Welcome to Blissful Birth Ask the Doula

question and answer forum!

Have a question about your pregnancy or birth? Ask your friendly neighborhood doula and childbirth educator! E-mail Jacque and I'll post your answer online. jacque(at)blissfulbirth(dot)com

 (note: Because of the legal environment in the state of Illinois, I would like to clearly state that I am not a medical practitioner. I am a trained childbirth educator and doula, and a mother. This information is not intended to be medical advice and should not substitute for the advice of a healthcare practitioner. If you have a medical concern, consult your midwife, doctor or natural healtcare practitioner. If you have concerns about your maternity care provider, listen to your instincts and find a care provider who supports you and your vision for your birth. If you would like referrals for a doctor or midwife who is supportive of natural birth, visit Birthlink.com or e-mail me for a referral. Thank you! :) )

I am expecting our second baby and had a c-section the first time around. I would like to have a natural birth without pitocin, an epidural or other interventions for this delivery. What can I do to help prepare for a VBAC?

VBAC or Vaginal Birth After Cesarean is a healthy, safe way to give birth for many mothers. With excellent prenatal care, thorough childbirth preparation with childbirth classes focusing on consumerism and natural birth and by selecting a midwife or doctor and a place of birth that is supportive of VBAC, you are on your way to a beautiful birth experience.

Here are some important things to keep in mind when planning a VBAC:

-Join and get involved in your local ICAN group. ICAN is the International Cesarean Awareness Network. They're an excellent resource for support, information and advocacy. Visit http://www.ican-online.org for information.

-Keep your pregnancy healthy and normal. Wellness is key. Be vigilant about eating a healthy, balanced diet. Stay active. Take prenatal yoga classes. 

-Choose your midwife or doctor carefully. Consider recommendations from other moms in your area that have had VBACs. Be willing to travel if necessary to get the best, most supportive care, rather than choosing the most geographically convenient office.

-Sign up for a Childbirth Education class that is independent (not affiliated with a hospital or a provider) and that focuses on natural birth.

-Learn about your c-section. The circumstances that led to your c-section are important determinants of if you're a good candidate for VBAC. Breech presentation, twins or "failure to progress," for example, are specific to your previous pregnancy and most likely will not have an impact on this pregnancy or birth. Ask for your surgical report. What type of incision did you have? What type of repair (single layer or double layer) did you have? Were there any complications? Be sure your provider has this information and ask questions if you don't understand your report.

-Explore your feelings about your c-section and work through your fears. ICAN offers monthly support groups to help moms who've had c-sections to work through their feelings about their births and get information and support for their VBAC.

-Create a clear, but flexible, birth plan and discuss it with your provider regularly during your prenatal care.

-Hire a doula. Having a trained professional doula at your birth has been studied extensively and is found to reduce many of the common interventions that can cascade into an unnecessary c-section. Though a doula can not guarantee any particular outcome, doulas provide expert advice and excellent support for you and your partner through your VBAC journey.

-Listen for clues during your prenatal care. Is your provider using language like "trial of labor" or saying that you could attempt VBAC, but recommending or suggesting a scheduled repeat cesarean section? Is your provider concerned that your baby "may be too big" or that your pelvis or cervix is "inadequate"? If you would like a VBAC, switching to a more supportive provider with more VBAC experience is wise.

-Understand your rights. Check out http://www.ican-online.org for current legal information

-Develop a back up plan. For many mothers planning VBAC, it is common to have a supportive doctor who decides late in your pregnancy that they think you should have another c-section. Sometimes, there are medical reasons for this switch. Sometimes, there are not. If you provider decides that you should have a c-section instead of a VBAC late in pregnancy, ask questions. Are there medical reasons for a repeat cesarean? Listen carefully to the answers. Get a second or third opinion from another doctor experienced with VBAC from a different practice. If you are uncomfortable, listen to your instincts and change providers.

-Visualize having a natural, healthy, uncomplicated vaginal birth. Your positive focus, your visualization and your prenatal preparation will go a long way to preparing you for a wonderful, healthy VBAC.

(c) copyright Jacque Shannon-McNulty, 2009 All Rights Reserved

Coming soon:

 My mom is freaking out about my decision to have a homebirth. Help!

I am from New Mexico and had my first baby with the midwives at a beautiful birth center. We moved to Chicago and I am pregnant with our second. Can you recommend a birth center here?