VBAC support - I don't know what to do!

Hi everybody,

It's been a long time since I've been on this forum! It's nice to be back. The support I received from here around my first birth and breastfeeding was wonderful. :)

My little girl is 2 years old now - she was an emergency caesarian birth, after an induction (which went a bit awry), then epidural, then her head getting stuck in a funny position in my pelvis and her going into distress. I'm fine with the fact that I had a C/S - she was in distress, I was in distress, it was the best outcome at the time. Of course, I would have preferred that things hadn't gone pear-shaped like that and it had been a normal birth, but I'm not dwelling on that - I have a wonderful, healthy girl. :)

So now I'm 10 weeks pregnant with my second! Hooray!

I will be going back to the public hospital where I birthed my daughter, as I was extremely happy with their care both before, during and after birth. My only concern is birth support.

When I was pregnant with my daughter, we discussed having a doula but didn't do anything about it. My partner wasn't convinced one was necessary, I wasn't fully convinced either, and so I didn't have one. Perhaps if I had, I mightn't have had an epidural with the first (I was freaking out as the induction had gotten totally out of control), but I might have anyway. Nonetheless, my partner's position on birth support could be classed as "cynical".

We haven't spoken about it for this child, but I'm starting to wonder whether it would be something worthwhile. I've done some reading and I'm aware how risk averse hospitals are, and I'm worried about my partner's and my ability to keep our heads clear throughout the birth. I think that birth support might be worthwhile, pending some more reading and research. I know that I can convince my partner to go ahead with support if need be - it's me giving birth, after all, not him!

So, my question is, what sort of support would be best in this situation - independent midwife, student midwife, doula? Does anybody have any experiences that they would be willing to share about situations similar to mine? Any other words of wisdom that anybody can give me?

Thanks in advance for all of your help. :)

Hi Pinkukuele,
I haven't given birth yet (I'm currently 34 weeks pg) and we decided to get a Doula. Even though we are birthing in a birth centre thats got a great reputation for supporting the couples choices, we've also hired a Doula. Incidently, she is a Doula that specializes in VBAC. google 'birthworks'. She's in Melbourne, so I'm not sure if that matches with you but if not, she may be able to point you to other vbac specialist Doulas.
She's very experienced and is an important support for us before, during and after birth. In our session with her, shes teaching us lots of very useful things to do to prepare for labor etc and talking through fears, concerns and our birth plan.
Its good to interview a few to find the one that you really gel with. The list of questions and info on Doulas in the articles section of BB are a great help. Id also recommend looking into doing Calmbirth- its very empowering for both partners.
Also, if you haven't read it yet, a book that's highly recomended on BB and helped me to trust my body more and feel empowered is Ina May Gaskins Guide to Childbirth- Definitely worth a read or two!
Happy to answer more question etc if you have more...

Hi,
I can't go past a vbac post and not respond. I also had an emerg c.s with my first, after being induced and not progressing as fast as the hospy liked. We enlisted a doula to help with our second pregnancy birth when I tried to vbac. She was invaluable support - my DH at first wasn't so sure, but it was the best thing we did. Lots of support for both of us.
Just be aware that a fantastic experience at a hospital for a first birth is not always the same experience going for a vbac. I went back to the same hospital for DS2 and they weren't that supportive of it. I had an 18 month gap and that was the shortest timeframe where they would 'allow' me to 'try' for a vbac. I had a really inexperienced Dr tell me that it could be disastrous and also bullied me about my birth plan. She was a b. I was given a tight timeframe to birth naturally and couldn't be induced again. I think it was something like 4 hrs plus 4 hrs and if not progressing fast enough, back to theatre. I didn't get into labour naturally, so they broke my waters (I was 2-3 cm dilated already) and it was so stressful trying to get into labour from a standing start. We also had the midwife/ice maiden who came in to check the monitors and walked out again. Our doula was priceless, she kept me calm and focussed. She also helped to make the space mine and advocated my wishes with the staff. Anyway, I didn't pop out a baby fast enough, so I had another c.s Stupid me for going back to that hospital - so definately ask lots of questions about vbac with your hospital of choice.

