Birth Story: When Things Did Not Go As Planned

Usually births do not go as planned, and the unexpected happens. I encourage pregnant mamas to actually expect the unexpected, make birth references known and fully prepare for the birth they want, choose their provider and birth team wisely, then be very present, flexible and surrender to and actually embrace whatever happens each moment as meant to be because it did happen (a higher level would be to know it happened for your benefit - but that is a spiritual perspective); I do what I can to help them know that they did their absolute best - there is no judgement, no place for shame and blame, while acknowledging their feelings and telling them it will take time and support to process. Most of the time the unexpected is innocuous and could simply mean you birthed in your bed when you wanted a waterbirth, you told your mom to take your kids out when you previously wanted them there, or you wanted your partner to help catch your baby when he ended up holding you in a standing squat and you told him not to move as baby was crowning. Sometimes it could mean medical intervention was needed in any setting; sometimes, less commonly, it means transfer to the hospital from a freestanding birth center or home, when being there is no longer safe or appropriate because of complications, and sometimes that could even mean surgical birth. This mama @holisticnutritionandme loved her birth and was extremely grateful for her care and the outcome, because she had excellent, personalized, compassionate, sensitive and respectful care and because of her attitude and mindset. She know she did her absolute best and interventions were needed. She writes her beautiful birth story in spite of the challenges. #BirthWithoutFear  

"My baby girl, Liliana Dylan, was born on July 5th at 41+2 weeks pregnant, weighing 7lbs 13oz and 21" long. I was in active labour at home for 12+ hours with my midwives, doula, husband (Daniel) and mom. I got through contractions by alternating between using a birth pool, my exercise ball, walking and moving around. Staying still intensified the pain for me. My#midwife broke my water and I reached 6cm dilation. For hours my contractions continued to get longer and stronger but I wasn't dilating further than 6cm. My baby was posterior which made it harder for her to drop and gave me excruciating back pain. My #midwives recommended we transfer to the hospital for an epidural and pitocin due to lack of progression. So Daniel and mom drove me to the hospital while I was on all 4s in the back seat trying to make it through my contractions. Another 19 hours of labour at the hospital and 2 hours of pushing and my baby finally arrived! Although I didn't get the natural home birth I had planned for, I'm so grateful for the way everything turned out. Birth plans are great to have, but ultimately you have to roll with whatever you're served with when the time comes. Getting my baby out safely was always my one and only priority. My midwives and #doula were warriors and cared for me from start to finish. Daniel and mom were my rocks and did everything to make me as comfortable as they could. I couldn't have done it without every member of my birth team. Liliana has been doing great, she nurses like a champion and is the light of my life." What an inspiring #BirthStory and outlook to learn from @holisticnutritionandme. It is also an ideal model of supportive home to hospital transfer for the compassionate use of epidural and needed interventions that enabled mama to have a deeply positive birth experience despite the challenges, despite her #homebirth not proceeding as planned, despite hospital care that became necessary.  All#BirthIsBeautiful and #WomenAreAmazing.

 I compiled a list of my favorite reads on the journey from birth to birth and postpartum, that also include inspirational books about being in the now and embracing what is - all with links on where to get them. Below is one for LIFE, as most of it does not go as planned and we all inevitably face unexpected challenges. I hope this helps!! 

The benefits of cultivating a regular yoga and simple meditation or spiritual practice are huge, when it comes to staying present, calming yourself, and embracing all of life - even when things happen that we do not want. To create your own home sanctuary, a place where you can practice, here are the supplies I use and recommend. Yogaglo.com has wonderful online classes and here are some great prenatal and postnatal yoga classes on my favorite list of movies - when you can not get to a local class.

Enjoy radio shows from some of the world’s greatest teachers in spirituality, health, and wellness. Begin your journey of personal growth and healing now by listening to HayHouseRadio.com – radio for your soul.

Educate and inspire yourself, ready your body, ready your mind, ready your heart with my list of TOP BOOKS of every category you can imagine listed  - with links on where to get them as books, listen on audio, or read them on kindle. The better prepared we are for a situation, the better the outcome will be. I feel passionate about empowering and educating women to get the most out of their womanhood, pregnancy, birth, postpartum, breastfeeding, mama, yoga and life journeys!

