VBAC After One, Two or More Cesareans

What is a VBAC?

A VBAC is a vaginal birth after cesarean.

If a woman has had a cesarean and wants to plan a vaginal birth for her next, it would be considered a VBAC, and the number after it depends on how many prior cesareans there were.

What are the chances of having a successful VBAC and who is a good candidate for a VBAC?

The stats range that 60-80% of women, who have had previous cesareans, are candidates for a successful VBAC. In actuality, most healthy pregnant women carrying healthy babies are candidates.

The chances of a successful VBAC are higher if a woman is using a midwife, even higher in free standing birthing centers and home settings.

Going to a hospital and working with an OB/GYN with high cesarean rates, will increase the likelihood that a woman will have another cesarean.

In some hospitals, there are a lot of restrictive procedures, like continuous electronic fetal monitoring, confining a laboring woman to lay in bed, not allowing her to eat or drink, routine IVs and time limits, which increase the risk of a cesarean.

There are many benefits to a VBAC, that are physical, emotional, mental, and spiritual.

These are only a few important benefits on the long list:

  • No risks from major abdominal surgery. This is huge.  Unfortunately, a cesarean can lead to trauma to the internal organs or reproductive tract, risk of hemorrhage, complications with scar tissue, long term post operative pain, wound infection, blood clots, stroke, and possible respiratory problems for the baby. High rates of cesarean section contribute to high rates of morbidity and mortality – and this is occurring in modern countries such as the US, which ranks among the bottom of them in terms of outcome stats.

  • Easier postpartum healing and recovery.

  • Baby receives needed bacteria for optimal health, from mother when passing through the vaginal birth canal.

  • Breastfeeding may be more successful

  • No potential harm to future fertility.

  • Feeling more positive about the birth experience

  • Increased sense of empowerment.

  • More involvement of family and support people.

  • Less risk of postpartum depression and emotional birth trauma.

What is the main risk of a VBAC?

The risk of separation of the one prior uterine scar is approximately 2 in 1000 VBACs, but often it is a mild superficial dehiscence (slight separation of some layers of the surgical wound) that has no clinical significance and does not impact the health of mom or baby. The risk of severe life-threatening emergency from a partial or complete uterine rupture of all the scar layers is significantly lower – a highly unlikely occurrence, significantly less than 1 %., 1.36% after 2 cesareans, slightly higher after three cesareans, with a higher comparative maternal and newborn morbidity with each repeat cesarean - but still in perspective, low, and depends on a variety of factors related to your individual situation. The main risk is of a VBAC is this rare catastrophic rupture of the previous uterine incision. This rare total disruption of the uterine scar risks both the mother and her baby, and can lead to catastrophic outcomes. It cannot be ignored and must be monitored for appropriately; but it cannot be exaggerated or make the risk of repeat cesarean less alarming. Frank uterine rupture is often mistaken for more common mild separation of the previous uterine scar without consequence, happens in less than 1% of all pregnancies. Even ACOG released guidelines that it’s reasonable to consider women with two previous low transverse uterine incisions to be candidates for trial of labor and to counsel on the combination of other factors that affect their probability of achieving successful VBAC.

But, it is getting harder to find a provider to attend to your desired vaginal birth after one cesarean let alone after two or more. It is still possible, and you have the right to decline another cesarean, but it is ideal for you to find a provider and setting most supportive to birth YOUR way safely.

Although every decision has risks, a VBAC is a reasonable, appropriate and safe option. If a woman panning a VBAC decides to give birth at home, I highly recommend working with a well trained and experienced midwife and consider the distance to a hospital (30 minutes or less driving time is ideal).

There are risks and benefits to every kind of birth and in every setting. I provide women with evidence based information, encourage each family to dig deep and look at the pros and cons to having a VBAC in a hospital setting, free standing birthing center or home, vs a routine cesarean and have informed consent for her birth.

Are there benefits to a cesarean?

A planned cesarean is in a controlled environment, and some women find great comfort in that knowing. Perhaps a woman has had a previous traumatic, long labor the first time and they just don’t want to go through that experience again. Some women are very anxious about that and they just feel safer knowing they will have another cesarean.

I take that seriously, because she won’t labor well if she doesn’t feel safe.

Like I mentioned before, the serious risks for a VBAC can be often prevented, treated or transferred to surgical care in time, with a skilled midwife or obstetrician who is attending to the laboring women, aware and mindful of the symptoms that lead up to that.

Thankfully some hospitals are now at least allowing more time for baby to get the cord blood from the placenta, skin to skin bonding, and her partner or main support person in the operating room. Some hospitals and providers are performing “gentle cesareans” – cesareans that are family and woman centered, and try to provide the environment of a natural birth as much as possible. This is a wonderful attempt to restore humanity to birthing in the operating room

In most cases, a VBAC is a safe option.

I share the opinion of many concerned with improving maternity care and reducing our rising rates of maternal and newborn death and serious health consequences from the interventions in childbirth, that a woman should not be forced to have a major surgery against her will, rather provided research and empowered to make her own decision, considering she is having a healthy AAOG removed the previous unreasonable restriction requiring immediate availability of a surgical staff for an emergency cesarean, as most hospitals around the country, let alone free standing birth centers and home settings, do not meet this criteria. Most hospitals are not able to have a surgical staff at all times and cannot perform an emergency cesarean in under 30 minutes.

Despite this, research is showing that far too many obstetricians and the midwives they back do not offer VBACs after one cesarean, let alone more. They routinely recommend repeat cesareans because they may fear law suits, succumb to scheduling pressures, have restrictive hospital or malpractice insurance policies, and/or feel pressured to uphold certain standards among their colleagues who are not supportive of VBAC. The hands of a midwife whose collaborative obstetrician and hospital do not support VBAC can often be unnecessarily tied as well for these reasons. Most repeat cesareans are not actually medically necessary, and are commonly recommended due to various non-medical reasons. This is very concerning.

What also concerns me is that the risks of a VBAC are magnified in conversation with women, while the risks of a repeat cesarean are downplayed, so women may feel forced, afraid and powerless.

I want women to feel like they have a voice, as they do have a legal and medically ethical right to autonomy over their bodies, their births and their baby’s.

Some women who want to VBAC have limited options and local doctors in the area are only offering cesareans. Some feel they have no option other than having an unattended homebirth, or labor alone at home until the last minute without any monitoring, or not be truthful with their providers about their previous cesarean birth – all of which can increase the risks for her and her baby.

