If you’ve had a caesarean section and are thinking about having a vaginal birth next time around, this article is chock full of advice, tips and beautiful birth photos from mothers who have done it “ planned their VBAC and succeeded! So if you’re after some VBAC inspiration and encouragement, read on!
I asked both VBAC and HBAC (home birth after caesarean) mothers a range of questions about what got them through and what they think made the biggest difference in achieving their goal. Here are their answers.
What Preparation Did You Do For Your VBAC?
My husband and I did a range of things:
- I got in touch with CARES-SA and met like-minded women to help me process the trauma of the caesarean section and what happened. Hearing the stories and experiences of the women in this group also helped me create a network within the South Australian birth community and to form my plan for my VBAC/HBAC.
- I sought counselling from various quarters in order to deal with my caesarean section experience.
- Research, research, research. This included trawling the internet, joining various online communities, reading books and literature, watching DVDs/youtube clips, talking to midwives, obstetricians and other health professionals as well as other VBAC-hopeful/successful mums.
- We found an independent midwife.
- We attended workshops.
- I wrote a birth plan. The process of writing the plan really helped my husband and I to solidify our thoughts and decisions around the birth, and once the plan was written I was freed of some of the anxiety around having to manage ‘the system’ should I need to birth in hospital. Knowing my wishes were on paper and no one needed to remember them was reassuring.
- I honoured my body. This meant regular osteopathic and physio treatments to make sure my pelvis stayed as it should, that my body was functioning at its best and that I felt well! I also attended yoga and pilates regularly ” yoga was a great way for me to remember to love my body and excellent preparation for the mental/spiritual rigours of labour and childbirth, and pilates helped me to mend the abdominal damage done by the caesarean section and to feel physically strong again.
- I had a Blessingway.” ” Tessa
For my first VBAC, I searched and searched for midwives (independent midwives, not hospital) that trusted that my body could do what it was made to do. For my second, I saw a doctor/CNM (certified nurse midwife in the USA) practice that claimed to be VBAC friendly and fired them when they weren’t!
I went to doula-run birth classes and did a lot of reading on the topic. I had to learn to trust that my body knew what to do. The doula birth classes really helped with this. My pregnancy and birth journey also helped me heal from the traumatic experience my firstborn’s birth was. ” Stacey
I had given birth vaginally before my caesarean section so I knew what to expect. I did read lots about how to help succeed with a VBAC. I do think I mentally prepared as much as I could. With the HBAC I read and read and read and read some more, felt very confident and my midwife was amazingly supportive having VBAC’s herself. ” Alison
Research, research and more research! Finding out how various interventions (vaginal exam, pain relief, foetal monitoring etc) can stall even a ‘normal’ (non-VBAC) labour and deciding whether or not I wanted to have them during my labour. I also hired a doula who has had her own VBAC and an independent midwife to to support and educate me in my decision. I also paid serious attention to my hips and back to make sure they were in optimal shape for labour and birth, as sciatic pain during my first labour had required pain relief long before the contractions were causing problems. It was all definitely worth while, I laboured much more efficiently and faster than the first time around! ” Miranda
I did heaps of preparation for my VBAC, my research and preparation began before I was even pregnant. I knew from my last experience that birth can sometimes go in ways we do not necessarily want or in ways we don’t plan for but I wanted to make sure that whatever the outcome in my second birth, I could be sure that I did everything in my power to have the birth I wanted.
Preparations included firstly finding a birth support team who were supportive, knowledgeable and experienced. I chose a midwife team with a proven track record of successful VBACs whose philosophy matched mine really well. Some other things I did was to research intervention rates at various hospitals and visited the BellyBelly forum, especially the VBAC sections and the birth stories. I read lots and lots of books, the best being:
- The Thinking Woman’s Guide To A Better Birth by Henci Goer
- Birthing From Within
- Ina May’s Guide to Childbirth by Ina May Gaskin
- Spiritual Midwifery by Ina May Gaskin
- >Silent Knife: Cesarean Prevention and Vaginal Birth after Cesarean by Nancy Cohen
- New Active Birth by Janet Balaskas
- Men At Birth by David Vernon
- Gentle Birth, Gentle Mothering: A Doctor’s Guide to Natural Childbirth and Gentle Early Parenting Choices by Dr. Sarah Buckley” ” Gen
How Supportive Was The Hospital Before The Birth? During?
