VBAC is an important topic in the childbirth world today. We know it is a safe option for women birthing after cesarean, and yet it can be hard to come by for many reasons. We are excited to share this guest post from Lauren McClain, one of our childbirth educators as well as a mom of three. She had a home birth, a cesarean, and then a VBAC (vaginal birth after cesarean) with her third baby. She is a wealth of knowledge and gives great advice regarding VBAC.

How To VBAC

Pretend it’s not a VBAC.

If possible, forget you are a VBAC candidate. You are a pregnant woman who wants a vaginal birth. That is not an unreasonable wish or pursuit. Not even with a scar on your uterus.

Every birth is different. Do not let your past control your thought patterns. Do not let your fear drive your decisions.

You must have a trusting, trusted provider.

You may have to find another provider. And then another. This is OK, and it is best. What I mean here is: Switch Doctors. Maybe try a midwife. You want a provider who really believes you can have a VBAC. A provider who wants you to have a VBAC. A provider who thinks it would be unusual if you didn’t.

So many women stay with their doctors in spite of their poor records with VBAC clients. You tell your doctor you want to have a VBAC and she says “we can certainly try, but…”

Run away.

Unless you have such a good relationship with your doctor that you would rather have another cesarean than see someone else, find another provider.

My amazing VBAC fortune-telling powers.

In my experience teaching birthing classes, attending births, and talking to other women who work with VBAC clients, nothing matters more than who your provider is. I’m going to say I can judge your chances of having a VBAC with 80-90% accuracy based on who your provider is. Here’s a good way to judge your provider’s VBAC-friendliness.

Your baby believes you.

My doula friend had a client with a baby who just wouldn’t come down. Hours and hours of labor, opening fine, but the baby wouldn’t descend. We can talk forever about why this might be, but there was clinically no reason for it. It was a VBAC baby of a mom whose doctor didn’t really believe she could do it and said so. A very educated, strong, and determined mother ended up with another cesarean. I do not know why this happened, but my guess is that she was brought to believe–deep inside–that she couldn’t do it. And her body believed her.

There are many reasons your provider makes a big difference—for any birth! Especially for women who want to have a VBAC, who is down there really, really matters. Depending on your cesarean birth, you may already have trouble truly believing, inside and out, that you can birth a baby naturally. If your provider often inserts lack of confidence, even through facial expressions, your body will read that as a threat and, in some small—or big–way, shut down.

Your baby believes whatever you tell it.

Remind your baby that you are both OK. Remind your baby that s/he is loved.

VBACs are risky. You may experience vaginal birth.

Sure, there is a small increase in risk for this VBAC birth. But history is not that likely to repeat itself.

If your cesarean birth was a pre-labor cesarean, like for a breech baby (cesareans not always necessary, by the way), once your labor starts none of that is a concern.

If your cesarean birth began as an induction, you likely had a cesarean because your body was not physiologically ready for birth. That won’t happen this time because you won’t be induced before 42 weeks. Right?

If your cesarean birth happened after long hours of labor, I’m sure you’ve looked into what you can do differently this time. Maybe better positioning for your baby? (Sometimes chiropractic care can help with better positioning for birth.) More moving around in labor? But even if you do nothing different, any woman with more than a couple babies will tell you that birth is just different with each baby.

This birth will be different.

You listen to your gut feelings, make your decisions based on love not fear, and choose your provider wisely. Then you Let. It. Go. It’s not your job to be cognizant of issues that arise—to wonder if every twitch is your uterus tearing a little bit. It’s your job to let your baby come down and out—by getting out of the way physically and emotionally.

Forget that it’s a VBAC—it has zero bearing on the way you birth your baby–it means nothing to you until you hold your baby triumphantly in your arms.

~

Lauren, teaching a birth class in Bowie, Maryland.

Lauren is a childbirth educator and the author of the Breech Baby Handbook. She also maintains a website to help parents of breech babies make decisions about their care (formerly MyBreechBaby). In addition to blogging at BetterBirthBlog, her work has been published in Holistic Parenting Magazine, Birth Issues, True Birth (2014), Mothering, Mama Birth and other places she can’t remember right now. She has degrees in literacy and teaching, enjoys camping, garage sales, and, inexplicably, action movies.