How to Plan, Have, and Rock Your VBAC
Didn’t think you could have a successful VBAC or vaginal birth after Cesarean? Keep reading to discover what’s possible for you.
If you’re a momma who has previously undergone a C-section birth, I want you to know that having a vaginal birth in the future is totally possible.
VBACs are more attainable and beneficial than you might think. While C-sections are absolutely appropriate in life-threatening situations, they do not (and, should not) have to become a routine.
There are some practical steps you can take to not only determine if VBAC is right for you, but also prepare for having a deeply positive vaginal birth experience that will have you feeling empowered in your own capabilities.
Hopefully, these practical tips give you the confidence to know that you too can have a wonderful VBAC.
How to Research When Planning a Successful VBAC
Why do You Want Your VBAC?
The first step, in any major decision, really, is to know and believe that you have a voice.
Take full responsibility for your pregnancy, and do not surrender it to others, especially to your health care provider and the hospital.
Don’t simply assume that a doctor or midwife knows what’s best for you. Only you can truly understand what you’re feeling and experiencing physically, emotionally, and spiritually.
Don’t skip this first step or even take it lightly. It’s the most important step and sets up the foundation for the rest of your VBAC journey.
So, how do you get started with your foundation? Ask yourself this simple (albeit, difficult) question, “What do I want, and why?”
This is your opportunity to educate and empower yourself.
The more you know, the more likely you are to make better decisions. The more you know about yourself, the more likely you are to make more harmonious decisions that coincide with who you are.
This is feeding your soul, your deepest truth!
Know the Real Pros and Cons of Both a VBAC and a Cesarean Section
The next step includes understanding the nature of both VBACs and C-section birth. Then, you should probably tackle their pros and cons.
A Cesarean section (or C-section) is a major abdominal operation in which the baby is delivered through a surgical incision in the mother’s abdomen and uterus while under anesthesia.
This is usually an epidural or spinal anesthesia, inserted via a needle and catheter into the space around your spinal cord, which attempts to numb you from the waist down. General anesthesia is medication given so you are completely out. Depending on the situation, you may be given such a high dose, you will need a tube inserted into your airway so that a machine can breath for you. It is is more often the method of choice in severe emergencies where time is of the essence.
While being a life-saving surgery, C-sections are meant to only be performed in cases of serious complications and emergency in which the mother and/or baby are in real danger.
Another advantage of repeat cesarean is that, if planned, it can take less of an emotional toll for some moms. A mom, for example, who’s very anxious about a past emergency or planned vaginal birth that did not work out, is extremely afraid of vaginal birth, or has a history of unresolved sexual abuse trauma can feel reassured by her perceived sense of predictability and controlled surgical procedure in having a C-section.
The trouble with C-sections is that they are, nowadays, becoming more and more commonplace, putting moms and babies at a significantly increased risk of poor physical and psychological health.
In fact, the USA is ranked among the highest in the world for cesarean sections at 30% and counting. In my area, some hospitals have a 40-50% C-section rate.
This is a lot considering the fact that C-sections are supposed to be rare! It is unacceptable, malpractice, and explains our country’s horrid outcome stats. We rank near the bottom as compared to other developed countries in terms of mothers and babies becoming seriously ill or dying during or soon after childbirth.
We have soaring rates of birth trauma for both mother and baby, which significantly impacts their lives in the short and long term. My cesarean section rate is 5% which is comparable to most homebirth midwives, within the ideal range of percentage rates of performed Cesareans.
Here’s the scary long list of risks that come with having a cesarean section: injuries to other organs during surgery, bowel obstruction, infection, hemorrhaging, having an emergency hysterectomy, blood clots, stroke, and maternal death.
You also run the risk of having pain if the anesthetic doesn’t work completely.
There’s prolonged, more intense pain postpartum, a longer hospital stay, readmission to the hospital, an upsetting or emotionally traumatic birth experience, less early contact and connection with the baby, depression and mental health problems, low self-esteem, relationship issues, difficulty functioning and doing usual daily activities postpartum, chronic pelvic pain from scar tissue, problems with and discontinuing breastfeeding - along with the associated risks to mom and baby of not breastfeeding.
There can be accidental cuts to the baby during the surgery, lung and breathing problems, including asthma for the baby. There could be future reproductive health problems like reduced fertility, infertility, negative feelings about childbirth and having another baby, higher risk for life-threatening complications in future pregnancies, including placenta previa, accreta or abruption, ectopic pregnancy, mild separation to frank rupture of previous uterine scar, fetal malformation or central nervous system injury, stillbirth and newborn death. The baby could also be born prematurely or with a low birth weight.
VBAC, or vaginal birth after Cesarean, on the other hand, is exactly what it sounds like. Having had a C-section in the past doesn’t mean that you’re required to have C-sections for every subsequent birth.
In fact, when all is well and healthy, the benefits of having a VBAC are quite numerous and significant. The risks of repeat cesarean birth far outweigh the risks of VBAC.