Being a public hospital I saw several different doctors, it took a while before I found one that was fully supportive of my decision. Once I did, he made sure that I saw him for every antenatal clinic appointment. However there were “rules” that I had to adhere too during labour, monitoring, good progress, etc. the usual bunch of rules they put on VBAC woman. However, I really got lucky! I got a fantastic midwife who had home birthed her children and had me off the monitor as much as possible, after 30 or so hours of labour and still only being 4cm the obstetric team warned me that I might be in for another caesarean section however, the obstetrician I had seen throughout my pregnancy just happened to be working and instead broke my waters. I had my son six hours later. I realise that my experience could have been VERY different had a different doctor been in that day. ” Stacey
While I had a HBAC (home birth after caesarean), I did come up against negativity and sceptical medical professionals during my pregnancy when I had to get involved in the ‘system’. The GP I visited to get a referral for an ultrasound gave me a very hard time for attempting a VBAC. Mind you, he knew nothing about my medical history or reasons for a caesarean section in the first place and he did nothing to try to find out any information about me. He simply harassed me with out-dated ideas about so called ‘dangers’ involved in having a VBAC and even referred to me as irresponsible. It was incredibly frustrating and offensive to be treated with such disrespect. If the doctor had actually had a conversation with me rather than disparaging me he may have realised I am not an idealistic fool but a well educated, well informed, rational thinking individual who was looking to do the best thing for myself and my unborn baby. I also ran into negativity from the ultrasound technician when he discovered I was having a VBAC. Again, with no information other than his preconceived ideas he felt it was ok to let me know he didn’t approve. After such negative experiences in the medical system I was only more confident in my decision to birth outside of the hospital system and work with my independent midwives. ” Gen
My hospital midwife was lovely! During labour she was fabulous, let me make all the decisions, never forced anything on me and only stepped in right at the end when she became concerned about blood loss. The obstetricians were dubious the entire time, including during labour “ when I refused certain interventions the obstetrician’s catch phrase was “I’m not trying to scare you but ‘xyz’ could go wrong if you don’t let us do ‘xyz’¦” ” Miranda
With my VBAC, the Obstetrician on duty for my first visit was the one to tell me (not suggest) I should have a VBAC, she was so supportive of me doing that considering my 1st baby was a 9p10 vaginal delivery. When it actually came to delivery day the on call Obstetrician was pushy and kept giving me time limits for when I had to deliver or else I would have a caesarean section (very stressful and not supportive in labor!) ” Alison
Did Your Carer Give You a Date or Deadline To Go Into Labour By? If So, What Was The Deadline and What Happened?
I had the normal two weeks over that they give every labouring woman. I was quite lucky “ my due date was around the 4th June but from the first ultrasound they had the 14th. I wasn’t going to correct them, knowing if I went over they’d watch me like a hawk this meant they’d leave me alone for an extra few days. In the end it wasn’t necessary because he arrived on the 31st of May which by the hospitals dates was 38 weeks. He was still 8lb, 1oz. ” Stacey
My last appointment with my midwife was at 38 weeks, and her advice was to walk, warning me that the obstetricians would get pushy about a caesarean at my next appointment (scheduled for 40w 2d). She personally had no deadline for me, she knew things would happen when they were ready. The obstetricians reminded me consistently that if I went past 40 weeks they would recommend a repeat caesarean after 40weeks+10days¦ I refused to schedule (despite the warnings that I might have to wait another couple of days after that ‘magic’ 10 days because the elective theatre spots would book out). However I agreed to electronic monitoring and ultrasounds to see the baby was fine, and informed them that unless there was something to indicate the baby or I were unwell I would be waiting for spontaneous labour. The obstetrician advised she would schedule me regardless if I had to attend my next appointment booked for 40w+11d¦ well I went into labour on their ‘magic’ date 40w+10d, and Liam arrived the next day at 40w+11d, about 4 hours after my supposed appointment! ” Miranda
I had no deadline imposed on me for when I had to go into labour. It was understood that we would discuss how things were looking if I got to 41+ weeks and that we would keep an eye on the heath of the baby at all times but I had no pressure or timeline highlighted. There was no threat of a repeat caesarean due to ‘going late’, only the options of employing less invasive induction techniques such as TCM (traditional Chinese medicine), homeopathic preparations, nipple stimulation etc. ” Gen (HBAC)
Were You Concerned About Uterine Rupture? What Were The Doctors and Midwives Attitudes Before and During the Birth? How Do You Feel About It Now?
