Let me set the record straight: No, I’m not a midwife. And no, I’m not a doula. But apparently when you spend any period of time posting and advocating for women and maternal health, this becomes a real assumption. (I get a lot of emails!) So let me make this clear from the onset: I am a regular mom – exactly like most of you reading this. I just happened to have a passion for “birthy stuff,” as my midwife friend Naomi puts it.
I’ve been pregnant three times, resulting in an emergency cesarean, a successful VBAC (vaginal birth after cesarean), and a miscarriage at 13 weeks. Obviously all three of these experiences were extremely different, and I’ve learned—am still learning—so much about what it means to not only deliver a child… but to birth a child into the world.
As my friend Becca says, “pizzas are delivered, babies are birthed”.
I am a passionate believer that birth should be family-centric; it’s not all about baby, nor is it all about mama. Birth is perhaps the most incredible—at least miraculous—right of passage for a woman and I believe it should be absolutely celebrated and approached in a way that is both empowering for a woman and loving for her baby.
For many women that means pursuing a VBAC.
I assume that most reading this post are here for that reason. Perhaps you still have doubts or questions and you’re on your journey to explore your options. I’ve decided not to get into the merits of VBAC vs. elective cesarean on this post, but at the end I will list several resources if you are still trying to decide what is safest and best. Obviously I’m pro-VBAC or else I wouldn’t be writing this, but I’ll let the experts tell you the expert stuff and I’ll just stick to my own experiences of what helped make my VBAC successful.
6 suggestions to help plan and prepare for a successful VBAC:
1) Learn, learn, learn.
Even though I had longed for a natural birth with my first son, when I first began to research my options for baby number two, I wasn’t yet sold on having a VBAC and was very open to having an elective ‘gentle’ cesarean. The competing voices confused me and I felt a measure of fear and inadequacy surrounding my ability to give birth naturally. But as I researched the real risks and benefits of a VBAC verses an elective cesarean, I realized that it would be far healthier for both my baby and I (and less risky) for me to plan for a VBAC. (Research = your care providers, Dr. Google, a birth center or hospital run prenatal/birthing class, real moms who’ve been there, etc.) Deciding I would pursue a VBAC is one of the best decisions I’ve ever made, but I wouldn’t have gotten there had I not done the research and weighed the options myself. Knowledge is power, ladies, and as natural a process as giving birth is, it’s one that requires us to be our most powerful selves. So get yourself informed, girls!
2) Find a supportive health provider.
This one was tricky for me since I was birthing my son through the public health system (in Australia) where you don’t have a specific doctor or midwife assigned to you. (Yes, I found that exceedingly difficult, but that’s another post entirely.) If at all possible, keep looking until you find someone. During my pregnancy I saw four different obstetricians, several midwives, and a couple of different specialists (because it was thought our son might have down syndrome). Even with all of the bouncing from office to office, we found nearly all were open to my pursuit of a VBAC. (I realize not everyone has it this “easy”. This is a comment on the wonderful level of care and support at my local hospital.) If you can, consider giving birth in a birth center. A recent study in the US found that the incidence of cesarean births for low-risk women in a birth center is four times lower than that of hospitals. (Links below.) So obviously, your care provider can make a massive difference in your success.
3) Write a birth plan.
You’re more likely to have a successful VBAC if you’ve thought through the implications and planned for your responses. In my opinion, birth plans are much more for the mother than the care providers because they will help you to grapple with important issues and address the ‘why’ of your decisions. As you grow in conviction about what you feel is best for your birth, it will help instill confidence for you to follow-through, even in the face of challenge. (Need help? Here are four reasons to write a birth plan and some practical tips for writing a birth plan.)
4) Get support.
This might mean finding a friend who’s gone before you, connecting with an online or local support group, or hiring a doula. (Statistically those who have a doula have a higher success rate for natural births and VBACs.) During my pregnancy I connected with three other women locally who shared their stories with me and encouraged me that I could do it.
5) Communicate your goals.
