Trying for a VBAC: Preparing

Our second baby is due at the end of April, and we are hoping and trying for a VBAC (vaginal birth after cesarean section).  This is one of a series of posts about Trying for a VBAC.  There are many reasons why we are heading this direction and I hope to share them with y’all over the next few months.  You can read the Bear’s full birth story here to see what our first child’s birth entailed.  If you read that story you will get a little glimpse into why we are now on this journey to VBAC and a normal birth.  This process has been all consuming for me and this blog is my space to express the way I feel about the whole situation.  Many folks have strong opinions about VBAC vs. repeat cesarean, and I hope that whatever your opinion might be you will respect mine.  VBAC is not the right decision for every c-mama, and it doesn’t always work out no matter how you prepare.  Our hope and prayer is that we can have the best birth possible for our little girl. *UPDATE* We had a successful VBAC with our daughter and you can read her full birth story here.

This week I’m sharing what we’ve done to prepare so far for a VBAC.  I’m not an expert by any means, but I’d love for others who are on this path to one example of how to prepare.

1) Do your research.  Read, read, and read some more.  Talk to your OB.  Talk to another OB.  Talk to the ladies in your local ICAN chapter or online.  Talk to your partner and get on the same page.  Watch The Business of Being Born together. If you come to the conclusion that you want to try for a VBAC, go for it!  The American College of Obstetrics and Gynecology has come out recently in favor of most c-section moms having a trial of labor after cesarean.  If your doctor says anything to the contrary they are going against their own governing body.  That being said, there is a small percentage of women who do not qualify for VBAC.  If you have found a doctor who is known for supporting trial of labor after cesarean (TOLAC) and she says you are not a candidate for a particular reason, that is important.

2) Find a supportive OB or Midwife.  My former OB is awesome and I love her as a person, but she just doesn’t do VBACs.  She told me that I was a good candidate but that she just didn’t do them.  I started looking for a new doctor soon after that appointment, long before I was even pregnant again.  My first choice was a midwife run birth center, but the one I like only does 2VBACs, not first time VBACs.  They recommended my new OB, as did my ICAN chapter.  The first time I met her I knew she was a great fit.  She loves natural labor and backs up the birth center I researched.  She read through my records and told me I should have at least an 80% chance of successful VBAC and she would be happy to support my birth choices.  Such a relief.  She doesn’t induce without medical reason, and won’t talk about induction for a VBAC mama until I hit almost 42 weeks.  Yay!  She even recommended I hire a doula, and gave me several cards of doulas she likes to work with.  This is not normal for OBs, but is sure does rock.

3) Hire a Doula.  A doula is a birth assistant.  They don’t take the place of your partner or your OB/midwife, but they can help coach you through labor and achieve your birthing goals.  Rates of VBAC drastically increase when a doula is part of a birth team.  Doulas cost anywhere from $250-over $1000, depending on the experience of the doula and the rates in your area.   I interviewed several doulas until I found the right one.  She will meet with us to create our birth plan and also work with us to teach us natural child birth techniques.

4) Take a Natural Child Birth Class. We took the natural childbirth class offered by our former hospital, and it was a joke.  This time I’ve taken some classes online, read several books, listened to Hypnobabies cds, and will have a private refresher course with our doula.  There are Lamaze, Bradley, Hypnobabies and Hypnobirthing classes in most metro areas.  If you live far outside a city, get yourself on Amazon and order some books.

5) Practice Relaxation Techniques and Positioning Exercises.  If you want to use a certain technique for labor, practice it now.  I’ve been working on my breathing, relaxing tense muscles, and repeating my positive birth affirmations (cheesy, I know, but people swear by them).  Bear was in a poor birthing position, so I’ve been practicing the exercises from Spinning Babies and using my birth ball instead of slumping on the couch. I prepared a DIY heating pad using rice and a sock, and scented with lavender essential oil for calming and relaxation.

6) Create a Birth Plan and Share It with Your Team.  I’ve worked on mine and have it narrowed down to what I want and don’t want for the most part.  I’ll flesh it out with Jed and my doula next week, then discuss it with my OB.  Last time I had a birth plan but I’m pretty sure none of the doctors or nurses ever looked at it.  I was so wishy-washy about what I wanted that I ended up with none of it.  This time around it may still go off course, but at least I will have made informed choices about my preferences.  I think this step would be especially important if your mom or other family members will be in the room.  They may get totally thrown off by delayed cord clamping or the squatting bar. You can read our complete birth plan here.

7) Make Sure Your Birth Location Lines Up with Your Plan.  If you plan to birth at home, this one is a little easier.  Most birthing centers and hospitals have policies in place that aren’t flexible.  You need to know what those are before you are there in labor.  Can you move around during labor?  Will you have access to a shower or birth tub?  Are birth balls provided? Can you eat or drink? Can you wear your own clothes? Can your baby stay with you for several hours after birth?  Whatever it is that is important to you, make sure you have peace of mind about it long before labor starts.  We were so relieved after our hospital tour because so many of the things we thought we might have to fight for are normal practice there.  Yay!

8) Trust Your Body and Your Instincts.  Your body was MADE by your Creator to do this.  You were given all the instincts you need to birth without assistance.  Technology is great, but it can also convince us that we are helpless without it.  You are not helpless.  You are an amazing woman who is carrying a life inside her and trying to do what is best for that baby and your own body.  Trust that.

From Growing Slower

Looking for resources and information about VBAC and cesarean recovery?  Try these:

How did you prepare for birth (of any kind)?