Birth: Expect The Unexpected

When it comes to birth, oftentimes things don’t go as planned. Sometimes this means a woman never makes it to the birthing tub she prepared, filled up and dreamt about birthing in, because in the moment of giving birth, she found her groove and prefers to stay on the squatting stool or her labor progresses quickly, and she needs to push before the tub is filled with water. Sometimes this means certain family members or friends aren’t present for the birth like originally intended because for example a mama is not laboring well with her kids present, they want to leave, or her best friend is sick and could not come to help.

Other times, when things don’t go as planned, this means a woman might need medical or surgical intervention. A common example: a mama is experiencing a hard back labor at home or free standing birth center, her baby persists in the posterior position, she is not progressing for hours despite trying everything and is exhausted; she is transferred to the hospital for Pitocin to augment her labor and the compassionate use of an epidural. A less common example is baby is not tolerating the labor, and is showing signs of worsening distress in any birth setting, and a cesarean is needed to save baby’s life.

Photo by Mary Elliott O'Haire

Overall, we must surrender to the process of labor and birth and know that we are being guided and well cared for. To avoid needless suffering, we must embrace what comes our way that is not in our control, as what is meant to happen – because it is happening or did happen; and we can raise to the level of being grateful that we were given exactly what we needed for our benefit, what we each needed on our own journey as a soul temporarily living in a body, even if we do not understand the whys. I am not apologetic about my spiritual perspective and my firm belief that the infinite all powerful being, Spirit or G-d of our own understanding is pure goodness and love for each and everyone one of us.

I’d like to address a question I get asked frequently.

Art by Catie Atkinson @spiritysol

Why do I mention cesareans in my online posts?

Cesareans can be both planned and unplanned for serious complications or illness. In both cases, they are indeed a birth. They are a birth for baby, a birth for mom, a birth for dad, and a birth of a new family unit.

I want all women to feel lovingly supported and cared for however they birthed and that includes a cesarean.

Art by Catie Atkinson of @spiritysol.

I like to post information on what I refer to as a gentle cesarean. It’s still using a home birth model of care, with the principle of restoring humanity to maternity and newborn care – especially in the operating room. A gentle cesarean would include possibly pulling the curtain down, allowing the baby to birth itself gently through the incision, encouraging mom to receive her baby directly from the surgeon, hold her baby skin to skin, delayed cord clamping and early breastfeeding; it can also include allowing her partner, doula and anyone else she needs in the OR by her side.

I want to offer support to all women, and especially women who feel their birth did not go as planned. Although it’s rare for normal births to lead to complications or emergencies requiring life saving medical and surgical interventions, most births don’t go as initially planned.

Photo Credit: @albanydoula

What do I do when things don’t go as planned?

In general, healthy mamas with healthy pregnancies have healthy births. The stats on homebirth  and free standing birth center outcomes are excellent when there is a trained experienced midwife in attendance.

My transfer rate from home to hospital in labor is 7% and that is comparable to those of my colleagues. The vast majority of transfers are non-urgent. In most cases, it’s usually first time vaginal birthers whose labor stops progressing with exhaustion despite us trying every one of our "tricks" to remedy the situation. The need to call 911 and have an urgent ambulance transfer has been a handful of times in 20 years.

The midwife is of course there as a lifeguard - as rarely emergencies do occur. I bring the same emergency equipment and medications that any free-standing birth center has. Most of the time I don't use it and all is well. But when I need it, I have saved lives, as any seasoned midwife can say.

I saw much more catastrophic events when I was an OB nurse in the hospital. I have never lost a mother, but our country's maternal mortality rates are among the highest compared to most modernized countries, and this is largely from risky hospital interventions, which are not happening at home.

I have had to resuscitate significantly less babies at home – we have a screened healthy low risk population, are watching closely and WITH the mama in active labor. We do not intervene unless medically necessary and do not cut the umbilical cord until it stops pulsing or placenta is birthed, unless there is a problem or a request for lotus birth.

In 20 plus years of homebirth midwifery practice I have had to transfer 3 babies to the hospital who did not respond to resuscitation and needed intensive care due to unrelated complications, and this is significantly less than our country's high newborn morbidity and mortality rates.

Yes, we need to be prepared for and have to manage a rare shoulder dystocia (stuck shoulders) but it happens less as our mamas are laboring and birthing in positions that use gravity and maximize the diameter of the pelvis. Yes we have had to treat postpartum hemorrhage not responsive to natural remedies, with medication and IV fluids.

