With about 1 in every 3 births in the United States ending with a delivery via C-section, the desire to try for a Vaginal Birth After Cesarean (VBAC) is also on the rise.
While having a VBAC at home or in a birthing center can often increase a woman’s chances of having a VBAC, it’s also possible to have one in a hospital with an OBGYN (like I did when delivering my 2nd daughter).
If a VBAC is your goal, you need to make sure that it’s the goal of everyone on your team, as well. Perhaps the single person who will have the biggest impact on whether or not you are able to try for a VBAC will be the doctor that you choose to see.
Not all doctors are the same. This came as quite a shock to me, as I assumed that all doctors in a certain medical profession had a standard set of rules that they follow, making the individual doctor irrelevant in the birthing process. This could not be further from the truth. While doctors do follow guidelines and regulations, childbirth can be interpreted differently from doctor to doctor.
For example, the OBGYN who delivered my first daughter preferred cesareans and “didn’t believe in VBACs”. The OBGYN who I saw during my second pregnancy was incredibly supportive of VBACs.
Had I done my homework with my first pregnancy and picked a different OBGYN, chances are I would have been able to have a vaginal birth with that pregnancy, too.
You live and you learn, though. Nothing can be changed at this point.
With my second pregnancy, I knew what I wanted (a VBAC, as long as it was safe for me and the baby) and did my homework early on in the pregnancy to give myself the best chance at succeeding. It paid off, too, because I was able to successfully have a VBAC with my second daughter.
If a VBAC is your goal and you’d prefer working with a doctor and delivering in a hospital, here are 5 important questions to ask your OBGYN during your very first appointment:
1. Do you support VBACs?
Don’t waste any time being indirect with your doctor if a VBAC is your goal. You need to ask this question immediately, and if the answer is no, you need to move on to another OBGYN right away. If you don’t have an OBGYN who supports VBACs, don’t expect to magically somehow have one.
2. How many of your patients have had successful VBACs?
While finding an OBGYN who supports VBACs is all well and good, you also want to be sure you pick someone who does more than supports the idea of VBACs; you want to be someone who has had patients successfully deliver via VBAC. Find out how many (or approximately how many) have been successful.
3. What percentage of your patients wanting to have a VBAC have been able to have one?
While it may seem like a great thing for a doctor to have had 40 patients deliver successfully via VBAC, if it’s 40 out of 3,000 patients who have wanted to have a VBAC…you may have uncovered a red flag. Make sure you ask for a success rate (or at least an approximate one).
4. What were some common reasons your patients haven’t been able to have a VBAC when that was their goal?
VBACs don’t always happen, and that’s absolutely okay. Healthy mom and healthy baby is always going to be Goal #1 of any pregnancy and birth, and sometimes that means the delivery doesn’t go quite how you’d expect it to.
That’s why this question is such an important one for you to ask. If the doctor says that most women who want to have a VBAC don’t because of a medical risk or because the mom changed her mind, that’s perfectly reasonable. If the doctor says that most VBACs don’t happen because “we only allow women trying for VBACs to be in labor for X amount of time before going in”, you may want to consider looking at another doctor.
A big key to having a successful VBAC is reducing the medical interventions. Any time you get the sense that a doctor is trying to get you on a schedule when it comes to labor and delivery, it could be a sign that s/he would be more supportive of a scheduled repeat c-section.
5. If you’re personally unavailable on the day of my delivery, will your on-call doctor support my VBAC birth plan?
Interviewing an OBGYN needs to include figuring out who is on their on-call team. No doctor is available 24/7 (because human), so there’s always a chance that the person in the delivery room with you won’t be the same person you saw during all of your visits.
Because of this, you need to make sure that everyone else who could possibly be involved with your delivery is also pro-VBAC. Ask about oncall doctors, and about the hospital where you’ll be delivering at.
Learning hospitals or hospitals associates with universities are often more VBAC-friendly, so consider researching doctors who delivery at those types of hospitals if you have one in your area.
Don’t ever be afraid to ask, and don’t wait to long to ask. Going for a VBAC is nothing to be ashamed of. Stay strong, mamas. You’ve got this!