So You Want a VBAC
Attempting a VBAC, vaginal birth after cesarean, is incredibly brave. It's a decision that comes with a lot of questions, uncertainty, and doubt. Labor of Love has supported so many VBAC families and most of them are successful. It is probably less than 2% that needed a repeat cesarean for one reason or another.
When we walk hand-in-hand with VBAC families it’s about processing, letting go and investing in your own empowerment. It’s about seeking out the right care provider, educating yourself, surrounding yourself with a positive support team, and surrendering to the moment.
When one starts to walk down the VBAC path it seems risky and scary.
The major risks with attempting a VBAC sound frightening:
A uterine rupture is when the incision scar opens during the process of attempting a vaginal delivery. While this sounds horrifying and is enough for a birthing person to start second guessing herself we must know that such an occurrence is extremely rare. Uterine rupture has a less than 1% chance of happening. With this in mind, hopefully we can feel more confidence if we choose to attempt one.
Placenta accreta is when the placenta from the second pregnancy invades the scar from the original cesarean. This means that the placenta grows too deeply into the uterine wall and won’t detach after birth which can lead to severe blood loss. The chance of placenta accreta is about .3% after one cesarean. This percentage does increase with more than one cesarean birth.
It is important to understand these over all risks and also know if you are a good candidate for a VBAC.
Qualifications as a candidate for a VBAC:
Your cesarean was preformed with a low-transverse incision rather than high.
There has been at least 18 months between pregnancies so that your uterus can heal.
You never had a uterine rupture before.
You have no other extensive uterine surgeries.
Your cesarean was not due to any abnormalities of the pelvis, uterus or other physically restraints. ** You will want to connect and talk to your care provider about the above.
With the strength and bravery to move forward with this desire, and attempt a VBAC, the following is a break down of how to increase your chances of a successful VBAC:
Find the right care provider.
This is paramount. Your care provider absolutely decides your birth outcome. They decide if they let you go past 40 weeks and are comfortable with spontaneous labor. They decide how they want to talk to you about a VBAC which has everything do to with your confidence in the process. Choosing the right care provide is the only way to success.
The provider you choose must have a reputation for supporting VBAC’s and allow labor to unfold. This means they don't say, "Yes, yes, yes," and then change their tune at 36 weeks. It is imperative to research and ask around to ensure you find a care provider that believes in you. Ask other women, question your favorite mommy group on Facebook, look at all their Yelp reviews and then question them face to face about your desires.
Find the Right Hospital.
This goes hand-in-hand with the above. While every provider has their own philosophy and practice, every hospital does too. Your hospital will have certain policies and standard of practice that they adhere to. While many modern hospitals are current with ACOG standards it can take years before such standards influence mainstream practices. You need to ensure that the hospital you deliver at is on board with your VBAC. Research their reputation and ask around for those that have achieved a VBAC and where they delivered.
Attend a Quality Childbirth Class
Educate yourself! When you understand and trust the birth process you are more likely to make better decisions for yourself and the care you receive. Knowing how to work with your body and allow birth to unfold spontaneously will get you closer to achieving your goals.
In addition, as a VBAC you will need to work through your first birth and come to a place where you can enter this new experience open and free. Attending a great childbirth class can offer this to you. We (of course) think our Connected Childbirth series is amazing and is the perfect fit. We work closely with our VBAC clients.
Hire A Birth Doula.
Invest in your experience and hire a professional birth doula. We have learned that the more support a women has in labor the better her birth experience will be. When attempting a VBAC encouragement and mental support is crucial, adding a doula to your team will help you get there.
With a professional birth worker by your side you will have the tools to help navigate any decisions that may arise leading up to birth, while in birth and moving forward. Labor of Love Birth Doulas specialize in VBACs and would love to be on your team! Equally, if you find yourself walking into a repeat cesarean having a doula help you through that process will make it easier all around.
Avoid Induction and Intervention.
To achieve a VBAC allowing your body to reach spontaneous labor can help tremendously. That means that you don’t have any pressure to be induced if it is not medically necessary. That means that your care provider allows you to go beyond 41 weeks pregnant if you find yourself there. That means that your care provide will not induce at 39 weeks because of maternal age or any other reason. That means that your body is given the time to start labor all on its own. With induction and any intervention ultimately comes a greater rick of repeat cesarean.
I hope that this has been useful - Labor of Love has worked with so many VBAC families over the last 9 years which has helped us understand the importance of the above. If you are seeking a VBAC we are celebrating you and sending you so much strength!