Not to offend animal lovers and vegans, but this moose provided a perfect home "IV pole" for a mama who needed intravenous fluids during her homebirth. Homebirth midwives must be creative.

I do not convince anyone to have a homebirth as it needs to be each mama's decision. I do provide information so she can make an informed one. She needs to birth where she feels safe or she won't labor well. 

It is one of my passions and areas of expertise to help mama's with these sorts of questions. I offer online consulting for mama's just like you, whether a one hour discussion or a package of consultations and email access from pregnancy through postpartum – which is great for mamas who want and need more personal attention and guidance to a holistic midwife as they have no access to one in their area.

To really best help a mama make a decision unique to her situation - I recommend a conversation. This is not something simply answered on social media, without discussion.

If you want to schedule an online consultation, please go to my website:  - I look forward to connecting more and answering your personal questions.

Photo by Megan Hancock Photography

Let Me Help You Create The Happiest Birth Experience Of Your Life...

Whether you're a first time or experienced momma,

Or a midwife, doula, or birth professional guiding mommas..

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…

You Really Can Create The Delivery Of Your Dreams.

And have a blissful birth wherever you are.

More Precious Than A Wedding...A Birth Should Be A Celebration!

Let me show you how to…

• 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 andcommunicate 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. 

Check out my pregnancy herbal tonic recipe and some of my favorite supplements I recommend below, to augment a wholesome healthy diet, so you can meet the increased needs of your body and your growing baby.

Do you need supplements? Here are some of my favorite I recommend to mamas in my practice.

Make your Red Raspberry Leaf and Nettle herbal infusion.....rich in needed nutrients and specifically nourishing for pregnancy, birth and postpartum. Place 1 oz of dried red raspberry leaf, 1 oz of dried nettle leaf in a quart-sized glass canning jar with strainer, fill it with boiling water, cover and steep for at least 2 -4 hours at room temperature. Strain and place in a covered pitcher. You can make it in larger quantities and store in the fridge. For taste, dilute with water or steep for less time (but no less than half an hour), add lemon or lime juice, mint leaves or a teaspoon of honey. Drink 1-4 cups daily hot or cold.

The Homebirth Midwifery Model of Care

           As a certified nurse-midwife with a full-scope group homebirth midwifery practice,  I am often asked what the homebirth midwifery model of care actually is.  I can speak for my philosophies, which are shared in general by many of my colleagues. We provide prenatal, labor, delivery, postpartum and newborn care, as well as breastfeeding support for healthy low risk families planning to give birth at home; we also provide gynecological and some primary care services to well women. We offer a unique, comprehensive model of maternity care that provides an exceptional level of holistic support and services to achieve optimum health. We believe there are several ingredients that contribute to a deeply positive and healthful pregnancy, homebirth and postpartum experience, in addition to our midwifery care. These include wholesome nutrition, whole food supplements and healthy joyful living, relevant health education with books, movies and childbirth classes, connection with a supportive community, regular exercise as well as an ongoing practice of yoga and meditation and other such methods to reduce inner stress and increase inner calm; we often draw on the expertise of additional professionals, such as doulas, childbirth educators, lactation consultants, acupuncturists, massage therapists, chiropractors or osteopaths, and mind/body medicine practitioners to name just a few. We also encourage each woman and partner to take advantage of the many classes and support groups we recommend  – from prenatal yoga, yoga for labor workshop, and postpartum mommy and me yoga classes, positive birth story pregnancy circles, community new mother blessing ceremonies, annual family reunion, postpartum mom circles, pregnancy retreats and a variety of other educational, supportive, and fun events, classes, and ways to connect with other likeminded people and build community – in an effort to bring back the needed village it takes to raise a new baby, and new parents.

           While we continue to expand in our academic, clinical and intuitive knowledge and wisdom, we are also growing in understanding, appreciation and awe of the sanctity of life and its many facets, transitions and phases. Most women are candidates for midwifery care and homebirth; over 92% of pregnant women in our practice will have a homebirth, and we maintain a cesarean section birth rate of less than 5%.  Ongoing individualized care determines the needs of each childbearing family. We have developed practice guidelines in conjunction with other homebirth midwives, evidence based research and the current midwifery literature; they reflect our philosophies and professional standards for practice, and they are reviewed and evaluated periodically as needed. We follow these practice guidelines to protect the health and safety of each individual in our care; and we try our absolute best, within our human capacity, to give our utmost attention and care with integrity, honesty, and heartfelt commitment and dedication.