A trained and experienced midwife who is continuously with the woman in active labor, can detect concerning signs and symptoms before they can become a crisis, and she be transferred and treated in time to save her and her baby’s life and heath.  A midwife wears many hats, one of which is protecting the space so the natural process of birth can proceed with ease and grace, and another is a lifeguard – to know when and how to intervene to prevent problems or manage emergencies.  There are many wonderful obstetricians supportive of VBAC who have this training and style of practice as well; they are just harder to find.You have the right to decline the repeat cesarean, and find a more supportive skilled provider at home. There are midwives and OBs who do it and post about it around the globe. It is worth every penny to even travel quite a distance to a practice who honors your choices. You REALLY have to want it, and you must prepare as best you can to set yourself up to succeed, like it’s your Mount Everest to climb, to have your healing, redemptive beautiful healthy birth.

Last tips:

If a woman knows she wants to have another baby, I would start with research and education. Ask yourself: “What do I want and why?”

A woman should get the support she needs. Most women who have had one or more prior cesarean births have issues they need to discuss and heal from.  One of my dedications and areas of expertise is creating space so a mom can debrief, process and recover from her previous upsetting or traumatic birth experience, as well as plan for a better one next time around. Schedule a coaching call with me for more personal guidance if you need.

I tell mamas to do what they can to educate, prepare and empower themselves in a whole different way than last time as I want them to succeed, build their circle of support, and include in their birth team advocates to speak for them when they are in the heat of labor. I tell them to prepare for a natural vaginal birth. The mind, body, heart and spirit can prepare for a natural vaginal birth - and a deeply positive, beautiful and empowering one. Yes, it takes work and practice, but it is worth every penny, every effort and amount of time you put in, if this is the birth experience you want and dream about. This is one of my passions and main focus of my online childbirth prep course Anne’s Guide to Pregnancy, Birth and Postpartum - sold separately or bundled together in adjunct to my Natural Birth Secrets books 2nd edition and Trauma Release Formula 2nd edition if you need help previous healing birth trauma - both extensive but very different resources that compliment each other to heal and prepare for your different next birth.

I also recommend hiring an awesome doula, as those who have a doula are less likely to have a cesarean.

A doula is amazing because they offer the mothering comfort and support that our ancestors had.  When women would give birth in their tribe or village, and they were surrounded by mothers, aunts, sisters, grandmothers, and the other women of their community, they received that mothering support by women who were comfortable with birth and relaxed around it. Fear has no place in birth, and a doula provides needed calm and loving support.

Remember, In the end it’s not in our control, and we let go and surrender,

If you do all of these things and end up having a cesarean, it’s not a failure. There is no failure in birth. It is a birth, a belly birth, and it’s the birth of your baby and you as a mother. It is the birth of your family and your partner as a parent. Stay present, stay involved and keep a positive mindset. Focus on the blessing, that you did all that you could, and thankful for modern medicine, which saved you and your baby’s life and preserved health. Also, you can ask for a gentle cesarean, which restores humanity to the operating room by doing such things as allowing your support people in with you, enabling baby to emerge from the incision simulating as much as possible a vaginal birth to help baby clear his/her own lungs, enabling you to participate by lowering the drapes so you can see your birth, giving you sterile gloves to receive your baby, optimal umbilical cord clamping so baby can benefit from the cord blood, encouraging immediate skin to skin bonding and early breastfeeding.  

Healing can occur afterwards, and may take time and lots of support. But there is no place for shame and negative self judgement here.

Questions to Ask When Interviewing Your Provider, Red Flags and Choosing Your Best Provider

Here are some key questions to ask your midwife or obstetrician if you want a natural birth. Listen to them and within you. You will get your answers about best provider for the birth you want. And do pay attention to red flags.

Do you have training and experience supporting natural physiologic undisturbed birth when all is well?

What’s your rate of primary cesarean?

If I need a cesarean, are you or your collaborative obstetricians experienced and do with gentle/family centered version?

Do you encourage VBAC? What’s your rate?

Are you skilled and supportive of physiologic breech and twin birth? What’s your rates?

Do you support my birth preferences and my right to decline interventions?

Do you advocate for doulas and other support persons I want?

Do you support and have training/skills for vaginal breech and twin birth?

What’s your rate and policy for induction of labor - like going past due date, suspected big baby, water breaking before labor etc.

Is your setting when you practice in alignment with you? What restrictions might be placed on me becasue their protocol?

Most importantly, do support my legal and ethical right to autonomy over my body, birth and baby?

Will my rights to make informed decisions about my and my baby’s care be respected?

If they don't support natural undisturbed health birth or evidence based care, their rate of primary cesarean section is above 10-15%, they don't support your birth preferences & right to decline interventions, they don't advocate for doulas & any other support person you want, they don't encourage VBAC and have rates lower than 70-80%, they have high induction rates for things like going past due date, suspected big baby, water breaking before labor, they don't support and have lots of experience with vaginal breech and twin birth, and/or the setting where they practice is not in alignment with them & they place a lot of restrictions on you because of protocols and policies you have your answer. You can switch providers anytime and hire one that is most in alignment with what you want, who will work collaboratively with you.

Here are some red flags, but here are so many others, especially when all is well with mama and baby such as:

They don’t support natural physiological birth.

They don’t care to read your birth plan or respect your birth preferences.

They don’t do VBAC.

They don’t do vaginal breech or twin birth.
They advise frequent ultrasound, routine multiple tests and procedures without discussion.

They perform weekly internal exams at 36 weeks.
They induce everyone at 41 weeks or sooner.
They do not believe in or practice natural physiological birth.
They don’t like or support doulas.
They do routine episiotomies on all first time vaginal birthers.
They do immediate cord clamping, or rush clamping without waiting until it is limp, white and pulseless.

