Here are my 10 tips for a successful VBAC – from my own VBAC journey.
My first birth was a non-elective (emergency) c-section. My next two births were both VBACs, so I know it is possible! For some women, subsequent births via c-sections may be necessary. Or it may be your choice. If you are having a subsequent c-section, check out my Positive Caesarean Course). For others, a VBAC may be the best option.
Once a c-section does not necessarily mean always a c-section. For many women, a VBAC (vaginal birth after caesarean, is not only possible but also a safe, positive way to give birth.
10 tips for a successful VBAC
1. Find the right caregiver
Shop around, talk to other women who have had a VBAC. Find a caregiver who is truly supportive of VBACs and not just tolerant of them. It is important to have a good relationship with your caregiver. You need to be able to ask them all the questions you want and feel confident that they are giving you frank answers (and not just those that suit their agenda). You also need to be able have honest conversations around your own circumstances – for example how much chocolate you eat. If you can’t do either of these things, you need to find someone else.
Some questions to ask might include;
- What is your philosophy on VBACs?
- Under what conditions would you not support a VBAC?
- What is your VBAC rate? How many VBACs have you attended?
- What is your philosophy on VBACs with a suspected big baby?
- What happens if I get to my estimated due date and my baby hasn’t arrived?
Make sure you have discussions around of whether your caregiver recommends certain procedures such as having a cannula inserted or an early epidural (just in case). If they are suggesting procedures such as this it may indicate that they are not truly supportive of VBACs.
2. Know the risks
Yes, there are risks associated with having a VBAC, but there are also risks with having a c-section. Do your research, talk to your caregiver and use the B.R.A.I.N technique to make informed educated decisions.
B- What are the benefits?
R- What are the risks
A – What are the alternatives?
I – What is your instinct telling you?
N- What happens if you do nothing?
One of the biggest risks cited with a VBAC is uterine rupture. The risk of uterine rupture in women attempting a vaginal birth after having a caesarean in the first birth is higher than those having subsequent c-sections. It is important to note that this risk is still less than 1%.
Ensure your partner is also aware of the risks involved in both VBAC and caesarean births. This study suggests that education that improves the father’s perception of the risks might increase the chance that the mother will attempt a VBAC.
3. Find out why your previous birth/s was a c-section
If you are not sure of the exact reason your previous birth was a c-section, talk to those involved and access your medical records. This will help in deciding whether a VBAC may be possible for subsequent births.
It is also useful to help you debrief your previous births, if necessary. This can be particularly helpful if your c-section wasn’t planned.
4. Know all of your care options.
Whether you choose to use public or private care; have a hospital or home birth (or birth centre if you have one that supports VBACs); have midwife-led, obstetrician-led or shared care, you should know all of your options first. By knowing your options first, you can then make informed decisions regarding the best model of care for you.
By choosing the best model of care for you, you may increase your chance of having a successful VBAC. Especially so if you are are choosing a VBAC friendly option or moving away from options and caregivers that are more caesarean-friendly.
5. Write your birth preferences
Not only write them out but go over them with your caregiver. Make sure you are all on the same page with regards to your VBAC.
Yes, things can happen and we can’t control how our birth goes, and that’s why I advocate for preferences, and not a plan. We can, however, make our preferences known and work together with our caregiver to have these met (in the absence of medical contraindications).
It may also be that you don’t have the same caregiver throughout your pregnancy and birth. If this is the case, having written preferences allows for all staff to quickly get across your birth preferences.
Ensure your partner understands your preferences and can act as your advocate, particularly during your labour and birth. My partner became my biggest advocate during my two VBACs. He was the one making my preferences known and asking questions on my behalf. That way I could concentrate on the most important thing – having a baby!
More over, have belief in your birth preferences. You need to believe in yourself and your ability to have a VBAC.
6. Have the right support
Ensure that your birth partner understands and is on-board with your choices.
