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How to prepare for an empowering VBAC

Many mothers give birth via caesarean for many different reasons. Some being for emergency reasons and some reasons because her medical care providers failed her, and sometimes, women make the decision to birth via a repeat caesarean.


Having a VBAC (Vaginal Birth After Caesarean) or BAC ( Birth After Caesarean) can be a stressful time, especially if your previous birth was a traumatic birth experience.


Knowing where to go to find support and what to do can limit the stress and help you find clarity during your journey.


Throughout your VBAC journey, you will find lots of articles, blogs, negative and positive stories on VBAC; but sifting through the pile to find evidence-based, real-life articles and facts can be like searching for a needle in a haystack.


However, there are fantastic articles written by some amazing birth professionals and mothers out there, but you'll need to find them.


During my VBA2C X2 journey, and while I was writing the VBAC practitioner Training, I realised how important it is for mothers to be able to connect with professionals who are real-life practitioners or have experienced having a VBAC personally.


These professionals tend to have an understanding of what support the VBAC mother needs and how she can achieve a rich birth experience. That's not to say birth professionals who have not experienced a VBAC personally or witnessed one doesn't have the skills to help you. It just means the more experienced VBAC birth professional or supporter most likely will have more information and tips for you.


Let me tell you about our amazing VBAC Live 24hr group for mothers.

Before we unfold all the astonishing tips to help you have a successful, empowering VBAC (Vaginal birth after caesarean), I want to offer you the chance to join the VBAC LIVE 24HR group on WhatsApp.


All you have to do is click the link here:  Access The VBAC 24hr Live Group Now!!


We have specialist VBAC Midwives, Doulas and mothers in this group together so you'll always have support right in your pocket whether you need VBAC support in London, Or VBAC support in Saudi Arabia, VBAC support in the United States Of America or VBAC support in Australia or Africa.... Wherever you are we have professionals waiting to connect with you.


Hopefully, we will see you in the group...


This article aims to provide you with some tips to have a VBAC and to help you understand what your body and baby need from you to birth vaginally after a previous caesarean.

So, what did I do and as well as many other mothers do to achieve their ultimate goal, to have a VBAC regardless of the country you're in or if you have support or not.


1. Have Debriefing Sessions

Having debriefing sessions is extremely important to help you understand why you had a particular experience with your previous birth, and why you had a c-section. The aim of having VBAC Debriefing sessions is to help you contextualise the events of your past birth, to help you come to terms with your emotions and to get you to a place of healing. Many VBAC mothers feel let down, disappointed or even frustrated with their previous births and are left with no one to support them postnatally. 



Birth debriefing sessions can be done face-2-face or online through a software that allows you and the birth Debriefer to meet and have a face-2-face meetings through your computer, phone or tablet.


2. Do your research

Knowing the facts will help you contextualise having a VBAC or not. You're probably bugging out about having a uterine rupture because you've been told it will or will likely happen to you. Actually, there is a strong chance it wont happen to you because under 1% of women have a uterine rupture.


The actual statistics is between 0.2% - 0.7% of women with a prior c-section will have a uterine rupture. Now, you're probably thinking thats not what I've been told or thats not what I thought, right? In fact, you're more likely to have a VBAC (Spontaneous Vaginal birth) if you try and take the right steps to prepare for it.


Having all the evidence to back-up your dream of having a VBAC will most definitely give you a reason to fight for it a little bit harder.



Disclaimer: For a small minority of women, having a VBAC is not a safe option. Make an informed decision to make sure having a VBAC is not harmful for you or your baby.



3. Reading List

Finding books that will give you a clear approach to childbirth is a good idea to get you thinking about what you want for your birth. There are many book available on Amazon that can be delivered to many countries around the world. 


Below I've added a few books to add to your library to give you a clearer picture about what you can expect embarking upon a VBAC.


Vaginal Birth After Caesarean

VBAC Companion

Don't cut me again

Aims: Birth After Caesarean

How to heal a bad birth

Birthing From Within

Ina May's Guide to Childbirth

Active Birth Book


Next year we will release our Naturelle VBAC™ Birth book so make sure to sign up to our mailing list to be the first to know about it's release.


