As I continue in my career as a doula, I'm seeing that more and more, the majority of the clients I serve are VBAC mamas. These ladies have had a prior cesarean section and are hoping for a successful vaginal birth after cesarean (VBAC) with this next baby. I have come to really love the journey of a VBAC and walking alongside these moms through pregnancy and their births. There is such an intentional nature during these pregnancies. The education, the empowerment, and the vulnerability of a VBAC mom is what attracts me to these clients. Prior experience keeps a humble and grounded tone, yet hope drives the pregnancy. There is one things that I've found to be true: VBAC moms tend to do "extra" to prepare for their births. These things help ensure the best odds for success. Each mom I have had has done things differently, but a mix of some of thee below has made for confident moms and healthy outcomes.
1. Your Provider
Not all OBs are created alike. VBAC is becoming more and more the norm and is supported by most OBs at this point, which is wonderful! However, a supportive OB in the office and a supportive OB through labor are two completely different things. Most OBs appear VBAC friendly, or at least open, however in labor when x, y, or z happens the rapport and trust with your OB comes into play. You and your OB are on a team. Your likely won't see your OB in the hospital until it's time to push, however he/she will be called several times through labor and has the final decisions on time restrictions, adding interventions or augmentation, and whether a cesarean enters the picture or not rides on him/her. The connection and trust between OB and patient is awesome and needed, I feel.
In the larger practices, there is more possibility of being one-among-many and even if you see the same doctor for office visits (and love them), whomever is on-call when you go into labor will be the one to decide how your labor is progressing. Often there are stricter protocols for VBACs in the larger offices, so the odds may be higher against you, just due to their protocol (interventions added in more quickly, shorter wait times if a labor stalls before a cesarean is performed, etc). In the smaller or solo practices, there seems to be a cautious-but-trusting nature. Protocols seem more purposeful and a mom's body seems to be better trusted. Also, you have that rapport with your OB. You create a relationship with the doctor who will actually be overseeing your birth. In addition, your OB knows you. Your wishes, thoughts, and intentions are known, which I think creates a better climate for labor.
Additionally, there are OBs who are specifically known for being VBAC friendly... those are always the best place to start. I have had great experience with 2 of the VBAC-friendly OBs here. I have much respect for them. They rocked major socks through pregnancy and in labor. If you are local, I will gladly share my lists of VBAC friendly OBs. Just email me.
**There is always the option for a home birth midwife as well.
2. VBAC Support Groups
There are a few general VBAC support groups on Facebook. For some the camaraderie and the "I did it, you can too" message is beneficial and keeps confidence going through their pregnancies. Turning to those groups to ask questions, reading personal stories, and lifting each other up can be calming and connecting.
VBAC meetings. The International Cesarean Awareness Network (ICAN) has chapters all over the country. These chapters typically host support-meetings monthly. Stories are shared and fears are addressed and eased. Again, that camaraderie is present, but this time in a face-to-face setting. Just knowing you aren't alone and that others have walked that path is uplifting. Our local Lehigh Valley is run by an amazing woman, Leah. Her meetings are wonderful and I would recommend them to any VBAC mom.
ICAN of the Lehigh Valley FB Page
Sometimes delving deeper into childbirth education helps. Knowledge is power. Knowing not only what your body is doing, but how to best respond to it can be pivotal. I recently had a client who took a comprehensive childbirth ed. class with her first baby. She was adept at everything that would happen in labor, however with this next pregnancy she pursued a Hypnobabies course. There was a deeper level of understanding the mind-body connection and she gained new tools to help herself through contractions thanks to Hypnobabies. Learning is always good and sometimes having that extra backing and knowledge can better prepare yourself and also boost confidence that comes with deeper study of our bodies and their capabilities.
4. Doula support
Ok, ok. I AM a doula, so I'm incredibly biased, right? Well, yeah, but that's not why I add this to the list. I've seen the benefit with my own two eyes. Having extra support through pregnancy and then through labor can positively impact your experience (found again and again). However, I will absolutely never take credit for a vaginal birth. Hiring a doula doesn't guarantee a vaginal birth. I don't birth those babies myself, nor do I wave my magic doula wand and grant a vaginal birth. What I do is support. I support your wishes. I support your goals. I support you emotionally. I support you physically and help make your labor as smooth as possible. If things go awry, I keep the calm. I keep perspective. I help your husband be a better birth team for you... I work with him, keeping him at the forefront of your support team. I have tricks and tools to make labor more comfortable and possibly quicker, but I don't gift you with a vaginal birth... I walk alongside you, helping you, as you achieve it. I help to keep you uplifted through your pregnancy, understanding your past experience, talking over any points of fear or hesitation, I educate on positions and comfort measures to help with contractions, and I am a steady force with you through pregnancy, labor, and birth.
Not every doula is for every woman though. Interview a few. When you feel a good connection with a particular doula... SHE is your doula. All of us, in this area, are well trained, are kind, and are professional. We all have different strengths and weaknesses and personalities though and that personal connection with a doula will be what brings you comfort and success in choosing one. You want her to jive with you so that she flows into your labor and ruffles no feathers. She should be a seamless addition to your birth.
5. Treat Your Body Well
Eat well. Fuel your body. If you exercised prior to pregnancy, continue to exercise and modify as needed. Do gentle yoga flows. Walk. Squat. All these things will keep you toned and physically ready for the marathon that is labor and birth.
I know many that don't believe in chiropractic, however I've seen it work wonders again and again in my own life and for birth, it just plain makes sense. Having your spine and hips aligned will give your baby a straight shoot out during birth... no extra twist or turns to navigate from misalignments. Being properly aligned will also help your hips be in the optimal position (and open) which will allow your baby's head to properly, and most efficiently, fit into your pelvis. Having your baby's head fit well will allow for contractions to be more effective because there is good pressure placed on your cervix with each contraction. Effective contractions will help the baby descend more quickly, and well... down and out is the goal.
7. Your Mindset
In preparing for a VBAC, thinking/talking over your past experience and mentally finding your confidence is key. Calm confidence will serve you well leading up to your birth. Recognizing that you may have another cesarean is healthy. With each client, we talk about the "if". For instance: If you end up with another c-section, what things do you hope go differently than your last (immediate skin-to-skin, clear drape, delayed cord cutting etc)? It is something we discuss because it truly is something to consider. However, that isn't dwelt upon, nor should it be. Like I said, hope leads...
Keeping a steady mental mindset can truly help. Ways to help bring the calm and confidence will look differently for everyone: Some may want to read positive birth books or birth stories. Others turn to prayer and to feel like God is guiding this process and that their hearts can be still by trusting in Him. Yet others meditate. Some exercise. Some talk (to a professional, to a friend, to their doula, etc). Whatever it is to make you feel confident and steady... do that. The mind/body connection... it's legit!
Want to know more. It's explained well here:
Truly, preparing for a VBAC simply means getting support around yourself and your birth (OB, doula, etc), coming to peace with your first birth, and setting yourself up well for this next one: physically and mentally. If you have done some of the things off this list, you are well on your way to being prepared for your birth ahead. I have complete confidence in you. Our bodies are strong and capable. Your body conceived and grew this baby perfectly. It knows how to birth this baby as well. Trust that. Trust you.
Best of luck!
-Susie (the doula)
Baby Love Blog
Here lies a stream of consciousness regarding, pregnancy, birth, babies, and my doula business...