How I Was Able to Have a Successful VBAC at Alaska Regional Hospital

Now that you’ve read all the details on Bjorn’s birth story, it is time to share how I was able to have a successful VBAC (vaginal birth after cesarean) in the end because just 9 day before Bjorn was born (on Wednesday, September 18), I had posted on Instagram that a VBAC was no longer an option for me, and I would be having a repeat c-section. At that point in time I did NOT think there was any possibility of having a vaginal delivery because I had exhausted ALL options between pleading my case to the two hospitals in town, asking my insurance to do a waiver–arguing that a vaginal delivery is cheaper for them, and calling (literally) almost every single OB doctor in town to see if anyone was willing to do a VBAC at Alaska Regional Hospital.

I had to fight until the end on this one, but thankfully it played out in my favor, and I will forever be indebted to the doctors at Alaska Women’s Health and the doctors at Women’s Care of Alaska for making my dreams come true!

Let’s back up and start at the beginning.

After having Cullen five years ago, I began to think about the possibility of having a VBAC. In my mind it is more natural to deliver vaginally, healthier for baby and mom, there’s less bleeding, the recovery time is quicker, you’re not having major abdominal surgery, and it is an experience I wanted to have. After talking to my doctor and other women who have the same insurance coverage, I realized that doing a VBAC was highly unlikely. The problem was that my doctor was unwilling to do a VBAC at my in-network hospital (Alaska Regional) because they have to be on site the entire time you are in labor and that means pulling them away from patients at the other hospital. The doctors at my practice (Alaska Women’s Health) could do a VBAC at Providence Hospital because there are two OB doctors on site at all times because of the NICU there.

During the five years between having Cullen and giving birth to Bjorn, I kept these things in the back of my mind knowing that a c-section was probably the route I was going to have to go, but also knowing I was going to do everything in my power to attempt a VBAC.

When I did get pregnant with Bjorn, I talked to my doctor at my first 10-week appointment in March about my wishes for a VBAC. She told me that no one in their office does VBACs at Regional for the same reason given before. She did mention that she had heard of women getting a waiver to deliver at Providence, so that a VBAC could be attempted, so I started with my insurance company. I first called them to see if a VBAC was even covered under my insurance. They confirmed what I thought and said a VBAC is covered by my insurance, but only at my only in-network hospital was Alaska Regional.

The next piece of information I needed was to call Alaska Regional and ask if VBACs are performed there, and if so, how often and who in town does VBACs. When I spoke to one of the nurses in the labor and delivery unit, she wasn’t too helpful. She said VBACs are done there, but she didn’t make it sound like they were done that often. She said she worked part-time and saw one every 2 or 3 months. Yikes! That did not instill any confidence in me that they were experienced with VBACs. When I asked her for the name of a doctor(s) who has done a VBAC there, she was unable to give me any names. I’m not sure if she wasn’t aware of any or legally unable to tell me.

So then I started calling around to OB doctor’s in town asking if anyone did VBACS. I called Geneva Woods Birth Center, the VBAC “specialist” in town, and any other lead someone gave me. I probably spoke to 8-10 different offices, and everyone said the exact same thing, “Our doctors will do VBACs at Providence but not at Regional” I was also told several times that Regional does not do VBACs. I immediately thought that was odd because I had spoken to someone at Regional and they said they do do VBACs. So now I’m confused as to why I am getting differing information.

My next phone call was back to my insurance company to ask them to confirm that Regional does do VBACs. After a couple of weeks of waiting, I found out that Regional does do VBACs, and I finally figured out that it is the OB doctors in town who just don’t want to do them there.

At my next prenatal visit, I spoke to my provider (Dr. Beery) about my situation. I indicated I was about ready to give up, but she encouraged me to keep fighting. She told me to contact my insurance company and ask them what they needed in order to have a VBAC at Providence since I could not find a single doctor to do a VBAC at Regional. I got the sense that she was very pro-vaginal delivery and wanted me to be able to delivery vaginally rather than have a c-section, so I kept fighting.

I called my insurance company, explained my situation, and they said I would have to contact Regional and get a letter from them stating that they don’t do VBACs. Through the grapevine, I had heard this has happened in the past, so I was hoping this might be my ticket out to deliver at Providence, which is the hospital that more people in town use and what feels like more of the premier hospital in town.

