5 Steps to Prepare for a Vaginal Delivery after Cesarean (VBAC)

 
5 steps to your VBAC
 

The number of Cesareans has risen steadily, leading to about a third of all women who have a birth story that ends on an operating table. I am not here to rant about the escalating C-section rate or blame countless entities for this statistical shift. I want to talk about the mommas who desire more children after a C-section, but who dread the thought of facing the knife again.

The truth is, that you have a choice. Just because you had a C-section the first time, doesn't mean that's your fate for every other birth. Excitingly enough, our local doula community has seen some amazing women continue to pursue what is important to them: a choice, a chance to try, and an ability to achieve a vaginal delivery. 

These are some key steps you can take that can have a great impact on your success.

1. Find a care provider who not only says he or she supports your choice but also has the reputation and experience to prove it.

You should click with your care provider, as in he or she should make you feel comfortable. However, when it comes to pursuing a VBAC, you need a care provider you not only click with but also who has a reputation for helping moms achieve VBAC's. When looking for a care provider, ask those in the birth community: childbirth educators, nurses, doulas, etc. They are the ones who can give you a referral without hesitation. 

2. Get educated! 

Start your search as soon as you can. Research reputable sources online such as childbirthconnection.org or ican-online.org. Decide on a childbirth method or course and stick with it whether it is Bradley, Lamaze, Hypnobabies, etc. Each method is fantastic in its own right. Look in the coming months for blog articles on some of the childbirth education options available to those living in the Gulf Coast.  I'm not going to lie, most education is going to point in the direction of minimal intervention and pain medication. Why? Because those things statistically lead to a greater chance of Cesarean. Finding a good method and sticking to it (that second point is key) better enables you to know your options when it comes to necessary interventions and gives you some handy tools to avoid needing pain medication. Your education doesn't stop there, find birth pros and other VBACers and ask questions. Ask about their experience and whether or not it's worth it...because I guarantee you, 100% of the time, they will say it is!

3. Surround yourself with a positive, supportive birth team. 

Make sure that whoever is in that delivery room with you is completely on board with your vision. If your partner silently believes that you will end up with a C-section, that feeling is enough to totally change the environment. That feeling leads to self-doubt which has no place in any delivery room, much less a room of a VBACer.

A doula is an amazing asset in a VBAC journey because they provide constant positivity and encouragement that has the power to change the environment. They also provide informational support to help your labor progress, so if your primary C-section was a result of failure to progress, they can guide you through techniques to help you progress or help you buy some time if that's what your body and baby needs. Doulas can prepare you for your VBAC by helping you understand your first C-section, get in touch with your local resources, and know what steps you need to take to better your chances.

Your birth team doesn't stop there. Nurses are incredibly important in your journey. Set a positive tone with your nurse from the outset. Don't bring a 10 page essay about your ideal birth experience. You can definitely write one for you and your partner, but leave it at home. A simple one-page list of preferences will suffice for your health care providers. Be assertive, but respectful and gracious. If you live in a city with multiple options for hospitals that support VBAC's, research which ones have the best track record. 

4. Optimize that baby's position! 

This is the one many articles leave out. So much of labor progress, labor pain, and pushing depends on baby's position as he or she descends through the pelvis and the birth canal. Check out spinningbabies.com for a ton of exercises and information about optimal fetal positioning (OFP). The tricky part is remembering and knowing what to do in labor. Once again, here's where a doula can help. A doula who is familiar with both warning signs and techniques for dealing with poor positioning is going to be your best friend in labor. When interviewing doulas, ask them about their experience and knowledge. 

5. Have a spontaneous labor. 

Spontaneous labor is a key component of making sure your baby is in the best position he or she can be in. Also, it is the best way to avoid interventions that can heighten your risk for a repeat cesarean. Elective induction after all is an UNNECESSARY intervention. 

 

If you had a C-section, it's not too early to start thinking about your options. It is better to find a healthcare provider supportive of your choices before you see that positive pregnancy test. Reach out to local birth pros and get connected with others who have similar goals. Start taking the steps necessary now for your vaginal delivery after a cesarean.