And there are so many more books to choose from


4. Finding a support team / provider

Unfortunately, not every woman trying for a VBAC finds her care providers as supportive as she needs them to be. Having a care provider that supports your decisions and supports VBACs is a massive bonus and really has a positive impact on your chance to have a VBAC. 


There are many ways you can find out if your care provider supports VBAC. Asking how many c-sections they've performed in the past 3 years and how many successful VBACs have taken place in their hospital is one way.


Sometimes, your care provider may not be as truthful as you need them to be. They may tell you they support your choice to have a VBAC but when you're in labour or in the 3rd trimester their words change.


Many mothers find their care providers scheduling a repeat c-section for them on the premise that their scar will rupture or their baby will die.


In  most cases this actually incorrect information and there are ways to minimise this happening to you.


Tolerated / unsupportive care provider signs:

  • Your care provider will reveal distinctive signs that will let you know they tolerate VBAC.

  •  Your baby must be a certain weight

  •  You must progress a certain amount each hour 

  •  You can't go past 40-41 weeks pregnancy gestation

  •  You have to have continuous fetal monitoring

  •  You have to come to the hospital very early when your in labour

  •  You must have an IV in place just in case of any emergencies

  •  Disempowerment

  •  Makes you believe you have a high rate of having a uterine rupture

  •  You are told you are high risk

  •  You are denied the right to be mobile during your birth

  •  You have to have an epidural

  •  They have a low VBAC rate and a high c-section rate

  • VBAC Friendly / Supportive care provider signs:

  •  They don't predict your babies too big for you to have a VBAC

  •  No limits are placed on how long you can labour for as long as you and the baby are doing good

  •  Inductions and augmentations is an option upon consultants decision

  •  Your voice is heard and your rights are respected

  •  Told to come in to the hospital later than earlier when you go into labour. This prevents the need for interventions that are unhelpful and help to derail your VBAC.

  •  They discuss all your options with you from having a VBAC, ELECTIVE C-SECTION, EMERGENCY C-SECTION

  •  They have a low c-section rate and a high VBAC rate

  •  They encourage movement during the birth of your baby

  •  They allow you to eat and drink during labour

  •  They help you create the perfect environment to increase and boost the hormones needed to help labour thrive

Knowing what your Obstetrician or Midwives views and care providers policies are will most definitely help you understand their ethos and the outcome you will most likely face during your labour. So it is paramount you find out. A woman trying for a VBAC for the first time or who has never had a vaginal birth has a 70-75% chance of having a successful VBAC and a woman whose had a successful vaginal birth in the past has a 80% - 90% chance of having another successful VBAC (1)


5. Decide what you want to do

Fortunately, more women are trying for VBACs and more professionals are giving mothers the option to try for a VBAC, even if they've had 3 or 4 c-sections previously. Standing firm on your decision and being clear on your options can make your journey easier. Having all the facts available makes things a lot easier too, but if for any reason you change your mind and want to opt for an elective c-section, you're within your own right and everyone involved in your care plan should respect your decision.


Trust me I know it can be a hard choice to make when there are people telling you how dangerous VBACs are. The reality is VBAC is safe for most women and you have a huge chance of having one too. I hope that puts your mind at ease.


6. Avoid Inductions 

One of the major reasons women attempting a VBAC end up having a repeat c-section. Some of the common issues that can arise from an induction is failure to progress or fetal destress.


Acog state:

Patients who undergo induction of labor are at a higher risk of cesarean delivery than women who experience spontaneous labor. This finding has also been observed in women with a prior cesarean delivery. Several studies have demonstrated that women who are induced in TOLAC have a 2- to 3-fold increased risk of cesarean delivery compared with those who present with spontaneous labor.Sourced from: Medscape


Many women have reported after being induced their birth became a route of medical interventions and nature wasn't allowed to take it's place. Once given one intervention another one is being prepared for you and before you know it a red alert has been declared and your going down for a c-section.


7. Hire a Doula 

Many women I've spoken to and introduced the idea of having a doula have looked at me like i'm crazy. One mum said " Why would I need to pay someone like a midwife to support me"? 


