c-section scar

7 steps to a successful VBAC

Byadminbrielle

What is a VBAC or VBA2C?

A VBAC is a Vaginal Birth After Cesarean or C-section. So when you see VBA2C that is a vaginal birth after 2 c-sections or 2VBAC is the second vaginal birth after a c-section (1 c-section followed by 2 vaginal births). Statistically 25-33% of women have a c-section. Some providers still have the old thinking that once a cesarean, always a cesarean, but this is not evidence based! 60-80% of women that try for a VBAC are successful. That’s great news!

c-section scar

Here are a few tips to have a successful VBAC.

Educate yourself on your options

Take a childbirth class NOT given by the hospital.

Clase prenatal class

Do your own reading.

Here is a list of books to read when considering and preparing for a VBAC:

Woman reading a Book

  • Baby Got VBAC: An Inspiring Collection of Wisdom for Better Births After a Cesarean

  • Give Birth a Chance: How to Prepare for an Empowered VBAC by Ilia Blandina

  • Birth after Cesarean: Your Journey to a Better Birth by Hazel Keedle, PhD

  • Optimal Care in Childbirth: The Case for a Physiologic Approach by Henci Goer and Amy Romano

Other options are to follow instagram accounts, listen to podcasts, take online VBAC courses, and read blogs online.

Be prepared to insist on evidence based practices - such as:

Hire a doula

Evidence suggests that women who are attended in birth by doulas have shorter labors, less interventions, and lower rates of c-sections. Doulas do many things to help during labor. I want to highlight 2 here.

Pregnant woman leaning on birth ball while husband uses rebozo with doulas help

They form part of the support team with the partner, mother, sister, etc. They help provide constant support to the laboring mother. Think bathroom breaks, food breaks, taking a quick nap or just needing some air to come back fresh. No matter who is supporting the laboring mother, they will need to take care of these basic needs and honestly, it is great for the support team’s morale and positivity throughout the experience. If you have at least 2 support people, the laboring mother will never be left alone.

Doulas believe in your ability to birth. This will help boost your confidence both before and during labor. This confidence will help you to advocate for what you want based on your understanding and research. Your doula will then support your decisions and help make sure your care team (doctors, nurses, midwives) do to.

Doulas can also do a lot to help ease discomfort during contractions, help you stay mobile during labor (even with an epidural), and support optimal positioning for you and baby.

*TOLAC means Trial Of Labor After Cesarean.

New mother and baby with husband and doula in hospital

Process your previous birth

Two women crying together

Especially if your previous birth was traumatic. Having unprocessed trauma can mess with hormones during labor which may lead to a stall.

Talking to family and friends can help, or talking to people who were present at your previous birth.

Having a doula at the birth can help you to process any feelings that may arise during labor.

Hire a professional if possible to work through what you can before the birth. Your feelings are valid.

Marii-Heleen Motsmees is a registered psychologist in Calgary. She specializes in perinatal mood and anxiety disorders and provides therapy virtually to women in Alberta, Nova Scotia, and New Brunswick. If you are struggling, reach out. It rarely just “goes away” on its own and if it does it takes way longer.

Get baby into an optimal position

A well positioned mother and baby will make for an easier more straight forward and faster birth.

Spinning Babies and/or the Miles Circuit

Both Spinning Babies and the Miles Circuit are great exercises to do if you are experiencing slow or no progress during labor.

Spinning Babies

Spinning Babies releases tension in the mother to help create space for the baby to pass through. Releasing tension, creating balance and space is their main philosophy. Doing the exercises during pregnancy and labor can help baby to turn through the birth canal and be in the best position possible through-out labor.

Prenatal instructor teaching how to use a peanut ball

The Spinning Babies 3 balances are:

  1. The Jiggle

  2. Forward Leaning Inversion

  3. Side-Lying Release

While these are the 3 main balances, they have other exercises, stretches, and techniques they recommend depending on baby’s position in the pelvis. I recommend hiring a doula who is trained in these techniques.

Miles Circuit

Pregnant Woman doing side lunge

The Miles Circuit has similar but not identical positions as Spinning Babies. The Miles Circuit is 3 steps.

  1. Open knee chest

  2. Exaggerated Side Lying Position

  3. Get Up and Moving (prioritizing asymmetrical positions like lunges and curb walking)

These positions help baby to get into a good position by giving them space and releasing tension. Check out their website for step by step instructions on how to do these positions.

Chiropractic Care, Massage Therapy, and Acupuncture

Chiropractic care and massage therapy during pregnancy can help ease tension in the body.

A chiropractic adjustment ensures better alignment which can help baby get into a better position.

Acupuncture during pregnancy can help ease back pain and pelvic pain during pregnancy and labor. It can also be used to help start labor naturally, if you are looking to avoid a medical induction.

Accupuncture on hand

Create a birth plan

Pregnant woman writing birth plan at computer

Some people are hesitant to create a plan since “birth is unpredictable” and never goes according to plan. However, it is essential to do your research and create a game plan. Get your whole team to understand what is important to you and why.

You wouldn’t go hiking without planning which route to take, what you were going to eat, who you were going with, and a first aid kit. You would also plan what to do in case of a landslide, encountering a dangerous animal, or getting lost. So why not make a plan for the different possibilities that can happen in birth.

Some common complications include:

Mother

  • High blood pressure

  • Fever

  • Exhaustion

  • GBS positive

  • Water breaks before contractions start

Baby

  • Variations in the heartrate (accelerations vs decelerations)

  • Low fluid

  • Big/small baby

  • Meconium in the fluid

  • Slow progress

Have a game plan for what you want to do in the case of these complications.

There are not an infinite amount of possibilities in birth.

Give birth at home or at a birth centre

Where you give birth makes a difference! It can mean the difference between a cesarean or assisted delivery (forceps or vaccum) and a vaginal birth.

Water birth at home with family

Additional Resources to help you prepare for a VBAC or VBA2C

VBAC link

VBAC link has a free essentials guide for preparing for a VBAC. Download it for free on their website.

Pregnant woman taking online prenatal class

You can also check out their online course here to get educated about the evidence so you will be a confident decision maker in your birth space.

VBAC Facts

VBAC Facts also has a great online course for expecting parents which you can find here. They review the evidence surrounding VBACs so that you can go in knowing the risks and having a great gameplan for a successful VBAC.

Evidence Based Birth

If you want to read detailed study information about specific complications and interventions, Evidence Based Birth is a great resource. It can be time consuming to research each interventions and should be done prior to labor so you can focus on contractions during labor.

They also have classes https://evidencebasedbirth.com/parentclasses/

Happy Birthing!