Photo by Niki Torres

            We firmly believe that pregnancy and childbirth are normal natural bodily functions, profoundly spiritual, truly inspiring and an empowering rite of passage for women and their families. We also believe that childbearing families are best served by caregivers who promote and encourage a loving, respectful, supportive, family-centered environment, and maintain trust and calm confidence in the normalcy of the process, until proven otherwise. We have taken and will continue to take every reasonable precaution to ensure safety, comfort, and deep satisfaction, which are our top priorities. A safe and wonderfully positive birth experience requires the joint cooperative efforts of both the expectant family and health care providers, with a relationship based upon good open communication, mutual respect, and shared responsibility. Education of women and their families is an integral part of our services, so that women are able to assume this responsibility for health maintenance and effective utilization of health care. Opportunity is offered to our clients to participate in the planning and implementation of their care, as emphasis is placed on an outcome that satisfies emotional, educational, family and spiritual concerns beyond the obvious physical needs. 

           We feel that every individual has the right to safe and satisfying health care by the provider of their choice, given with respect for personal preferences and cultural variations. We believe that normal, healthy women have the right to birth at home if they choose to do so, and as licensed practitioners, feel an obligation to make birth as safe and satisfying as possible for them. For the overwhelming majority of families, the childbearing experience is one of health rather than illness, and there is a need for preventative and loving supportive care that is not only safe, but also sensitive, compassionate and empowering. We believe in enhancing the normal processes of the female reproductive cycle, pregnancy and birth through education, physical and emotional support, and involvement of significant others according to the choices of each expectant mom and those she chooses and wants to be involved.

            Our responsibilities include review of each woman’s complete health history, physical examination findings, and lab results to determine her eligibility for continued midwifery care and homebirth, as well as ongoing evaluation and guidance throughout pregnancy, labor, birth and postpartum with attention to signs of normalcy and/or signs of complications.  All findings are discussed openly; and there will be no routine procedures or interventions unless medically necessary and mutually agreed upon. While childbearing is a healthy, normal and natural process for the vast majority of women and babies, problems can infrequently occur, and need to be recognized and attended to. Although many complications can be prevented or handled simply within our practice, some do require consultation with a collaborative physician or transfer to medical and hospital care to increase the likelihood of a safe outcome.  It is our philosophy that decisions regarding each woman’s care are informed and collaborative, and ultimately hers to make; however, rare emergent situations may arise in which the professional judgment of the midwife and/ or consulting physician must be relied on exclusively for the safety of mother and baby. We are grateful for life saving hospital medical and surgical care when there are serious complications and illness; and it is my hope that the homebirth midwifery model of care can be applied as much as possible in all birth settings, including the operating room, if surgical birth is needed.            

           There is an overwhelming cultural belief in the United States that hospitals are the safest place to give birth, regardless of the extensive scientific data that planned homebirths with skilled midwives suggest otherwise. Numerous studies around the world have documented the safety of planned homebirth by trained professional midwives, with outcomes at least as good, if not better than those occurring in a hospital.  This is especially true of women who have delivered vaginally before. The total slight increase newborn mortality risk of home birth is estimated to be 10 per 10,000 babies born at home, and that 1 in 1000 babies born at home may be adversely effected by the extra transport time in reaching advanced care in the hospital; the absolute risk is small however. Despite spending the most money on obstetric care, the United States ranks among the lowest of industrialized countries around the world in neonatal mortality and morbidity, and ranks quite low in maternal mortality and morbidity as well. Countries that consistently demonstrate the best maternal and newborn outcomes have a large percentage of midwife led maternity care for healthy women experiencing normal pregnancies - which constitutes the vast majority - a higher percentage of homebirth midwifery care with supportive hospital/medical transfer arrangements when needed, while the obstetricians attend to the women with high risk complications and serious illnesses, which is how they are educated as surgeons and medical doctors.  When midwives and obstetricians work together as a team, both using their unique skills, knowledge, expertise and training, the outcomes for moms and babies are far superior. Midwives are trained in guarding the normalcy of pregnancy, birth and postpartum, not disturbing it when all is well, knowing when to compassionately observe with loving support, and when and how to use holistic remedies, or medical intervention only when necessary as a last resort; they are also educated in prevention, assessment and treatment of complications, which most times can be managed simply and naturally, but sometimes involves consultation or referral to an obstetrician. Although unforeseen events and emergencies can occur in any birth setting, some of which can be best handled in a high risk hospital, a low risk healthy woman entering the typical U.S. hospital expecting a normal vaginal birth is subjected to a routine barrage of procedures and interventions that dramatically increase the risk of complications and problems, with potentially longstanding physical and emotional ramifications for both mother and baby. 