Their cesarean rate greater than 10-15%.
scheduling a cesarean because they tell you your baby is too big

Unless you are planning to birth in an out of hospital freestanding birth center or at home with authentic midwives, most maternity care practitioners and the settings they work have not seen natural undisturbed birth - and they are trained and quite used to disturbing it. They think it’s necessary to fix what isn’t broken when all is well. It’s like everyone trying to interfere with your heart beating or your lungs breathing when it’s doing just fine on it’s own. It is a sad state of affairs with what’s going on in most modern hospitals especially in the US. I’ve had obstetricians, nurses and even medwives (midwives who practice more medically like many OBs) tell me they have never seen a natural undisturbed birth. Some actually want to shadow me to see one! I love when I do hospital shifts and the med students follow me - it may be their only chance to see natural undisturbed normal physiological birth. That’s the vast majority of what I see and I don’t get how it can be otherwise. Why is this happening as if it were some cool freak show, when the research supports it, when it’s evidence based care, when this is how birth occurred for thousands of years since the beginning of time, and still is the way it happens for the majority worldwide.

Here is a wonderful testimony sent to me from a mama who took my online Guide to Pregnancy, Birth and Postpartum, prepared, informed and empowered herself to tell her obstetrician (the only provider in her rural area) who never saw natural birth, to do nothing but be a fly on the wall, just in case of emergency. He said he never did that, does mostly inductions, medicates births and cesareans. But she respectfully spoke up and he finally agreed. And who was touched to tears, crying the most at her beautiful natural birth? Think of the ripple effect that has on his care for other mamas? If you want a natural birth without disturbance-ask your provider if they’ve seen one. You’ll get your answer whether you should run or not, to a provider and setting where it’s the norm.

I want to thank you for your online course. Because of it I was able to do a home waterbirth in Nicaragua where it is not common at all. I live abroad so it was my dream to have a natural birth in my home. Little did I know there are no doulas or certified midwives in the country. Your course helped me through it! My father-in-law who is an OBGYN in Brazil caught the baby and also has never done a home or natural birth. He only does cesarean. What a special moment for the family! Thank you again for the knowledge I was able to achieve online!!! Here’s a video of our special day :)
— — Brittany S, Nicaragua


If you choose to stay with such a provider with so many red flags, you have to prepare even more, fight even more for what you want, make sure to have an advocate, and know your legal rights to autonomy and informed refusal so you don't allow anyone to dictate you to do anything against your will or manipulate you with playing the fear of dead baby card when there is nothing wrong. Dig deep - is this what you want to be doing during your pregnancy and such a sensitive time as labor?

For more information on how to best prepare for having your baby, feel well educated and informed , confident and empowered, bust through fears and trust the process, and have the most beautiful birth of your dreams take my online signature comprehensive prep course - Anne’s Guide to Pregnancy, Birth and Postpartum and read my Natural Birth Secrets 2nd book edition. I created them for you to do just that, based on over two decades of holistic nurse midwifery experience and attending over 1000 births.

I’ve taken everything I’ve learned, trained, and supported women locally for over 28 years in my private practice and I’ve poured all of my love, passion, knowledge, and experience into creating something truly special for you… my new and updated Pregnancy, Birth & Postpartum Guides. Same Beloved Content Plus Over 40 Added Bonus Videos! Buy Here Now!

They can be used via the mobile App or on your desktop! It’s the most up to date combination of Love Your Birth and Walk With Anne for Mamas online courses at a cheaper price! And they have an option for direct access to me for your questions and concerns!!

Whether you’re an experienced or new parent, there are hours of videos, workbooks, and PDFs to answer all of your questions. Everything is searchable, so you can just type or talk and it’ll bring you right to the exact moment in the video where I answer your question. It’ll blow your mind! If English is not your strongest language, you can even change the captions or even the audio to the language you prefer. The Prenatal, Birth & Postpartum Guides can be sold separately or in a bundle to buy only the section you need or get ALL of the guides for a limited-time offer of 50% off -> RIGHT HERE!

The key to a positive birth is feeling confident, strong, relaxed, and empowered during the entire process, regardless of the twists and turns it may take. I give my full heart and all I know in everything I do to support Mommas.

Getting Real With A Mama in My Practice Who Rocked Her VBAC

Part one and two of a an awesome video I was invited to do with Joni, a mama in my practice who had a homebirth birth after cesarean, that really brings together many things pregnancy, birth, and breathwork, holistic health and healing.

Learn how to rock your VBAC and have the birth of your dreams with these three different but crucial resources - so you can prepare like a boss!

Love Your Birth Course
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Get deep in this childbearing bible, a reference guide for the whole journey from planning a pregnancy, expecting, birth, postpartum and newborn care, with effective holistic modalities for common discomforts and issues along the way.

Get deep in this childbearing bible, a reference guide for the whole journey from planning a pregnancy, expecting, birth, postpartum and newborn care, with effective holistic modalities for common discomforts and issues along the way.

Singing and Dancing My Way to Natural Birth With Pre-Eclampsia

 
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My heartfelt thanks for reading my story. I'm so blessed and honored that you will post my birth story on your blog and social media.  I hope and pray that this would inspire more women to try birthing naturally and perhaps encourage them also to sing and dance their way through labor! 

I was diagnosed with Pre-Eclampsia with severe features due to the extremely high amount of protein in my urine. My blood pressure remained normal, below 120/80, all throughout my labor, delivery & recovery. This is my 5th pregnancy. My first pregnancy was with twins.  The 1st twin, Annalise, was born naturally (no anesthesia, IV, oxygen, pain meds) in our church's birthing clinic.  The 2nd twin, Therese, was born via CS in a hospital. I was transferred because Therese went transverse when Annalise came out and it was Therese's hand that first came out.  My midwife put her hand back twice before transferring us to the hospital.  

In most hospitals, 24 hour monitoring is only done in the High Risk unit, so when my fluid was low, I had to be monitored for a full 24 hours before I transferred to a regular room.  I went back to the High Risk unit again for the Magnesium sulfate, to counter possible seizure or convulsions, according to my OB.  They also don't allow the natural birthing suite for high-risk cases like mine, because I already underwent Caesarean in a previous pregnancy, even though I've already had 3 VBACs.

Valentine’s Day, Thursday, Feb. 14, 2019, I was looking forward to a lovely dinner that night with my husband of 13 years, Ritche, to celebrate our 15th year of being together, when we received news that my husband’s 98-year old maternal grandmother “Lola Auring,” whom he was very close to, had just passed away peacefully in her sleep.  He regretted not being able to visit her sooner when she was still alive but looked forward to flying out from our home in Metro Manila (Philippines) to their province to be with her for the last time.  

