Your Pathway to a Successful VBAC
Wanting to rock your VBAC? Know the facts, do your homework and check out our Top Tips to give you the best possible chance of achieving a successful VBAC.
GATHER YOUR SUPPORT TEAM AND CHOOSE THE RIGHT MODEL OF CARE.
One of the most important things (if not THE most important thing) you can do to ensure VBAC success is to surround yourself with a team of people who support you. That includes your professional care providers, partner and family.
Your partner and family need to be on board. If they are not on your side, it’s going to be very tough for you emotionally to get through the pregnancy, let alone the labour, without their support. Often, their lack of support is really their fear exposing itself. They also need to know the facts, so ensure that you pass on current, evidence-based research to them too.
The next person you are going to need is a DOULA or BIRTH ATTENDANT. When the going gets tough, you’re going to want more than ice chips. You’re going to want a damn good doula.
You need to decide what kind of model of maternity care suits you best. Generally speaking, you will increase your chances of VBAC success by being cared for by a private, independent midwife or an obstetrician known for supporting VBACs.
CHOOSE WHERE YOU ARE GOING TO GIVE BIRTH VERY, VERY CAREFULLY.
In terms of priority, right after WHO you birth with, WHERE you birth is going to be the next most important thing that you need to consider. If you are planning a hospital birth, are you going public or private? Are you considering a home birth? If you are planning a hospital birth, have you investigated their VBAC and Caesarean rates? If you are going to a private hospital, then you need to research the VBAC and Caesarean rates of your doctor – not so much the hospital itself.
ARM YOURSELF WITH THE LATEST EVIDENCE-BASED RESEARCH SO YOU CAN SEPARATE MYTH FROM FACT.
Women planning a VBAC are undoubtedly going to face opposition. From their care provider, from their hospital, their partner, family and friends. They will likely be told horror stories and scary statistics about uterine rupture and told that their decision to VBAC is risky and selfish. It’s important to know that there is a lot of excellent, highly scientific, evidence-based information out there that you can freely access. Do your homework.
Be proactive and work out how to separate fear-mongering from facts. At the end of this article is a list of great resources for you.
MAKE SURE YOU’VE DEALT WITH YOUR LAST BIRTH.
There is no easy or polite way to say this. You need to sort out the shit in your head that has lingered since your last birth, especially if it was traumatic. I guarantee you that you will carry that baggage forward into your next pregnancy and it WILL impact on your ability to labour and birth naturally. Seek out a perinatal psychologist or counsellor who specialises in birth trauma and get some counselling.
ATTEND A CHILDBIRTH CLASS OR REFRESHER COURSE, IDEALLY ONE THAT FOCUSES ON VBAC.
Even if you went along to a childbirth class the first time, you can never be too prepared or learn too much about birth. Remember too, that each pregnancy is unique (as is every baby) and you and your partner will definitely benefit from attending a good course, especially if there is a VBAC focus. Going to a class is also a wonderful way for you to get back into the headspace of labour and birth – which can be particularly hard once you’ve had a baby and your whole world is revolving around caring for your other child/ren.
FIND YOUR TRIBE.
I am a big believer in surrounding yourself with like-minded people who will understand and support you. There are some fantastic online support groups and organisations, as well as face-to-face gatherings. Search online and seek out those people in your area. Their collective power and positive energy can be extremely healing and an incredible source of support.
WRITE A BIRTH PLAN FOR A VAGINAL BIRTH AND ONE FOR A REPEAT CAESAREAN.
Of course your focus is (and should be) on having a normal, physiological vaginal birth. Spend some time developing and writing your birth plan. Work on it with your doula as well as your primary medical care provider (midwife or obstetrician).
Don’t spring it on people when you arrive in labour at the hospital. Ideally, your birth plan should be a part of your medical records so that the hospital staff (if you are having a hospital birth), are well aware in advance of your wishes and preferences.
Keep it short and sweet and to the point. No more than one single-sided A4 sheet of paper. Make several copies so you can give one to each midwife who comes on shift during your labour. Blu-tak a copy to the wall of the birthing suite as well (it’s a good reminder for you too!)
You may not like this – but I also think you should make a Plan B, repeat Caesarean birth plan too. Chances are pretty high that you didn’t have much say in how your Caesarean section went the first time around. That’s probably because you never thought you’d end up having one. So much of the trauma that women experience is precisely because they are unprepared – emotionally, psychologically and many women have no idea what is even involved in a Caesarean surgery, let alone recovering from one.
