I was able to have three vbacs after an unplanned c-section with my first baby. Some of the challenges in pursuing these vbacs were the same for each pregnancy—2nd, 3rd, and 4th.

This is written out of conversations I have had with women wanting to have vaginal births after unexpected c-sections. It’s not for everyone, and the language likely won’t make much sense to you if you have not experienced what I’m describing.

This is a topic for which I feel deep empathy. I hope that my discussion of caregivers does not offend caregivers reading this. Much of what I describe was subtly implied and my focus here is on the fragility of those hoping to be brave.

Here we go.

Pursuing a vbac takes mustering together as much courage as you can and keeping that courage by your side throughout the pregnancy.

Pursuing a vbac asks you to balance the fragility you feel about your c-section and take it in hand with the hope you feel about a future birth.

It takes educating yourself about the risks which caregivers will be concerned about, and having a sense of what they are going to say before they say it.

Pursuing a vbac means making space to be disappointed when a caregiver may ask you at each appointment—“And…are you still planning to try for a vbac?”

Pursuing a vbac means digging back up the trauma you felt in your first birth, and working through it.

In my case it took acknowledging that this hope was the current deepest hope of my heart, but that it was one I was only just grasping with fragile fingers, because I also somehow believed that my ability to give birth had in fact been sliced from me.

It means going into the required meeting for your “consultation” about a “trial of labor” at a hospital knowing that you may have to disagree when/if they say, “Wouldn’t it be safer to have another c-section?”

All of this is totally worth it.

Here are some things that helped me pursue vbacs:

1. If you have mixed feelings about the care you received in your first birth, consider switching to a new hospital. I would not have undertaken this myself, but the doula I hired for my second birth sensed how hurt and resentful I was about certain elements of my care, and encouraged me to switch to a nearby community hospital.

• Reasons for leaving can be both leaving behind a place of emotional trauma, and pursuing a different type of care, it doesn’t have to be one or the other.

2. Ask for the c-section rate at your hospital. You can check it online, and it is good to ask in person as well. Ask the care providers at the hospital how they feel about their rate, and use it as a discussion tool. This is a good idea for discussion for when you go into your required consultation before the “trial of labor.”

3.  Check your personal vbac success rate calculation before you discuss your plan with providers. This will give you a sense of what concerns they may have, like your weight, your previous labor experience, and your age. The facts don’t need to defeat you, but it is good to know them.

4. If you are switching hospitals, visit the previous hospital’s medical records office, and obtain the record of your birth to review with your doula or new caregiver. I went to the medical records office with my little toddler in a stroller, and we sat as the employee printed off a six inch stack of paper and handed it to me. Then I brought that to my new midwife and we talked about it together…

5. Find someone to process your c-section with. This could be a doula. This could be your new midwife. This could be a counselor, or a friend who is a really good listener. Allow yourself to mourn what hurt you about the birth, and then: let it fall away from you. After talking with my midwife, and some of the doulas that I interviewed to hire, I was shocked to find myself felt ready to let my disappointment go and move on.

6. Cleansed of some of the elements of grief and disappointment, now reflect on that birth and think about what you can change for the next time:

• For example, I decided that getting an epidural was not an option for me going into my second birth. I felt that statistically the chances of having another c-section went up dramatically if I got an epidural. So I took that option off the table beforehand, committing to myself that I would not do it. I would sometimes share this commitment and the reasoning behind it with caregivers. They would usually shrug and say something like, “Well, every birth is different.” I felt this was not only statistically misleading, but also it wasn’t helpful to me to hear it, so I did not engage with these comments.
• A decision that followed this decision was that I couldn’t be as overdue with my second baby as I was with my first (two weeks overdue, supposedly).
• So I did two things:
  • First, I educated myself about my cycle and learned that I had a 31 day cycle instead of a 28 day cycle. Caregivers typically calculate your due date based on a 28 day cycle, unless you tell them otherwise. Throughout my pregnancy, I had to remind caregivers that I had a 31 day cycle to be sure they were calculating correctly. Sometimes it was correctly recorded, other times it was not.
  • As I approached my due date, I asked for any natural inductions that they could offer. That meant making an appointment on my due date for sweeping my membranes.