But, first things first… I had to go to St. Luke’s Medical Center in Bonifacio Global City, for my routine 36th week checkup & ultrasound.  My OB did a Biophysical Score of our baby and told me that my fluid was low.  In my mind, I thought, “Okay, I’ll just have to drink up at home then.” But, my OB had another plan... I needed to be admitted to the High Risk Pregnancy Unit and hydrate via IV. I called Ritche and he agreed for me to be confined, thinking we’ll just stay overnight until my fluid goes up in 24 hours.  

So, aside from the IV drip, I tripled my water intake to 3 liters in the morning, 3 liters in the afternoon and 2 liters at night, which equated peeing almost every hour! AND I had to be hooked to several machines so my heart rate, blood pressure, baby’s heart rate and my contractions will be monitored for 24 hours. It was super uncomfortable but I thought, “No problem! As long as baby’s fluid will go up right away.”  We then asked our churchmates and close family & friends to pray with us.  I also prayed that I would be discharged as soon as possible so that Ritche could still travel the next day to be with Lola Auring.

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24 hours later, Friday afternoon, my fluid just increased a tiny bit so my OB double checked the protein-creatinine ratio in my urine. While waiting for the results, we got a regular room and waited another 24 hours.  My husband already cancelled his trip and let my mother-in-law, Mama Tess, go ahead to their home in the province.  My UPC ratio was still extremely high, which made me a candidate for severe pre-eclampsia. We couldn’t believe it.  Even my OB couldn’t believe it, either. I’ve always been careful with my diet, preferring veggies & fruits. I always made sure I had regular exercise.  My blood pressure has always been normal.  How could I have pre-eclampsia?   

We’ve been praying for Baby Abe to come out at least on his 38th week so, imagine our surprise when she advised us on Saturday afternoon that we’ll both be safer if he came out as soon as I reach my 37th week, which was the following day, Sunday!  Questions ran through my mind.  We knew 38 weeks is the ideal.  How do I induce labor?  We’ve always just waited for me to labor naturally.  With Agatha, our 5th child, we had to keep her in as long as possible.  With Abe, it seems, we now had to bring him out as soon as possible! We hadn’t even packed our hospital bag! We were just supposed to buy baby boy stuff this week!

I had my Birth Plan printed out for the doctors and nurses and went back to the High Risk unit so that I can be given magnesium sulfate to counter possible seizure/convulsions.  I was also given 4000 mg of Evening Primrose Oil every 4 hours to soften my cervix. It just seemed so foreign and unnatural to me that we had to naturally induce labor.  How do we do that?  

My husband comforted me and reminded me that we have a great and awesome God and that so many people are praying for us.  He had been diligently communicating with and updating our close friends.  My dearest friend Kartika from Singapore visited me twice. My best friend and sister, Lala and her husband, Solomon, came all the way from Carmona, Cavite, to encourage me with their love and presence.  Our dear godparents, Fr. Dino and Sis. Anj, braved the 3-hour traffic to show their support and pray with us. When they mentioned the words “total trust” and “perfect peace” in their prayers, I was inspired by the Holy Spirit to write down the alliterations the Lord revealed to me as they were born in my heart so I can meditate on them:

“Total Trust in Thee”  “Perfect Peace in the Prince of Peace”  “Sweet Surrender to My Savior”  “Calm and Courageous in Christ”  “Blissfully Blessed and Brave to Birth our Baby Boy”  “Relaxed, Rested and Ready”

Most importantly, my mother, Mama Lou, my father-in-law, Papa Adelo, and our 5 beautiful and wonderful children, gave me so much encouragement that I knew that we can bring Baby Abe out in God’s perfect timing.  The Holy Spirit will lead me and guide our baby out.

Monday, after the magnesium sulfate treatment, I had another ultrasound.  Baby’s fluid had significantly increased from 7.89 to 13!  Praise God!  We could really feel the prayers of everyone.  We were ready to induce natural labor.  My OB mentioned that Baby Abe could even be born on Thursday, which was her birthday!  But I thought to myself that I didn’t want to labor that long.  Our churchmates, Dcn. Jojo and Sis. Evelyn, brought homebaked muffins along with much laughter and prayed over us before leaving.

We finally finished my IV (Yay!) and I drank my red raspberry leaf tea, walked about our windowless room, slow danced, bounced on a birthing ball. Contractions were very mild at 3-5 minutes apart, but they weren’t “painful.”  Mama Chato, our midwife who helped me naturally birth our other children, taught us that we must reframe contractions as “good pain” because it helps bring the baby down.  The more you welcome each “good pain” and embrace the sensation, the more relaxed you will be and fear will leave you.  So, everytime I felt a contraction coming, I relaxed my facial muscles, my jaw, my shoulders and let the tightening sensation do its work on my belly. The uterus is a very powerful muscle and I looked forward to the pressure, imagining that every contraction brought Baby Abe closer to being in my arms.

The resident doctor did my first internal examination and said I’m only 2cm dilated.  Well, at least it’s not totally closed, right?  However, at 530pm, I had an unexplainable occurrence of “chills” where I suddenly felt like I was freezing.  I couldn’t stop my teeth from chattering and my body from shaking violently. My mom wrapped me in thick blankets, wore socks on me, rubbed my legs. I called my husband to hurry, as he was getting some documents for our hospital stay. I placed my cold hands in my armpits and prayed that the nurse won’t peek in and report that I’m having some kind of seizure.  The chills passed after 20 minutes.  My husband warmed me with his embrace.  However, I couldn’t sleep a wink that night.  My husband decided we transfer again to a normal room with windows so I could be more comfortable.  I searched online “how to dilate cervix fast” and visualized my cervix opening and prayed constantly to the Lord to give me thoughts of peace and not anxiety.  The baby knows when to be born.

Tuesday, I had a prenatal massage to relax and press those labor-inducing points, drank more red raspberry leaf tea, bounced on the ball and did more than walking, I did some dancing, too!  Contractions were still mild at 3-5 minutes apart. I had another bout of “chills” at 530pm so my mother wrapped me again and I rebuked every thought of convulsion or seizure.  I kept telling myself that this will pass and Baby Abe is safe in my womb. The chills stopped at 6pm. By 8pm, I was so tired from the lack of sleep that I was able to sleep very well, even with the regular rhythm of my belly tightening.  We continued to entrust everything into the Father’s hands. 

The next day, Wednesday, February 20, I was determined to up my natural induction techniques.  My OB was pleased with the progress of my labor but reminded me not to wait until my water broke.  She reminded me to let her residents know when I’m already 4cm dilated, because I gave birth so quickly to our last child, she almost didn’t make it.  

