Considering a VBAC?...Doulas Are Essential

“Giving birth should be your greatest achievement, not your greatest fear.”
— Jane Weideman

You may have been ready for this journey since you cries tears after realizing that your baby was going to be born in the OR or you may have had a provider suggest that it would be a great choice not to have a repeat cesarean. However you arrive there, making the decision to do a vaginal birth after cesarean (VBAC) isn’t easy. There are always those “what if” thoughts going on inside your head. You may think that after having one or two cesareans that there is no way you can VBAC. Parents planning a VBAC find themselves diving deep into learning more and planning to make the best decisions for themselves and their baby.

Have you considered talking to a doula? Doulas assist in that process to ease the worries and help parents understand what to expect. We are here to help provide the knowledge you need about VBAC and increase your chances of having a vaginal birth!

What is VBAC?

Vaginal Birth After Cesarean. If your last birth was a cesarean and you’re pregnant again, you will likely be able to choose between scheduling a repeat cesarean or a vaginal birth after cesarean (VBAC). A VBAC friendly provider can help you make that decision.

What is TOLAC?

Trial Of Labor After Cesarean. This is an attempted vaginal delivery following a cesarean. Sometimes, there is a need to change the plan and a TOLAC results in another cesarean birth. When the TOLAC results in a vaginal delivery, the birth is considered a VBAC.

What Makes You A VBAC Candidate?

You should talk with your medical provider about having a VBAC and chances are in your favor that you are a candidate if you have some of the following:

  • Having a low transverse incision done from side to side across the lower, thinner section of the uterus. It’s the most common type of incision and has the lowest risk of rupturing in the future.

  • You have had a successful vaginal delivery (either before or after a cesarean birth).

  • No major medical problems.

  • The baby is head-down.

  • Your labor starts on its own (some providers may require this, some may not).

  • It has been over 18 months since your last delivery.

What To Expect:

If you’re having a TOLAC (trial of labor after cesarean), you’ll likely be told to go to the hospital soon after labor starts. After being admitted, you may have a blood test as well as an examination. An IV port will be placed to have quick access if fluids or medicine is needed. You and your baby will be closely monitored throughout labor and a doula is there by your side to not

What You Should Know If You’re A Candidate:

  • Choosing the right provider

    • Doulas have worked in all local hospitals and can provide input on choosing a VBAC provider.

    • It is important to choose a care provider who is an expert in VBACs. They will understand your birth plan because it is what they already do every day.

    • The most common VBAC provider is an OB/GYN. They do work in hospitals and are likely to recommend common procedures such as epidurals, inductions, and cesareans.

    • Midwives have a lower rate of intervention, lower cesarean rates, and greater VBAC rates. Of all the provider types, they are most likely to be VBAC friendly.

    • Ask VBAC providers about their personal history with VBAC. The higher their VBAC success rates and lower their cesarean rates, the better!

    • When searching for providers, ask them about their requirements needed for a VBAC candidate and most importantly, their VBAC success rates.

    • You can do some research on your hospital’s cesarean rates from cesareanrates.org to see if they would be VBAC friendly or not. It breaks cesarean rates down by state and hospital. If cesarean rates tend to be on the higher side, you should consider searching for a different hospital and provider.

  • VBAC is often less risky as a repeat cesarean

  • VBAC is the best for your baby

    • When your baby is ready to be born, labor begins to ensure that the lungs are mature and the brain has developed. 

    • Your baby will be exposed to your good bacteria as well as antibodies if you give birth vaginally.

  • It’s a different recovery after birth

    • Recovery is much easier following a vaginal birth, especially in the early days because you are more likely to get up and walk to the bathroom and shower soon after giving birth.

    • You may feel uncomfortable, bruised, weary, and possibly have stitches after a vaginal birth, but it is not the same as recovering after surgery.

Most women choose to VBAC because they want to have the birth they missed out on last time. It’s a true positive and empowering birth experience that can be healing for a previous trauma.

Risks Included With VBAC:

The biggest risk while attempting VBAC is a uterine rupture. Though uterine rupture is rare, it happens in less than 1% of women with a low transverse scar who attempt a trial of labor after cesarean. Your provider will be there to monitor you and your baby at all times to make sure everything is going well and if needed, you will be taken to the OR to have your baby. Most parents choose to have the medical support of a hospital for access to quick support, but others choose to have their babies at home (HVBAC). Just remember to trust your body, trust your baby, and trust the process. As much as you can, stay relaxed, calm, and fearless.

Why TOLAC Is Done:

  • Impact on Future Pregnancies

    • If you are planning on having more children, VBAC might help you avoid the risks of multiple cesarean deliveries.

  • Lower Risk of Surgical Complications

    • Successful VBAC is linked to lower chances of severe bleeding, infection and blood clotting in one or more deep veins in the body, as well as a lower risk of uterine surgery and harm to abdominal organs like the bladder or colon. (scar tissue in repeat cesarean)

  • Shorter Recovery Time

    • You’ll have a shorter hospital stay after a VBAC than you would after a repeat cesarean. Avoiding surgery will help you resume your normal activities sooner.

The VBAC Link Group

There is so much support out there for moms that are having their first VBAC or maybe even their second or third. “The VBAC Link” is an organization that provides all information about VBACs including blogs, resources, podcasts, and more! Sign up for their facebook group to connect with others who have similar experiences and have shared their VBAC stories. Click down below to listen to their podcasts.

Allison RollansVBAC, Labor DoulaComment