            There are many other benefits of homebirth midwifery care, in addition to safety, which provides an alternative to the impersonal, fear based, law suit prevention oriented medical and hospital care that has become prevalent in our society. These benefits include but are not limited to the power of the human touch and presence, of being surrounded by supportive people of a family’s own choosing, security in birthing in a familiar and comfortable environment of home, feeling less inhibited in expressing unique responses to labor (such as making sounds, moving freely, adopting positions of comfort, being intimate with her partner, nursing a toddler, eating and drinking as needed and desired, expressing or practicing individual cultural, value and faith based rituals that enhance coping) -- all of which can lead to easier labors and births, not having to make a decision about when to go to the hospital during labor (going too early can slow progress and increase use of the cascade of risky interventions, while going too late can be intensely uncomfortable or even lead to a risky unplanned birth en route), being able to choose how and when to include children (who are making their own adjustments and are less challenged by a lengthy absence of their parents and excessive interruptions of family routines), enabling uninterrupted family boding and breastfeeding, huge cost savings for insurance companies and those without insurance, and increasing the likelihood of having a deeply empowering and profoundly positive, life changing pregnancy and birth experience. Getting holistic prenatal through postpartum care and birthing in one’s own home attended by a skilled midwife, is a refuge for those who want to protect the normalcy and sanctity of pregnancy and birth. But focusing on the normal does not mean that problems go unrecognized or unattended; rather they are viewed as imbalances that need to be righted, not expected or feared. 

           That being said, certain hazards do exist however, in all settings, whether childbirth occurs in or out of the hospital; and there are risks unique to each setting.  Some of these risks will never be eradicated no matter what our state of technology or medical advancement. The safety of home birth is well documented, but childbirth by its nature is a threshold passage for the mom, and the baby.  Some babies are born with defects and injuries despite all the technology, tests, and skills of the attendants.  In spite of the fact that that hospitalization of birth has failed to eliminate fetal or neonatal death, there is a cultural expectation that doctors and hospitals can guarantee a “perfect baby” every time. This is a pervasive myth. It is impossible for any provider to guarantee much of anything. Birth defects may or may not be detectable by prenatal testing. The practice of midwifery, nursing and medicine are not exact sciences and no assurances can be made regarding the results of examinations, diagnostic tests, treatments, procedures, or interventions. It is impossible for any provider to guarantee a normal healthy birth, mother or baby. Part of the wonder of the miracle of birth is the inherent lack of guarantees in life and birth, and the surrender to a power far bigger than ourselves. Part of life is death, and we often do not know why a person lives or dies. We do have a spiritual perspective, and believe that while we can do our best to do what is humanly possible, most of life, birth and death are ultimately not in our control; we do believe that everything that happens is meant to happen, because it did, and that it happened for our benefit, even if beyond our understanding, as we are souls temporarily residing in bodies, and know that G-d/Spirit of our own understanding is only good. Conception is the beginning of life, yet every life must end sometime.  Part of pregnancy is the excitement of new life and the fear of its loss. This is normal human reality and is in part why pregnancy deepens and matures a woman and man spiritually and emotionally.

Art by Spirit Y Sol

Photo by Megan Hancock Photography

           We try our hardest to give the best care that we possibly can, pray we make the right decisions and that our hands are blessed. But we are all only human.  Midwifery and obstetrics are such humbling professions. And I would choose no other. 

Let Me Help You Create The Happiest Birth Experience Of Your Life...

Whether you're a first time or experienced momma,

Or a midwife, doula, or birth professional guiding mommas..

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…

You Really Can Create The Delivery Of Your Dreams.

And have a blissful birth wherever you are.

More Precious Than A Wedding...A Birth Should Be A Celebration!

Let me show you how to…

• 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 andcommunicate 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. 

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VBAC - A Hot Topic

PHOTO CREDIT - THE UNISON PHOTO CNM

Correction - ACOG is the American College of Obstetricians and Gynecologists; ICAN is the International Cesarean Awareness Network

VIDEO IS NOW HOSTED ON MY LOVE YOUR BIRTH ONLINE COURSE

What is a VBAC?