Slightly, during my first my midwives and I had thoroughly discussed warning signs, etc. I didn’t let my thoughts about those signs overtake my labouring brain, but they were in the back of my brain. “ Jessica
The first few obstetricians I spoke to were concerned about uterine rupture but the one who supported me never even mentioned it. The reading I had done previously told me my chances were the same as a woman who had never birthed before. The only time it really became a concern was when I was getting close to my due date and I began to second guess my decisions (pre-birth jitters) however, the fear of another caesarean section was a much bigger fear for me ” and still is. ” Stacey
I was not especially concerned. I had had the best Obstetrician in the area perform my caesarean section, and I felt healthy, my scar felt strong, and I knew the odds were remote. The doctors were quick to remind me of the risk and how dangerous everything I was doing was. My hospital midwife was a little concerned during labour (not because anything presented unusually but because I was her first VBAC birth) but respected my decisions for low-intervention. However with my permission she checked baby’s heart rate regularly with the doppler to make sure everything was progressing well. ” Miranda
Initially it was a consideration, but when I put the risk into perspective (i.e. I am 30 times more likely to suffer a post-partum haemorrhage than uterine rupture) it no longer concerned me. My midwife discussed the uterine rupture risk with us ” we discussed intermittent monitoring with a doppler, what the early signs of uterine rupture are, how this would be managed if it occurred and what the outcomes would likely be for baby and me. We felt that we had bases covered and we were comfortable accepting this risk. I decided I would much rather accept a tiny risk of uterine rupture at home than a 30% or greater risk of a repeat (and probably unnecessary) caesarean section in hospital. ” Tessa
I was a little concerned but did my research and the figures actually made me more confident, plus it had been 5 years since my caesarean section so my uterine wall was as healed as it could get. The hospital gave a class I attended and that added to my confidence. During the pregnancy a lot of demons relating to the trauma of a caesarean section were raised and I didn’t realise how much it had affected me. ” Alison
I was concerned about the possibility of uterine rupture when I first looked into a VBAC option based on the prevailing fear that is in the general population about it. Uterine rupture certainly is a concern, however, it needs to be put into perspective and it needs to be weighed up in relation to other risks and in relation to what options you have to decrease the likelihood that it will happen. I looked into the issue in my early stages of pregnancy by reading all I could on the subject including research papers. Based on this research my concerns were all put to rest and I was completely happy to go ahead with the VBAC as I could see that the chance of a rupture was a very low one. I had confidence in my carers that they would know what to do to avoid a uterine rupture and that they would be able to recognise and act quickly if it happened. I felt that the risks I faced if I had a repeat caesarean were much higher and much more traumatic than those I would face if I was to have a VBAC. ” Gen (HBAC)
Did You Have Any Pain Relief? If So, What?
Nope, I laboured in a birthing tub with my first and used my shower intermittently for pain relief during my second. “ Jessica
No. Just good old fashioned endorphins and lots of groaning. ” Tessa
After an unpleasant reaction to pethidine previously and a very traumatic epidural experience with my first birth, the only medicated option was gas. I used this from about 11am till Liam arrived at 2.45pm. I had been using heat packs and warm water (bath at home, shower at hospital) before that point. ” Miranda
I ended up with nitrous oxide (gas) for the hospital VBAC and nothing but freedom and relaxation for the home birth. ” Alison
What Were Your Friends And Family’s Attitudes To VBAC/HBAC And Did It Affect You And Your Decisions?
During my first, I didn’t really talk about it with family because they are fairly medically minded. My mom wasn’t thrilled with the idea at first, fearing that I would die. But after she met the midwives and saw the birth center for herself, she was all for it. “ Jessica
My mother had only had 2 children and both were caesarean sections and she was the most worried out of anyone. My husband was supportive but I knew inside he was extremely worried about a VBAC and then a HBAC! His hair got much greyer over that period! But unlike the hospital having my own private midwife eased everyone and there was less worry around the HBAC then the VBAC (but I think this is because I had already proved I had it in me). ” Alison
My friends’ and family’s attitudes towards VBAC were generally quite ignorant and ill-informed, but their attitudes varied. Some still believe the ‘once a caesarean, always a caesarean’ mantra and don’t even know why this was the recommendation once upon a time. I think the people who affected my decisions the most were those whom I felt had the best understanding of my situation and context ” these ended up being my IM (for obvious reasons) and the girls I met through CARES because they had had similar caesarean section experiences and ‘got’ my compelling desire for a vaginal delivery. While I valued the opinions of my less-approving family and friends, and acknowledged that their fears were out of love for me and my baby, I could not afford to take on board such concerns when they were so often ill-founded. ” Tessa
Most of my friends and family were very supportive and interested in the idea (especially as many hadn’t heard of VBAC before.) Although I was already confident in my decision it was great having that support and knowing there would be so many fingers crossed for me when the time came! There were a few hesitant/negative responses (from nurses in my family) however they were willing to respect my ability to research and decide the best choice for myself. Once Liam had arrived safely, the people who were less enthused were just as, if not more proud and supportive that I had achieved my goal. ” Miranda
My friends and family were mostly supportive. My Dad was just worried and didn’t really understand the big deal about having a VBAC and couldn’t understand why my last experience imprinted on me so much. Their opinions didn’t really affect my decision if it did I think I would have had an elective c-section. My husband however, was very supportive of my VBAC and is very supportive of OUR choice to homebirth our next baby whenever that may be. ” Stacey
What Were The Biggest Challenges To Planning and Achieving Your VBAC?
