimes actually higher for a Cesarean than a vaginal birth. It’s just important to know all of the risks. I think sometimes we hyper-focus on the risk of VBAC instead of going through and looking at things. Evidence-Based Birth has such an amazing article and I think it was actually even a podcast episode on VBAC. She talked about how there are a ton of studies within here. She goes through the maternal outcomes here. Susana: That’s awesome. Meagan: Yeah. It shows the maternal outcomes and the newborn outcomes. It says, “Maternal adverse events or bad outcomes were more frequent among women who had a C-section birth after Cesarean,” meaning they attempted a VBAC but it ended up in a Cesarean compared to those who had a VBAC. That’s another risk. We have Cesarean risks. We have VBAC risks and then we have where we are going for a VBAC and it goes into a Cesarean. There is also risk there. We really need to just pause and stop and look at everything. I mean, literally, everything before we make a decision. There are so many times like with your first birth, there was so much going on. You had such an unfortunate event happening with the loss of your loved one and a provider was saying, “Oh, you’re only at 3 centimeters and 60% effaced so this is probably not going to happen,” when in reality, that vaginal birth probably very much would have happened but we just didn’t know. We didn’t know. Susana: Yeah, totally. Yeah. Meagan: It’s so hard because there are so many times where we hear these things from a provider. Me too. I did too. I was like, okay. We trust them and we don’t want to not trust our provider but at the same time, we want to make sure that we do get informed. I’m so proud of you for along the way getting informed and learning about your options and I’m so happy for you that you were able to have your vaginal birth. Susana: Yeah, thank you. Thank you so much. I can say at least here, I think younger OB/GYNs are more open to support VBAC than the older OB/GYNs. I don’t know how it is in the United States, but here, I think that is happening. Meagan: Yeah. I think it takes us all continuing to advocate for ourselves to have these providers stop and change their point of view because I believe that so many times, even if the evidence is there, there are so many times that it takes seeing it to believe it. You can look at a piece of paper and look at the evidence and you can see that, but at the same time, you’re like, Okay, yeah. Sure. That probably can’t happen, even though it’s right there on the form, but seeing it really can change a lot of people’s perspectives and just opinions. I think that is what you probably did to that entire hospital. Like you said, “Vaginal birth after five Cesareans in here!” Yeah. They were all blown away and you really did. You changed their perspective. Susana: Yeah. I am so happy to help another woman, to inspire, to read, to find information, real information. Don’t let the doctors scare you. There is risk in all of pregnancy. It can be risky. Life is risky. Meagan: Life is risky. You’re not wrong there. There is risk everywhere. It’s just important to know the risk and then decide if that risk is acceptable to you. If that risk is acceptable to you, then great. Go for it. If not, that’s okay. Susana: It is worth every moment and every pain. Everything, it was worth it. Meagan: Yeah. Well, I’m so happy for you. Congrats again and thank you for being with us today and sharing a VBAC after five Cesareans story. Susana: Oh, thank you so much. I’m so happy and I hope that a lot of women hear this podcast and are inspired themselves. ClosingWould you like to be a guest on the podcast? Tell us about your experience at thevbaclink.com/share. For more information on all things VBAC including online and in-person VBAC classes, The VBAC Link blog, and Meagan’s bio, head over to thevbaclink.com. Congratulations on starting your journey of learning and discovery with The VBAC Link.Support this podcast at — https://redcircle.com/the-vbac-link/donationsAdvertising Inquiries: https://redcircle.com/brands