My Mama Lou and I danced belly, hip hop, Zumba to the jiggiest songs I could find (Think “Trolls” soundtrack, “Walking on Sunshine” “Moves Like Jagger” “Waka Waka” you get the picture) and I sang my heart out to our Hillsong & Bethel favorites (Oceans, What a Beautiful Name, O Praise the Name, Open Heaven/River Wild, It Is Well, No Longer Slaves, etc.) when I rested. The doctors and nurses were amazed I could still sing and dance through my contractions.  Haha!  It actually took my mind away from the pressure.  By 530pm, I thought my water was leaking so I called a resident to examine me.  No water, just the EvePrim Oil melting but I was 3-4cm dilated.  Yay! She then asked me to go down to continue laboring in the High Risk unit.   Labor progressed very quickly and I did feel more and more pressure every minute!  

Shout out to the doctors and nurses of St. Luke’s BGC for honoring my Birth Plan as much as possible and I agreed that I will only be hooked to the monitor for 20-30 mins every 2 hours.. No pitocin, no IV, no oxygen and no pain meds.  By 8pm, I was 5cm dilated.  Hooray! That pushed me to do even more dancing, bouncing, marching, swaying & singing during contractions, with my husband playing every song I requested.  The pressure was already immense at this time, and I had a tugging feeling I was very close to transition, although it’s only been a couple of hours.  I was thankful that my husband was just right there to tell me I’m doing great, and my mother was also with us, cheering me on.  Whenever I felt the tremendous pressure, I would say, “Baby’s going down, down, down!  Yes, yes, yes! Go, go, go!” and I knew that they both agreed with me and believed with me.  

I was already speaking in tongues, asking the Holy Spirit to be my Comforter, my Teacher, my Guide.  I envisioned Mama Mary giving birth to our Lord and Savior Jesus Christ.  I remembered all our children who are happily awaiting their baby brother at home. They’re counting on me to give birth to Baby Abe soon.  I wanted to birth this beautiful being in my womb without fear, only love and joy and peace... Feelings of indescribable bliss welled up in my heart for this boy whom Ritche and I had so conceived in love.  I was determined to confidently bring him out in that same love that conceived him. 

At 1030pm, I asked the resident to check my cervix, which had already dilated to 7cm, with a “bursting” effacement.  I had to be strapped again so I lay down waiting for the nurse when, a minute after, the nurse relays the message from the doctor to tell them right away if my water bag ruptures. She hadn’t left the room yet when my water bag burst!  It felt like a water balloon popped out of me. 

I excitedly told everyone, “Baby’s coming out!”

 They wheeled me out our room into the delivery room right away.  I felt the head of Baby Abe crowning.. I thought I couldn’t hold him in anymore.. but I tried to relax, as the doctors were still preparing, I had to be moved from my bed to the delivery bed and my husband, Ritche, was also getting into scrubs. I requested that I be more upright and not lying down.  Our OB was nowhere to be found but already gave instructions to her three resident OBs present in the room.  I already felt like pushing but was holding Baby Abe in.. I was so excited.. I called my husband.. “Daddy!” and told the nurse, “The cellphone!” Haha!  I didn’t want the nurse to miss taking Daddy Ritche’s picture catching Baby Abe.

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Finally, it was only a matter of minutes before I told them I had to push Baby’s head out.  The doctors assured me and said they won’t hinder me from pushing.  His head came out and the doctor was wise enough to remind me not to push anymore because he slid out so easily! It’s a birth phenomenon they call the “Fetal Ejection Reflex.” Pushing would have made the baby fly out.. Haha! It was amazing to see my husband “catching” our son!  As with all our other children (except Therese who underwent emergency CS), he did the ceremonial cord cutting after the cord stopped pulsating.  Baby Abe had already pooped meconium but miraculously, he didn’t ingest any and his Apgar score was 9 out of 10.  Thank God!

I delivered the placenta within 5 minutes. And our OB, Dra. Bambalan, arrived moments after to check on me.  Everything looked good.  My blood pressure stayed normal all throughout. I had a 1 mm tear that didn’t need any stitching. 

They were amazed at how easy the birth was and how fresh I still looked even after giving birth.  We all laughed at how my primary concern was to get the cellphone to the nurse and how Baby Abe didn’t want to have the same birthday as Doc.  Everyone in the room was lighthearted and Dr. De Guzman exclaimed that this was one delivery she will never ever forget!

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All in all, we stayed in the delivery room for 18 minutes then I was brought out to the Recovery Room for 4 hours to check on Baby Abe and me.  By the end of the recovery period, my BP was still stable, Baby Abe and I had skin to skin contact and he latched on the breast perfectly, but there was just one problem.  The nurse said that they’d have to put a catheter on me if I didn’t urinate soon. No way!  I gently pressed on my bladder and, sure enough, I was able to pee on my own.

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The next 48 hours were critical for me and Baby Abe. I recently saw the diagnosis of my OB upon discharge.  It was Pre-eclampsia with Severe Features.  But, thank God, we never manifested any complications.  No headache, nausea, vomiting, seizure, swelling, convulsion, shortness of breath whatsoever.  My blood pressure never elevated all throughout.  Baby’s oxygen levels were stable.  I didn’t go into shock, stroke, had brain damage or any organ failure. I didn’t need any kind of pain medication.  

Within 48 hours of delivery, we went home to our family, carrying our 6thbundle of joy, our second boy, whom we named "Abraham Nickola."  So thankful to all our family, relatives, friends, and churchmates for keeping us in your thoughts and lifting us up in prayer.  I believe that Ritche’s grandmother, Lola Auring, was also looking down from Heaven and interceding for us, along with all the saints and angels. To God be all the glory, honor and praise!  He is a miracle-working God who faithfully keeps all His promises and grants us the desires of our hearts!

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By: Chat Jandayan @chatjandayan

Most of the photos were taken by my husband and my mom.

This is why excellent childbirth education is a must, why planning for your birth and the unexpected challenges that can arise, is so important today, and is a major reason why I created my Love Your Birth course. It is a comprehensive online course that teaches women what they need to know about planning and carrying out the birth that they want in all settings - the hospital, birthing center or at home. It’s a course on how to have a holistic, healthy pregnancy for the body, mind, and soul - and is how I have guided thousands of women and their families in my midwifery practice for over 21 years.

