Planning Your VBAC – Where to Begin
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Planning Your VBAC – Where to Begin

I open today's post with the reminder that April is Cesarean Awareness Month. The World Health Organization and evidence-based practice only supports a cesarean rate of 15% or less.

While a cesarean birth can be life saving and necessary, and we are so grateful for the technology when our students need this intervention, we encourage you to know the difference between a variation and complication. Is Mom okay? Is Baby okay? If yes to both questions, asking for time can spare both Mom and Baby from an "unnecesarean". 

The current cesarean rate in the US is around 32-33%, so our wish at Sweet Pea Births is that by raising awareness, only the necessary cesareans are performed, and that over time we see our national cesarean rate back down to at or under 15%.

If a VBAC is not an option you want to explore, I encourage you to explore the ideas and additional readings HERE to learn more about a family-centered cesarean that may be a gentler experience for both mother and baby.  With time and planning with your care provider, these are possible and a beautiful option for families that want and/or need a repeat cesarean.

On to the topic:  Where do you begin if you want to plan for a Vaginal Birth After Cesarean?  

These notes are from an ICAN meeting presented by ICAN of Phoenix chapter leaders Stephanie Stanley and Jessica Franks on January 23, 2013, hence they get the author by-line on this one.  Thank you, ladies, for your constant support of the cesarean community in the Phoenix area.  Here are the steps that Stephanie and Jessica identified in hindsight of their VBAC journeys.

Step 1:  Find a supportive care provider
Your options for finding a supportive care provider in Arizona include an obstetrician in a hospital setting, a Certified Nurse-Midwife in a hospital setting, and Naturopathic Doctor who also holds a Certified Professional Midwife license in a home setting.  In addition, you an interview at Women’s Birth and Wellness Center in Mesa, Arizona, to see if you are a candidate for a VBAC at their birth center.  If you are in the Phoenix area, you can check the ICAN Phoenix provider list HERE to see which care providers have been supportive as per first-hand experience from VBAC mothers.

Step 2: How do I know if someone is truly supportive?
The only way to really know if a care provider is going to go along with your choice for a trial of labor that you hope is going to lead to a vaginal birth is the interview them.  Schedule an appointment with them and meet them face-to-face.  Here are some questions you can ask – you want to keep them open-ended so that you hear their spontaneous answer.
  • How do you feel about letting a VBAC mom go to forty-two (42) weeks gestation?
  • How do you feel about natural birth?
  • What are specific protocols and what is the timeline you follow with a VBAC mother?
  • Which pushing position do you support when a mom is attempting a VBAC?
  • How do you feel about doulas in the labor and delivery space?
  • What are my options if I should need a repeat cesarean?
  It is important to get out of the mindset that the obstetrician or care provider as the authority over you.  You are the consumer.  You are hiring a person to care for you and your baby.  A big red flag warning is the statement, “Well, we’ll deal with that when we come to that.”  That usually means that, “When we get there, we are doing it my way,” so consider it a sign that it may be time to move on to the next person on your list.
Step 3: Be Healthy, Starting Now
Your nutrition is vital to your health, your pregnancy, your baby and your birth.  Maintain a healthy diet and exercise on a regular basis.

Krystyna’s note:  A comprehensive childbirth education class, like The Bradley Method®, prepares mothers over the course of the twelve week series to eat well to build a strong body and a strong baby, and we have a pregnancy exercise program that builds stamina as well as the three major muscle groups that support pregnancy and labor: Back, Belly, and Bottom.

Step 4: Mental Health
Your mental health plays a significant role in your pregnancy and birth.
A childbirth preparation course can educate you on the course of labor so that there are *less* surprises – all labors have an unknown factor and you can’t be “completely” prepared.
  • Work through any fears you had going into your last birth, or that have arisen as a result of your previous birth.
  • Strive to reduce stress and tension in your daily life.
  • Surround yourself with supportive, positive, and helpful people.
  • Be honest with yourself and with your partner – you need to address how both of you are feeling in regards to your past birth and the preparations for a VBAC.
  • Identify what your needs are, and what needs to be addressed.  Do the same for your partner.
  • Evaluate your mindset: are you going to go along with what your doctor tells you to do, or are you going to educate yourselves as a team so that you can make informed decisions?