With my VBA2c attempt this year, we had the same doula again and she was just awesome. She does reflexology - the best foot massages I have ever had and lent me hypnbirthing cds' and books on vbac to give me confidence etc. She referred me to a local chiro who worked magic on my back/pelvis and getting the baby into a good position. She also visited me at home after bubs was born, to provide support. I ended up getting pre-eclampsia at 40 weeks and so had another c.s but for medical reasons this time. I found a private obs who really supported vba2c (which most Dr's aren't keen on). Anyway, enough of my rambling - just make sure that you do lots of research, really quiz your hospital on their vbac success rate, their hospital policies/timeframes etc for vbac and also read lots of vbac stories. I can't say how much a doula would be beneficial in helping with your vbac. Wishing you all the best for a happy and healthy pregnancy and a great vbac!

Hi,

I am going for a VBAC this time around and you do need the right support and have people support your choice for VBAC. I have found most people assume I will just be booking back in for a c-sect, which there is no medical reason to so I am not.

I am not hiring a doula or IM as I feel I have the right OBS who I have discussed at length with about VBAC and is thoroughly supportive. He won't place time limits on me (as Three Graces had) and the private hospital I am going to has over a 70% success rate with VBAC, which is considered high for a private hospital. My husband is my primary support person with my sister & mum as backup. I do really believe you need to find a supportive OBS, midwives, hospital etc.... firstly (if planning on going to a hospital or birth centre) or consider a homebirth. There is a homebirth thread & a few have had their first bubs via c-sect then successfully HBAC with IM's.
I also do yoga and see a chiropractor, have just started RLT and listening to hypnobirthing CD. Closer to my EDD I will seek out optimal birthing positions from my yoga teacher & chiro.

Thanks everybody for your support.

I guess that one of my biggest questions for those of you who have/had a doula is why a doula? Why not an IM? I'm really not sure on the pros and cons of each.

I'm pretty sure that my hospital is pretty supportive - I've looked at their stats, read their policies, read stories of VBACs and also have a couple of friends who have had successful VBACs. Of course it might be different when I start having appointments there, but if it is I'll reassess then.

Neither myself nor my partner are comfortable with the idea of a homebirth, for us. I was actually planning (when pregnant with the first) to have a vaginal birth in hospital for the first then homebirth for the second... clearly that didn't work, and after our last experience I think we'll feel a lot better having a surgery right there, if needed. So we're stuck with going to a hospital. The local birth centre won't do VBACs.

I am in Melbourne, Frangipani Lou, and will google your Doula! Any other recommendations most welcome! :)

I guess at this point I need to do some more reading and more thinking. If anybody has any further experiences or stories or questions for me, please share - I'm open to any opinions or help that I could get. :)

I think one of the advantages to hiring an IM is that you can work on a plan to stay at home for most of your labour - not a bad idea when going for a VBAC. She is able to check on you and the baby and provide proof that you and baby are safe and well, and it is fine for you to keep on labouring at home.

An IM is also wonderful to have in your corner if they try to put the frighteners on you about going past 42 weeks or if your membrances release and you don't start having contractions. They often don't give you info about Expectant Management in such scenarios, to allow you to make an informed choices rather than a coerced choice ("your baby might die"). But if you have an IM, you can get another opinion and this can buy you time.

I have attended several VBACs where the mother hired an IM and a doula!

I also warmly recommend Erika Munton. Erika took care of one my clients when I was not available (because I was having my own baby!) and she was excellent.

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I think one of the advantages to hiring an IM is that you can work on a plan to stay at home for most of your labour - not a bad idea when going for a VBAC. She is able to check on you and the baby and provide proof that you and baby are safe and well, and it is fine for you to keep on labouring at home.

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I think this is definitely a key point. I don't have a doula or IM (personal choice) & am going to have to chat to my OBS about when to go to hospital b/c the chat I had with a midwife from the hospital was along the lines of call us when things start happening, which is not what I want to do. So I need to be quite clear with what the expectation is from my OBS, the hospital and what I am comfortable with. I know once I walk in that hospital door that they are going to commence monitoring me & put a canula in readiness / just in case, which I do not want too soon as this is where things went pear shaped last time for me.

