Pregnant after a cesarean? You have options! Look into everything and decide what sort of birth is best for you and your family.
By Brittany, Contributing Writer
Soooo…you’re pregnant. You want to and can’t WAIT to push a baby out of your vagina. But, there’s thing….you’ve had a prior cesarean (or two, or three…).
VBAC. It’s controversial when it really shouldn’t be. In case you didn’t know, VBAC stands for Vaginal Birth After Cesarean.
The national average for Cesarean birth in the United States is nearly double what the World Health Organization recommends (10-15%). Having a baby via cesarean drastically affects your ability to have a vaginal birth in the future. Lots of doctors currently are intolerant to VBACs despite it being the lower risk, healthier option for almost all moms and babies.
The most common concern regarding VBAC is of a uterine rupture. The event of a uterine rupture is actually very rare– less than 1%. Of the doctors I spoke to, only one had seen a uterine rupture in his 14 years as an OB-GYN.
The risk of UR is significantly higher with repetitive Cesareans than as a VBA1C. Statistically speaking, you have a higher chance of a UR with an induction via Pitocin than by letting your body naturally labor. This was a huge concern of my husband and I. After speaking to a variety of “birth professionals” I deemed it lower risk than another cesarean. While both have their own sets of risks, VBAC repeatedly came back as the healthier option for me.
3 Options for Getting Your Dream VBAC
1. Hospital Birth
Perhaps you’re seeing the same practice you had with your prior birth. Interview your provider, ask her what she thinks about VBAC. Try to get a sense of if she’s VBAC “friendly” or just simply VBAC “tolerant.”
Ask if they will encourage you to go to term or if they’ll force a timeline for you to deliver by. Will they ‘allow’ you to have an unmedicated birth or do they prefer you to have an epidural in place in case of another c-section? Have a list ready with any question imaginable and have your provider answer them (the ones I’ve provided are a good start). Remember, they work for you, not the other way around. If you’re not satisfied, fire them. Don’t let them bully you. 🙂
• Will they encourage you to go to term? Will they demand induction?
• What percentage of their births end in cesareans? What percentage of births are cesarean at the hospital in which you will deliver?
• Will they allow you to forego any unnecessary monitoring? (ie: Internal Fetal Monitoring, External Fetal Monitoring (via ultrasound or doppler) etc.
• Will they IMMEDIATELY hand your baby to you for skin-to-skin, nursing, and allow you to delay cord clamping?
2. Homebirth/Birth Center Birth
A Homebirth is, obviously, in your home. A birth center is, usually, much like a homebirth but in a quiet, calm setting away from home. Both are typically attended by midwives. Either of these births is for the woman who doesn’t want a medical birth or interventions but still needs the level of comfort and expertise that a midwife offers. Still, make a list of questions when you’re interviewing midwives and doulas.
Some questions I asked (and was concerned about):
• What will they do in the event of a postpartum hemorrhage?
• What percentage of women do they transfer out to hospitals?
• How many VBAC births have they attended?
What I loved most about my midwives was how they came to me. My house could be a disaster, my twin toddlers running around in a t-shirt and shorts with no shoes on, no makeup and it didn’t matter. I was still treated like the woman I am — with the dignity and respect I deserve. I delivered my daughter on my bathroom floor and nursed her within five minutes of her being Earthside. Within two hours, I was up, showered and relaxing in my bed. It was amazing.
Lying in bed with my daughter, Sophie, 2 hours new
3. Free Birth/Unassisted Birth
The title really gives it all away. While I look at it like we’re ALL birth Warriors, this is just inspiring to me. I wish I could do this but I just loved my midwives too much (and wasn’t confident enough….maybe next time). 🙂
Free birth and Unassisted birth are..exactly that. Completely unassisted, usually at home. It’s a complete trust and faith in your body doing EXACTLY what it is meant to do and was created to do. This is foregoing any/all prenatal visits and ultrasounds while monitoring your pregnancy at home. Birth is a biologically normal process and is NOT a medical emergency; thus making this not dangerous for the average pregnancy. No one is more in-tune with their body than the woman who lives in it. According to Ina May Gaskin (one of the nations leading Midwives, owner of The Farm Midwifery Center), birth is not a place for Doctors or Hospitals; it
Birth is a biologically normal process and is NOT a medical emergency; thus making this not dangerous for the average pregnancy. No one is more in-tune with their body than the woman who lives in it. According to Ina May Gaskin (one of the nations leading Midwives, owner of The Farm Midwifery Center), birth is not a place for doctors or hospitals; it has never been.
That’s not to say that birth doesn’t sometimes have risks or problems, it definitely does, however, the average pregnancy is not the medical emergency that society implies. If you were to choose an unassisted or free birth, research. Remember that you can change your mind if need be and seek medical attention if the need or desire arises. Free birth/Unassisted births are the ultimate experience of birthing on your terms, completely unhindered by Doctors, Midwives or anyone’s standards or ideals but your own.
If you were to choose an unassisted or free birth, research. Remember that you can change your mind if need be and seek medical attention if the need or desire arises. Free birth/Unassisted births are the ultimate experience of birthing on your terms, completely unhindered by Doctors, Midwives or anyone’s standards or ideals but your own.
Birth is beautiful no matter which way you look at it. A healthy, happy baby AND a healthy, happy mama are what matters most. The most important thing in any aspect of childbirth is that you felt empowered to make the decision for yourself and that you had options when doing so.
Did you or would you have a VBAC? Can you share how you chose to do it?
International Cesarean Awareness Network: http://www.ican-online.org/faqs-about-vbac/
World Health Organization: http://www.who.int/mediacentre/news/releases/2015/caesarean-sections/en/
Ina May Gaskin: The Farm Midwives (Documentary)
The VBAC Companion: The Expectant Mother’s Guide to Vaginal Birth After Cesarean
By: Diana Korte