A VBAC is a vaginal birth after cesarean.

If a woman has had a cesarean and wants to plan a vaginal birth for her next, it would be considered a VBAC.

Cesarean Surgery

Cesarean section is major abdominal surgery that involves serious potential risks for both a mother and her baby.

When medically necessary, it can be life-saving. I am very grateful for this. And it is still of course a birth to celebrate.

Unfortunately, cesareans have become so routine. I believe women are not given the opportunity to explore all their options and are not offered education and empowerment to have a vaginal delivery after a previous cesarean, other than a repeat cesarean birth, if that is their choice.

Statistically, the United States ranks among the highest in the world among cesarean rates. It’s approximately 30% and rising.

It’s as high as 40-50% in some areas near to where I live, and this is absolutely unacceptable.

Benefits of a VBAC

There are many benefits to a VBAC. These are physical, emotional, mental, and spiritual.

These are only a few important benefits on the long list:

• No risks from major abdominal surgery. This is huge.  Unfortunately, a cesarean can lead to trauma to the internal organs or reproductive tract, risk of hemorrhage, complications with scar tissue, long term post operative pain, wound infection, blood clots, stroke, and possible respiratory problems for the baby. High rates of cesarean section contribute to high rates ofmorbidity and mortality – and this is occurring in modern countries such as the US, which ranks among the bottom of them in terms of outcome stats.

• Easier postpartum healing and recovery.

• Baby receives needed bacteria for optimal health, from mother when passing through the vaginal birth canal.

• Breastfeeding may be more successful

• No potential harm to future fertility.

• Feeling more positive about the birth experience

• Increased sense of empowerment.

• More involvement of family and support people.

• Less risk of postpartum depression and emotional birth trauma.

Image by midwife @lindseymeehleis after mama's triumphant and healing VBAC.

Major Health Care Regulators and Advisory Organization Support VBACS

Most major health care regulators and advisory organizations like the World Health Organization encourage VBACS.

“The World Health Organization recommends that the caesarean section rate should not be higher than 10% to 15%. According to the Society of Obstetricians and Gynecologists of Canada (SOGC), vaginal delivery represents the safest route for the fetus and newborn in the first and subsequent pregnancies” – World Health Organization website, http://www.who.int/bulletin/volumes/85/10/06-039289/en/ This is generous, as when cesarean section was originally implemented, it was intended to serve 5% of the birthing population – those with serious complications who really needed surgical intervention.

Also encouraging of VBACS are the American College of Obstetricians and Gynecologists (ACOG) (link to their website: http://www.acog.org/ , The National Guideline Clearinghouse https://www.guideline.gov/  ,  Agency for Healthcare Research and Quality, and the American College of Nurse Midwives

No words can describe this amazing mama's feelings after her VBAC, captured by @skyla_walton

“The AAFP strongly recommends that clinicians inform women who have had a prior vaginal birth, either before or after a prior cesarean birth, that they have a high likelihood of VBAC. Unless there are specific contraindications to a vaginal birth, these women should be encouraged to plan a labor and VBAC and should be offered referral to clinicians and facilities capable of providing this service, if it is not available locally. (Quality of Evidence: High)” – Source: The National Guidelines Clearinghouse website https://www.guideline.gov/summaries/summary/49115/clinical-practice-guideline-planning-for-labor-and-vaginal-birth-after-cesarean?q=vbacs

In most cases, a VBAC is a safe option.

I share the opinion of many concerned with improving maternity care and reducing our rising rates of maternal and newborn death and serious health consequences from the interventions in childbirth, that a woman should not be forced to have a major surgery against her will, rather provided research and empowered to make her own decision, considering she is having a healthy pregnancy.

AAOG removed the previous unreasonable restriction requiring immediate availability of a surgical staff for an emergency cesarean, as most hospitals around the country, let alone free standing birth centers and home settings, do not meet this criteria. Most hospitals are not able to have a surgical staff at all times and cannot perform an emergency cesarean in under 30 minutes.

Despite this, research is showing that far too many obstetricians do not offer VBACS. They routinely recommend repeat cesareans because they may fear law suits, succumb to scheduling pressures, have restrictive hospital or malpractice insurance policies, and/or feel pressured to uphold certain standards among their colleagues who are not supportive of VBAC. The hands of a midwife whose collaborative obstetrician and hospital do not support VBAC can often be unnecessarily tied as well for these reasons. Most repeat cesareans are not actually medically necessary, and are commonly recommended due to various non-medical reasons. This is very concerning.

