VBAC (Vaginal Birth After Cesarean)
What's a VBAC?
This means a person who gives birth vaginally after they have had a cesarean in a past pregnancy!
Common VBAC terms
VBAC- Vaginal Birth After Cesarean
HBAC- Home Birth After Cesarean
TOLAC- Trial of Labor After Cesarean
VBA2C- Vaginal Birth After 2 Cesareans
VBAMC- Vaginal Birth After Multiple Cesareans
Low Transverse Scar/Incision- A typical cesarean scar that goes across the bikini line horizontally
Special Scar/Incision- any scar that is not a low transverse scar on the uterus or other surgical incision on the uterus (myomectomy ect.)
ERCS- Elective Repeat Cesarean
CBAC- Cesarean Birth After Cesarean
Facts and Statistics on VBACS
90% of people who have undergone a cesarean are candidates for VBAC!
60-80% of people who have had a cesarean can give birth vaginally!
Maternal mortality is 0.0038% for people who plan a VBAC vs. 0.0134% for people having a cesarean. The risk for baby is 0.13% for VBAC and 0.05% for repeat cesarean.
The risk of uterine rupture for a TOLAC is 0.47%, the risk of uterine rupture for an elective repeat cesarean is about 0.026%. Having an induced labor can raise the risk of a rupture in a VBAC to 1.1% with pitocin, 2% with use of prostaglandins, and 6% if misoprostol is used.
Going beyond 40 weeks is NOT a contraindication according to ACOG.
ACOG also states that, "given the overall data, it is reasonable to consider women with two previous low transverse cesarean deliveries to be candidates for TOLAC and to counsel them based on the combination of other factors that affect their probability of achieving a successful VBAC.” They also removed the "requirement" of having a vaginal birth prior to the cesareans from their guidelines in 2010.
In the 1990's VBAC rates were near 28%, in the early 2000's the rate declined to around 10% due to concerns about the risk of uterine rupture. The rate currently is about 13-14%.
Here is some research on VBAC
Choosing what is best for your body and your baby
Both ERCS and VBACS are VALID options! Educating yourself on all options and using your BRAIN (Take a look at my post on that acronym) can help you make a decision that you are most comfortable with. True informed consent is the name of the game here!
Tips on VBAC
So you've made the decision that you're planning a VBAC, now where do you go from here?
Choosing your provider:
This is a BIG one. Ask around in VBAC groups, look up hospital cesarean rates, ask local doulas, ect. Finding a provider that truly supports VBAC is one of the bigger hurdles most VBAC parents have! There are VBAC tolerant providers and VBAC friendly providers. It's important to know from the jump, who is going to truly be a support to you in your journey. Don't settle if you can help it! Interview as many providers as you see fit and then make a decision! Here is a great list of questions to ask a provider when you're planning your VBAC:
Hire a VBAC experienced doula:
Having someone on your team who is well versed in how to support VBACs can be so beneficial!
Not only may they have the latest research, but they will also have lots of resources, tips, and tricks to help you along the way!
Eat well & Hydrate:
You want to take care of your body well through your pregnancy. Nourishing your body with whole foods, protein, and lots of veggies will help your body prepare for the work of labor (this is true for everyone who labors!). I love the book, "Real Food for Pregnancy," when it comes to nutrition! You need about half your body weight in ounces of water a day during pregnancy. I know this probably sounds redundant, but I believe sometimes this gets overlooked when we are trying to do all the things to set up for a successful VBAC.
Sign up for a private childbirth education class:
Private classes don't teach by policy or what they're "allowed" to teach. Most private childbirth educators teach evidenced based, science backed information! Some even teach about the rights you have! These classes take a deep dive into the birth process and how to cope with labor. Knowing what's normal in labor can better prepare you for your birth!
Move your body:
staying active can help with a myriad of things while you're pregnant. There was a study that stated people who walked >200 mins/week had a higher likelihood they would have a successful VBAC. Find an exercise you enjoy and do it often! There are also some daily exercises you can do to help with comfort and the positioning of baby. You can find those here:
Bodywork:
The body remembers trauma. Bodywork can help by releasing the trauma response cycle and help you reconnect with your body. Body work can include myofascial release, somatic therapy, breathwork, grounding, and massage! I highly encourage clients to dive deep into processing their past births with me while also receiving bodywork through their pregnancy!
Chiropractic Care:
Chiropractic care can be very beneficial when planning a VBAC. They can help align the spine and pelvis through your pregnancy. As the hormone relaxin hits the system, it makes things relax! Seeing a chiropractor regularly can help make sure everything is aligned well for birth! One of the techniques that is particularly helpful is the Webster Technique. This technique is used to reduce tension and misalignments in the pelvic region, creating more specific for baby to move and get into a better position for birth!
Pelvic Floor Therapy:
This one is a big one! Pelvic floor therapy can help assess the pelvic floor muscles and improve pelvic floor function. They can also address issues with scar tissue, help with pelvic alignment, and make sure there isn't issues with the muscles that could hinder a baby coming down through the pelvis! Everyone should truly see a pelvic floor therapist after every birth truthfully, but if you haven't you can still see a pelvic floor therapist during pregnancy as well!
NORA Tea:
This is a hill I might die on, honestly. I swear by this tea. I personally used it through my pregnancy, and I encourage all pregnant beings to reap the benefits of this nutrient dense tea daily through pregnancy and postpartum! NORA stands for Nettle, Oat straw, Red Raspberry Leaf, and Alfalfa. There are SO many benefits to NORA tea (I'll have to make a post about it), but if you want you do some research and read about the benefits, start here: https://www.organicpregnantea.com/blogs/spilling-the-tea/meet-nora?srsltid=AfmBOopg6QnyiCbR_4jVo79qSrK1jVW1-Ly3VN4vfDofgQLVFr2LhiPl
Everyone's VBAC journey is SO different, these are just some tips that I have picked up over the years of supporting VBAC's both in and out of hospital!
This is YOUR journey, empower yourself through it!
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