How to Have a Successful VBAC
Once a cesarean, always a cesarean
The term was dubbed back in 1916 by Edwin Cragin after finding that Cesarean sections were extremely dangerous to both the mother and the baby. Due to the risks already associated with a primary cesarean delivery, subsequent births would have to be cesarean sections by default.
Initially, cesarean sections were avoided at all costs due to this fear. The rates at that time were at an all-time low, about 5%.
But, as technology advanced and more research was done to prevent injury to mothers and their babies, cesarean sections were posed as less risk to mom and baby. Suddenly, it was “safer” and more “convenient” to schedule cesarean sections.
Despite Cragin’s motto being rebutted in 1984, the rates of cesarean sections were still increasing at an alarming rate. Having a successful VBAC was still an option but rarely attempted.
The Rise of Successful VBACs
Then, VBACs started to make a comeback. VBAC, or Vaginal Birth After Cesarean Section became increasingly popular and increased 23% from 1985-1996. However, the rate of cesareans continued to rise. To battle the increase in cesarean sections, new guidelines from ACOG (American College of Obstetricians and Gynecologists) were released in 2010 to make VBACs more available to women. It states,
Vaginal birth after cesarean delivery (VBAC) should be attempted at maternal care facilities that typically manage uncomplicated births if they are capable of performing emergency deliveries.
Initially the ACOG guidelines stated that VBACs should only be performed at facilities with anesthesia and operating surgeons immediately available. A successful VBAC wasn’t even an option if the hospital you chose to deliver at didn’t meet this criteria prior to the new guidelines.
Even though VBACs are becoming a more viable option, cesarean section births are still extremely high at 31.9% according the CDC data in 2016. This means about 1 in every 3 births are delivered by cesarean.
So Why Should I Chose a VBAC if C-Sections are So Common?
Reasons to chose a VBAC over a repeat cesarean section
- 60-80% of women who have had previous c-sections go on to have successful VBACs
- No surgery complications like DVTs, Pneumonia, Infection, and Increased Bleeding
- Shorter Hospital Stay
- Faster and Smoother Recovery
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How Can I Have A Successful VBAC?
#1. Choose a healthcare provider that is very supportive of VBACs
Having a supportive provider is extremely important. You don’t want someone who says they will “let you try” but then quickly revert to C-section at the first sign of non-progression or fetal distress.
Here are some questions that you can ask your provider:
- What is your VBAC success rate?
- How many VBAC births have you attended?
- What are your restrictions to attempting a VBAC?
- At what point would you end trial of labor (TOL) and decide to do a cesarean section?
- What are your repeat cesarean section rates?
- Are there resources you recommend that will increase my chances of having a VBAC?
#2. Choose facility supportive of VBAC or natural births
The facility you choose should have low RCS and high successful VBAC rates. You may find that this information is not readily available to consumers so will have to do a little digging. Choosing a facility that supports VBAC is very important. If your doctor or midwife is unable to attend your birth, you’ll want to be at a place that will support your decision. Luckily, this was my experience. My OB was not present for my birth and I was nervous that the other on-call doctors wouldn’t support me or let me labor as long as they did. I was surprised that they were just as supportive as my primary OB was.
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#3. Write a birth plan
You may hear that it’s pointless to write a birth plan. But if you choose to give birth in a hospital setting, know that nurses typically work 12 hour shifts. You don’t want to continue to explain the birth plan over and over. Make a short (one paper) depiction of your birth plan and give it to your nurses so that they know what you want. They will support you. Make sure they know that it’s important for you to have a VBAC.
#4. Educate yourself on a Successful VBAC
The more you know, the more you can be proactive in your birth plan. Below are some great books to get you started to feel knowledgeable, empowered, and awfully inspired.
Birthing From Within by Pan England
Cut, Stapled, and Mended by Ina May Gaskin
Ina May’s Guide to Childbirth by Roanna Rosewood
Similarly, the VBAC Education Project aims to provide women with mound of information and support in their VBAC journey.
#5. Hire a Doula
Doulas are special women. They have immense knowledge in the birthing process and can assist you in the most difficult times. It’s so much more than having your own personal coach at your bedside. Some of the benefits of having a doula are:
- Increases confidence
- Increases breastfeeding rates at six weeks postpartum
- Lowers the chances of having a c-section
- Lower chances of medication during labor
- Shortened labor
- Higher five-minute APGAR scores in the infant
- Less likely to have an instrumental (vacuum or forceps) delivery
Yoga is an incredibly valuable tool in assisting in balancing your spine and pelvis. I followed both Yoga with Adrienne and Katy Appleton during my pregnancies. I highly recommend them. The series below is specifically for pregnancy by Katy Appleton. She goes into each each practice for each trimester and eases into each pose to allow for grace.
#7. Labor at Home as Long as Possible
It is best if you can labor at home and allow the cervix to ripen on its own. This will decrease your risk of induction which will decrease your risk of having an epidural (prolongs birth) which can decrease your overall risk of having to undergo a repeat cesarean section.
Chiropractors can have a great affect on the woman’s body to align her pelvis and get her baby in the optimal position for birth. If possible, look for a Chiropractor that is specifically trained for pregnancy related care. This will not only help with position of the baby, but allow for adequate blood flow through the spine to nourish the rest of your body.
#9. It’s okay to switch providers (even in your third trimester)
If you find that your provider is not really supporting you, then know that you have the option to change providers. In fact, I urge you to change if you don’t feel supported.
#10. Find Inspiration and other Successful VBAC stories
I read so many successful VBAC stories to get myself into that mind frame that it will happen. Just when you think that it won’t happen to you or when you think you won’t get to VBAC, there is a woman out there who has done it. You can do it too! Don’t be discouraged mama, your body can do way more than you think!
#11. Get Support
Having the support of like-minded mamas has helped tremendously in my journey for a successful VBAC. In talking with other mamas on various Facebook groups, you can find support and similar fears about undergoing a VBAC. It helps to talk it out. You can find support groups and inspiration here:
#12. Try to avoid induction for a successful VBAC
Uterine rupture is the main reason people are weary of a VBAC. Reducing the need for labor induction with pitocen can lower the risk of a rupture and increase the chances of a successful vaginal birth.
#13. Try to avoid epidural
Pain medications such as an epidural have been known to slow the baby’s heart rate and make labor longer. These side effects can mimic warning signs of uterine rupture, so avoiding an early epidural or forgoing all together can help increase your chance of a successful VBAC.
I hope these tips find you well and good luck on your successful VBAC, mama!
Please feel free to ask any questions below or email me if you’d like at marissa@simplisanders(dot)com