Good communication is key here. Perhaps your partner has reservations about you having a VBAC, maybe they are unsure how to support you during labour. Perhaps they assume the safest option is another caesarean. Talk through these things together. Attend independant childbirth classes together and attend antenatal appointments together, if possible.
It is one thing for your partner to be supportive of during your prenatal visits with your caregiver but will they still advocate for you in the middle of your labour? If you feel you need extra support, perhaps consider hiring a doula – one who shares the same values as you.
7. Attend independant childbirth education classes
‘If you don’t know your options, you don’t have any’
Diane Korte
Attending a reputable evidence-based childbirth education class will let you and your partner know what your options may be during pregnancy, labour and birth. By knowing your options, you are able to research, ask questions and have conversations with your partner and your caregiver to make informed, educated decisions.
It is important to have these conversations during pregnancy. That way, if anything comes up – especially during labour – you have an idea of what you may want to do, or at least have a framework to ask questions. By knowing your options, it helps you to be an active participant in your birth and not just a passenger on the journey.
The best classes will also give you and your birth partner a range of tools and techniques to help you during your labour and approach your birth with confidence. One study concluded antenatal classes that included complementary therapies, such as breathing techniques, relaxation and acupressure reduced epidural use and the risk of caesarean.
Classes should also help you reduce the fear that may be associated with birth – especially as it is often the unknown that we fear. My Hypnobirthing Australia Positive Birth classes give you all the tools and techniques to approach your birth with knowledge and confidence.
8. Watch birth videos and read birth stories that inspire you
Too often all we hear or see about birth are horror stories. Or an emergency requiring a high level of medical intervention. If this is all that we see or hear, then this is what we are likely to believe, whether we recognise it or not. Surround yourself with positive birth stories. Join VBAC support groups and read books that speak about pregnancy and birth in a positive – yet realistic- light.
Here are some of my suggestions;
This is my VBAC story
VBAC birth stories from Hypnobirthing Australia
9. Educate yourself
In addition to childbirth education classes, I suggest doing further reading and research around not only VBAC but birth in general. There are some great books and websites around to help you make informed decisions around birth. Many of them also show you just how powerful our bodies are – particularly when it comes to birthing our baby.
Again, some suggestions for you;
Sara Wickham ‘What’s Right For Me?’ This is such a great book going through what decisions you may face during pregnancy and how to make informed decisions that are right for you.
Ina May Gaskin – ‘Ina May’s Guide to Childbirth’
Grantly Dick Read – ‘Childbirth without fear’
ICAN – International Cesarean Awareness Network
10. Believe in yourself
This was probably the biggest game changer for me.
I had such self-doubt after my first birth where I had spontaneous labour which ended in a caesarean. I needed to let go of the self-doubt and fear I had surrounding birth. I had to re-program my brain to truly believe that my body was indeed powerful.
This took a fair bit of work – I spent a lot of time on birth affirmations and visualisations. More importantly, I recognised that it was my pregnancy, my birth and my baby and I had the right to make informed decisions regarding these things. This gave the confidence to ask questions, have proper conversations around different options and then make my own decisions.
I just had to believe in me!
Kate Vivian is a self-professed pregnancy and birth geek who is finally learning to embrace the chaos of having 3 kids. It was the birth and ‘bringing baby home’ experience of her first baby, and the overwhelming guilt that went with it, that led her to start Bright Mums – and create a world where Mums matter.
A Certified Hypnobirthing Australia Practitioner, childbirth educator and postpartum doula, Kate works with Mums-to-be not only supporting them through pregnancy, and birth but also teaching them to honour themselves at a time when the world is telling them their baby is the most important thing.
With almost 2 decades in adult education, Kate has the ability to create a safe space, a non-judgey space. A place where Mums can relax and feel supported regardless of what their journey looks like.
A keen traveller in a former (pre-kids) life, Kate dreams of the day her kids are big enough to take skiing and they can completely show her up while she is busy falling down mountains.
Want to know more? Click to here to find out more about Kate