top 4 tips to have a successful vaginal birth after cesarean (VBAC)
If you have had a cesarean birth, consider yourself one of many families who have done the same. In the United States in 2019, cesareans made up for nearly 32% of all births. It was once commonly accepted that if a person birthed their baby via cesarean, each subsequent baby must then also be a c-section, but it is now becoming more widely known that repeat cesareans are not always medically indicated and can sometimes present more risks than benefits.
According to the American Pregnancy Association, 90% of people who birthed their babies by cesarean are considered great candidates to attempt vaginal childbirth, also known as a VBAC or Vaginal Birth After Cesarean. Other terminology you may hear is “Trial of Labor After Cesarean” or TOLAC. Both mean that you and your medical provider have agreed to labor and birth vaginally, if all is clinically well.
Reasons that someone might consider having a VBAC include the desire to experience a vaginal birth, wanting to avoid the risks of surgery, having a shorter healing period, to experience less medical interventions and side effects, to overcome prior birth trauma, to exercise body autonomy, wanting a birth outside of a hospital setting, the benefits of birth through the vaginal canal for their baby and more.
Although most people who have had a previous c-section are good candidates for VBAC, there are some risk factors which might make you a better candidate for a repeat cesarean. For example, if the same circumstances that required the initial cesarean present themselves again. However, it is crucial to note that just because you’ve had one cesarean, that alone is not a medical indication to have more, in most cases.
If you are interested in attempting a VBAC or TOLAC, talk with your doctor or midwife to confirm that you are a good candidate and then consider the following tips to give you the best chance:
Find a VBAC-supportive medical provider
One risk factor for a repeat cesarean is your doctor and their views on VBAC. If your doctor doesn’t support you and your preference of attempting a VBAC, unless they have a medical reason explaining their decision, consider getting a second opinion from another provider. If you don’t have any major risk factors, attempt to find a practitioner who not only supports your choice, but is enthusiastic about it as well!
Get your support team on board
Having a supportive medical provider is important in attempting a VBAC, but so is having the support of your partner, family or friends. You’ll want the people closest to you to understand what you are attempting to do, especially if any of those people will be present while you labor. Hearing supportive words of encouragement while laboring could be the difference between continuing to work through a long or difficult, but non-problematic labor and deciding to move forward with a repeat cesarean.
Hire a birth doula
Doulas are a wonderful support no matter which kind of birth you intend to have. Hiring a doula means having the emotional and physical support of a birth professional before, during and after labor. Emotional support will be helpful if you need to make medical decisions. You’ll be thankful to have someone with expertise working for you, who also knows your birth preferences. Physical support will be helpful during labor to help you avoid medical interventions (for example: keeping you hydrated, rested and moving, and knowing optimal positions for different labor circumstances). People who have the continuous support of a birthing professional such as a doula have a 25% decrease risk for cesarean.
Prepare your mind and body
Watch VBAC birth videos, look up VBAC success stories. Fill your feeds with inspiring anecdotes and information on VBACs. Look up affirmations that resonate with you so that when labor is becoming difficult, your support people can remind you of them and keep you uplifted and encouraged to go on. Work on believing that you and your body are capable of incredible things you’ve never done before. Talking with a therapist can help you work through any lingering fears or doubts. There is also some evidence supporting that regular chiropractic care is beneficial in vaginal childbirth due to pelvic alignment.
A cesarean birth is major abdominal surgery and if you want to avoid the risks and complications that are sometimes associated with repeat procedures, talk with your provider and support team to find out what your options are. Chances are, you are an ideal candidate to attempt a VBAC or TOLAC. Being a good candidate is the first step towards a successful VBAC but to truly increase your likelihood of success you’ll want to be sure to have a VBAC supportive provider, your support team on board, including hiring a doula, and being mentally and physically prepared.
As with all birth preferences and plans, it’s important to leave room for flexibility as often plans can change during labor. Knowing your options and the variables that influence them can be empowering and can lead you to having the best chance of having the birth you truly want!
Laura Max is a birth and postpartum doula, available on the boober platform, having served clients in both the Tri-State Metro area and in mid- Michigan. She is a wife and the mother of two, a teenager and an 8 month old. When Laura is not supporting new families, you can find her out in nature with her own. Laura is available on the boober platform for matches.
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