In Birth, Exercise, Nutrition, Pregnant

Vaginal Birth After Caesarian (VBAC)

When you are pregnant you suddenly start understanding all kinds of acronyms and one of these is VBAC. It stands for Vaginal Birth After Caesarean and is often something that expectant mothers ask me about. If a previous pregnancy or labour has led to medical intervention in the form of a C-section, then your existing medical team of doctors will be able to tell you whether or not it is safe for you to try for a vaginal delivery with subsequent babies.

If a vaginal delivery is your preferred choice for your next birth and you’ve been told that it does not pose a health risk, then please have faith in what you’ve been told. No doctor or midwife will recommend a VBAC unless they deem it medically safe and have assessed your current pregnancy and previous history in full.

Caesareans happen for all kinds of reasons and it’s important to remember that in most places they are only carried out to ensure the health and safety of you and your baby. I’ve supported countless women through a successful vaginal delivery after a previous C-Section and have some tried and trusted advice that can help you to prepare for a positive VBAC experience.

Find The Right Support

I definitely think that pregnancy is an excellent time to be selfish and demanding. You are growing a baby and this experience should be one that is supported by the right people. I’ve seen too many incidents of the wrong kind of “support,” which only leads to anxiety and stress. My first tip would be to surround yourself with the right team – a team that makes you feel empowered, comfortable and understood. See if you can choose which doctor will be following your pregnancy. Ask them about their experience with VBACs and don’t hold back in requesting their statistics for how many successful VBACs they have under their belt.
Having a doula or midwife that you’ve built a strong working relationship with during your pregnancy, can also be especially helpful during a VBAC situation. They will be aware of your wishes and will be able to provide extra support and care when you’re in labour.

Keep An Open Mind

Having worked with so many mothers I know there’s only one guarantee when it comes to birth plans – and that’s giving birth. For all mothers-to-be, but especially those trying for a VBAC, it’s important to keep an open mind about your birth and labour experience. Hope for and prepare for a vaginal delivery but keep in mind that it is not something that can always be guaranteed. Taking an unbiased educational birth preparation course can help familiarise you with the risks, decisions and scenarios that you may have to face and will make you feel better prepared.

Natural Birth After A C-Section

Many women (naturally) want a natural labour. But there are a lot of interpretations of this term. For some ‘natural birth’ can mean going without any pain relief at all, and for other’s it is simply the action of giving birth vaginally, whether assisted or not. It’s worth remembering that in a VBAC situation you will need to be monitored from early on in the labour and this means you’ll be given a drip and will be offered continuous electronic foetal monitoring. This may mean that you need to adjust your visualisation of a ‘natural’ labour and birth.

Rethink Pain Relief

I advise all my VBAC clients to rethink pain relief as something completely negative. It is not a sign of weakness, it is merely available as a supportive measure should you require it – and many women do! Giving birth is such an emotive experience and requires a lot of psychological preparation to be able to see the process through all the permutations of what may or may not happen.

Understanding what pain relief is available and what the risks are of a VBAC will make you better able to cope with the birth experience that comes your way, whatever it may be. During a VBAC labour it’s often the case that you will be under constant foetal monitoring and will also be linked up to a drip. This can mean it’s harder to use movement as a coping strategy, as such can sometimes mean that an epidural is required.

Understand The Risks

No one likes to think about things going wrong, particularly if your heart is set on a natural birth. For many women wanting to face a VBAC delivery, there is an element of proving to themselves that they can deliver vaginally and often they feel cheated of this experience from having had an unplanned C-section in a previous birth. These feelings and thoughts are all completely valid and you’re absolutely entitled to your personal emotions on this matter. However, it is only sensible to educate yourself on the risks that come with a vaginal delivery after a previous C-Section. Your doctor or midwife will be able to elaborate in accordance with your own personal medical history.

With any VBAC there is a small risk that the scar from your previous caesarean could tear, this is also known as uterine rupture. This is not common and only effects one in 200 women who are attempting a VBAC. It is however a serious condition and could be life-threatening for your baby. This is why medical teams and midwives monitor your contractions and your baby’s heart rate so closely during your labour. It’s also why women are given a drip, so that in the rare case that uterine rupture does occur, action can be taken immediately with an emergency C-Section. These precautions can be viewed as practicalities and are not intended to make you fearful or uncomfortable.

Be Mindful

I urge all my clients to practice mindfulness so that they can really get in tune with their emotional, mental and physical state throughout pregnancy, but crucially during labour and birth. For me, mindfulness is a coping mechanism that focuses you absolutely to be in the present. It can be easy to spend a lot of your pregnancy worrying about what may or may not happen during your VBAC, but in fact it is much more beneficial to start strengthening your capacity to deal with whatever situation comes your way through mindful meditation.

Nurture and Prepare Your Body

There really isn’t any argument against good nutrition and reasonable, modified exercise during pregnancy. Labour and childbirth are incredibly demanding physically (not to mention early motherhood) so preparing your body by eating well and exercising within your means is important. This will help you to deal with labour better and can increase your chances of a positive VBAC birth.

Holistic Help

If anxiety is something you suffer from then the effects of acupuncture can be incredibly beneficial. I also advise women wanting to have a VBAC to try acupuncture for natural induction of labour. It can be very effective – and even if it doesn’t work for you, it can be a very relaxing and calming way to wind down ahead of your baby’s birth.

Prepare Your Pelvis

It’s worth investing in preparing your pelvis for a vaginal delivery. I’d recommend seeing an osteopath or physiotherapist regularly during your pregnancy. Try and find someone who specialises in maternity. They will be able to ensure your pelvis is well aligned which will help you to maximise your chances of a smooth and fulfilling VBAC birth experience.

It’s worth saying once more, that whatever birth plan you have, there is really only one guarantee – and that’s giving birth. Taking stock of your options and understanding what you can do to prepare for your VBAC is important, but the most important thing is to have an open mind.

If you would like to have a personal consultation with Sofie Jacobs to discuss childbirth, a VBAC, or any other element related to your pregnancy and labour you can book a session here.

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