It contains a rolodex of my favorite resources with over 200 of the best books, movies and supplies I use personally and professionally with my clients, family & friends. Even diving into a fraction of this list will have you feeling empowered and prepared for conception, pregnancy, postpartum and parenting...It includes resources on improving and even ensuring ensuring healthier pregnancy and birth outcomes than the status quo, and preventing and healing from birth trauma so prevalent in the modern world!  

Be prepared to do some research on your own, but knowledge restores your power. I also help you prepare your mindset for such a task, to debunk myths, and to reframe any current ideas or conditioning about pregnancy and birth that can use a change in perspective or that are simply incorrect and do serve you. After finishing the course, the idea is that you are now able to create and have the healthy, beautiful and empowering pregnancy and birth that you want - so you can ROCK your birth, however it unfolds!

It’s wonderful alone, a great refresher or adjunct to any other course!

 

HBAC Birth Story - Homebirth After Cesarean

 

“Having a HBAC was really so special after a totally unnecessary c-section with my first. I’d love to spread the word that it’s possible. So many people think it’s not.

And Then There Were Four

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The last time I typed up a birth story it wasn't one I was super excited to share with the world. I'm eager to get this one down before I forget it since labor amnesia sets in quick and because this one could not be more different than the last. A friend of mine who also had a particularly difficult first labor said that when she had a second child she wanted a do-over. At the time I was telling myself that all that matters is getting a healthy baby and while I still believe that, I am very happy that things went the way I wanted them to this time. 

[ I am not sure I need to but I would like to stop here and warn any readers that since this is a blog entry about giving birth, there is some TMI. ]

Last Friday I was 39 weeks. It started like any other day since I became full-term, with me thinking "Will this baby come today?" followed immediately by "Nah, I have tons of time left" followed by a much quieter "...maybe."  

Because Thora's birth was such a mess and because I believe it was the four days in a row of acupuncture that my midwife sent me for before my due date that started my prodromal labor and not Thora herself, ready to be born, I was treating this time like it was my first time. Lots of people said that since Thora was born four days before my due date, this one would be early too, but I was telling myself just in case that I really didn't know when Thora would have come, had circumstances been different. This one could very well wait until long after my due date. I knew four or five other people who were all due around the same time as me and I kept saying they'd all be first, just so I wouldn't be disappointed if I went on to 41 or 42 weeks. 

So on Friday morning I didn't think anything of going to work like usual.  I had a lot to do, including dealing with three chickens I was fostering in my tiny shared work space. (Don't ask!)

Johnny, on the other hand, seemed to know something was up. The night before I'd had what I thought could be a little leaking of amniotic fluid. (Any expecting parent has to be familiar with the awful "here, smell this, is this pee?" ridiculousness) Even though he didn't say so, he was on high alert. That morning he drove me to work so Thora could see the chickens, and en route he announced that he was cancelling the plans he had with his friend for that night just in case the baby came. I told him not to be silly and encouraged him to go ahead because my due date was still a week away and who knew when he'd get to go out again. Likely that leak was nothing. But he insisted. 

At the office, I managed to knock out a few things before everyone else arrived. I did an interview and wrote up a document I really needed to get out. I exchanged emails and calls with a few people. All the while I was having contractions and they were pretty regular but mild so I didn't say anything to anyone, just kept working and waited for them to pass. Around 1 pm when we were discussing lunch options, I felt a sudden gush and ran to the bathroom. Knowing that only 8% of labors start with the water breaking, I wasn't exactly sure what I'd find but I did not expect to see a lot of bright red blood. A lot. I had also passed a clot the size of my pinky. It didn't look like a mucus plug, it looked like a blood clot. And sitting there, I passed another. So I completely panicked. I called my midwife who seemed calm but mildly concerned. A few minutes later she called back: she'd been able to get me an emergency appointment at the women's ultrasound office I'd been going to, which was up on Madison Ave about a fifteen minute walk away. She encouraged me to put on a pad so I could see how much I was bleeding and said I should call her from the doctor's office to let her know what was going on. I called Johnny, who wasted no time getting into the car and on his way.

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I threw my stuff into a bag and fled. As I waited impatiently for the elevator, a coworker and mom of three passed me in the hall. She took one look at my face, nodded and said "Oh yeah," in a knowing voice. "Good luck!" In my mind I was thinking "But I'm not in labor!" though I wasn't about to stop to explain.

Of course it was pouring rain so finding a cab was virtually impossible. Frustrated, I called Johnny again and reminded him that my first labor was during a blizzard and complained that it wasn't fair that this happens to us during horrible weather. Someone from my office accompanied me to the corner of First Ave with a big umbrella, trying to help me flag down occupied cab after occupied cab. There were a handful of other people doing the same and I ran in front of them, totally focusing all of my fear into anger at them for not seeing me standing there and giving me the first cab that pulled up.

Meanwhile Johnny and Thora were stuck in traffic on the FDR drive on their way to meet me at the ultrasound place. In the cab, my contractions slowed and my bleeding too. I could still feel the baby moving so I knew she was alive, but bright red blood is never a good sign in pregnancy so I was still very worried. I raced into the office and told them who I was. The woman at reception reminded me that I didn't have an appointment, that they were fully booked but would see me when they could. I reminded her as sweetly as I could that I was 39 weeks pregnant and bleeding a lot. Then I sat down to wait. My name was called not two minutes later and Johnny and Thora arrived about two minutes after that. The ultrasound showed that the baby and her heartbeat were fine, there was a lot of amniotic fluid, the placenta was intact, and everything was overall peachy. Both the doctor there and my midwife on the phone said they could not easily explain the blood, that they guessed it was either my mucus plug or a small placental abruption. My midwife ordered me to go right home. "Do NOT go back to work," she said sternly. How did she know what I was thinking?! She insisted I rest and check in with her in another hour or so. Feeling calmer, I apologized to the receptionist on our way out. She looked relieved. I thanked everyone for seeing me so quickly and we headed back out into the rain.

We did go right home. My contractions continued, mildly. Johnny and Thora took a walk to Uptown Juice Bar, our neighborhood veggie restaurant, to pick up some dinner, while I tried to nap. By 5 pm or so we were timing the contractions but they seemed pretty stable at 5 minutes apart and lasting only 30 - 45 seconds. After Thora's birth, which was a full five days of contractions like that and two hospital visits during which I was checked and promptly sent home, I was determined not to be the boy who cried wolf a second time, so I kept telling the midwife it was no big deal, that I wasn't concerned yet.

