author: Jeanette Mesite Frem

Did you know that the research on VBAC success says that 60-80% of women who had a previous Cesarean are able to have a successful vaginal birth…yes, as high as 80%.  Then again, I know one midwifery practice in the Boston area that one year had an 85% success rate.  It may not seem like that number of mamas are having Vaginal Births After Cesarean, because not all women know how to align the stars to make it more likely to happen for them.

How do you increase your chances of being part of the successful group of mamas? 

ONE Choose a care provider with a proven track record?  It’s not good enough, frankly, to have a doctor or midwife that says that they will “allow” a “trial of labor”.  Instead, find a doctor/midwife/birth team that has a reputation amongst doulas that they do everything possible to make a VBAC possible.  They do exist.  Unfortunately, it’s rare to find a practice that releases data on individual practitioners but some practices (especially the ones that have high VBAC rates) do release practice-specific data.  So, call a doula and ask her who she thinks are the best providers.  Additionally, and this recommendation goes along with the provider, choose a birth place (hospital/birth center) that supports VBAC.  For example, if your provider is awesome but you go into labor on a day they aren’t catching babies, your chances of a VBAC may plummet.  The attitude of the nurses is also important.  And as far as homebirth midwives, some are more comfortable with home VBAC than others.  For example, my favorite VBAC story that I was involved in was a mom who was told by her obstetrician that he would “allow” a trial of labor but that the baby might be “too big” for success.  She switched to a hospital-based midwifery practice with a high VBAC success rate and I witnessed her push out her almost 11 pound baby after taking many hours to get from 9 cm to fully dilated. But she did it.  And she was thrilled. Booyah!

TWO Hire a doula.  The data on doula support shows that women who have a birth doula report higher satisfaction with their births, have lower rates of postpartum depression, have lower rates of using pain medication in labor, lower rates of interventions and lower rates of Cesarean birth.  And partners are psyched to have someone else to help with massage, help keep them calm and explain what’s going on and help provide information when it comes time to make decisions.  Just be sure your doula either has experience with VBAC client or has specific training and education related to helping you achieve a VBAC.

THREE  Take a childbirth class (yes, even if you took one for your first baby).  It’s great to have a review class (a 3-4 hour class) but some parents love having a date night with their labor support person to really focus on this new baby and really review all the information (and in many cases learn the info they didn’t know during the first birth) so they are better equipped to have a fabulous vaginal birth this time (or even an awesome Cesarean, if a repeat Cesarean is needed).  I actually had an anesthesiologist take my full 16-hour natural childbirth class recently (and yes, she had a successful VBAC!).  I’ve also had a few mamas who had natural births for their first baby who took my natural childbirth series because they really wanted to be sure they could have a natural birth again and that she and her partner were ready to do this AGAIN!  There was a father in one of my childbirth classes recently who said his grandmother gave birth eight times and told him to definitely take a childbirth class–she had taken a class for each of the eight babies.  Yeah, that’s a cool grandma!

FOUR Read some key books and watch some key movies.  In the doula and childbirth educator world, the #1 book is Ina May’s Guide to Childbirth.  Hands-down a favorite of moms and dads who read it, too.  Ina May Gaskin is the author and legendary midwife around the world.  Watch her TED talk and any YouTube video you can find with her talking.  She just rocks.  The way she describes things, tells stories and inspires women to trust their bodies is amazing.  There’s also another VBAC-specific book called TheVBAC Companion which is also heplful.  And the third one that would be fabulous for you to read is The Thinking Woman’s Guide to a Better Birth (you ARE a thinking woman, aren’t you?).   There are also several movies that I recommend:  The Business of Being Born, Orgasmic Birth and More Business of Being Born (which has a specific section on VBAC and another specific section on doulas).

FIVE Eat well and exercise.  You are what you eat.  We hear that all our lives but it’s so true.  Your baby is what you eat, too.  What you eat does matter.  It also helps all of your body’s tissues be healthy, which increases the likelihood you’ll get through pregnancy without complications and have the energy and good health to labor well.  Vitamin C and protein are important.  Check out the Brewer Diet (adding extra protein daily and ensuring you are getting lots of fresh vegetables are the cornerstones of this diet).  Good nutrition makes you feel good and actually builds a healthier placenta (your baby’s lifeline).  Exercise increases blood flow to your placenta and thus builds a bigger and stronger placenta (which decreases the likelihood of placental issues or growth issues with your baby).  Really, i know women who have run up to 8 months of pregnancy (then again there was that woman in Chicago who finished the Chicago marathon and immediately went to the hospital and gave birth on the same day.  Wow.)

SIX  Trust.  As Ina May Gaskin said, “Your body is not a lemon.”  Trust that your body knows how to build a baby and thus knows how to get it out.  Work on reducing your fears around birth.  See a birth counselor.  Talk through your past birth experience with a doula/childbirth educator to find out what you might have done differently or what you might need to know this time in case the same issues come up.  Go into labor on your own (and if that’s past your due date, work with your awesome provider to monitor your baby and decide whether a gentle induction is what makes sense for you or not).  Meditate on your own, repeating positive mantras about the power of your body and how smart your baby is.  Talk to your baby and tell him/her how to navigate through and that you know he/she can do it.  Hey, no one can hear what’s going on in your mind so don’t be embarrassed to do this!

Women who have successful VBACs say that they find healing in the experience–healing from the trauma, negative memories and/or disappointment they felt with their Cesarean birth.  They are also thrilled that they heal faster postpartum and are more able to enjoy their older child(ren) in addition to lift the baby and feed the baby without pain from surgery.  Then again, women who work for a VBAC and end up having a repeat Cesarean after laboring with a doula and supportive care provider also say that while they are disappointed they didn’t have the VBAC they hoped for, their experience with having labor and support helps them feel more comfortable with why their repeat Cesarean was necessary and report that they found the repeat Cesarean more enjoyable.

How your baby is born is important.  Not only because of the emotions mom and her partner might have but for the health of the baby.  But ultimately, it’s vital that each mother get LOTS of information and support about VBAC as well as Cesarean because it IS possible ENJOY BIRTH, no matter how it happens.

For more information about VBAC, see:  http://www.ican-online.org

Did you have a VBAC?  Comment here about why you think you had VBAC success!