In addition to your discussions with your health provider, make sure to take the time to communicate with your husband or partner so he can understand why you’re making the decisions you are. If he is included (not just ‘informed’) then he’ll be able to advocate for you more effectively if there comes a time when you need it. He’ll also be in a better position to support you personally during birth.
6) Don’t rush to the hospital and limit interventions.
In most of our hospitals, once you’re admitted the clock starts ticking and most centers have policies in place that dictate “acceptable” time periods for the different stages of labor before different interventions are introduced. (Sometimes these will be suggested, sometimes they will be “required” – find our your local hospital’s policies in advance.) If you can hold off, try to make sure you are well established in active labor before you make your debut in the maternity ward. If you’re able to stay home as long as possible and avoid all the ‘clocks’ being set you’ll have the highest chance of a successful VBAC by limiting the amount of interventions. (Again, for all the expert reasons why, see the resource list below.)
I can tell you from personal experience that having a VBAC was both healing and empowering. To this day it was perhaps my proudest, most triumphant moment. Even though it was the most physically grueling thing I have ever been through (I had a difficult labor and birth due to Judah’s positioning), it was absolutely the most thrilling and empowering experience of my life. To say I felt like Superwoman for a short while after my VBAC is an understatement. I was basically on top of the world – I’d wish that feeling on any new mother.
Use your brain and your intuition.
When making your decision whether or not to have a VBAC or not, here is my number one tip: Use your brain and your intuition. Both are important. Ultimately you are the one poised and responsible to make the best decisions for you and your baby. Your OBGYN or midwife should be your biggest ally, most skilled coach, and most intentional cheerleader. Not only is she there to expertly handle an emergency situation, but she is there to advise you, support you, and help empower you to have the best birth possible for you and for your baby. (If you feel she isn’t, then you might consider finding a new one.)
You can do this, mama. If it’s a VBAC that you want, pursue it and pray for it and plan for it. The odds of having a successful one are in your favor.
Dear mama-friends, have you had a successful VBAC? What do you think best helped in your preparations for birth? And if you are considering pursing one but are still on the fence, what is most holding you back? (I hope the resource list below will help.)
p.s. Need some inspiration for your decision or preparation? Here’s my VBAC story, including some amazing birth photos of the entire process (minus a couple of the most-awesome-but-too-graphic ones of course) or a rare piece of poetry of that I’ve published.
VBAC & Cesarean Birth Resource List:
- VBACfacts.com: 13 Myths about VBAC
- Birthworks resource list (books, websites, support groups, DVDs, and workshops)
- Cesarean Awareness Network Australia
- Making Informed Decisions About VBAC or Repeat Cesareans (VBAC.com – a women-centered, evidence-based resource)
- Midwifery Today – A VBAC Primer
- Midwife Thinking – VBAC: Making a Mountain Out of a Molehill
- Madeleine’s Birth: An HBAC video (just a bit of beautiful inspiration for you!)
- American Association of Birth Centers research
- Maternal-Fetal Medicine Units Network – VBAC Calculator
- Natural Forces – Essay on VBAC & Scar Integrity
- BellyBelly – VBAC: On Who’s Terms?
- Birthrites – Healing After Caesarean
- VBAC landing page on Pregnancy.com.au
- Caesarean Birth and VBAC Information from Caesaren.org.uk
- Mothering.com – Protecting a Mother’s Right to Choose a VBAC
- International Cesarean Awareness Network
- The Epidemic of Unnecessary C-Sections
- Amnesty International – Deadly Delivery: The Maternal Health Care Crisis in the USA
- How to reduce your risk of c-section – Dr. Heather Rupe, OBGYN
- American Pregnancy Association – Risks of a Cesarean Section
- BabyCentre.com.uk – Caesarean Birth: What are the risks and benefits? and Vaginal Birth After Caesarean (VBAC)
- I also have many resources and articles pinned to my Bump, Birth, & Baby pinterest board or my VBAC & Cesarean Birth pinterest board, as well as a series called Plan Your Best Birth part 1, part 2, and part 3.
- Hello Judah: A Successful VBAC Birth Story (including birth photos)