Facing the negativity of the general public and the medical professionals I came across and the costs involved in having the birth that I wanted and that I believed would give me the best chance of having a VBAC ($4000 for a homebirth with independent midwives). Other than that, it was a piece of cake! ” Gen (HBAC)
Finding a supportive doctor in the public health system and keeping him! Typically you see a different doctor every appointment so I was terrified I wouldn’t keep my support! Getting the right support during labour was also a challenge, in the end I took my husband, my mum, a student midwife and a close friend who is also a midwife just so that I knew my wants would be heard! And that if something went wrong I had two other professional opinions I could refer to so I knew I wasn’t being manipulated again. In the end I ended up with the most amazing birthing team but it really was just luck. “ Stacey
Hospitals! Without even reviewing my history or the reason for my previous caesarean section, midwives I spoke to when ringing hospitals to find out about their VBAC policy deemed me ‘high-risk’ and advised I attend a hospital that I was not comfortable with. ” Miranda
I think the stigma and uneducated fear in society was the hardest thing to overcome. I was confident and ready, but so many women just want to tell you horro stories and add fear and struggle to an already emotional time. I ended up not discussing my plans or pregnancy with anyone outside my little family support group, because I just couldn’t take the negative self righteous crap anymore. My HBAC, however was freeing and I just threw caution to the wind in social situations. I felt empowered and proud and didn’t care what people thought. They could say what they wanted and it just didn’t register with me. ” Alison
At first I thought the biggest challenges were external ” negotiating ‘the system’, ‘fighting’ medicos, setting up a birth team ‘army’ to protect me… But, when we decided to homebirth and many of these challenges became irrelevant, I realised that the single biggest challenge in achieving my VBAC would be myself; I really had to get a handle on the negative self-talk and low self-esteem I suffered following the emergency caesarean section if I was to truly trust my body and its ability to birth. It is amazing how I had internalised the Obstetrician’s voice and had such deep-seated doubts about my VBAC chances, even though ” intellectually ” I knew they were good. Once I found a place of peace and felt better within myself, I knew I had completed my VBAC preparation. ” Tessa
What Are The 3 Most Important Things That You Think Contributed To The Success Of Your VBAC?
Knowing I had done it before (inner confidence), being pro-active and seeking info and resources and having support from loved ones. ” Alison
My mindset, my husband’s support & midwives that knew it would be fine as well (for the first). For the second the third thing was my improved knowledge of the birth process and trusting it to work without a trained professional in the house. “ Jessica
Choosing the right model of care for me “ Independent Midwives and choosing carers who had a proven track record for successful VBACs. Birthing at home. Being in a positive mindset and relaxed about giving birth. This was a result of being well read well researched and prepared. ” Gen
By far, the most important thing that contributed to my successful VBAC was my Obstetrician’s support. The second thing was that 4 1/2 years had passed since my surgery. I know that had a lot to do with me feeling confident in my body being fully healed. Finally, my husband’s full support was very important also. He never doubted my body. ” Marivette
Research into hospitals so I could choose the right one, a fabulous doula and believing that I could do it. ” Miranda
Good support from people who truly believe in VBAC (care provider/s, family, friends). The power of knowledge ” making informed decisions! Trusting birth, trusting my body, trusting my baby ” Tessa
Support; my husband, my birth support and the doctor/midwife support). Knowledge of the risks, and also knowledge of the risks of caesarean sections, I had made an informed decision and I knew this was the safest choice for me and my baby. Doctors often don’t tell you the risk associated with caesarean section so I had to find this out myself and I urge EVERYONE to look at this cause as a patient I feel there is a lot we are often NOT told. And finally, trusting my body. ” Stacey
Would You Do Anything Differently If You Had Another VBAC?