What also concerns me is that the risks of a VBAC are magnified in conversation with women, while the risks of a repeat cesarean are downplayed, so women may feel forced, afraid and powerless.

I want women to feel like they have a voice.

Some women who want to VBAC have limited options and local doctors in the area are only offering cesareans. Some feel they have no option other than having an unattended homebirth, or labor alone at home until the last minute without any monitoring, or not be truthful with their providers about their previous cesarean birth – all of which can increase the risks for her and her baby.

A trained and experienced midwife who is continuously with the woman in active labor, can detect concerning signs and symptoms before they can become a crisis, and she be transferred and treated in time to save her and her baby’s life and heath.  A midwife wears many hats, one of which is protecting the space so the natural process of birth can proceed with ease and grace, and another is a lifeguard – to know when and how to intervene to prevent problems or manage emergencies.  There are many wonderful obstetricians supportive of VBAC who have this training and style of practice as well; they are just harder to find.

What are the chances of having a successful VBAC and who is a good candidate for a VBAC?

The stats range that 60-80% of women, who have had previous cesareans, are candidates for a successful VBAC. In actuality, most healthy pregnant women carrying healthy babies are candidates.

The chances of a successful VBAC are higher if a woman is using a midwife, even higher in free standing birthing centers and home settings.

Above photos of rockstar mama's VBAC are by @karinariveraphotographer

Going to a hospital and working with an OB/GYN with high cesarean rates, will increase the likelihood that a woman will have another cesarean.

In some hospitals, there are a lot of restrictive procedures, like continuous electronic fetal monitoring, confining a laboring woman to lay in bed, not allowing her to eat or drink, routine IVs and time limits, which increase the risk of a cesarean.

What is the main risk of a VBAC?

The risk of separation of the prior uterine scar is approximately 2 in 1000 VBACs, but often it is a mild superficial dehiscence (slight separation of some layers of the surgical wound) that has no clinical significance and does not impact the health of mom or baby. The risk of severe life-threatening emergency from a partial or complete uterine rupture of all the scar layers is significantly lower – a highly unlikely occurrence, significantly less than 1 %.  The main risk is of a VBAC is this rare catastrophic rupture of the previous uterine incision. This rare total disruption of the uterine scar risks both the mother and her baby, and can lead to catastrophic outcomes. It cannot be ignored and must be monitored for appropriately; but it cannot be exaggerated or make the risk of repeat cesarean less alarming.

Although every decision has risks, a VBAC is a reasonable, appropriate and safe option. If a woman panning a VBAC decides to give birth at home, I highly recommend working with a well trained and experienced midwife and consider the distance to a hospital (30 minutes or less driving time is ideal).

There are risks and benefits to every kind of birth and in every setting. I provide women with evidence based information, encourage each family to dig deep and look at the pros and cons to having a VBAC in a hospital setting, free standing birthing center or home, vs a routine cesarean and have informed consent for her birth.

Are there benefits to a cesarean?

A planned cesarean is in a controlled environment, and some women find great comfort in that knowing. Perhaps a woman has had a previous traumatic, long labor the first time and they just don’t want to go through that experience again. Some women are very anxious about that and they just feel safer knowing they will have another cesarean.

I take that seriously, because she won’t labor well if she doesn’t feel safe.

Like I mentioned before, the serious risks for a VBAC can be often prevented, treated or transferred to surgical care in time, with a skilled midwife or obstetrician who is attending to the laboring women, aware and mindful of the symptoms that lead up to that.

Thankfully some hospitals are now at least allowing more time for baby to get the cord blood from the placenta, skin to skin bonding, and her partner or main support person in the operating room. Some hospitals and providers are performing “gentle cesareans” – cesareans that are family and woman centered, and try to provide the environment of a natural birth as much as possible. This is a wonderful attempt to restore humanity to birthing in the operating room.

Last tips:

If a woman knows she wants to have another baby, I would start with research and education. Ask yourself: “What do I want and why?”

A woman should get the support she needs. Most women who have had a prior cesarean have issues they need to discuss. There are therapists who specialize in this.  One of my dedications and areas of expertise is creating space so a mom can debrief, process and heal from her previous upsetting or traumatic birth experience, as well as plan for a better one next time around. Schedule a consult with me here. http://homesweethomebirth.com/chat-with-anne/.