First of all, avoiding major surgery is a crucial health benefit in and of itself - it avoids all of the above-mentioned risks of cesarean. Almost all other surgeries that were once major are now done laparoscopically with much smaller incisions to minimize risk.
Also, you significantly increase the chances of having a more positive birth and postpartum experience. Healing and recovery are much easier, and there are fewer chances of enduring postpartum depression and emotional birth trauma. There are shorter hospital stays, fewer readmissions, and the increased opportunity for earlier and more prolonged contact and bonding with your baby. There’s more likely to be success with breastfeeding, especially after a natural birth.
But, as with everything, there are risks with a VBAC. The main risk of concern is the partial or complete separation of your previous surgery’s scar that may or may not have any impact on you or your baby. The numbers are about 2 in every 1,000 VBACs, but this risk doesn’t have any effect on the health of the mother or baby, as it refers to partial or slight disruption of the prior incision without clinical significance.
A significant uterine rupture which would, in this case, be a life-threatening risk is actually even less likely to happen. These numbers are less than 1%.
There are also risks of some vaginal pain or tearing that takes a few weeks or few months to fully heal (a much shorter time than it takes for for the cesarean wound to heal), a slight increase in urinary and rarely anal incontinence, and birth injury to baby from the uncommon complication of shoulder dystocia.
As a midwife, I fully support a momma’s choice to have a VBAC. But, there are many important reasons why you could find yourself in a condition to have either a scheduled or an unplanned repeat C-section birth.
For example, your baby may be in a transverse position (lying in the uterus across your abdomen), or you may be nearing your term and have placenta previa - especially if the placenta is completely or partially covering your cervix. Read up on these situations to further understand what truly are indications for undergoing a C-section.
Once you’ve learned and weighed the pros and cons of both a VBAC and a C-section, complement your research with the knowledge and experience of your trusted doctor and/or midwife.
Find the Right Health Provider for You
After you’ve gathered your information and have made a few decisions as to what you’d like to do, it’s time to find the provider that will work with you toward your vision of a successful vaginal birth.
Ask various providers their VBAC rates as compared to their repeat Cesarean rates. This is important—look for, of course, the providers with whom their VBAC rates are higher than the repeat C-sections. They should not have a VBAC rate lower than 70-80%, if you want to maximize your chances of vaginal birth.
If you’re planning on having the birth of your baby in a hospital, then you can equally research your local hospitals and get their VBAC rates as well, gauging in the same way.
It is worth mentioning that a natural birth gives you your highest chances of having a successful vaginal birth after Cesarean. Just know that while many wonderful obstetricians have high rates of VBAC, they are highly skilled surgeons who specialize in higher risk complications.
They can look for them, diagnose and treat them medically and/or surgically. Going to a surgeon and having a natural vaginal birth may be extremely challenging in many cases.
Most midwives whether they practice in or outside of hospitals have some of the best VBAC to repeat C-section ratios. You might have to dig a little deeper in your research, however, to find midwives who practice in-hospital. Sometimes, their hands are tied by limiting obstetrical or hospital policies and malpractice insurance companies. But they still tend to have higher VBAC rates than most OB/GYNs.
Related article: Can All Women Have a Homebirth?
Prepare to Rock Your VBAC
How to Deal with Emotional Trauma From Previous Cesarean?
Now, that you’ve done your research and you’ve decided that you’re going to have a VBAC, it’s time to prepare yourself, mind, body, and spirit.
This is particularly important if you’ve previously had a traumatic experience with a C-section birth.
There are actually therapists whose specialty is to help women overcome the trauma of the last upsetting unplanned cesarean birth.
That is what I do for the women in my local practice and online via Skype or Zoom for the global community. I work with you not only to heal, but also help you to approach your next childbirth experience with positivity, confidence and joy. Also, that is a main focus of my comprehensive online course, Love Your Birth, in addition to helping you achieve optimal health of the mind, the heart, the body, and spirit along the entire journey from pregnancy to birth and mamahood.
I have personally found the most effective form of trauma healing to be: Clarity Breathwork - it is so much more powerful than most any other modality, including medication and talk therapy alone. I tried just about anything, and nothing worked. I had such profound healing using Clarity Breathwork, I became a practitioner who provides private and group Clarity Breathwork sessions and assists at larger workshops, to help others experience the huge healing and transformation I did and witnessed in so many others. Additional incredibly effective methods of trauma healing include Somatic Experience and Organic Intelligence.
My goal is to create for you the springboard you need to heal fully, then create for yourself the deeply connected, positive, and empowering experience that childbirth truly can be.
Your VBAC Community
Another very important component to preparing for your VBAC is to gather around you a community of women who are on the same wavelength as you in terms of mindset and experience.
It is actually easier than you think to find women who’ve gone through what you’re going through, given the high rates of cesarean birth in our country.
Do a bit of research on ICAN, a nonprofit organization whose goal it is to educate and support women through their Cesarean recovery. They also seek to support families in their communities advocating for vaginal births after Cesareans.
