Thursday, 25 August 2011

Tips for a Successful VBAC

I think that really, most of what I will suggest here are more like tips for planning any birth.  In my case, it took the second time to put more thought into it.  But really, if most women put more thought into what they wanted to achieve through their birth experiences right off the bat, I'm sure most of them would end up getting the result they were hoping for.  Anyways, I did learn a lot through my second pregnancy and VBAC experience, and am more than happy to share some of the things that I thought were important during the planning process.

First and foremost, make the decision to have a VBAC.  Most women I have talked to in a VBAC situation didn't start their journey thinking they wanted to have one.  It was more of a "well, let's see how things play out" or "I'll decide closer to my due date" sort of a situation.  In my personal opinion you are setting yourself up for failure leaving it to chance.  If you know a vaginal birth is something you want, for yourself and for your baby, make the commitment right away.  If you are unsure initially, do all the preliminary research to help you make this decision.  Don't let it go on and wait to decide later. 

Read and research about VBAC.  Even if you are not pregnant yet but think that you want a VBAC for your next birth, start now.  I started reading about VBACs when my first son was only weeks old and continued my research throughout that first year even before we knew we wanted to have another baby.  Seek out other women who have had VBACs to share their stories with you.  Hearing from others first hand is very inspiring.  I was fortunate that my mother in law had experienced a VBAC, 25yrs previous, and in less than ideal circumstances when it was not the norm.  Sharing her story with me gave me a lot of hope for my own VBAC.

Find a care provider who supports VBAC.  And I don't mean a doctor who tells you "sure, you can give it a shot".  To me that is also setting you up for failure.  Your doctor or midwife should be supportive right off the bat, and there should never be any doubt that it is achieveable.  A good care provider will give you all the proper information up front, and answer any concerns you have honestly and without judgement.  If he/she has any reservations, I can almost guarantee they will cast a negative cloud over your efforts.  If for any reason you feel like your doctor is not supportive, don't hesitate to get a second opinion or even change care providers.

Hire a doula.  Especially if this will be your first labour and you don't know what to expect, but even if it's not every birthing couple will benefit from the added support and knowledge a doula will bring.  We didn't decide to hire ours until I was in my 6th month of pregnancy, but I had always felt we would benefit from having one.  And I was right.  A doula is not there to replace the support from your partner.  Many partners (mine included) may feel threatened that you would like to have a third party involved at such an important time.  But the support from a doula is invaluable.  She is not there just for the mother, but for the whole family.  She can provide lots of information throughout your pregnancy, not just at the end when it's time for baby to come. 

Prepare your mind.  This is one of those things that every pregnant woman should consider anyway, but I felt that in my VBAC situation especially, with the added pressure of success, I really needed to focus on my preparations.  I felt a lot of anxiety throughout the later months of my pregnancy, anxiety about the position of the baby (my first son being breech), about whether my body could handle labour, about whether I could handle labour, about going into labour on my own, and of course about the pressure of being successful and how I would cope if I wasn't.  Talking with friends, my husband, my doula, my midwives, and other members of my support team helped with this.  It helped me to air my frustrations and worries, and to be reassured that I could do it.  I also found that practicing my Hypnobirthing breathing techniques helped me relax and release any fears that I had.

Prepare your body.  Again, a good tip for any woman planning her labour but even more so in a VBAC situation, at least for me, because of the desire to be successful.  Perhaps in the case of the woman who attempted labour and ended up with an emergency c/s, she may feel that her body somehow failed her.  Spending extra time preparing your body for labour may give you confidence and peace of mind that you can do it.  I found in my case especially, since my first son was breech, I was always wondering if there were ways I could have encouraged him to be in the right position.  So for my second pregnancy I was very attentive to my posture, making sure not to put my pelvis in any positions where it might be out of alignment.  I attended regular chiropractic and osteopath appointments.  The knowledge I gained from my chiropath and osteopath was invaluable.  I consulted with my naturopath to find out how I could be as healthy as possible through my pregnancy.  I stayed active and did moderate exercise.  In the weeks approaching the time my baby was due, I used several different homeopathic and herbal remedies to help prepare my body (on advice of my naturopath.  I would urge any woman interested in this route to seek advice of a qualified professional).

Consider fetal positioningSpinning Babies is an amazing website and resource when it comes to learning about fetal positioning and how it affects labour.  In the case of a previous breech baby (like mine) you might be more worried about a second breech.  Or in the case of the mother who was told she had to have a c/s because her pelvis was too small (something that is actually not truly likely), position may be even more important.  There are things you can do to help baby get into the right position for birth, which in turn may be the difference between a quick labour or a more drawn out one. 

Avoid induction.  Actually, every woman should avoid induction VBAC or not, but that could be another topic altogether.  Depending on where in the world you are, induction may not even be an option, as many medical methods of induction increase the chance for uterine rupture (not just in VBAC situations, but in all births).  The best thing for you and your baby is to go into labour spontaneously.  Many inductions will go on to end in c/s, even for the woman who is not trying for a VBAC.  I remember feeling very nervous about baby going post dates (it also helps to remember that full term is 42wks, so there is no need to hurry the baby out before that point or even after in most cases), but I found that since I had prepared myself both mentally and physically, and practiced fetal positioning, we were all set and my son made his appearance on his own, and in good time.  He was ready, we were ready.

Trust your body.  Probably one of the most important points.  Remember, a woman's body is designed to give birth, it is a natural event.  It helps to remember this when you are stressed or worried about labour and birth.  If left to unfold as nature intended, the birthing process will almost always go smoothly.  Trust in yourself, and your baby, that you will know what to do.

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