I then called Regional asking for a waiver to deliver at Providence. I spoke to a financial counselor there, who said she had to ask higher up management about my situation. A week went by with no answer, so I called to find out where they were with my situation. She didn’t know anything more, so I waited another week. I finally got a call back saying that they were unable to grant my request for a waiver because they do do VBACs. I pleaded, “But literally no doctor in town is willing to do a VBAC there, what am I supposed to do?” She (of course) did not have an answer for me. She referenced the decision was made by the Chief Medical Officer at the hospital, and she could no longer help me in any way.

I hung up the phone and bawled. I was furious! First of all, I am not a crier (even when I’m pregnant), so I knew this was some real emotion being exhibited.

I was also perplexed. Why was she so unwilling to budge? She has to know that doctors aren’t willing to do VBACs there. The best explanation I could come up with was that it was her job to keep as much business there at the hospital, and if she granted waivers for people like myself, that would pull business away from her hospital.

I was furious! Didn’t these companies exist to provide their patients with the best health care services for each person? Isn’t being able to deliver vaginally more natural, better for baby and mom, and a safer alternative than major abdominal surgery?

I wasn’t willing to give up at this point. I called my insurance company back, explaining what would had happened and pleaded to them to let me deliver at Providence and have it be billed as in-network–stating that a vaginal delivery was cheaper for them anyhow. The didn’t buy it. They told me, “yes, but it is cheaper for you to stay in-network. And if you deliver at Providence, they could still stick you with a bill for the charges.” Ugh! I hung up with them and bawled my eyes out again. Another door closed in my face.

At this point, I became furious that no one was willing to fight for me. I was just a number to everyone–a voice on the phone–not a real person with a passion for doing what I thought was best was for myself and my baby. Everyone was just out to protect their own business and not really help people achieve the best medical care.

While I was incredibly furious, I was even more upset for those people who have to fight with these companies on a regular basis for their daily quality of life. My situation was a one-time thing that would end up with a baby being born into this world one way or another. My quality of life wasn’t being impacted nearly as much as those who live with a chronic disease or illness on a daily basis.

Craig suggested I make one last phone call to Providence Hospital. Maybe they were willing to take me on as a patient–for them to gain some business. I once again explained my situation, pleading for help from them, but they said they couldn’t do it. Another door closed.

At this point, I posted on Instagram on Monday, September 16th stating that I would be having a c-section in less than one month. At this point my c-section had already been scheduled for Friday, October 11 at 7:30 a.m. at Regional Hospital. This would put me at 39 weeks pregnant, which is when they like to do a scheduled c-section to avoid your body going into labor naturally.

The thought of going into labor before my scheduled c-section had been a thought that crossed my mind but not something I really thought would happen. I did bargain with myself that I could labor at home as long as possible and then show up at the hospital ready to push. But truthfully, I know I wouldn’t wait at home that long since that would be a risky situation.

That week on Wednesday (September 18th), everything started to change. I went to my OB doctor’s office (Alaska Women’s Health) for a regular check-up. I had seen Dr. Beery the last couple of times but ended up seeing Dr. Tania Hall this time. I usually choose to see a variety of doctors at the practice because you never know who will be on call and deliver your baby when the time comes. When I met with Dr. Hall, I could tell she was bummed that I was hitting so many road blocks with my attempt at a VBAC at Regional. She said that there was a meeting with all the OB doctors in town that afternoon, and she would “ask around” to see if anyone was willing to take me on as a patient of theirs (mind you I was just shy of 36 weeks pregnant at this point in time)! “Seriously,” I thought, “someone who is willing to fight for me?!” She said she wouldn’t ask just any doctor, which I truly appreciated!

That evening as I was driving home from Cullen’s swimming lessons, I got a call from Dr. Hall saying that she had found someone (Dr. Counts) who was willing to take me on as a patient and try for a VBAC!! Holy cow! What a turn of events! I got home, told Craig what had happened, and immediately he got a look of terror in his eyes. (Truthfully he wasn’t in love with the idea of doing a VBAC from the beginning.) We talked about it, and he said he was worried because he felt like trying to do a VBAC was too risky.

I told him that we should keep both options open because I, too, had some hesitations about doing a VBAC and ultimately wanted to meet with the doctor to see if I was a candidate for a VBAC. As much as I wanted to do a VBAC, I also wanted the support of the doctor and for them to feel that I wasn’t making a decision that would put me or my baby in harm.

The next morning, I called Dr. Counts’ office, told the receptionist my situation, and made an appointment to come in that next day (Friday, September 20) to meet with the doctor’s nurse practitioner. That next morning, we gave the nurse practitioner a detailed health history, talked about our concerns, and what our next steps should be. I knew that a couple of the parameters for being a good candidate for a VBAC included the size of the baby, baby’s head size (especially since that was the reason I had to have a c-section with Cullen), and the thickness of my incision from my c-section.