Absolutely not. I will plan another HBAC, I will use the same IM and I will again ensure I am physically, mentally and emotionally prepared for birth. However, what I would like to do differently is to stress less about the next VBAC now that I know it is possible because I have done it! While I don’t think it could ever have been any other way, it is a shame that much of my last pregnancy was spent reflecting on negative stuff rather than on looking forward to the positive ” I hope I will spend my next pregnancy rejoicing in the wonderful experience of being pregnant and anticipating a beautiful birth. ” Tessa
Yes. Next time I’ll give birth at home. This avoids my health being in the hands of a doctor who I might not even know until I’m in the room. It avoids all the problems that I feel I had last time going into a public hospital. I could always hire my own obstetrician but I prefer the care of a midwife. Also now with two boys I’d love them to be at the birth of their next sibling. ” Stacey
What Is The Biggest Piece Of Advice You’d Pass On To Other Women Wanting A VBAC?
Seek out lots of answers and assistance from those in the know, doctors, midwives, doulas, mothers who have done it before, your birth records from your previous birth and research. Knowledge is power! ” Gen
Read lots of books by Penny Simkin and Sheila Kitzinger and trust your body! “ Jessica
Trust yourself, don’t let other peoples ignorance sway your inner confidence and be pro-active and seek info! ” Alison
Get informed! There is nothing more powerful than knowledge ” learn about ‘the system’, learn about your choices, learn about birth, learn about your body, and learn about your inner self. ” Tessa
You absolutely can do it if you believe in yourself. Don’t let policies, text books and pushy obstetricians scare you. You have woman and maternal instincts for a reason, listen to them! ” Miranda
Read! Read! Read! And get your partner to read too. The more knowledge you have the subject the better. If a doctor says you can’t have one get a second opinion! ” Stacey
Make sure you find a doctor who fully supports VBAC without question. Find a doctor who will trust your body to perform to it’s own level of ability, a doctor who will listen to your desires for a VBAC. If the OB even questions your body’s ability or is slightly hesitant, find a different OB. ” Marivette
Hire a doula ” having someone there that knows what they are doing and can help you focus and stick to your plan is awesome. I never thought I would use one and decided against the idea after the caesarean section when it was suggested. But with several things occurring in our lives in the lead up to this birth, we decided to look for some additional support as my husband was concerned that he would not be able to be the support I needed (he was fantastic however). Having someone there that knew the process of birth, had done it before and was ‘on my team’ was invaluable. She provided me the support I didn’t know I needed! ” Samantha
What Words Would You Use To Describe Your VBAC Experience?
Perfect, amazing, wonderful. ” Jessica
Empowering, rewarding, and satisfying. ” Marivette
Hospital: Achievement, pride, vindication. Home birth: Beautiful, free, relaxing, natural and surrounded by love ” Alison
Positive, empowering, joyous, calming, triumphant. ” Gen
Surreal, empowering, amazing, awe-inspiring, pure, unhindered, loving, safe, satisfying, cleansing, healing. “ Tessa
Amazing, intense, powerful and intense! ” Miranda
Sensational, amazing and healing “ it undid the hurt and trauma associated with my first birth.
Validating “ I CAN give birth naturally. Rewarding “ having a baby to hold and feed and love straight after birth instead of being left alone in a recovery room with nothing but my feelings of failure and missing out on the first hour of my baby’s life. ” Samantha
It was the most amazing, incredible, exhilarating experience of my life “ mind you I wasn’t saying this at the time! “I want an epidural” and “Just give me a caesarean section!” I yelled out more than once but my support knew I definitely didn’t want this! ” Stacey
That leaves just one last question left to ask¦. and I will let the answers speak for themselves!
If You Had To Do It All Over Again, Would You?
Absolutely!! ” Jessica
I would have done both at home. ” Alison
Most certainly! VBAC was the best decision I could have made to birth my son. ” Stacey
In a flash! I wish I could do it all over again right now ” my HBAC baby is already 7 weeks old and the birth experience is starting to seem like a dream! ” Tessa
Without a doubt. ” Samantha
Absolutely. There is no question about it, if we are having a third baby, I will be having another VBAC! ” Miranda
Absolutely! And I hope to. In hindsight I believe that a lot of the preparation I did for my VBAC I should have done for my first birth. I don’t think that birth and VBAC are all that different in the end or that they should be. I think that to ensure a successful natural ‘vaginal’ birth in the modern day with the maternity system the way it is, it is almost necessary to undertake preparations such as those I did for my VBAC. ” Gen
Read More and Join In!
Be sure to stop by in the BellyBelly VBAC forums for even more support, information and stories from others researching and planning their own VBACs and HBACs.
Recommended Reading For VBAC’ers
- Birthing Normally After a Cesarean or Two
- Silent Knife: Cesarean Prevention and Vaginal Birth after Cesarean
- The Thinking Woman’s Guide To A Better Birth by Henci Goer