Step 5: Take A Childbirth Education ClassThere are several options for birthing families these days.  Here are some of the classes mentioned in the meeting:
  • Birthing From Within
  • The Bradley Method®
  • Hypnobirthing: might work better if you have a yoga background
  • Hypnobabies: some consider it a more “user-friendly” version of Hypnobirthing
  • Private Comprehensive Class taught by a doula or independent childbirth educator

Krystyna's Note:  The Bradley Method® is fabulous as a comprehensive preparation course. You can click HERE to see what is taught through the  course of the 12-week series.  However, we do not do anything in-depth to address any past birth trauma or fears that you may be bringing to the birth space.  If you are interested in The Bradley Method®, please contact me to discuss some additional resources I recommend for VBAC couples enrolled in our course.

Step 6:  Plan To Hire A Doula
Doulas are an essential part of your birth plan.  A doula is a woman whose only role is to support a family through their labor, birth and the choices they want for their birth.  They may offer ideas for labor positions, moral support and hands-on help, among other things.  Typically people hire their doula between 24-30 weeks.  There is no “right time” to hire a doula, so even if you are earlier or later than this window, you can make phone calls and find the right person to support you and your partner through your birth experience.  Some insurance companies cover the doula fee, so call them and ask!
Step 7:  Get Family Support
The support of the people closet in regards to your decision to VBAC is very important. 
  • Educate your family – invite them to come along to a cesarean support group meeting, such as ICAN.
  • Honestly express why this is important and what led you to this decision.
  • Understand that if something or someone is not helpful, supportive or positive, then it or they do not need to be a part of your birth.

Krystyna’s Note: My favorite line of conversation I have heard at an ICAN meeting, and that I know share with our students in regards to birth choices is this: 
“I have taken the time to educate myself and make the right choice for our family.  Do you really think that I would make a choice to intentionally harm myself, or our child?  If we cannot come to an understanding, or at least agree to disagree, this topic is off the table and no longer up for discussion.”

Step 8: Educate Yourself
Knowing the facts about VBAC will give you more confidence in your decision, as well as prepare you to educate those who may question the safety of your decision.
  • Read, read, read.
  • Read positive VBAC birth stories
  • Talk with your care provider – know their VBAC numbers
  • Ask questions and research the information you are finding

 Step 9:  From a Birth Plan
A birth plan is a great way to organize and prepare your goals.  It is a tool to help you articulate the vision you have for this birth.  Birth plans are typically written around 30 weeks, but there is no “right time” to write a birth plan.
  • Write your VBAC plan
  • Consider writing your cesarean birth plan
  • Talk with your care provider about your birth plan.  If your care provider is not on board, talk with them to explore if there is a way to make it workable.  What are your absolutes, and are your communicating them effectively?
If you are absolutely confident that other care providers have supported the choices you are making, then it may be time to interview other care providers.

Step 10:  Breathe
It will be okay!  Your body knows how to have babies.  In the swirl of activity, remind yourself to relax and enjoy your pregnancy!   
Krystyna’s Note:  However this birth is going to go, your body is still in the midst of the miracle of creating an entirely new human being over the course of the pregnancy.  You are an amazing, creative goddess – enjoy the glow and revel in your growing baby bump!
Are you planning/have you had a VBAC?  What is/was been important to you?
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*I think* that the amount of traffic you so generously generate has led to a lot of spam posting.  In an effort to keep the spam to a minimum, I am taking the time to moderate comments now
Bradley Method® natural childbirth classes offered in Arizona: Chandler, Tempe, Ahwatukee, Gilbert, Mesa, Scottsdale, Payson
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The material included on this site is for informational purposes only.
It is not intended nor implied to be a substitute for professional medical advice. The reader should always consult her or his healthcare provider to determine the appropriateness of the information for their own situation.  Krystyna and Bruss Bowman and Bowman House, LLC accept no liability for the content of this site, or for the consequences of any actions taken on the basis of the information provided.  This blog contains information about our classes available in Chandler, AZ and Payson, AZ and is not the official website of The Bradley Method®. The views contained on this blog do not necessarily reflect those of The Bradley Method® or the American Academy of Husband-Coached Childbirth®.

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