Honestly, Doulas are not midwives. They are your back bone always there to uphold your birth wishes. The one who if need be will speak up for the mothers honour, modesty and birth rights. She's the one who when you need evidence-based information will guide you and when your in labour she's right beside you. We call it mothering the mother and if thats not brilliant, she's there breathing and labouring with you... Always in your corner fighting with you. Doulas are absolutely amazing! 


Lets get to the evidence for doulas because I've just painted a dream right??

women whether from a poor or well-off social economical background were found to have better birth outcomes when they had a doula support them.


Research shows that women value and benefit from the presence of a support person during labour and childbirth. This support may include emotional support (continuous presence, reassurance and praise) and information about labour progress. It may also include advice about coping techniques, comfort measures (comforting touch, massage, warm baths/showers, encouraging mobility, promoting adequate fluid intake and output) and speaking up when needed on behalf of the woman.


Lack of continuous support during childbirth has led to concerns that the experience of labour and birth may have become dehumanised. Sourced from Cochrane 

Women who received continuous labour support may be more likely to give birth 'spontaneously.


The evidence that supports doulas says when women have  a doula or continuous support during pregnancy and throughout labour the mum has reduce risk of having a C-section, having an instrumental birth, reduced need for pain relief or the use of Epidural. The mother has a reduced need for an induction of labour. Women who hire doulas have shorter labours according to the research and the mother are more satisfied with their birth experience. Breastfeeding becomes more likely and easier to initiate


Here is a link to an amazing blog I love that will give you the best explanation for doulas and why you should probably hire one. 


Women who have hired Doulas all say they couldn't have done labour or pregnancy without them. The doula provided substantial support to her and their family. There are three types of doulas you can find:


1. Birth Doula - Will provide support to the mother throughout the mothers pregnancy and will attend the birth of the baby. She will also see the mother two times after the birth of the baby.


2. Postnatal Doula - Will provide extensive support to the mother after the birth of her baby. She may cook for you, watch the children, give you massages, help you get back on your feet. She may do the shopping for you, watch your new baby while you have a nap or a shower, pick the children up from school but most importantly she's there to give you support which may include referring you onto different services and being that ear you can talk to.


3. VBAC Practitioner Doula - Will  provide the same as a birth and postnatal doula does but she is also trained in VBAC specifically. she has tools techniques to  support you when you need debriefing, when you're having problems with your care providers, she also has tools to help you create the best birth team and birth plan.


If you hire a VBAC Practitioner you will be provided lots of literature you can keep to help you reach your ultimate VBAC Goals. Your VBAC Practitioner  knows many techniques to help you turn your Breech baby around to a better position, She knows how to change your limiting beliefs you may experience.


She is there for you when you need to speak and as all the evidence suggests She provides continuous support during pregnancy, attends your labour and supports you postnatally.


You may find a doula who is a postnatal and birth doula and she may be a VBAC practitioner. You can find a VBAC Practitioner in your country here:

Find a VBAC Practitioner to support my VBAC


You can also find a Doula who is an antenatal teacher here:

Find a Naturelle VBAC doula practitioner A doula may be trained in other areas she may be a breastfeeding counsellor, Midwife, Hypnobirthing Practitioner, VBAC practitioner, Nutritional Therapist, or even a Dr.

A doula will empower, educate, support, encourage you, praise you, listen to you, provide continuous support for you, guide you and most of all she will mother you.


8. Find Childbirth Education Classes

Childbirth Education Classes are available internationally for anyone expecting a baby even if you're pregnant with your first, second or fifth baby. These  classes will teach you whats required of your body during pregnancy and birth. You will learn about the best foods you should eat to provide rich nutritious foods to support your babies growing needs. You will also learn about the different stages your baby may go through whilst learning about the different comfort measures which could help you have a quicker birth experience.


Some topics may include: Physiology of birth - Nutrition in Pregnancy, Breastfeeding, Comfort Measures, Pain Relief - Fetal Positioning - Birth and pregnancy Choices - Where to give birth - Learning about birth Partners - Relaxation Techniques - Medical Procedures - Caring for your baby - Your health and so much more...


Finding the right Childbirth education class is vital to how you approach childbirth especially labour. I always suggest to VBAC mothers they should find VBAC Childbirth Education classes because they will cover your normal childbirth class as well as topics specifically for VBAC.