This commitment is also what encouraged me to hire a doula, though it felt expensive (see #8).

7. While it was wonderful to have had such a happy, big 9lb 10 oz first baby, I decided it would be better for me to do what I could to have a slightly smaller baby the second time around. For my second pregnancy I tried to stop eating as soon as I was full (rather than finishing the dish just because it was in front of me) and I always ate protein first, carbs second.

• In case this is a question in your mind, I typically weigh around 100lbs and I typically gained 30lbs for my pregnancies. I gained 50lbs in my first. The birth weights for my children were as follows, the first birth was a c-section: 9lb 10 oz | 7lbs 11 oz | 8lbs 5 oz | 9lbs 1 ounce.

8. It is definitely worth considering hiring a doula. Yes, it is expensive. Yes, it could be seen as “only” self care. Even though your insurance won’t acknowledge the money saved, the fact is you could very likely go from a $50k birth to a $2k one. If you have great insurance, your doula fee may indeed be equal to what your insurance charges you for your birth. Keep in mind there are doula services offered at reduced rate for certain income levels, but you would want to research these options early in your pregnancy as they book up quickly.

But you won’t have many births in this life, and hiring an doula experienced with vbacs will very likely completely change the birth for you and your partner. Doulas like to interview their potential clients and they want you to interview them as well. So take some time to call and email people, have an interview together, and share your hopes upfront in the conversation.

That’s everything I would tell you, if we sat together and you said you wanted to try for a vbac this time. Know what you want to fight for and feel bold about sharing it, xo.

I confess I was not brave enough to eat my placenta but I did manage to get it home in a food-safe container and into my freezer–two big steps up from my last birth when I rolled my eyes at the midwife for suggesting I’d want to do anything with that thing. So I was delighted when my sister-in-law agreed to write about her brave entrance into the world of health-rumors and nutritional risky business. I love her medley of honest storytelling and humorous side eye at all the threads we find ourselves googling in this day and age.

by Hannah Cusack 

Pregnancy: that time in life in which you surprise yourself again and again. The stories of strange, never-before-seen cravings and inexplicable emotions are over-told, but even still, as you watch yourself (your very normal self!) pass through each phase, it really does not fail to shock. But there are even stranger acts pregnancy invites us to than pizza rolls with peanut butter—anyone else google Evening Primrose Oil in the last trimester and stare open mouthed at the screen, reading that you can not only take it orally but also vaginally? Anyone else do it anyway?

I tend to veer on that side of things in general—I can’t resist a totally unresearched, totally natural, and allegedly miraculous supplement or an old wives’ tale that’s researched and “proven” wrong, but still sworn to be true. I’ve only been pregnant once, but the list of the things I tried during those months without (or even despite) conventional advice is pretty long:

• Megadosing vitamin c (8,000-12,000mg per day): for overall health and ~vitality~
• Blending raw frozen chicken livers into my smoothies: basically, it’s a multivitamin!
• Supplementing iodine: to make the baby smarter, of course
• Aforementioned evening primrose oil: two ways, to encourage labor
• Acupuncture during the last trimester: for “sending my energy downward”
• Collagen powder: to prevent stretch marks and perineal tearing
• Ketogenic diet: to prevent morning sickness, gestational diabetes, the afternoon slump
• Incredible amounts of very strong red raspberry leaf tea: for“toning” the cervix
• Eating raw fish, eating tons of fish: for baby’s brain
• Planned a home birth: for all the reasons people do that

Other things I reluctantly tried, but tried nonetheless: eating whole pints of ice cream with my husband just before bed, not exercising or moisturizing my skin a single time, getting out of bed in that way you’re not supposed to for the sake of preventing diastasis recti a hundred times every. single. night.

One strange pregnant-person thing that I knew I’d do from the beginning is also the one that many people tend to be most shocked by. In my second trimester, a friend of ours was over for a Bible study dinner and made a joke about how the wildest thing one might do is eat the placenta, like Brad Pitt and Angelina Jolie! There was such an expectation of communal, fellowship-building shock and horror in the joke; it filled me with such delight to say I absolutely planned to. In a different Bible study, years before, I got to know a pregnant person for the first time in my life. She glowed and glowed and then disappeared for a while, and when she reemerged she had a beautiful baby in tow. One night, less than a month before she delivered, she told us her OB had said it takes three years on average for a mother to restore the nutrients depleted during pregnancy. I’ve never found the research to back that up, but it’s always stuck with me. Sometime later, not in a Bible study, I heard about the practice of placental preservation. My first impression was that the idea of consuming the vessel by which your nutrients are transmitted and depleted seems kind of genius.

