If you read my first VBAC story, you’ll see what a fight I had on my hands. My OB, and the hospital staff, worked against my intentions for a normal birth every step of the way. Most mammals could not have labored healthfully through the stress I was put under. The fact that I was able to get my VBAC in those circumstances was somewhat of a miracle and I contribute my outcome only to a few small advantages I had as a well-informed consumer. But your VBAC doesn’t have to be like mine. Your VBAC can be peaceful, and calm, and beautiful.
In the nearly two years since my VBAC, I have had the pleasure of bearing witness to a plethora of other VBAC stories through my connection to the birth community, and through my ICAN chapter. Even though my own VBAC birth was worth whatever stress I had to go through to get it, I now know that with the right preparation and support, it doesn’t have to be an either/or situation. You can have your vaginal birth, and it can be battle-free.
So, knowing what I know now, here is my advice on How to Have a Better VBAC:
Before you even think about getting pregnant, get a supportive VBAC provider.
Do not assume for a minute that your doctor or midwife supports VBAC. Don’t even assume it if they tell you they do. The OB in my story said he would support my VBAC – even as he was stapling up my cesarean. That’s why I went back to him for my second pregnancy. However, his true intentions were not made clear to me until I showed up to a prenatal appointment with my natural-minded birth plan in hand during my 3rd trimester. When he went through my birth plan with a red pen, I realized he wasn’t going to be as supportive as I needed. I wanted to switch doctors then, but my HMO insurance told me I couldn’t. That’s why I was stuck laboring with, what I call, the “Bait & Switch Doctor.”
However, despite my experience, you can always try to switch providers, no matter how far along you are. Of course, earlier is better, but I’ve seen a mother switch at 40 weeks pregnant. Call your insurance company. If you don’t like the answer you get, talk to someone else. Explain to them that you feel your rights as a pregnant woman are not being supported, and that you could save them money by changing providers. Don’t give up. Think outside the box. A bit of work on the front end could save you a lot of stress on the back end.
Finding out if your doc or midwife supports VBAC involves more than just asking them. You need to ask them questions about their VBAC success rate, and what type of restrictions they’ll place on you due to their policies. If you don’t like the answers to those questions, get out yesterday. If your hospital won’t allow eating during labor, or requires IV’s for no medical reason, or requires any other medical interventions that are not evidence based OR warranted, having a healthy intervention-free labor with them could be a battle.
Get Informed about Normal, Healthy Birth
If you have had a cesarean, you may never have experienced a normal, intervention-free birth before. I ended up with my cesarean for all the wrong reasons. During my first pregnancy, I watched one too many episodes of “Deliver Me” and “A Baby Story” – which depicts all births as disasters waiting to happen. After watching those shows, I thought birth was a dangerous, emergency, medical event that could only occur with a huge team of doctors waiting by for everything to go wrong. I signed up for an unnecessary induction, and because of that choice, everything did go horribly wrong. It was a self-fulfilling prophecy.
I now know that those shows are the epitome of everything that is wrong with maternity care in this country – and birth has gotten a bad rap. Like much of the medicalized birth industry, those sensational shows prey on the fears of pregnant women and can easily convince them to become consumers of drugs and procedures they don’t know much else about.
But birth itself is a normal, biological function, where mother and baby usually fare better without those (often unnecessary) drugs and procedures. If you study natural birth, you will see that women possess a powerful, innate wisdom about how to birth their own babies. Through your studies, you will learn to believe in yourself, no matter what may have sabotaged your previous birth. Take a good, long natural birth class. Read, Read, Read.
My recommendations for the two essential natural birth books:
- Ina May’s Guide to Childbirth
- Birthing from Within: An Extra-Ordinary Guide to Childbirth Preparation
Learn About Those Interventions, and about VBAC itself
Being an informed consumer is one of the single most important steps in preparing for any birth, especially a VBAC. No matter if you’re laboring in a hospital, birth center, or right at home, you need to have a basic understanding of the machines that go “Ping!” Read about the risks and benefits of all the basic procedures that could be presented to you. Otherwise, you won’t know what you’re agreeing to, whether it is truly necessary, or whether there is a better, safer option for you. I spent my whole labor rejecting the bad medical advice I was being given, but I wouldn’t have been able to do that if I hadn’t researched the interventions and scare tactics they were pushing on me. Of course, if you’ve taken my advice and gotten yourself a better provider, you may not have to reject a whole lot. BUT – be prepared for anything. If you’re having a hospital birth, your favorite OB or midwife may not be on call, and the on-call doc might have their own ideas about how to “manage” your labor. If you’re having a homebirth, you’ll want to be prepared for the slim chance of a transfer. The more informed you are, the better equipped you are to make the choices that you are comfortable with – even in a pinch.
My recommendations for learning about commonly used birth interventions and VBAC:
- The Thinking Woman’s Guide to a Better Birth
- Born in the USA: How a Broken Maternity System Must Be Fixed to Put Women and Children First
- The VBAC Companion: The Expectant Mother’s Guide to Vaginal Birth After Cesarean
Get Yourself a Doula
I cannot stress this enough: trained labor support is worth its weight in gold, especially through a VBAC. If your previous birth ended in a cesarean after a long, hard labor – or, if you never got to labor at all – you may need an experienced support person present through your VBAC to help keep you strong, and to help you understand what’s normal. Doulas usually believe in the beauty and safety of vaginal birth, so you can count on them fully support your desire for a VBAC. Doulas have been shown to help decrease the rate of cesareans and other interventions, and mothers who use doulas report more satisfaction with the overall birth experience. My doula saved my VBAC. Without her, I might be telling a very different story.
My recommendations for finding a doula that’s right for you:
And on the topic of support people – make sure the people you’re allowing into your birth space are wholly supportive of your needs, and understanding of your desire to have a VBAC. When dealing with family or friends who may not support your choice, keep the discussion about your birth to a minimum. Provide them with good information about VBAC during your pregnancy if they’re interested, but keep in mind their opinions have no place in your birth. It is your body, your baby. Do what is right for you, and ignore any negativity.
Once you’ve done your homework – RELAX.
Now that you’ve prepared yourself to have a better VBAC, that is probably exactly what you’ll have. Visualize your beautiful birth. Will your beautiful birth into existence. Even if life throws you a curve ball, or if your baby does truly need to be born by cesarean for some reason, the steps you have taken to empower yourself can help the experience remain as satisfying, beautiful, and safe as possible.
Want to learn more about VBAC and cesarean recovery? Gina will be in the Houston, TX area this July 13th and 14th teaching two separate and distinct VBAC workshops for moms and doulas (and other birth workers.) For more information and Early-Bird registration discounts, visit http://thefeministbreeder.com/contact-tfb/vbac-workshops/ for more information. Space is limited so sign up today!
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