Another major importance is figuring out whether you will attend an independent out of hospital class series, or attend your local hospitals VBAC antenatal class which may be FREE or available for a small price.


Independent classes tend to focus on all the evidences available and how that may work for you as a real mother. They also focus on exemplary models that may go against hospital policies. Remember: VBAC mothers are always going against hospital policies when they want to have a fair shot at childbirth.


Some examples of hospital policies:

Woman attempting a VBAC must have continuous fetal monitoring

She must have a drip in and she can only have a certain amount of time to birth...

We know if the VBAC mother did this her chances of a successful VBAC are slim to none. I also find independent antenatal teachers have a real passion to educate mothers and it's not something they do just as a job description. 

Childbirth education sets the mother up for the best birth experience...

📷

9. Write a Birth plan that will speak for you

Writing a birth plan provides clarity on the type of birth you want. For a VBAC mother, it's wise to keep your birth plan short and sweet with all the important things you want and don't want to happen written clearly.


During your stay in hospital, if you decide to have a hospital VBAC, you may come into contact with one or two midwives throughout your labour due to shift changes, which may happen every 12 hours. Having everyone on board of your plan will likely make things easier for you and your goal of a VBAC more likely to happen.


Another thing I recommend is having your birth plan signed by the consultant midwife in charge. This will ensure all the midwives follow your plan because the midwife in charge has agreed to your plan. Also have your birth plan added into your maternity notes. A copy should be given to your Doula, your husband or partner, and you can keep a spare in your bag just in case. I usually have my birth plan taped to the wall. This way it cannot be missed. 


Make sure your birth plan is clear to read as this will make it easy for the midwives to read. As you know childbirth can change route so I would suggest creating two plans to safe guard you from anything you don't want to happen. Making a  plan B birth plan which would be your c-section plan will give you the chance to have a VBAC on your terms.


I normally write as a heading "VBAC BIRTH PLAN" in bold at the top of the birth plan. This will let the professionals know your plans as soon as they look at your plan.


Writing a birth plan ensures everyone in involved in your

care are aware of your birth preferences.


C-Section Birth Plan

A c-section on your terms is also known as a Gentle or family centred c-section.

Some will say whats the point of writing a c-section birth plan because I'm not having another c-section, but as I said earlier, childbirth can be unpredictable at the best of times. Having a contingency plan in place means you can a caesarean on your terms. 


What does a Caesarean on your terms look like:

You can bring your own music or audio

You can have the drape lowered

You can have your baby placed on your chest after your baby has been born

You can have your partner with you

You can have immediate skin to skin

You can ask to sit up slightly whilst still laying down to see some of the birth of your baby.

You may be able to ask for your baby to be delivered slowly

And so much more...


10. Purchase the VBAC Empowerment Cards

For the first time ever, mothers and birth professionals have access to Powerful cards to support the VBAC mothers journey. I know first hand how stressful my journey was and how much I needed extra support at times. Sometimes I would call someone for advice or uplifting and other times I would internalise the emotions and thoughts I had. Now you can Hire a VBAC Practitioner to support, empower and protect your birth rights and she's been trained in VBAC and in childbirth.


You can also purchase the VBAC Empowerment cards which is a VBAC mothers best friend. When you need encouragement theres a set of cards for that. When you have fears which as you know these emotions and thoughts come and go throughout the duration of your pregnancy, especially if you have anxiety, something mothers can develop during pregnancy. Theres also a set of affirmation cards all in one box which contains over 50 cards for you to work with.


Nonetheless, these cards are so empowering and powerful your VBAC Practitioner can use them to coach you on every session or during your calls. They are truly amazing and you can purchase them here.


Buy my VBAC Empowerment cards now!


Conclusion:

1. Have debriefing sessions

2. Do your research

3. Find Good books to empower, educate and encourage you to adopt a good birthing practice

4. Find a care provider and support team that supports, encourages VBAC and has a high VBAC rate and low c-section rate

5, Make up your own mind and stick to a birth on your terms.

6. Stay away from interventions and inductuctions

7. Hire a doula

8. Take VBAC childbirth education classes

9. Write a C-section & VBAC birth plan

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