I tell mamas to do what they can to educate and empower themselves, and know they do have a voice, build their circle of support, and include in their birth team advocates to speak for them when they are in the heat of labor. I tell them to prepare for a vaginal birth. The mind, body, heart and spirit can prepare for a vaginal birth - and a deeply positive, beautiful and empowering one. This is one of my passions and main focus of my online childbirth course.

PHOTO CREDIT – THE UNISON PHOTO

A woman is more likely to have a vaginal birth if she has a natural birth. Although this is not in all cases, a woman who is educated, empowered and prepared for a natural birth has a greater chance for having one.

Things a woman can do to prepare for a vaginal birth:

• Take an excellent childbirth course! My online LOVE YOUR BIRTH course is available here. 

• Check out www.vbacfinder.com to find VBAC rates for local hospitals.

• Check out ICAN (http://www.ican-online.org) for more information; seek out VBAC groups in your community, on Instagram and on Facebook, to connect with other women who have had successful VBACS.

• Watch movies of women who have had VBACS… inspiring stories of healing, beauty and empowerment.

• Create your tribe, in your pregnancy, of like minded women who have gone through what you’re going through.

• Interview providers, and choose one that aligns with you the most – one that has high rates of VBAC and low rates of repeat cesarean. It is very important to ask them their rates, and if you are planning a hospital birth, research the hospital rates here (link to http://www.cesareanrates.org/2015/01/what-is-my-hospitals-cesarean-rate.html

   Most midwives, especially those who practice out of hospital settings, have the highest rates of VBAC and the lowest rate of repeat cesarean, but plenty of hospital midwives and obstetricians have similar stats – they just may take some work on your part to seek them out.

I also recommend hiring an awesome doula, as those who have a doula are less likely to have a cesarean.

A doula is amazing because they offer the mothering comfort and support that our ancestors had.  When women would give birth in their tribe or village, and they were surrounded by mothers, aunts, sisters, grandmothers, and the other women of their community, they received that mothering support by women who were comfortable with birth and relaxed around it. Fear has no place in birth, and a doula provides needed calm and loving support.

Lastly, I recommend drawing and journaling , mediation and visualization – which tap more deeply into her intuitive self. A woman can imagine how she’d do it differently or what she wants for herself. And she can face her fears head on, which often lessens them, or she can be with them and plow forward with courage in spite of them.

Remember, In the end it’s not in our control, and we let go and surrender,

If you do all of these things and end up having a cesarean, it’s not a failure. There is no failure in birth. It is a birth, a belly birth, and it’s the birth of your baby and you as a mother. It is the birth of your family and your partner as a parent. Stay present, stay involved and keep a positive mindset. Focus on the blessing, that you did all that you could, and thankful for modern medicine, which saved you and your baby’s life and preserved health. Also, you can ask for a gentle cesarean, which restores humanity to the operating room by doing such things as allowing your support people in with you, enabling baby to emerge from the incision simulating as much as possible a vaginal birth to help baby clear his/her own lungs, enabling you to participate by lowering the drapes so you can see your birth, giving you sterile gloves to receive your baby, delaying the umbilical cord clamping so baby can benefit from the cord blood, encouraging immediate skin to skin bonding and early breastfeeding.  

Image by angiebeehotz

Healing can occur afterwards, and may take time and lots of support. But there is no place for shame and negative self judgement here.

Image by Megan Hancock Photography

Let Me Help You Create The Happiest Birth Experience Of Your Life...

Whether you're a first time or experienced momma, planning a VBAC

Or a midwife, doula, or birth professional guiding mommas..

Regardless if you are intending to birth at home, a hospital, a birth center or need a cesarean section, or if you are taking another childbirth education class…

You Really Can Create The Delivery Of Your Dreams, ROCK your VBAC

And have a blissful birth wherever you are.

More Precious Than A Wedding...A Birth Should Be A Celebration!

Let me show you how to…

• 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 andcommunicate 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. 

Some other resources:

• Home birth cesarean resource (http://homebirthcesarean.org/) “This website provides support, resources, and awareness around planned out-of-hospital births that end in cesareans, referred to as Homebirth Cesareans (HBC).”

• www.Vbacfacts.com

• www.Vbac.com

• Books on my website, www.homesweethomebirth.com

In the end, how a woman births is her personal decision and the more informed she is and empowered to play a large role, the greater the likelihood is she will have a positive birth experience.