Tips for VBAC

[mummaofchaz]

Just wondering if anyone can give me some helpful tips and advice about attempting a VBAC. I am scared i'll chicken out towards the end as I wont be having a doula or private midwife to help keep me focused and I don't know if there is anything exercise wise I could try to help with the attempt.
What sort of answers could I give to the OB if he tries to spin off the risks etc.?

[Hannahbanana]

I just posted in your other thread but will post here too.

I think exercise wise, just staying active is enough.....pushing your other child in the pram for a walk on a regular basis is enough if your not into the whole exercise thing. I was gyming before I got pregnant with my DD2 but didn't keep it up while I was pregnant, but I walked with my other 2 in the pram to the shops and back heaps.

As I said before read up on VBAC's and birth - Silent knife is an excellent book and it helped me make the decision to have a VBA2C - that way you will be informed and won't have to rely on the obs to inform you of the risks. When they do bring up the risk involved you can say "yes I am well aware of the small risk of VBAC, what are the risks of repeat CS??" If you show them that you are educated about VBAC they are less likley to try to scare you out of it.

I also watched a lot of birth DVDs and doccos and watched the montages on youTube. They were great for inspiration especially when I was feeling a bit overwealmed about it all.

As for the Doula and IM, they are truly well worth the expense. Having someone on your side for your whole labour is invaluable to both you and your DH/DP. If the expense is an issue you could see if you could find a student doula or midwife. They need to be a part of a certain number of births before they can be fully qualified and they don't usually charge anything.

If you won't be having one as you said then I think the best thing you can do is to educate your DH/DP or whoever will be coming with you during labour. I got my DH to read everything I read so that he was fully informed about VBAC's and birth too. That way we were both on the same page about what we wanted and when the time came he wouldn't be easily scared into anything either.

Everyone gets those moments of 'I don't think I can do it' towards the end. Thats when you read birth stories and watch the montages and.....my personal favourite....use the mantra 'women do this (give birth) everyday....so can I!!'

[*suz1*]

Hi mummaofchaz,

Posting on BellyBelly is a great start. I got loads of invaluable support from the VBAC forum. As HannahBanana said, keep active and read lots. I found the follow up book to Silent Knife called 'Open Season' to also be very helpful. Write a birth plan, they aren't a waste of time. It'll help you to have an empowered birth and if your VBAC is unsuccessful then your birth plan can pave the way for an empowered and satisfying c-section. Choose a care provider that you trust and birth your baby in a place that you feel comfortable in. There are several websites that helped me, ican-online.org is a good start. I think there are more listed on the BellyBelly articles on VBAC. I hadn't made it to the second stage of labour before, so I read up on the stages of labour and as I planned to do it drug free (epidurals aren't recommended for VBACs) I read books like Birth Skills by Juju Sundin and listened to hypnobirthing CDs such as A Labour of Love by Gabrielle Targett. I also watched c-sections and VBACs on youtube. If you don't have a doula or private midwife (I used a birthing centre with team midwife care) make sure your birth partner is prepared to perform the duties of a doula. I am convinced I would have had a repeat c-section if my DH hadn't taken the active role that he did.

A lot of it really is mind over matter. I was down to the last few pushes and I realised that everything had been done and the success of my VBAC was up to me. My body was tired and I was scared of tearing my perineum, but I told myself that if I didn't get my baby out in the next few pushes that it would mean a c-section (in reality it probably meant forceps or ventouse). It was enough motivation for me to birth my son with the next 3 pushes!

Good luck with your VBAC!

[fourthontheway]

You can get a doula free of charge from a doula training college.

My tips would be to stay home as long as possible, stay home until leaving is difficult. Stay home until you feel like pushing - seriously!

Refuse Electronic Fetal Monitoring and request only doppler.

Drink fluids after every contraction, even if you don't feel like it. Refuse to have a drip with fluids because it will mean your movement is limited, you want an ACTIVE birth.

Refuse VE's, they can dishearten you and make hospitals doubt that your labour is progressing.

Refuse surgery for failure to progress, or "post dates". Be very clear that you will ONLY have surgery if you or your baby are in danger. Be well informed about those things so that you can't be pressured.