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We got Thora to bed around 7 and settled in front of the TV for some Netflix streaming. I texted my sister to tell her I thought I was in labor. Then I sat on the birth ball and moaned and yelled my way through three episodes of Breaking Bad before Johnny told me that the contractions were obviously getting longer and more intense. I was still in denial because they weren't any closer together. I called our midwife again around 10 - a full 45 minutes later than she'd asked me to, she reminded me. I had a contraction as we talked and I tried my best to talk through it. I did not want her to have to come all the way here only to tell me I was having prodromal labor and then go back home. She said she was ready to go whenever we said the word, but I told her we were still fine. 

Oh the stupid things that go through a laboring woman's head. At this point I was thinking "What would a woman birthing with Ina May Gaskin do now?" I tried to channel the birth stories I'd read over and over in Spiritual Midwifery. These women would have made food, cleaned their RVs, worked in their garden, gone for a hike, hugged a tree, or gone to sleep. Remembering that with Thora I gave up pushing for a c-section because I was too tired to keep going after five days of being too excited about having a baby to rest at all, I picked sleep. I took a quarter of a Bendaryl and lay down. I knew that if this was really it, the contractions would not slow. But they did, to about 8 minutes apart.

I did manage to doze a little between contractions but they kept waking us both up and after an hour or two, they got more and more intense. By 2 am they were 2 - 3 minutes apart, lasting 90 seconds to 2 minutes. I was nauseous and restless and knew sleep was now out of the question. Benadryl or no, I was wide awake and in agony. Soon I was in pain even between contractions and I was suddenly throwing up and having to poop and everything else all at once. This was it. 

Johnny called Joan while I ran the bathtub. She'd been asleep but was instantly alert. The no-nonsense woman she is, she declared me to be in active labor and said she was on her way. Still not wanting to be humiliated for thinking I was in active labor when I wasn't, I was nervous that the bath might slow things down by the time she arrived. But it didn't. 

Between contractions in the water, I was fine. I sat there in the candlelit darkness and tried to relax. I could talk, even joke around a little. The contractions were painful as hell but in between them there was a minute of reprieve. Also they felt very different from the ones I had with Thora. Thora was posterior (meaning she was face up) and the resulting back labor was agonizing in a whole different way. At the same time, this was pain like nothing I ever knew. 

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Joan and her assistant S. arrived around 2:45. Joan checked me right away. 7 centimeters. She said "The rest could either be slow or fast but I'm thinking fast" and went back to making her preparations. There was no time, she said, to set up the birth pool. I was going to have the baby in the bathtub.

They started setting things up while Johnny sat with me and made sure I had water, Emergen-C, whatever I would drink. S, Joan's assistant, held my hand ("but only if it's not annoying," she reminded me) and helped me keep my sounds low and my shoulders low and relaxed. The pain got more and more intense and I got louder and louder. I surprised myself by how much I was screaming and howling and growling but it was what I had to do. Joan shrugged. "Some people just need to roar their babies out," was all she said. This kept on. I beat my hands on the lip of the tub with every contraction and screamed this guttural, totally insane scream. I was sitting cross legged, sort of like in lotus position, in the center of the tub, leaning over the middle of it. My head was resting on a towel they put on the lip of the tub and my hands were hanging over the side so I could remember to keep them unclenched. Rayna, my cat, was sitting right beneath my hands keeping a close watch on things. Johnny sat on the closed toilet seat and S sat on the floor next to Rayna. Joan left me to it for the most part, but came back in periodically to tell me I was doing great. I panted and screamed and shrieked and didn't believe her. "I don't think I can do this!" I heard myself whine. "You ARE doing it," everyone chanted, in unison, in response.

Then all of a sudden everything changes. My growl gets deeper and I hear myself scream like I never, ever have before. It gives me chills to think about it now. "That sounds like pushing!" calls Joan from outside the bathroom. She is suddenly there, checking me, asking if I feel like I need to bear down. "I don't know what I feel," I say. I am hoarse and my mouth is dry and I'm starting to whine again. "I feel her in my butt now and it really, really huuurrrtttss."  Yep, she says, that's pushing. And then I am at my absolute least attractive, retching and vomiting and panting and feeling like I'm crapping my brains out and watching the water around me get redder and redder. I'm babbling like a fool, asking how soon I can get an IUD, asking if I am going to make it through this, begging for it to stop. My head is filled with wild images: I'm thinking of my birth mother who should be there with me but isn't, of long-haired hippies who don't feel any pain as they push, of how I am certainly waking our daughter, asleep in the next room, of how I am definitely terrifying our neighbors and scaring my husband from ever wanting to look at me naked again, of being split open, of living through this to meet my baby.

Joan is suddenly all business. She kneels down and makes me change position. "If you are going to have this baby here, you need to stretch out and lie down on your right side and hold up your leg like this." She holds up my left leg like this. She gives Johnny the job of holding it up even further and pushing it back against the wall of the tub. She lets out some of the disgusting water and runs more warm water in the tub and over me, saying now it's too cold for having a baby. 

And then I am gone. What takes over is this primal thing, barely human, screaming and roaring. From a million miles away, I hear "I can see her!" and "She went back in, but that's okay, she's stretching you so you don't tear" and I'm panting and and my voice is saying "I can't" and then I'm wailing again and there are hands on me that I push away and suddenly I feel a pop and I hear "That's the head!" One more howl and a huge push that takes everything out of me and the next thing I know she's crying in my arms and there's a warm blanket and a towel being draped over her and I am spent but I have my baby and I did it, just like the women in the hippie books and exactly how I always wanted, with my husband next to me and my daughter asleep in her room just ten feet away and we are all in our element in our home and I can't believe it. It is 5:33 am on Saturday, September 24. I have been in labor for over seventeen hours and I have pushed for only 23 minutes.

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Freyja Rae is teeny. She is coughing and sputtering. I count fingers and toes, look at her tiny face, pick some vernix out of her ears. I push out the placenta and then a few minutes later, I manage to cut the cord myself because Johnny doesn't want to, snipping Joan's finger in the process. I smile and apologize. She shrugs and says she's been cut worse. I ask her if this ever gets old for her and she says with a smile, "Nope. Never." Everything is quiet. Then at some point, I ask how in the world women go through this pain. Her answer is simple. "We can do it because it ends. No matter how long it lasts, it always ends." 

