Dr. *** (name left out for privacy),

              I want to thank you for your concern and for your efforts to allow me to have a VBAC at the base hospital.  However, I have decided to continue with my birth at home.

             When you and I originally discussed my desire for a VBAC in September, I specifically mentioned that if the base did not allow me to VBAC there, then I would be having my baby at home.  At my mention of a home birth, you expressed your disapproval, but said that the only thing you could do was give me a referral to an off-base doctor willing to take my case.  Though I had a few promising leads, my requests were denied by each doctor, and I ended up with a choice between surgery and home birth.  It truly amazes me that women can choose to have a cesarean for no medical reason and quadruple their chance of death, increase their risk of infection, increase their risk of hemorrhage, as well as increase their baby’s risk of injury, breathing problems and nursing problems, but at the same time, I could not find one doctor in Las Vegas who would give me the opportunity to have my child naturally.  When faced with the choice between surgery and home birth, I chose home birth because it was the better of the two options.  Today, after your much delayed offer to VBAC in your hospital, I am choosing home birth because it is the best of every option.

             Your specific reasons in September for not allowing me to VBAC at the base hospital were:  1) the base hospital does not have enough blood for my type of emergency, 2) the base hospital does not have a NICU and 3) the nurses in your hospital would not be prepared for my type of emergency.  I am honestly confused why, four months later, and only after you discovered I will be doing a home birth, the hospital’s capacity to support me has changed.  The tone of my email may give you the impression that I am angry with you and the base hospital, but this is not the case.  I know your hands are tied in many ways because of ACOG requirements and risk of malpractice suits.  However, those hospital concerns should not affect me or my baby when it comes to the best way to bring her into the world.  I am thankful that in this country home birth is still an option and I hope that when my daughters have their babies, the option will still be there for them.

             I feel certain that the best place for me to birth my baby is at HOME, despite the scars on my uterus.  I have looked at my risks and I know that I am healthy, my baby is healthy, and our chances of a rupture are very low.  I do not consider myself a “high risk” case, as you apparently do, and my midwife agrees with me.  She has attended over 1000 births, 300 of which were VBACs (some after four cesareans!).  She has never seen a rupture.  I am certain that she and I will know whether my baby and my body are progressing well in natural childbirth.  Her equipment, her knowledge and her personal relationship with me and my baby make her well equipped to know whether either of us is in distress early enough to transport me to the hospital in a timely manner.  I know I am in good hands.

             I need to be surrounded by people who will be patient with my body, my baby, and our progress in a natural labor.  More importantly, I need to be surrounded by people who believe in me.  I know the kinds of restrictions that would be placed on me in a hospital.  They were clearly outlined by you and by one off-base doctor at my initial consultation with him.  ACOG requires you to order many things I cannot agree with.  I know that I have the right to deny those “requests”, but I do not believe that continuous conflict with the hospital staff would provide me with the best chance for a VBAC.  Even if there was another doctor in Las Vegas that would allow me a “trial of labor”, I believe there is no hospital that would give my baby and me what we need to bring her into this world naturally.  I have tried to do this twice, and twice my children have been surgically removed from me unnecessarily.  With my first labor, “failure to progress” with an absence of fetal or maternal distress was no reason for a surgical birth.  With my second pregnancy, my doctor would not allow me to attempt a VBAC simply because my baby appeared large.  I have a strong suspicion that this birth would end the same way if I put myself in the hands of a hospital and any obstetrician “risking his career on me” (as the midwife in your office so honestly put it).

             Thank you for your efforts on my case.  I know that of all of the doctors in your practice, you were the most understanding and I know you worked hard to help me in the end.  I hope you meet more women like me in your future:  women who are well-informed of their choices, the risks involved, and who take responsibility for their health, their births and are willing to fight for what they believe is right for their babies.  When you do meet these women, I hope you and your colleagues take their convictions seriously from the very beginning.  I hope you belay any personal feelings or ACOG restrictions on how women “should” give birth to their babies, and you don’t force them to fight (during pregnancy or during labor) to bring their children into the world the way they believe is best. Thank you again for your time, your efforts and your understanding.

Sincerely, Alexandra Orchard

My third daughter was born on her due date, a date she chose for herself.  My labor was 30 hours long and I pushed for 1 hour and 39 minutes.  In so many ways, this labor was similar to my first labor.  It took 11 hours of hard labor for my body to efface before I started dilating.  I had to fight for each centimeter every step of the way.  My labor stalled at 8cm; the point at which they took my first daughter from me.  My midwives did so many natural things to help me get through the final stage.  Even when her head was out, I was still saying, “I can do this!”  Everyone in the room would shout, “you ARE doing this!”  My husband and I pulled our daughter up out of the water ourselves and the first thing I said was “I DID IT!”  The second thing I said was “I’m holding my baby!!!”  I wasn’t able to hold her two older sisters for some time after their births.  It was amazing, it was peaceful, it was empowering, and I knew in that moment that I had to do something to change birth for women.  I knew I had to do something to make sure that my three daughters could bring their children into the world the way THEY CHOSE TO.  I started my path to becoming a midwife then.  When my youngest was 8 months old, I started my studies and my apprenticeship.  I became active in the local chapter of the International Cesarean Awareness Network and the local Birth Year Network.  I am determined to be part of movement that is giving birth back to women and their babies.  I have to be part of the fight to make sure that my daughters have a CHOICE in how they bring my grandchildren into the world.

The story of my VBA2C in pictures.....

                    "I DID IT!"           "I'M HOLDING MY BABY!"

The first face my daughter saw was MINE and the first hands she felt on her body were MINE.

I could not have done this without my husband.  He never left my side and he was my rock, my constant voice of strength.  You can see in the picture below how I knew that we did this TOGETHER.

Our Midwives:  Jill Colin (red) and Marvelys Lopez (grey)

Our three week checkup.  The women who supported me for so long: (from left to right) Melissa Kneen (my doula), Jill Colin, (myself holding my daughter), and Marvelys Lopez.

THANK YOU FOR BELIEVING IN ME!