One way of categorizing the strange things I love to try is this: low risk, high reward. As of now, there are no known risks associated with consuming the placenta, when it’s properly preserved, and the list of potential benefits is impressive: Replenishing your stores of nutrients. Preventing or aiding postpartum depression. Encouraging faster healing post-birth. There are also claims about stem cell therapy, which I don’t know enough about to go into, but are extremely interesting and nothing but positive. For me, the nutrient repletion is enough. Sign me up.

People do it two ways— dehydration or freezing. There are specialists who dehydrate and encapsulate it for you, so you’re truly just taking an extra capsule every morning. The stem cell benefits are only kept intact if frozen, but for all other purposes, dehydration is absolutely fine. I once ran into my midwives’ birth assistant on the sidewalk. She was carrying a drab little lunchbox with a new mom’s placenta inside to go dehydrate. Actually, you can even dehydrate it yourself in the oven! Though then you either deal with using the powder somehow (think smoothies) or encapsulating it yourself, and that’s probably not the thing you’ll want to spend your time on in those early days.

I decided to freeze mine for the sake of simplicity: I didn’t have to hire anyone, and I didn’t have to bake anything. Homebirth made this infinitely easier for me, but as demonstrated by the lunchbox anecdote, it really can be done any which way as long as you keep it very clean. (By very clean I mean use a brand new zip-lock bag.) The most important thing is to develop a simple plan, to be fully executed by someone other than you. Talk to your healthcare provider about your plan, and designate a specific person to handle the passing of the placenta (from medical table to oven or freezer to your re-possession). Talk to your partner about your plan in case you forget to tell other people your plan. I totally forgot to do this—I had the general plan in mind but didn’t designate anyone or talk to my partner about specifics. So if I correctly recall, my muscles were still spasming from childbirth as I instructed my doula to chop and freeze it. She had never done it before, which I say to demonstrate how truly easy it is to do. My midwife stepped in to explain the process of washing it and wringing it out until it’s a “bubblegum pink color.”  So she did that and then chopped it into pill-sized pieces and dropped them into an ice tray to freeze. After they froze, I put them into a zip-lock and back into the freezer. I swallowed 1-3 pieces every day, like a pill, until they were gone.

A final placental anecdote: My husband and I spent the first few years of our marriage living in Northern Ghana where he started an agricultural trading company. We had these massive windows on all sides of our living room, and I decided to start trying to grow some herbs. I had a shelf made by a local carpenter to fit the window that got the most light and gathered some seeds and soil. I spotted some pots along the roadside near our house that looked perfect and took a Ghanaian friend with me to buy them. The woman selling the pots didn’t speak much English, so I essentially mimed to communicate that I didn’t need the lids to the pots. She looked a little surprised. I told her I needed nine of them, and she looked absolutely shocked. The friend I’d brought with me often made jokes with strangers when we were out, so I didn’t think it odd that she was laughing hysterically along with an older woman standing nearby as I loaded the nine pots into the back of my car. As we drove away she just could not get herself together, and eventually she told me why: the pots I bought are made specifically for placentas. Traditionally, new fathers come to the birth site after the baby is delivered to gather the placenta into a single pot, with a lid, and bury it securely. This is rooted in the local religion, which is rooted in superstition, so really, I’m glad that all parties involved were able to laugh. The laughing only stopped when I told her about the plans for my own placenta—she was even more shocked than my Bible study friend who made the Brad Pitt joke.  For whatever reason, my herbs never grew more than an inch.

Hannah’s inadvertent collection of placenta pots and cacti pictured in the opening and closing photos. 

