If so, you might be wondering how to prepare, both logistically and emotionally, to give yourself the best odds of having the outcome you want. The VBAC rate has fallen dramatically in recent years, making preparation and planning very important.
So we assembled this list of steps you can take in preparing for a VBAC. Consider it a starting point, and feel free to add to it in the comments!
Choose providers carefully, and don’t be afraid to shop around. Probably the most important decision you’ll need to make is your choice of provider. Obstetrical and midwifery practices can have widely varying VBAC success rates, so it’s important to shop around. This might lead you to change providers, which you can do even in the final weeks of pregnancy. You may feel uncomfortable switching practices or shopping around, but a provider’s VBAC history is the factor most likely to determine a birth outcome. Concerned about having to drive a little longer to get to the hospital? One mom we know puts it this way: Would you drive an extra 15 minutes to get to a good hairdresser? (And in a true emergency you’ll end up at the closest hospital anyway).
How should you judge the best place for a trial of labor? Look at the practices’ VBAC rates, including the number of women who have had a trial of labor and the percentage of those labors which ended in VBACs. If this isn’t available online, call and ask the practice for their rates in the last year or two. If they are unwilling to share this, consider that important information. Also check the hospital’s rates, which are more likely available online, but understand that most hospitals host several practices, so this number is a combination of the practices’ rates. When interviewing providers, try to learn as much as possible about practices’ VBAC policies: How long can you go “post dates” and still try for a VBAC? What kind of monitoring do they do? Can you labor in water? If you end up with a CBAC, can your doula be present in the operating room? What do they think makes someone a “good candidate” for a trial of labor? In your search, remember that, while there are many wonderful obstetricians, certified nurse midwives in general have lower cesarean rates.
An important tool in researching your options is the International Cesarean Awareness Network (ICAN) website’s VBAC policy database. ICAN members contacted every maternity hospital in the U.S. to determine which had bans on VBAC – both outright and “de facto” (those without an official policy but in which no practice would attend a VBAC) – and found that roughly half of all hospitals do not allow a trial of labor. So you may want to begin here in your research.
Hire a doula. Labors with the trained support of a doula are less likely to send in cesarean births, so be sure to have a doula or other trained labor support person present. When looking for a doula, try to find one who has experience with VBAC labors and who is knowledgeable about providers’ VBAC practices and policies. If you can’t afford one, see our post on ways of finding good labor support when a doula isn’t in the budget.
Get peer support from other mothers who are in your position. Even when mothers get great support from their providers and partners, it can be isolating to try for a VBAC and it’s often very powerful to have peer support from people who understand how you feel. ICAN is one such organization, and you can find a group here. If there isn’t a group near you, you can find support in their closed Facebook page, and the forums of a number of other websites. You may also want to read VBAC birth stories, and there are many on the ICAN website.
Learn non-medication based methods of reducing discomfort in labor. As with birth generally, the longer you can relieve pain without using medication during a trial of labor, the better your chances of having a vaginal birth. That’s because medication-based means of pain relief often trigger a “cascade of interventions” which leads to a cesarean. So learn about ways of relieving pain, such as movement, deep relaxation, partner massage, visualization, breathing, water, and others. Of course, it’s definitely possible to have a VBAC with medication, so if your labor ends up going in that direction all is not lost!
Learn about fetal positioning. If your cesarean birth was due at least in part to fetal positioning (having a posterior or “sunnyside up” baby), learn more about that topic and choose providers (including doulas) who are skilled at helping babies settle into optimal position for vaginal birth, including during labor. The Spinning Babies website and chiropractic care from someone trained in Webster’s Technique can be helpful. Be sure to listen to our podcast on posterior babies and what can be done to change their positions, including the “belly lift” and “sifting” with a rebozo.
Prepare for the possibility of another cesarean birth. Even moms who are completely focused on having a VBAC need to have a back-up plan they’re comfortable with. Explore the possibility of family-centered cesarean, which may include options such as doing skin-to-skin and/or breastfeeding in the operating room, having your arms free to touch the baby, a slower birth through the incision, lowering the drape so you can see the baby being born (if you want), and other less frequently used practices. Meet with the obstetrician who would be performing the cesarean to work out your backup plan. And you may want to listen to our podcast on family-centered cesarean.
Work on processing past experience. If the prior cesarean was traumatic and strong feelings are affecting emotional preparation for your next birth, do the hard work of processing it. EMDR and other therapies can be very useful for this. Discuss your prior experience with your providers and briefly explain it in your birth plan. Other emotional preparation, such as visualizing a repeat cesarean or peering into the OR, may be useful. You may also want to read our post on getting help for traumatic birth experiences or listen to our podcast on traumatic birth.
Stay active. Exercising reduces your risk of gestational diabetes and having a large baby, both of which can affect your chances of having a VBAC. You’ll also be in better shape for the workout that is labor and birth.