This is a time to work closely with your midwife or obstetrician on bringing to life the successful birth you’ve envisioned for yourself.
Make your needs and goals very clear (your midwife or I can even help you to hone in on what those needs and goals might be), so that all you have to focus on is delivering your baby when the time comes.
Surround Yourself with Positivity and Joy
Lastly, be on the lookout for positive VBAC stories of healing, beauty, and empowerment to encourage you. We always seem to envision these horrific and traumatic scenes when it comes to birth.
Fill your mind with positive birth stories, and what’s possible for you instead of what you fear might happen.
I have collected my favorite resources for mamas in a free Ebook. It contains 154 of the best supplies, books and movies I use personally and professionally with my clients, family, and friends. Even diving into a fraction of this list will have you feeling empowered and prepared for conception, pregnancy, postpartum and parenting!
Draw, journal, meditate, visualize, play sensual music and let yourself freestyle dance to it—these things help you to heighten and easily tap into the intuitive, feminine self. This is your heart and gut, your truth, your wisdom, the part of you that knows what you most deeply desire and the part of you that knows exactly how to give birth.
With easier access to this huge part of your being, you will more easily determine what it is that you want and need. This creates more confidence and assuredness in the decisions that you make, no matter what the rest of the world might be telling you.
Now that you know where to begin, take responsibility for your pregnancy and childbirth. This is the most empowering thing you can do for you and your baby. It is also the healthiest, and will bring you a deep sense of inner peace and joy.
You’ll find that there are actually many resources and communities that can help you to have the kind of birth that you envision for yourself.
Know what you want and why you want it. Find healthcare providers as well as other women who support you in your decisions and who can help you on your journey. Hire a doula and learn why this is so important especially if you are planning a VBAC and you do not have that kind of calm mothering support for the big day.
A woman’s childbirth is her own and she should have the freedom to experience the full power of what she is capable of.
A glowing vaginal birth after Cesarean is possible for every momma.
Your many questions may be more common than you think! Subscribe to my monthly Ask the Midwife Newsletter where I answer common questions in written or video format.
I have a holistic approach to life, including healing after pregnancy and birthing. Nothing replaces abdominal toning and exercise for restoring muscle strength and tone - which I encourage for all mamas as soon as they feel up to it postpartum. Nothing replaces touch, slow deep abdominal breathing, and a 'love your postpartum body' perspective that I promote. But I have found many mamas simply feel comforted by this support garment, especially early postpartum and temporarily as needed....to be used without forfeiting abdominal toning and strengthening exercise, breathing well and touch. I have found Bellefit supportive garments to help like they use belly binding around the world such as in Indonesia. They do aid in early postpartum healing and provide support many mamas feel comforted by. I deal with human beings and the reality is many postpartum mom's struggle with body image, feel frustrated that getting back to themselves takes longer than expected. Being into holistic health and healing includes being sensitive to real human struggles - the mind, body, heart and soul of each person and their unique situation. Having helped countless women with these issues after having a baby as a midwife, I have found many still love that binding and feel better with this support, and ability to fit into their pre-pregnancy clothes comfortably and sooner than they would if they went through a C-section or natural childbirth recovery without it - especially when they have to dress up and fit into a certain favorite outfit for a special occasion or wedding not long after having a baby. For more info on the Bellefit girdle, check out my blog about it here. Have a Great Postpartum Recovery (with a little help from Bellefit)! I am thrilled to announce that you get a $20 Off with code: ANNE20 at checkout - if you purchase here.
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Regardless if you are planning a birth at home, a hospital, a birth center or need a cesarean section, or if you are taking another childbirth education class…
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Understand the sensations of your body and connect your intuition with how your body is communicating and leading you towards what to do during labor
Tap into your inner calm to deeply relax yourself, letting go of busy, stressful and fearful thoughts on demand for the health of baby
Speak your truth from your heart in a way that deepens your relationships, sets clear boundaries, and has people listen to you and support you before, during and after pregnancy
Trust yourself, connect with your body wisdom and communicate with baby in belly
Connect with natural time and sync your body and mind up with your unique biological clock for ease from pregnancy to postpartum
Reprogram negative patterns, stories, and beliefs that undermine your confidence, strength and self trust so you can rock your birth
Physicians and midwives around the world recommend my teachings to their pregnant clients and many Doulas across the country learn the secrets of blissful birthing from me to supplement their Doula Training & Certification process!
To learn more, visit: LOVE YOUR BIRTH Online Childbirth Course!
It is based on my years of experience, as a midwife and yoga teacher, helping thousands of women tap into their calm and live and birth from a place of grounded relaxation and joy.
It’s wonderful alone, a great refresher or adjunct to any other course!
“Forget your childbirth class, and take steps to your most empowering experience. If you are thinking about conception, pregnant, or love someone who is, take it from me that her wisdom is life-changing.
Yours in the truth
— Kelly Brogan, MD