Read up on the physical symptoms of rupture, and be aware that the chances of a rupture are actually less than the chances of complications from repeat surgery. If you are personally aware of the symptoms of rupture you are les likely to be scared during labour and less easily pressured into repeat surgery for the hospital's FEAR of rupture.

I very strongly suggest reading "Silent Knife - Vaginal Birth after c/sec". No one will EVER pull the wool over your eyes when you've read that. That book should be a MUST READ for anyone who wants a VBAC in a hospital.

I had a vba2c in hospital. I arrived when I was 10cm and pushing and they still tried to tell me I needed surgery. I pushed my son out in 20mins, which is less time than they could have had me in surgery! You can do it too, it takes A LOT of preparation and knowledge to guarantee it though. Good luck! xxx

[BellyBelly]

Honestly, the best chance at a VBAC you'll have is at home with an independent midwife. Second to that, if you birth in hospital, hiring your own independent midwife or doula to be there with you. Studies from around the world show that women who use doulas have 50% less c/s which is what you want, but the system is not very VBAC friendly, with VBAC rates in metro hospitals anywhere from the 14-30% mark. If you go out to a great hospital like Warragul, you'll get more like 70%. But logistically its not possible for most women. Check out the link I have posted with the % VBAC rates by hospital and see if you can pick the best one in your area. Good luck - get as much support as you can because the system just isn't there to support most women's choices.

With all the suggestions above, expect no from most doctors (as well as possibly being told you're endangering your baby), and be prepare to fight. If you know facts ad figures, you'll feel more confident doing that.

[Curly]

It might take a bit of shopping around but there are obstetricians who will support VBAC. My own OB, in her standard literature that she gives out to all her new patients, states that VBAC is safer than having a 2nd caesarean.

My GP was very handy when I first got pregnant, I told her that I wanted a low intervention ob and that was very useful for her and she told me she was glad I mentioned that because she could then steer clear of referring me to obs who had quite interventionist reputations. I used to live in Melbourne and I am quite sure my previous ob would have supported VBAC and a very good friend of mine in Melbourne had a VBAC just yesterday. PM me if you would like the names.

[Laranna]

I had to shop around for my OB who was supportive of VBAC. I made a clear birth plan and we discussed the risks and I assured him that I understood them and this was my decision to VBAC. He was ok with that.

I seriously considered a doula for the reasons Kelly posted above, but I procrastinated too long and didn't end up hiring one. So yes, my VBAC was successful in a hospital with no doula, just two on duty hospital midwives and the ob at the end.

I really recommend arming yourself with as much info about labour and birth as you can - start at your local library and get some books out. I never read Silent Knife although it's highly recommended. I read A Labour of Love, a few Sheila Kitzinger ones and Juju Sundins Birth Skills. I also borrowed a hypno birthing CD and ripped it onto my ipod and listened to that in bed every night. Plus, read LOTS of VBAC birth stories and watch video clips on You Tube. They are great to get you inspired.

Physically, I kept up with my exercise - pilates and walking and started antenatal aquaerobics. I took RLT and EPO from 36 weeks and also used the Epi-No.

Leading up to the labour, I made sure DH knew what to do. I made a list for him so he didn't have to think about it on the day. We also attended birth classes run by a physio which taught us about positions and breathing in labour. I hired a tens machine and used that as soon as labour started.

When labour started, I started moving. Walked around the block, around the house, rocked on the fitball but I also rested in between contractions. I used the shower and bath at home. Like someone else mentioned, stay at home as long as you can absolutely manage! That was my intention too and it worked. I was 7cm and in the beginning of transition stage once I arrived at hospital.

Oh and visualisation helps as well. I constantly pictured myself giving birth vaginally, feeling the contractions, imagining pushing and having the baby come out and being placed on my chest. I never entertained the thought of another c/s. Our thoughts create our reality! That was my favourite affirmation that I read in one of the books.

Good Luck - you can do it! I did!

[LisaL]

Great tips girls!! Im about to attempt a VBAC and i have made an effort to stay active and make sure i go walking every day, OB is confident of VBAC assuming I come into labour on my own, which I did with DD so im not too worried about going post dates etc.. and neither is the OB. Im letting nature take its course and making sure I have an active labour, and the rest is all up to me! I love reading all your advice, it gives me even more confidene, I know I can do this and Im sure you will too mummaofchaz!!