Finally, you may want to listen to Motherlove’s podcast on VBAC – an interview with he president of ICAN.
Charlie spoke about how few moms have paid parental leave, how much leave moms actually take, the health and economic costs of our current policy, how current policy affects the role of partners, and what Moms Rising is doing to advocate for better policies.
Whatever you call it, if you’re pregnant and want a more satisfying cesarean experience should one be necessary, you’ll want to learn more about it.
In this podcast interview we talked with Robin Elise Weiss, author, childbirth and postpartum educator, certified doula, doula trainer, and lactation counselor. Robin is the Pregnancy and Childbirth expert on About.com and is the author of numerous books, including The About.com Guides to Having a Baby and Baby Care, The Everything New Mother’s guides to The First Year, Pregnancy Fitness, and Getting Pregnant.
We discussed what a family-centered cesarean looks like, what it means to moms and for birth outcomes, how moms can advocate for a family-centered cesarean, and whether this new trend will harm efforts to reduce the historic high cesarean rates of recent years.
What is birth like for them? How long do they have with their babies before they’re separated? Why do some birth in shackles? And is it possible for incarcerated mothers to breastfeed?
To answer these questions we spoke with Marianne Bullock, co-founder of The Prison Birth Project, a non profit organization providing support, education, advocacy, and activism training to women at the intersection of the criminal justice system and motherhood.
We’re very happy to share a podcast interview on trauma from childbirth, with Dr. Kathleen Kendall-Tackett, health psychologist and trauma expert.
Dr. Kendall-Tackett is health psychologist, and Clinical Associate Professor of Pediatrics. She is president-elect of the Trauma Division of the American Psychological Association, and the incoming editor-in-chief of the Journal of Psychological Trauma. She has authored more than 300 articles and 24 books on maternal depression, trauma, family violence and breastfeeding, including Depression in New Mothers and Breastfeeding Made Simple.
Dr. Kendall-Tackett discussed what trauma looks like, what experiences tend to cause trauma, partners and trauma, strategies for healing from trauma, ideas for preparing for a subsequent birth, and post-traumatic growth. She also discusses the relationship between trauma and breastfeeding, and answers your questions submitted on Facebook.
We’ve got a salve for that!
Motherlove’s line of protective and soothing herbal salves provides natural and effective relief to get you through many skin problems:
Motherlove’s Pregnant Belly Salve is an all natural way to prevent and soothe stretch marks. Certified organic herbs added to a scar-healing base of shea butter do wonders to prevent, soothe, and minimize stretch marks. You can use our Pregnant Belly Salve on dry heels, elbows, your c-section scar, even chapped lips. The stars of this salve are marshmallow, which softens skin and soothes skin irritations; rosehips, which helps prevent scarring and hydrates the skin; calendula, an an all purpose skin healing herb; and chamomile, an anti-inflammatory herb which softens skin.
Motherlove’s Green Salve is all-purpose, multi-tasking soother and healer. This organic, all natural salve is the perfect remedy for rashes, and chapped or irritated skin, including eczema. In winter it’s great for dry, chapped skin; in summer it’s great for taking the itch out of bug bites, bee stings, and poison ivy. Green Salve contains extra virgin olive oil, beeswax, plantain herb, comfrey herb, marshmallow root, and calendula flower. Plantain herb is known as “nature’s band aid” because it is excellent for healing wounds and drawing out toxins. Comfrey herb is nicknamed “knitbone,” as it quickly heals wounds and prevents scarring. Marshmallow and calendula soothe, heal, and soften skin.
Motherlove’s Nipple Cream is made with all certified organic ingredients which heal and soothe sore, cracked nursing nipples. Motherlove’s Nipple Cream contains extra virgin olive oil, beeswax, shea butter, marshmallow root, calendula. All ingredients are safe for ingestion, so it does not need to be washed off prior to nursing. Have leftover Nipple Cream? Here are 13 more ways to use our Nipple Cream including using it on chapped lips, dry elbows, and even to tame frizzy hair!
Motherlove’s Diaper Rash & Thrush is an all-natural salve made with certified organic ingredients for persistent, inflamed diaper rash. It contains healing herbs oregon grape root to clear up skin conditions, yarrow to soothe rashes, myrrh to fight bacteria and yeast overgrowth, and calendula to soothe skin. If you’ve been treating diaper rash unsuccessfully with other products, your baby may have a yeast infection which requires a product with antifungal properties. Our Diaper Rash & Thrush salve is diaper safe and compatible with all diapers including cloth. This salve can also be used on nursing nipples, and does not need to be washed off nipples prior to nursing.
Motherlove’s Tattoo Care is a certified organic salve which provides optimal moisturizing and healing properties for a new tattoo, yet retains a consistency that is comfortable to apply while tattooing or to a fresh tattoo. Unlike petroleum-based products, Motherlove Tattoo Care allows the skin to breathe, and allows ink to fully penetrate the skin. Made with calendula flowers and marshmallow root, infused in extra virgin olive oil, beeswax, and shea butter, it keeps pores from getting clogged and promotes a quicker healing time.