Though we’ve never met in person, I consider Amelia a close internet friend, a longtime reader, and a woman of enormous wisdom and warmth that she can’t keep from effusing through her digital self. If I could convince her to write a weekly column for us, I would! But meanwhile, her presence on Instagram is a generous window into her humble, gracious approach to life and motherhood. In her essay shared with us here, I love the way the idealism of to-do meets elevation of memory.

by Amelia Markgraf

It all begins with the right atmosphere. There should be a decent amount of time to think and write. A favorite pen is lovely, good posture allows for penmanship you can be proud of, and no children on your lap/on top of the table/trying to chew on your pen is ideal.

This doesn’t happen to me very often.

At this point in my life, I make lists in my head, in the quiet busyness of making beds and putting dishes away and in the pick-up line at school. I forget them all by bedtime. Still, somehow, even just thinking the lists, one by one, helps me. Like taking the messy pile of thoughts in my brain and clacking them on a desk till they form a tidy stack. I feel better, even if they eventually flutter out of my brain like leaves down the street.

When I do have time to write them down, I like to keep my lists in notebooks. By now I have enough of them to line a shelf in my living room. Though I’ve never been good at keeping a diary or organizing photo albums, I can crank out enough lists to fill a notebook in a matter of months, and flipping through those old notebooks provides the same kind of nostalgia as any diary could. Who needs journals full of thoughts and confessions when you can recall exactly how life was just by looking at a grocery list you made as a newlywed? One of my favorite notebooks holds all the lists I made as I transitioned to motherhood. One page has a list of last minute nursery tweaks, and the very next contains nothing but a column of feeding times, along with which side my newborn son fed from last. The handwriting is scrawled and crooked. The page itself is literally coffee stained. It is the most accurate time capsule.

I’ve been using list-making as a way to calm myself and sort my thoughts for years. I take it very seriously. Some lists are a comforting constant, and remain the same through the years: January lists are full of health goals and house projects and so much hope. Spring lists are all about garden plans and cleaning sprees. Summer lists are few and far between, and then August lists come with a vengeance and great detail. Parenting goals! Meal plans! School supplies! Vows to reinstate order after the wild days of summer. Then the cold, dark months come and the pages holding Christmas lists and Advent activities are decorated with stars, doodled to look as bright and twinkly as possible.

Some lists are new. For example, after six straight years of being pregnant and/or nursing a baby, I am suddenly not. So, in the spirit of my newfound freedom, I dared to make a short list of restaurants to try. Date night ideas! New territory.

Some lists are ever changing and growing. I have a To Read list, a Songs for a Good Cry list, a Things I Want My Husband to Build for Our House list. The Jobs I’d Maybe Like to Have One Day list feels exciting and scary, and my heart flutters when I add to it. I don’t know if I’ll ever create illustrations for children’s books or be a Home Economics teacher, but they’re on the list and I feel like that counts for something.

It’s easy to look through my notebooks and find the times in my life where I struggled. Almost two years ago my husband and I sold our house, moved to a small apartment with our children, and welcomed a new baby a few weeks later. The year that followed was the hardest of my life. My baby cried for months, I lived in an uninspiring place that did not feel like home, and I worried constantly that I wasn’t giving my children what they needed. I longed for a home, for some peace, for some sleep. I had no time for any sort of creative outlet, and all my emotions poured out into my lists. Oh, the detail of those lists! The order! The desperation. My handwriting was sharp and upright and eager, like if I wrote down what I wanted with enough gusto, maybe it would come. Those lists are hard to look back on.

There have been other moments of struggle where my lists lose order of every kind, and instead become long, flowing paragraphs of prayer. Prayers for myself and for loved ones. Prayers for health. Prayers for clarity and faith when I feel like I’ve lost my way. I love to look back on those lists, because they’re tangible evidence of prayers answered. Problems solved. Clearly, lists are a way I try to keep control of my life. But when I re-read these lists of pleading prayer, I’m assured I’m not really in control of any of it. Thankfully.

Over the weekend my daughter became very sick with a high fever. I accomplished nothing but the basics, fretting over temperature readings and trying to keep my hot baby comfortable. I did, however, manage to make one tiny list. It was actually more of a chart— two doses of amoxicillin for 10 days, Tylenol and ibuprofen, rotated, and the times administered. That small act of writing a list gave me a little bit of control when things felt out of my control. Some order when I was worried. A stacking of mental papers. She would be better, I knew. I wasn’t really in control of it anyway, thankfully.

But, of course, the list helped.