We decided to booked an appointment with the ultrasound technician for Wednesday, September 25 at 8:45 a.m., and then I would meet with Dr. Counts at 11:15 a.m. after the ultrasound to go through what they found.

Wednesday, September 25th came, and I was anxious for more answers as to whether or not I was a good candidate for a VBAC. I coached that morning at 6:00 a.m. and ran a mere 0.5 mile on the track. The previous Wednesday I had run 5 miles, but every day following that, I could barely run a block without excruciating pain on my pelvis and cramping/tightening of my belly unlike before. (In hindsight this all makes sense as Bjorn was probably starting to drop and get ready for birth.)

After practice, I came home, got Cullen, and headed off to the office where there would do an ultrasound. The ultrasound technician said everything looked great, baby was healthy, but she predicted his weight at 8 pounds already! Yikes, an 8 pound baby, and I have about 3 weeks remaining! I didn’t feel like I was carrying an 8 pound baby and the doctor last week said she thought the baby was on the smaller side.

I immediately texted a couple of my other mom friends asking if the prediction for their baby was also off. Everyone said their prediction was wrong but some said the prediction was lower while others said it was higher.

After the ultrasound, Cullen and I had a couple hours before we had to be at the doctor’s office, so we made a pit stop at Market Juice for a snack.

Afterwards, we went to the doctor’s office for my appointment to meet with Dr. Counts to have her take a more in-depth look at the possibility of me doing a VBAC.

At the appointment, we ran through my health history and what had happened during Cullen’s labor. She said that she was concerned the baby was measuring on the larger side for just shy of 37 weeks pregnant. She also said my c-section scar was not as thick as they like to see. While she didn’t write the VBAC off at this point, it didn’t see like things were looking too promising. She said she wanted to read the in-depth report on my labor, and after she did that, we would touch base again.

At this appointment, I also mentioned to the doctor that I had a red bump (a collection of blood vessels) on my collar bone that had developed just a couple months ago, and it was continuing to get bigger and was constantly “molting.”

*Warning: the next picture is a little gross.*

She said I needed to get it removed as soon as possible, so she made an appointment for me that afternoon with the dermatologist because it was either now or not until November.

Cullen and I left and then headed to a friend’s for a play date for a couple of hours before my dermatologist appointment. After that was over, I dropped Cullen off with Craig, and they went to swimming lessons while I went to the dermatologist.

I spent more time waiting in the waiting room to see the dermatologist than it took for them to remove the thing. The doctor took one look at it, rattled off the medical name of it, and then burnt it off. The whole process took less than 10 minutes, but I was glad to have it gone because it was really gross, and I had bumped it the other day which caused it to bleed profusely. Also, as a side note, the smell of dying flesh is not so pleasant.

As I was walking back to my car, I snapped this picture of the mountains with the “termination dust” (aka ‘snow’) and the leaves starting to change colors. It is hard to deny how beautiful it can be here.

Since that was done with so soon, I was able to meet Craig and Cullen at Cullen’s swimming lessons. It was time to head home finally after being gone for nearly 12 hours that day.

Truthfully, I don’t even remember what we did that night, so it was probably your standard eat dinner, clean up the kitchen, and then go to bed.

Thursday morning started out like almost every morning. I got up to exercise as the sun was coming up. I would have run, but every time I tried to run in the past week I had too much pain, so I ended up taking Sadie for a walk instead. It was a crystal-clean morning but a cold 32*F out.

When I got back home, I started getting ready for the day but ran out of time to fully get ready, so I decided to take Cullen to preschool and then come back home after that to finish getting ready. Literally just minutes after getting home is when my water broke. And if you read Bjorn’s birth story, you know what happens after that!

But for the sake of concluding this post, I went to the hospital to meet with the doctor–explaining where I was in the VBAC process, not even sure I was a good candidate for one. She said she was willing to give the VBAC a try if that’s the direction I wanted to proceed. We took it hour-by-hour–making the best decision at the time, knowing that I still may have to do a c-section again. Thankfully, things progressed nicely, and I was ultimately able to have a vaginally delivery. (Read Bjorn’s birth story for all of the details!)

I cannot thank Dr. Beery and Dr. Hall at Alaska Women’s Health enough as well as Dr. Counts and Dr. van Haastert at Women’s Care of Alaska. None of this would have happened if they hadn’t been on my side from the beginning. I had to fight for this like no other, but they kept me going and helped make this a reality for me!