Freyja and I lie there together for a few minutes in the gross bathwater while I think that over. We are happy and exhausted and I'm thinking about Rocky calling to Adrian that he did it. Johnny snaps a few pictures and S snaps a few more.

Then Joan wraps her in another warm and dry receiving blanket and hands her to her father, saying she's not ready to nurse yet but that she needs skin on skin contact with Daddy, and then I am fading away and I'm gone. 

I smell ammonia and hear someone say "smelling salts." My blood pressure is so low they can't even get a reading, but the smelling salts are so awful they wake me up enough so I can turn my head away. This feeling is nothing new for me. I have low blood pressure all the time so when I am sick or weakened I always react by getting dizzy and feeling faint. I am not concerned, but Joan and S are. A peanut butter sandwich appears before me and a glass of some flavor of Emergen-C that I didn't pick out is shoved in my face and a straw stuck in my mouth. I want to be in bed, with the AC on, wrapped in a blanket snuggling with my new baby but I know I can't make it there so I take slow bites and sips and wait.

Gradually I regain strength. We drain the tub and I am able to stand long enough to rinse off in the shower while they make a bed out of a plastic tablecloth and wee wee pads, right there on the tiles. I lie down and as I do, I hear Thora, awake. Freyja is passed back to me and I latch her on for the first time while Johnny brings Thora right to us in the bathroom. She's not fully awake and is very unsure of what's going on. "Mama?" she asks dubiously.

I sit up and nurse cross legged on the bathroom floor while they set up a spot for me in the living room. Moments later, Freyja and I make our way over to the couch. S hovers and makes me eat and sip sweet tea while I nurse Freyja. Johnny is next to me cuddling Thora, who asks for a pinky. A blissful moment: I am with my family.

But I am tired. Joan examines Freyja and prepares to weigh her like a bunch of bananas. "Any guesses?" We venture a few, but we are all off. She is much smaller than her sister was, only 6 pounds and 12 ounces. 19 inches long. Head and chest circumference are both 33 inches. "She's symmetrical!" Joan laughs. Freyja is perfect. And since we are at home, nothing invasive happens. She hasn't been suctioned. There is no ointment in her eyes. Joan doesn't even clean her off. Instead she rubs what's left of the vernix into her skin and wipes her down with some olive oil. She grabs a onesie from the pile, a white one with a pink and black skull and crossbones, a gift to Thora from our friend Missy Church. I smile and say she's dressing her like a punk rocker. "For you, nothing less!" she smiles back.

Johnny gets up to dress Thora. I help her on with her shoes and give her a big hug and kiss. Johnny brings her downstairs to our neighbor to hang out with her two girls for the morning and I throw on a shirt and get into bed with my new daughter. Joan hugs me and tucks me in. I hear Johnny come back in and he joins me a moment later, closing the bedroom door behind him. We hear cleanup noises in the rest of the apartment, and a few minutes later, the front door opening and quietly closing, as we three drift off to sleep.

I did it!”

Mama @thewriteaimee

Photo credit to @db4johnny (my spouse)


Was your birth upsetting or traumatic? Do you have more questions about processing your birth and need help healing? Arrange some time to chat with me. I’d love to answer your questions and help you heal and get yourself back - I have a program specifically for you, that can also include this revolutionary and powerfully effective, natural healing modality called Clarity Breathwork.  Helping women heal from birth trauma is one of my passions and areas of expertise. So is preventing it in the first place.

This is why excellent childbirth education is a must, why planning for your birth is so important today, and is a major reason why I created my Love Your Birth course. It is a comprehensive online course that teaches women what they need to know about planning and carrying out the birth that they want in all settings - the hospital, birthing center or at home. It’s a course on how to have a holistic, healthy pregnancy for the body, mind, and soul - and is how I have guided thousands of women and their families in my midwifery practice for over 21 years. It contains a rolodex of my favorite resources with over 200 of the best books, movies and supplies I use personally and professionally with my clients, family & friends. Even diving into a fraction of this list will have you feeling empowered and prepared for conception, pregnancy, postpartum and parenting...It includes resources on improving and even ensuring ensuring healthier pregnancy and birth outcomes than the status quo, and preventing and healing from birth trauma so prevalent in the modern world!  Be prepared to do some research on your own, but knowledge restores your power. I also help you prepare your mindset for such a task, to debunk myths, and to reframe any current ideas or conditioning about pregnancy and birth that can use a change in perspective or that are simply incorrect and do serve you. After finishing the course, the idea is that you are now able to create and have the healthy, beautiful and empowering pregnancy and birth that you want - so you can ROCK your birth!

You can get a free nugget from my course - all about creating your ideal birth plan here. A huge part of preventing birth trauma is getting clear your birth preferences, knowing the pros and cons about all the tests and procedures, all the interventions your may be faced with, so you can make informed decisions - rather than simply give over your body, your choice and voice to your health care providers and institution you choose.

I have a holistic approach to life, including healing after pregnancy and birthing. Nothing replaces abdominal toning and exercise for restoring muscle strength and tone - which I encourage for all mamas as soon as they feel up to it postpartum. Nothing replaces touch, slow deep abdominal breathing, and a 'love your postpartum body' perspective that I promote.  But I have found many mamas simply feel comforted by this support garment, especially early postpartum and temporarily as needed....to be used without forfeiting abdominal toning and strengthening exercise, breathing well and touch. I have found Bellefit supportive garments to help like they use belly binding around the world such as in Indonesia. They do aid in early postpartum healing and provide support many mamas feel comforted by. I deal with human beings and the reality is many postpartum mom's struggle with body image, feel frustrated that getting back to themselves takes longer than expected. Being into holistic health and healing includes being sensitive to real human struggles - the mind, body, heart and soul of each person and their unique situation. Having helped countless women with these issues after having a baby as a midwife, I have found many still love that binding and feel better with this support, and ability to fit into their pre-pregnancy clothes comfortably and sooner than they would if they went through a C-section or natural childbirth recovery without it - especially when they have to dress up and fit into a certain favorite outfit for a special occasion or wedding not long after having a baby.

For more info on the Bellefit girdle, check out my blog about it hereHave a Great Postpartum Recovery (with a little help from Bellefit)!