Preparing for a vaginal birth after cesarean (VBAC) isn’t a whole lot different than planning for a natural birth. Tell people you want to push a baby out of your vagina without drugs, they may look at you like you have three heads…the same goes for VBAC. There tends to be a lot of fear surrounding VBAC and a woman who is planning one may unexpectedly invite opinions from dozens of people around her, most of them negative. People often want to spread rumors about the very worst scenario because it’s far more interesting than what is normal.
There are some things you have to take really seriously in order to accomplish your goals. Below is a list of some of the most important steps you should take when planning your VBAC.
First of all, finding a truly supportive provider is probably THE most important piece to your journey.
Why? While we all know from research that VBAC is almost always the safest option for both mother and baby (and ACOG agrees), many providers put unnecessary restrictions on VBAC moms. Some common examples are “You have to go into labor before 40 weeks (or 39 weeks).” “If your baby is measuring big, you will need a repeat C-section.” “You will need to come to the hospital ASAP in labor and be on continuous monitoring.” “You will not be allowed anything by mouth (no drink, no food) in case you need an emergency C-section.” “I will not use pitocin under any circumstances.” “If your baby has any heart decelerations at all, you will be taken in for a C-section.”
None of these restrictions/guidelines are evidence-based for any laboring woman, even VBACs. Women attempting a VBAC deserve to have just as much freedom to labor and birth as any other woman. Familiarize yourself with the guidelines of the Mother-Friendly Childbirth Initiative and find someone who best fits those guidelines. That will be your best bet at a wonderfully successful VBAC and will be safest for you and your baby. These restrictions only increase your chance of having another C-section without improving outcomes.
Second, you need to deal with your emotional healing regarding your C-section.
Meet with other women who have had similar experiences, in person if possible, or online, or both! Talk to a counselor if there are issues you are not able to move past. Eliminate the naysayers. If there are friends are family who are not supportive, you have to avoid the subject with them or stay away from them. Even people who are neutral are not necessarily a great presence at your birth. I distinctly remember my mom and dad sitting in the corner of the hospital room looking at me laboring with my first attempt at VBAC . Seemed like a good idea beforehand, I mean my mom pushed out 7 babies like a birth ninja, including one homebirth and a set of full-size twins, baby A was breech. But….it was not a good idea…birth is intimate and while I don’t want my parents watching me have sex or poop, they shouldn’t have been watching me labor either. They did not get invited to my next birth.
Third, get educated with your partner!
Learn everything you can about birth that is going to HELP you have your VBAC . Be empowered by the information you get. Take a GREAT childbirth education class with your husband so he can be on board and help you during this amazing journey. Chances are, both of you are not reading all the exact same childbirth info or perceiving it the same. Get interactive with a classroom and a teacher…find a class with great statistics on vaginal and natural birth. Yes, natural birth. Even if you aren't sold on natural birth, take the class because it will give you more tools and more tools increase your odds. Just take the plunge!
Fourth, don’t skimp on your doula just because you have a great provider and a super supportive husband.
An experienced doula (find one who understands VBAC thoroughly) can help you where you don’t know you need help. She can protect your peaceful bubble. She can take you further than you ever thought you could go. However, a doula can’t birth for you, so it’s important that you set the stage so that she can help you on your own journey. Dads can remember to ask nurses to keep the lights low and use soft voices. Create a space, and a team who will work together seamlessly to give you what you want for this amazing birth.
Now let’s talk about physically what is happening. You have a scar on your uterus. That’s it. Your uterus has healed enough to make and grow a baby and odds are in your favor that you can birth your baby without incident. Do your research, know that VBAC is safe with the right support.
Fifth, get moving! Exercise is important.
Walk a mile a day and stay active. Stretch. Do prenatal yoga, it helps with stamina, breathing, relaxation, and so much more. Find a CHIROPRACTOR who is trained in the Webster technique. Even if you don't ‘believe’ in chiropractic care, you are a having a VBAC , you need your pelvis to be aligned properly. One of the biggest causes of C-section is a baby who doesn't want to move down into the birth canal…and the biggest cause of a baby who doesn't want to move down is either the mother’s hips are torqued, the baby’s head is not positioned correctly, or both. Chiropractic care solves both. Start seeing your chiropractor around 20 weeks for the best results. Also find out if they are willing to adjust you in labor…this is fabulous!!
Sixth, eat great, amazing foods.
Fall in love with REAL food and nourish your body and your baby. Make sure your muscles are strong and ready to do the work of labor. It’s not easy stuff. It’s a marathon and like any other athlete, you need to treat your body like a machine that is made for this process. Don’t junk it up.
Seventh, ABDOMINAL BREATHING.
Do it!! Do it every time you feel a braxton hicks contraction. Practice, practice, practice. It needs to be second nature by the time you go into labor and you should do it with contractions without even thinking about it. It helps direct baby’s head onto the cervix and makes contractions more effective. It also gives you something to focus on. I credit my very short active phase of labor to abdominal breathing.
Eight, learn about Spinning Babies, as in www.spinningbabies.com.
Gail Tully is amazing. She gives a list of daily balancing exercises (they might look a little crazy) that really really work. You MUST pay attention to your posture, stop sitting on furniture (because it causes malpostioned babies) and keep your belly forward leaning to encourage your baby in a good position. Say goodbye to your recliner until after baby is born. Squat, sit on the floor, or on a birth ball, not the soft, cushy couch. Get on your hands and knees and rock your pelvis a LOT!.
Ninth and last but not least, once you have really stacked the deck of cards in your favor, stop reading birth stories. Stop talking about birth. Let go of any expectations or prior feelings about birth you had when starting this process.
You’ve chosen great people to help you, you need to let go, breathe, and let them support you. Your only job during birth should be to breathe and relax…not be worried about what is going on around you. This is your journey. It is unique to you and your baby and your body. It does not have to follow suite to any other birth you have read about or seen or heard of. This IS you. Love yourself and be gracious for every wonderful, powerful contraction and milestone that brings you closer to your new baby.Abbey Robinson is a natural birth teacher and doula in South Lake, TX. A mother of four, she had three cesarean sections before her vaginal birth. Abbey also serves on the Advisory Board for Birth Boot Camp as our resident VBAC expert. She also works as a chapter leader for the Tarrant County Birth Network and with ICAN (International Cesarean Awareness Network). You can find her at www.SouthLakeBirthClass.com.
Curious to learn more about Birth Boot Camp and our natural childbirth classes? We have an online birth class option and natural birth teachers in your area. We also offer a comprehensive two disk breastfeeding DVD, “Breastfeeding: The Ultimate MRE”.
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