If a repeat Caesarean is medically necessary, then you can take back your power and ensure that you have a hell of a lot more say the second time around. Google “family-centred Caesarean” or “Woman-centred Caesarean” to find some excellent ideas and resources on how to ensure that your Caesarean birth is a positive and empowering experience. That might seem hard to believe – but it is possible. Scroll to the end of this article though, as I have included some great links.
SURROUND YOURSELF WITH POSITIVE AND EMPOWERING MESSAGES AND IMAGES OF BIRTH.
It’s pretty much impossible these days to avoid scary, anxiety-inducing messages and images about birth. Between Dr Google, social media, reality television and our well-intentioned, but often ill-informed family and friends, it is no wonder that most women hurtle towards childbirth in an advanced state of panic. The short answer is, if the information you are accessing is not contributing to your own philosophy of birth (i.e. it’s a normal, physiological event), then stay the hell away from it! Instead, seek out empowering birth stories, watch amazing birth videos, immerse yourself in the birth wisdom of writers like Ina May Gaskin, Penny Simkin, Henci Goer, Sheila Kitzinger, Sarah Buckley, Janet Balaskas, Rhea Dempsey and Katrina Zaslavsky.
TAKE CARE OF YOU.
Yes you mama. Remember her? I know how hard it is to look after and pamper yourself when you are forever chasing after a little person, juggling work or home life (or all three!) But self-care is essential. Not optional. Essential. Even if it is just once a week (hopefully it’s more than that), but if you can only grab an hour, once a week which is exclusively YOU time, then you must do it. Go for a walk, go to the gym or a prenatal exercise class, treat yourself to a mani and pedi, get a massage, catch up with a friend for some girly time, go to the movies on your own! Whatever you choose to do, just make sure you do it. Your body and soul will thank you for it.
BELIEVE IN YOU.
It’s normal to have those moments of utter negativity and self-doubt. It’s not helped when it seems that no one is on your side or supporting you. Learn to switch off that negative inner-voice. Surround yourself with positive, affirming messages and people who are barracking for you all the way. Read those beautiful VBAC birth stories, get a virtual hug from your online communities of women who understand what you’re going through. Share your fears with your counsellor or therapist.
The support is out there. You just need to know where to find it.
Please visit our Resource page and click on the section “Caesarean Prevention and VBAC” for lots of great information and evidence-based resources.
(Many of the resources listed below are for Australia, but there are undoubtedly local equivalents for your area).
If you are Melbourne based, please check out our one-day VBAC Your Way course. We are very excited to announce that we will be offering an online version of this course later in 2019!
VBAC Your Way – http://birthwellbirthright.com/645-2/vbac-your-way/
Evidence-based VBAC Information
The VBAC Education Project
Childbirth Connection – VBAC or Repeat Caesarean?
Lamaze International – A Woman’s Guide to VBAC
VBAC – Yes! It’s an Option (Lamaze infographic)
ICAN – International Caesarean Awareness Network
What every woman needs to know about Caesarean Section (Childbirth Connection)
So you want to have a VBAC? Here is where to start.
Royal College of Obstetricians and Gynaecologists (RCOG) – updated guidelines for birth after previous Caesarean (October 2015)
CANA – Caesarean Awareness Network Australia
Birthrites – Healing After Caesarean
Birth Goddess VBAC Support
Maternity Choices Australia fact sheet http://www.maternitycoalition.org.au/uploads/1/5/1/4/15149676/infosheet_vbac.pdf
Family or Woman-Centred Caesarean Information
A Woman-Centred Caesarean (excellent YouTube video)
How to create a Caesarean birth plan
Caesarean Section Support Australia (Facebook group)
The Natural Caesarean (great article)
Information on Maternal Assisted Caesarean
Tanya Strusberg is the founder of birthwell birthright and the co-founder of Lamaze Australia. She is a Melbourne-based Lamaze Certified Childbirth Educator, doula and a Fellow of the Association of Certified Childbirth Educators (FACCE). Tanya is also a member of the Lamaze International Board of Directors, the first non-North American to ever serve on the board in Lamaze’s 60-plus year history. She is a passionate advocate for women’s maternity care and her articles have appeared in The Journal of Perinatal Education, Australian Midwifery News, Science & Sensibility, Interaction – the journal of the Childbirth and Parenting Educators Association of Australia (CAPEA), International Doula, Empowering Birth Magazine and Rockstar Birth Magazine. Through her internationally-accredited Lamaze Educator Training program, she is very excited to be training a new generation of Australian Lamaze educators. Last, but absolutely not least, she is also the mum of two beautiful children, her son Liev and daughter Amalia.