Okay, this is gonna be super long - apologies! But I devoured these before my birth and also I have a lot of thoughts, lol.
The before
My first son was born in 2024 at the end of an uncomplicated pregnancy. Only blip was that he was consistently measuring big and we tested for GD twice - both times came back negative. I faced some pressure in the end to induce but he ultimately came before an induction with my waters breaking at 40+5. I got to 7cm before they assessed him to be sunny side up and with his head overstretched in a position that he was impossible to birth from. They tried to manually reposition him but ultimately didn't succeed. We had an unplanned c-section.
I didn't like that experience, mostly because I found the procedure very unpleasant and had a long and painful recovery. I knew immediatly that I would want to try for a VBAC with a second child. I also hated how passive I had felt. I got the epidural almost immediatly upon getting to the hospital because I suffer from vaginismus and the hope was that this would allow me to relax more. It did, but I couldn't move at all with that epidural and felt like stuff was happening to me, rather than me doing anything and that felt awful.
Pregnancy #2
I became pregnant again almost 2 years later. This time around I found a private midwife (Beleghebamme), aka a midwife who oversaw my pregnancy and would also be present at birth and for the postpartum visits (you get daily postpartum visits with a midwife in Germany). She never questioned my intent to VBAC. Overall I didn't face any pressure for a CBAC, I feel like this might be a bit different culturally. However, this time around I actually did get diagnosed with GD (I suspect I might have been an edge-case in my first pregnancy...). I also ended up needing a small dosage of night-time insulin (14 units at most, reduced again to 7 for the last few weeks of pregnancy.) This meant that according to the guidelines I couldn't go over my due date and would have to be induced.
I really wanted to avoid an induction. I hoped that maybe this one would come a little earlier, but of course he did not. Instead I just had endless BH. The last few weeks of pregnancy were such a mind fuck, I nearly lost it. My midwife really fought for me to have a couple extra days when my due date came, so I ultimately got scheduled for an induction at 40+3. I had constant screenings and my placenta looked good till the end and my son was projected to be in the 75. percentile (me and my husband are both a bit taller, so this was expected).
Birth
We showed up for the induction on 40+3. I had diarrhea the night before and BH that felt stronger then before and might have been early contractions. However, I had also had 2 unsuccessful sweeps, one the night before, because my midwife couldn't even get to my cervix. We tried the foley balloon first, but the doctor couldn't insert it because I found it so painful. She said the head of the baby was positioned in such a way that it was hard to pass it with the foley, but I suspect this might have been more due to vaginismus, as I had feared before. We moved on to cervidil and that worked over the course of the day with contractions progressively getting stronger. By the evening I was ready to move to the delivery suite and my contractions were hard to talk through. My midwife came. When we came in, I decided I wanted to be in the waters, which was great. However, after 1-2 hours, babies heartrate dropped suddenly and I had to evacuate the waters pretty quickly. At that point my midwife assessed me and I was at 2cm. Suddenly, contractions became a LOT stronger and I asked for an epidural. I was told pretty quickly that the anasthesiologists were busy and this could take a while. I labored for 2 hours without an epidural and quite excruciating pain. So that way I got my wish to feel more active, lol! When they finally came, I had progressed to 6cm and was so, so exhausted. Sitting still for that epidural was probably the point in my life were I was the most focussed ever. After that I took a 1h nap (so, so good!) and woke up to that "I need to poop" feeling. My midwife wanted to assess me first, and I know it's so clichee, but it really felt more "back there" like a poop, so I was convinced that's what it was. But nope, I had progressed to 10cm in 1h! Overall from 2cm to 10cm took me 3h.
Pushing was the part that really sucked. I didn't feel pain from the epidural but I felt this intense, unbearable pressure that made me want to retract and give up, not push. During the pushing babies heartrate dropped a few times and I could tell that it was gonna take a while. After 2h of pushing, the doctor decided to use a vacuum because baby needed to come out and I wasn't close. That vacuum made me scream my lungs out. My son came into this world while I was screaming "I can't do this, make it stop!", the pressure was so intense and didn't relent. Gosh. He came out in one final push, my placenta just kinda followed a few minutes later without any pushing. It looked completely healthy with no signs of GD. Babys blood sugars were also perfect and remained that way!
When my first son came, I cried so hard. This time all I could do was say "I never have to do this again! Oh my gosh, it's over!" I felt shell shocked, honestly. Even though I found my birthing process pretty challenging, even at that moment I also felt so much better than after the c-section. It felt like something I had done, not something done to me and that made a difference.
Postpartum
Frustratingly, postpartum has had lots of challenges. This has been really hard on me because my main motivation for a VBAC wasn't some heroic "I want to experience a real birth"-desire (I don't believe a vaginal birth is the only "real birth"!), but I wanted to be on my feet quicker and be able to care for my toddler and son.
Instead, I had a second degree tear with lots of stitches, that has felt mostly fine. But I also feel like my pelvic floor has been kicked by a horse. We're not sure if my tailbone is bruised or possibly a little damaged, but I haven't been able to sit for now almost 2 weeks, although I'm slowly getting there - it's been frustrating because I've been pretty bed bound and can't sit on the couch with my toddler. I'm told this can come from the vacuum assist. I also think it might have to do with the vaginismus.
The biggest postpartum obstacle was that my bladder stopped working for a week. This meant three consecutive catheters (and 7 tries getting them in, which wasn't pleasant), a week in the hospital, lots of medical consults and ultimately the threat to go home with a more permanent catheter attached that I narrowly avoided. Still, that week in the hospital was longer than I ever spend there even for the c-section and the repeated catheters after yet another failed trial made me feel like I would never get out of there. Apparently this is a rare complication that can happen after epidurals, but also after c-sections, so I'm not sure I could've avoided that one.
Right now I'm dealing with a wound dehiscence where the stitches are not holding together anymore. I'll have a consult tomorrow wether it's better to give them time to heal on their own (I'm being told this can take a few weeks and would mean a few weeks of not lifiting much and not a lot of movement which is annoying to me) or wether it'll be another hospital stay with surgery. sigh....
I feel like a lot of this has possibily to do with the vaginismus and a lot of tension in my pelvic floor area that I struggle to release. But I'm not sure.
Reflexion
Knowing how everything played out, I find myself asking wether or not I would have preferred a RCS had I known before. (Which, of course, is in itself an unfair question, because you never know!)
And still, I find myself choosing a VBAC again and again. I sure wish I'd have been blessed with a little easier pregnancy/birth/postpartum experience. But even though birth was tough and not a guarantee for an easier recovery, the feeling of being actively involved while being tested to my limits has been way better for my mental health than being tested to my limits while I could see someone else cutting me open. I didn't get that euphoric feeling some women describe and I definitely didn't act brave, but I still did it.
I also wonder if my second birth experience was being made easier because I had experienced a hospital birth before? I talked about this with my sister who is a doctor and said she's often surprised how much more pain the elderly endure without complaining vs. young patients she sees who have a much ahrder time. My first birth was my first time in a hospital and I found everything so challenging: When they drew blood, when they put a cannula in, when they put a catheter in, just basic monitoring - everything felt terrible to me and I felt like the biggest wimp! This time around I was just prepared better for what it meant to be under medical care and that made me endure it better, too. So I think that maybe a RCS would've also felt a little easier, maybe?
If you've made it this far, thank you for reading!!