04/10/2026
This is so well told. Midwives lowering the unnecessary c-section rates one mama at a time is one of my favorite things!
I’m also proud to call this midwife one of my besties. ✨
Imagine the pure joy and relief a mama would feel when she has a beautiful natural birth, after experiencing 3 past c-sections and secondary infertility.
The tears of joy. The realization that her body isn’t broken. The past trauma beginning to melt away.
Can you imagine?
Now imagine for a moment that none of those cesareans were necessary in the first place, and all the trauma from these surgical deliveries could have been avoided.
I’ll try to summarize:
👶 Baby #1: Cesarean chosen by doctors, due to Breech presentation. No other indications for cesarean. Only because Breech isn’t “allowed” there. Pre-labor cesarean preformed. “Oh, don’t worry,” she was told, “you can always have a VBAC next time.”
(Can you feel the lack of autonomy? This mama would have chosen a breech vaginal birth, if she wouldn’t have been told no.)
👶 Baby #2: Her doctors say: “Yes, you can have a VBAC. But you can’t go past 39 weeks. We’ll just induce you.” This time she has a cephalic presentation [head down baby], so “it should be a pretty straight forward birth.”
Induction began, and was going along well for a while. Then as labor advanced, she began showing signs of uterine rupture, so she was rushed to the O.R. for an emergency cesarean.
(Rates of uterine rupture is known to be higher when paired with induction, compared to the body’s spontaneous, non-augmented labor. But she’s told to be grateful that she was in the hospital and that they ‘saved her baby’s life.’ Of course she’s grateful. But she’s also traumatized, as well as confused about their opinions that claim she needed induction.)
👶 Baby #3: She’s told now that she is far too high risk to have a VBAC. “You have a uterine rupture in your history. You are not allowed to have a vaginal birth.” A pre-labor cesarean was planned for 37 weeks, due to the doctor’s worry of this mama going into labor.
(Again, the doctors choices. Not the mother’s. And do you notice how each subsequent cesarean is simply a side effect of the risks that were created by doing the first cesarean? And do you notice how the first cesarean was caused by stripping away the woman’s autonomy to have a breech vaginal birth?)
🤷🏻♀️ Then comes 5 years of secondary infertility. She’s told “this is a known side effect of having c-sections.” And it’s true. This is the reality for many women. “Scar tissue build up is often part of the problem.” Yes, that’s true too. Not the only cause, but certainly a part of the problem in many cases.
🙋🏼♂️At 4+ years postpartum, she had moved to another area. She decided to seek fertility and potential VBAC option advice of a local Midwife who her sister had hired for one of her recent Homebirths. After doing so, she began a strict nutrition regimen of foods and supplements, and fascia release as well, to promote fertility and heal internal scar tissue as best we can. The results weren’t guaranteed. But they were worth a solid try. Her mama heart deeply desired another baby.
👶 Baby #4: At more than 5 years after her 3rd baby, and about 1 year of being on the nutritional protocols, she became pregnant!
🙋🏼♂️ She decided to call that same Midwife again. This time it’s because she wanted to discuss the idea of a Homebirth. Every hospital within a number of hours of her would not ‘allow’ a VBA3C attempt. Every one of them would require a pre-labor cesarean at 37 weeks. Or an emergency cesarean upon arrival, if she were in spontaneous labor.
✅ But is it safe? Yes, it is—statistically speaking, still safer than the risks of a repeat 4th cesarean, but only if done spontaneously, without induction or augmentation. We discussed all the things we can do to set her up for the very best chance of success. But there’s also the chance of transfer for an emergency c-section if things don’t go as planned.
📉 The statistics say that VBA2C has a 1.8% chance of uterine rupture. But these studies include a huge percentage of induced labors. So we know that statistic is flawed, and the chances are actually less. But we don’t know how much less, because those statistics don’t exist.
📉 Also, published statistics for VBA3C don’t exist in large enough sample sizes to know the actual risks. And again, the numbers that do exist include mostly hospital stats that induce the mothers.
Making the plans for a safe delivery:
✅ Alternative birthing location planned/found within a few blocks of a large hospital.
✅ Assemble the birth team (thankful for 2 experienced Birth Assistants for this birth).
✅ Support labor starting ASAP to properly monitor (not waiting for active labor).
✅ Have a plan in place for quick transport if needed.
✅ No artificial labor encouragement (this includes herbs and ‘natural’ methods).
✅ Full informed decision making and consent with this mama, to honor her autonomy. Discussion of the risks including the worst possible outcomes and best possible outcomes, and EVERYTHING in between. (She appreciated these plans in place, even with the logistics they entailed. She wanted a solid chance. She deserved a solid chance.)
✅ And so so much more.
🤰🏼👶😍 What she got in the end:
✔️Zero restrictions of food and hydration during labor, to keep her energy up.
✔️Her first ever natural labor.
✔️Her first ever vaginal birth.
✔️Her first ever birth without unnecessary trauma.
✔️A supportive Birth Team who respected her informed decisions, and the backup plan that she was comfortable with.
✔️A calm birth environment with her husband and a dear friend present.
✔️As much immediate breastfeeding as she wanted.
✔️As much immediate skin-to-skin as she wanted.
✔️And so so much more.
Now imagine a world where Vaginal Breech Birth is fully supported by trained Providers—in hospitals, in birth centers, and in homes. And imagine how the above situation, along with all its traumas and major surgeries, could have been avoided.
And lastly, imagine a world where births after multiple cesareans are supported. Fully supported. (Not fear monger ‘supported.’ Not only-if-induced ‘supported.’ Not only-if-labor-by-39-weeks ‘supported.’ Because we all know that isn’t actual support.)
😍 A huge thanks to the family who hosted this beautiful birth!
😍😍😍 And a huge thanks to my Birth Assistants, and Midwives-in-training, Stephanie and Christina for their excellent help—as always!
Edited To Add: If you’re a Provider looking for Breech training, you can find it! There are many options out there, once you start looking. The best place to start is to look up Breech Without Borders. Midwives and Doctors with BWB are training Midwives and Doctors ALL OVER THE WORLD to be skilled in Vaginal Breech Birth! Find the training nearest you. Go! Learn! Become the change that women are seeking, whether it’s at home or hospital! Support VBB 😍
