When I was on the table getting ready to delivery my first daughter via c-section after almost 48 hours in an aggresively-induced labor (that was the polar opposite of the natural vaginal birth that I wanted), a highly-experienced nurse offered up a piece of advice:
“Make sure you pick a different doctor if you ever have another baby and you want to try for a VBAC. This one doesn’t believe in them.”
In that moment, VBACs (Vaginal Birth After Cesarean) were something that I knew absolutely nothing about.
After going through the cesarean, falling completely in love with my daughter, and realizing that at some point I would probably be interested in trying to create a sibling for her…my journey into learning about VBACs began.
Three years later, I was able to deliver my second daughter via the birth method that I had planned for my first: vaginal and unmedicated.
Looking back over both experiences, there are 5 key things that helped make a VBAC possible for me that I would love to share with anyone who may find them helpful:
1. Pick the Right Delivery Environment for Your Situation
The reason for your cesarean can help you determine what kind of environment you would ideally want to deliver in.
Did you have a baby who was breech, but a healthy, low-risk pregnancy otherwise? A birthing center or home birth could be a good option. Did you have complications that lead to an emergency c-section? You may feel better trying for a VBAC in a hospital.
Once you know what your ideal birthing environment is…RESEARCH.
This is especially important if you’re planning on having a VBAC in a hospital setting.
Find out if the hospital offers any courses on VBACs. The hospital that I delivered at had a class called “VBACs: You Can Do This!” where mothers who have gone through a vagional birth after a cesarean spoke to pregnant women about doing the same — a good sign that the hospital was supportive of VBACs.
If no classes are offered, don’t be afraid to jump right in and ask about hospital policies surrounding VBACs, statistics on how many successful VBACs have taken place, whether or not the on-call doctors support VBACs or not. All of this information will be incredibly important when it comes to finalizing your prefered delivery location.
2. Pick the Right Doctor or Midwife
One of the most important things that you can do to increase your chances of having a successful VBAC is to have a baby-birthing team who is supportive of VBACs.
Seems like a simplistic, common sense thing, but it’s of the absolute, utmost importance. Whether you plan to deliver in a hospital, a birthing center, or at home, having the right professionals around you could make all the difference.
As soon as you decide a VBAC is your goal, start assembling your team. Meet with doctors or midwifes. Tell them that your goal is to have a successful VBAC and listen to their response carefully. Typically, medical professionals who are truly supportive of VBACs will tell you they support it directly, and those who don’t will sometimes dance around the subject a bit.
Like you did when picking a delivery location, don’t be afraid to ask direct questions. There are 5 key questions that you should ask a doctor or midwife if you’re hoping to have a VBAC, so make sure you ask each and every one of them.
Your doctor or midwife can shut down a VBAC attempt in an instant, so you really want to make sure you have some who will only do that if it’s medically necessary.
3. Thoroughly Research VBACs
Dig into everything you can find on VBACs.
Read accounts of women who have gone through them (or actually speak with women who have, if you can).
Read current medical documents about VBACs.
Research changes in policies surrounding VBACs.
Read about common reasons that VBACs don’t take place.
Read accounts from women who tried to have VBACs and didn’t.
Literally anything you can get your hands on related to VBACs—read it. Study it. The more knowledge you have, the more tools you’ll have at your disposal. You’ll learn the right questions to ask. You’ll learn common roadblocks. You’ll learn when you can push back and when it’s beyond your control. Research. It’s worth it.
4. Make a Realistic Birth Plan for You and Your Birthing Partner
While the “Birth Plan” sheets that you complete and stash in your hospital bag for the big day are all well and good, the most important person for you to plan with is your birthing partner.
This person —partner, husband, parent, friend, whoever— needs to have a plan in place that allows him/her to advocate for you and your VBAC goal in the event that you cannot. S/he also needs to have the necessary tools to support you, physically and emotionally and in every way in between. All that great VBAC research you did? Let that fuel this plan.
Another important element is making sure that you’re plan is realistic.
There’s no such thing as “VBAC or bust!” birthing. A repeat cesarean could, and, in some cases, should happen. Prepare yourself for the idea of it being okay if it does.
A repeat cesarean does not equate to failure. Lemme say that again. A repeat cesarean does not equate to failure.
While we all wish that every woman who tries for a VBAC could safely achieve one, we all know that isn’t the reality of life. Things do happen. Situations do arise during pregnancy and childbirth. With that in mind, an important point of conversation to have with your birthing partner is what to do if a repeat c-section does happen.
What will the recovery look like? How will s/he emotionally help you work through the change in your plan? Ask these questions and put a plan in place before you’re in the hospital.
5. Don’t Go to the Hospital Sooner Than You Need To
This piece of advice came straight from my wonderful, VBAC-supporting OB-GYN. I’m not sure how many times she repeated these words to me, but they were golden.
The reasoning here is that the longer you’re in the hospital, the greater your chances of interventions taking place. The more interventions that start to take place, the greater your chances of having a cesarian.
This can be true for women going through labor for the first time, and it’s even truer for women trying to have a VBAC.
Thus, if you’re able to hold off going to the hospital through early labor, you could increase your chances of having a VBAC in a big way.
Now, that being said, ALWAYS DO WHAT YOU AND YOUR DOCTOR OR MIDWIFE FEEL IS SAFEST FOR YOU AND YOUR BABY. If they say you need to come in, go in. If you feel like you need to go in, go in. Remember, there are things we can control and things that we can’t. If you feel that you can safely labor at home for a little while, and your doctor agrees that it’s fine…go for it. If not, it’s not worth stressing over. Believe that.