Motherlove’s Rhoid Balm is a certified organic balm which provides immediate relief for inflamed tissues. It contains a soothing combination of herbs including witch hazel, recommended by moms and doctors alike to reduce swelling, slow bleeding, and ease the discomfort of hemorrhoids
As many as 18% of all women experience trauma related to childbirth, one third of whom experience Post Traumatic Stress Disorder (PTSD). Yet despite its widespread nature, the experience of birth-related trauma can be an isolating one, as mothers are encouraged to focus on their babies and quickly “get over” their birth experience. Trauma can affect a mother – and a partner’s – ability to connect with their baby, carry out normal activities, and can also impair breastfeeding.
Fortunately there are some good resources available to mothers who are experiencing birth-related trauma, which we are happy to share below. But first, some common questions about birth-related trauma.
Do you have PTSD related to your birth? Here are some common characteristic features, according to the Birth Trauma Association:
What are some common triggers for birth-related PTSD? Again, according to the Birth Trauma Association:
What are some resources for help for mothers and partners experiencing birth-related PTSD?
Connect with other moms. Connecting with other moms helps you see that you’re not alone. There are a number of online communities for mothers experiencing birth-related trauma, including Solace for Mothers, Birth Trauma Association’s Facebook page, and Baby Center.
EMDR (Eye Movement Desensitization and Reprocessing) therapy is considered by trauma experts, including the U.S. Departments of Veterans Affairs and Defense and the American Psychological Association, to be a front line treatment for PTSD. EMDR involves thinking about the traumatic experience while experiencing a stimulus engaging both sides of your perception. This might mean moving your eyes back and forth, listening to a tapping sound in alternating ears, or feeling a tapping on alternating knees. EMDR typically reduces symptoms after just a few sessions. To find a certified EMDR professional, see the EMDR Institute or the EMDR International Association.
Cognitive Behavioral Therapy (CBT) is a form of therapy which addresses beliefs caused by trauma and helps to counter conditioned-fear responses related to the traumatic experience. To find a CBT therapist, search the websites of the National Association of Cognitive Behavioral Therapist’s or the Association for Behavioral and Cognitive Therapies.
Medications. You may want to discuss medication options with your healthcare provider. A summary of medication options is provided here.
Care for partners. Partners can experience trauma related to childbirth as well. Encourage partners to seek help if they are experiencing trauma.
Herbs can be a huge help in maintaining the health of your skin during pregnancy, soothing and preventing stretch marks. But did you know that they can also help heal and minimize your cesarean scar?
Here are some herbs which can applied topically – once your incision has fully healed and your health care provider approves – to assist in the healing and minimizing of your c-section scar.* You may also want to listen to our podcast on caring for your c-section.
And when looking for products which contain these ingredients, be sure not to choose ones with body care ingredients to avoid.
Aloe vera is a classic skin healer, used for nearly thousands of years to soothe burns, moisturize, and condition skin.
Calendula, an herb we use in our Pregnant Belly Oil, Pregnant Belly Salve, Nipple Cream, Diaper Rash & Thrush, Rhoid Balm, is an an all-purpose skin healing herb used to stop bleeding, wash wounds, heal cuts, abscesses, rashes, boils, chapped skin, and eczema.
Sea buckthorn is an orange berry heralded for the its rare omega 7 fatty acids, high Vitamin C content, and its anti-inflammatory properties, all of which can condition the skin.
Jojoba seed oil was first used by Native Americans in order to heal and condition skin and hair. It’s also useful as a treatment for burns.
Gotu kola has been used for centuries to heal wounds and treat skin conditions.
St. John’s Wort is better known for its effects on mood, but it’s also a useful herb for skin healing and burn care.
* This information is provided for educational purposes only, and is not medical advice. Consult your health care provider before using this information, and never apply topical agents to your c-section scar before it has healed.
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What can you do in pregnancy to keep your baby in the anterior position? And can you change the position of the baby once labor has started?
Our podcast guest, Michelle L’Esperance answers these questions and more. Michelle is a certified professional midwife, doula and doula trainer, and runs workshops on creative movement for birth which help parents encourage optimal fetal positioning.Pin It
What are hemorrhoids, and why are we more likely to get them during pregnancy?
Hemorrhoids are a result of increased blood flow in pregnancy, particularly to those below your uterus. These veins can become dilated and swollen, and itch, burn, and bleed.
How can you prevent hemorrhoids in pregnancy?
The key to preventing hemorrhoids is avoiding constipation, which puts extra pressure on your rectum during bowel movements. To prevent or reduce constipation, you can:
If you have hemorrhoids, what can you do to treat them?
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