This article may be helpful when approaching VBAC (or any birth really)

https://www.facebook.com/notes/melbo...40649589289329

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Your First Night of Labour

If this is your first baby, it is not unlikely that your labour may begin in the late evening or the wee hours – because hormone levels rise after the sun goes down. Oxytocin likes darkness, peace and quiet, and privacy! It is realistic that your birth may unfold over a couple of days. So mentally prepare for the possibility of two nights of little or no sleep, it is better to be prepared and pleasantly surprised, that unprepared and taken aback by how long a first labour can take. Sleep deprivation can be an unexpected factor that can potentially de-rail a great birth plan. Some women are really psyched up to deal with the normal pain and exertion of birth – but the unexpected exhaustion of sleep deprivation is what pushes them over the threshold of ‘coping’ to ‘not coping’. So let’s get real.



A first labour can involve hours, sometimes even days, of warm-up or pre-labour. Your body is doing important work to soften and thin your cervix and get everything soft, warm and stretchy for birth. It’s all good! But it can take some patience. Don’t pay too much attention to these early cramps and warm-up contractions. It’s not time to start your mental “labour-metre” or begin the floor show. Kind of ignore what is happening, don’t pay it too much attention. Wait till labour demands your full attention and focus. If it is night time, focus on relaxing and napping as much possible.



Gloria Lemay, a Canadian midwife, has some sage advice about working with your natural bio-rhythms when labour starts in the wee hours. It is apt for any birth - especially first births and VBACs. Gloria writes:



"Many births begin in the night…. the woman will get up to wee, feel her membranes release and then an hour later begin having sensations fifteen minutes apart. Because we think of birth as a family/couple experience, most women will wake up their husbands to tell them something’s starting and then, probably because we all hope we’ll be the 1 in 10,000 women who don’t experience much pain, we start getting the birth supplies organized, fill up the water tub, etc.



I have seen so many births that take days and days of prodromal (under 3 cms. dilation) sensations and they usually begin this way. The couple distract themselves in that early critical time when the pituitary gland is beginning to put out oxytocin to dilate the cervix. Turning on the light causes inhibition of the oxytocin release. Many couples don’t call their midwives until they’ve got sensations coming 5 minutes apart at 7:00 a.m. but they’ve been up since midnight timing every one of the early sensations. If they had called their midwife at midnight she would have said “Turn off the light and let your husband sleep as much as possible through the night. You, stay dark and quiet. Take a bath with a candle if it helps and call me back when you think I should come over.”



That first night can make all the difference and yet so many couples act like it’s a party and don’t realize they are sabotaging their births right at the beginning. Staying up all night in the early part does two things–it throws off the body clock that controls sleep and waking and confuses the brain AND it inhibits the release of the very hormone you need to dilate effectively. When you begin to have sensations, I urge you to ignore it as long as you possibly can. Don’t tell anyone. Have a “secret sensation time” with your unborn baby and get in as dark a space as you can. Minimize what is happening with your husband, family and the birth attendants.

What would you rather have–a big, long dramatic birth story to tell everyone - or a really smooth birth? You do have a say over your hormone activity. Help your pituitary gland secrete oxytocin to open your cervix by being in a dark, quiet room with your eyes closed."



Remember: denial is not just a river in Egypt. It’s your friend in early labour!

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And Gloria Lemay on the "Very Beautiful and Courageous Birth": http://melbournedoula.blogspot.com.a...tiful-and.html

Thanks for sharing Julie. Will keep that in mind, certainly am expecting alot of pre labour again - I had four days of it with my DD :-/

Wow, that is an amazing article, thanks for posting Julie.
I already have a successful VBAC under my belt and am due any day now with what i hope to be my 2VBAC baby. For the last week I've been having lots of prodromal labour and getting a little impatient, but after reading this I'm happier to let things go slowly. I also feel reassured that the 2 nights that I went to bed to sleep and my contractions fizzled out, that it was the right decision and staying up wouldn't necessarily have established my labour.