This is a subject that I get asked about frequently. There are many mamas out there, who, for a variety of reasons, are looking into their options concerning a pregnancy and birth after a previous cesarean section. The first question usually centers around whether or not I will take on a VBAC client…so let’s start with that, and then look into some ways to make achieving a VBAC a reality.
When it comes to considering a VBAC mom as a possible homebirth candidate, it’s helpful to have an idea of why the c-section was performed in the first place. You have the legal right to your medical records, so ask for them! Sometimes they don’t shed light on the subject, but frequently you’ll have a clue as to what actually happened, which may not have been clearly explained to you at the time. Was it due to a surprise breech? Was baby’s head in a bad position (such as posterior or asynclitic)? Did your water break, putting you on the clock, and labor didn’t start in time? Was it a case of “failure to progress”, where labor didn’t proceed, or you got “stuck” and then were tired? Or perhaps baby’s heart tones dropped, making it a fast emergency? Whatever the case, understanding what all took place helps to paint the picture, and give me an idea of what hurdles you might face in this next birth. And it might help you in knowing what to prepare for-for instance, if your c-section was due to a bad position of the baby, then we’ll be much more proactive at integrating exercises to help with optimal positioning. There are very few situations which risk a mom out of the option of a homebirth, but getting a clear picture of what happened before helps us to determine your eligibility. And perhaps you would feel more comfortable pursuing your first VBAC in the hospital setting…either way, these next suggestions can be beneficial and productive in helping you prepare for your birth!
I like to tell VBAC moms the same thing I tell first time mamas…preparing for birth is like preparing for a marathon. You don’t just decide to run a marathon today and achieve it tomorrow. It takes WORK to prepare your body for it! Most mamas planning a VBAC have not yet had a baby vaginally, so in that respect, we focus on preparation in the same way we do for a first birth. Not to make things sound negative, but it’s good to be prepared for the long haul-and prepare your body to be able to cope with it. Eating a healthy diet and consistent exercise both contribute to this. Regular walks, workouts, squats, etc. can all help to build up your stamina for labor and pushing. I’d also suggest seeing a chiropractor, especially during the last trimester, which can help to ensure good alignment of your pelvis and good positioning for baby. I highly recommend checking into Gail Tully’s website: spinningbabies.com, as well as following her suggestions in her DVD entitled “Daily Essentials”.
Besides getting your body ready, you need to prepare mentally and emotionally…and this includes educating yourself about the particular risks and concerns that affect VBAC mothers and babies, as well as talking with others who have gone through similar experiences. This support can be invaluable in helping you to work through your past disappointments and set realistic expectations. Some excellent resources that I encourage all VBAC moms to consider are:
- VBAC Facts by Jen Kamel (She teaches an amazing class based on research surrounding VBAC safety. You can attend a live seminar, or take a webinar at your convenience.)
- Read books on the subject:
C-Section by Mark Zawkowski, MD, Natural Childbirth After Cesarean: A Practical Guide by Karis Crawford
- Look into the “International Cesarean Awareness Network” (ICAN) and glean from their website…there are chapters throughout the US that meet regularly, where you can talk with other moms and learn from their experiences.
- Join a facebook support group for VBAC mamas, and ask questions and hear about how other mamas achieve their VBAC.
- Read evidencebasedbirth.com, and consider taking the class they offer online regarding “Failure to Progress”.
This information is hopefully enough to get you started with resources…blessings as you pursue your quest for a beautiful, natural and safe birth!