Hey Tribe! On The Village Blog I love connecting with professionals in the community to share their knowledge regarding all things health and family related. This week we have a person and topic that is very near and dear to my heart- Vaginal Birth After Cesarean. Having gone through two unexpected cesarean births, I am still on my journey of a VBAC and am honored to have our guest blogger, Chelsea Tate, chapter leader of ICAN of the Triad, presenting this week. Enjoy!
Ever heard the phrase “Once a cesarean, always a cesarean”? This used to be true back in the 1970’s. This was before technological advances allowed us to perform cesareans in a way that would make VBAC a safe and reasonable option for most women.
In the present day, VBAC (Vaginal Birth After Cesarean) is becoming more and more common as women and families learn the benefits of giving birth vaginally after having a previous cesarean birth.
What makes VBAC safer now than back then?
In the 1970’s, the national cesarean rate hovered around 4%. This was largely due to the fact that cesareans were only performed with a “classical” or “inverted T” incision and carried a much higher risk of bleeding and infection. Cesarean techniques began to change as technology advanced. Doctors discovered that doing a low “transverse” incision was safer and would allow VBAC as an option for subsequent births. While these advances are praise - worthy, it is also directly correlated with the rapid rise of the national cesarean rate. Many doctors continue using the “safer” method of cesarean birth as a reason to perform more cesareans, mostly out of profit and convenience. Finding a truly supportive doctor has become controversial and difficult.
You’ve decided to VBAC - now what?
1. Find A Supportive Provider
The first and absolutely most important thing you can do to increase your chances of having a VBAC is finding a supportive provider. There is a huge difference between a VBAC tolerant provider and a VBAC supportive provider.
A tolerant provider might say any or all of these things to you during the length of your pregnancy:
- Must go into labor by 40 or 41 weeks
- Won’t induce labor (or augment) under any circumstances whatsoever
- Baby must be under a certain weight/ in a certain percentile
-Must dilate X number of cm per hour
- Must be admitted during early labor
- Have to get an epidural "just in case"
- Uses a VBAC calculator to predict your chances of success
- Does not practice "Informed Consent" but rather uses "Scare Tactics”
- Does not practice evidence based care
- Has a very high c-section rate/ won't share their statistics with you
A VBAC supportive provider may say any or all of these things to you during the length of your pregnancy:
- No restrictions on length of pregnancy (evidence based)
-Induction/augmentation are options if medically necessary
- No weight estimates (especially based on a late-pregnancy ultrasound) used to discourage you from choosing TOLAC/VBAC
-No restrictions on length of labor (unless medical complications arise)
-Low cesarean and high VBAC rate
-Practices informed consent
- Practices evidence-based care
2. Create A Supportive Birth Team
Hire a VBAC knowledgeable doula and/or make sure that whoever you have in the room with you is supportive of your wishes. They will also need to be willing to stand up and/or advocate for you if you become unable to speak for yourself during labor. Increase your chances of optimal fetal positioning for birth by having a prenatal chiropractor on your team that you see regularly.
3. Make A Birth Plan
Research your birthing location’s protocol and decide what you are okay with and what you aren’t. ASK QUESTIONS! If something doesn’t make sense, don’t be afraid to call your provider and ask. Accumulate all of your wishes into one document and print it out so you can bring it with you during labor. Make sure you print extra copies for your birth team and the nursing staff. Your doula can help you come up with a birth plan.
4. Work Through Past Trauma
If you are still emotionally struggling with any previous birth trauma, it will be imperative to process and work through that before you give birth again. Find a local counselor or therapist you can talk to for professional help. Going into labor with any mental blocks could stall your labor or make it more difficult.
5. EDUCATE YOURSELF!
Join a VBAC group and start asking questions. There is so much information and research out there about VBAC. It can be overwhelming but if you start early, you can sift through it before it comes time to make any decisions. Arming yourself with research, evidence, and statistics will not only empower you during labor, but it will make it easier to stand up for your wishes should you need to.
We highly recommend a VBAC class and joining ICAN of the Triad’s local meetings. A great place to start research would be ACOG’s website and Evidence Based Birth. www.ICAN-online.org is also full of valuable information.
6. YOU Are In Control- Remember THAT!
YOU are the one having this baby. YOU are in charge and get to decide what happens to your body - no one else! Do not be afraid to ask questions, take your time making decisions (given no emergencies arise), and don’t be afraid to say no to things you don’t want.
Chelsea Tate is the owner of La Bella Birth and Baby and is the chapter leader for ICAN of the Triad. The International Cesarean Awareness Network (ICAN) is a nonprofit organization whose mission is to improve maternal/fetal health by reducing the number of unnecessary cesareans. This is accomplished through support and education about VBAC (Vaginal Birth After Cesarean). ICAN of the Triad hosts local meetings where families can come to find support and connect with other families. Their first meeting is February 22 at 7pm at Village Family Chiropractic and we'd love to see you there!