In America, one in three women give birth by cesarean section and those numbers are climbing. Cesarean sections are incredibly common and because of this, women are being faced with trying to decide how to give birth to their subsequent babies. Many women are choosing what is known as a “VBAC,” or a vaginal birth after cesarean. A VBAC has many health benefits such as a shorter recovery time, less risks to both the mother and child, less risk of post partum depression, no need for strong narcotics after delivery and much less expense is involved. However, many women are facing obstacles on their journey to vaginal birth after a cesarean and some of them, just don’t know what to do. There are many things a mother can do to give herself the best chance of having a successful VBAC.
Find a Supportive Caregiver
This cannot be stressed enough. When deciding to pursue a vaginal birth after cesarean, it is critical that you find a care provider that is truly supportive of your desire to give birth vaginally. Many doctors may say they allow patients to attempt a VBAC, however, this answer isn’t enough. Be sure to question them thoroughly, and remember that you have the right ask questions. When you see a care provider, you are hiring them to provide care for you, and if they don’t meet your standards, find someone else. Some examples of questions to ask would be:
What is your personal philosophy on a woman’s ability to birth naturally, even after a cesarean?
What is your VBAC success rate? How many VBAC’s have you attended that failed and ended up in a repeat cesarean?
What is your position on inducing women who are attempting a VBAC? (Induction in women who are hoping for a VBAC is contraindicated because it increases the risk of uterine rupture.)
Your caregiver should be able to provide the answers to these questions, or get back to you with the answers if they are unable to answer them off of the top of their head. It is important when selecting a caregiver that you find someone you feel comfortable with. Preferably, someone who seems to truly love what they are doing and is very enthusiastic about birth. You may see several caregivers before you settle on which one you like.
If your state allows midwives to attend to VBAC clients, it is highly advisable to consult with a midwife, rather than an obstetrician, as midwives tend to intervene less and allow nature to take the proper course. They are however, very well trained to recognize emergency situations and transfer the patient if necessary.
Start Exercising Now
As soon as you find out your are expecting (and even before) try to keep up with a regular exercise routine. The exercises don’t need to be strenuous or muscle building; walking is one of the best exercises you can do while pregnant. Simply walking a couple miles a week will help strengthen and tone the pelvic and abdominal muscles, which help strengthen the body for labor. If you have difficulty getting the motivation to walk, try getting a walking buddy to accompany you for a two mile walk once or twice a week! It’s a great way to stay in shape and catch up with friends!
Be Your Own Advocate
Make sure to research VBAC’s and understand what the who process entails. The more informed you are, the more likely you are to make the best decisions for yourself and your baby. Do your research and don’t be afraid to seek out answers.
Hire a Doula
A doula is a trained labor support professional. A doula, although sometimes pricey, is an incredibly valuable source of support to the pregnant and laboring woman. You can begin contacting and interviewing doulas at any point in your pregnancy to find the one that is right for you and your situation. A doula, much like a caregiver, should be a good fit and you should feel comfortable with them. Many doulas have experience with supporting clients hoping to achieve a VBAC, and research has proven, having a doula present at birth reduces the occurrence of cesarean sections. If money is an issue, many doulas have a reduced fee or payment plan available to clients. Student doulas often offer their services for free in order to finish their certification requirements, however, they may have less experience.
Keep a Positive Mindset
Many women go into a VBAC saying they will “try” to have a successful VBAC. Instead of thinking of “trying,” instead think “I will have a VBAC.” It’s amazing how much a little bit of positive thinking can change the outcome of a situation and help a mother to remain steadfast in her decision.
Understand Hospital Bans
Many hospitals have bans on attempting VBAC’s in their facility. However, if you are in labor, they cannot refuse to treat you, and they cannot force you into a surgery that you refuse to consent to. This is where having a supportive caregiver comes into play. If you are delivering at a hospital with a ban in place, a non-supportive caregiver may try to pressure you into a cesarean.