Rebecca James, ICAN Chattanooga co-leader, has written a post about something close to her heart: having a successful VBAC. She’s done it twice so far! But being an ICAN co-leader, she’s heard many things care providers say to mothers and wants to share some advice about when you should change. As she mentions, any expectant mother can get something out of this as well.
And please understand that here at Childbirth in Chattanooga - we’re about education, advocacy, and making the right decision for your family & situation. Not everyone who’s had a cesarean will chose a VBAC for subsequent pregnancies – but many do. It’s definitely something that should be researched and considered – just like researching the possible risks for subsequent cesarean sections.
Thank you, Rebecca, for this wonderful post!
This list of reasons can be specific to VBAC, but there is certainly a lot of overlap for those wanting a non-interventive, and/or unmedicated birth. So even if you have not had a cesarean, read on! This may very well help you as well!
1 If your care provider is in a practice of 2 or more (or 8!?) doctors who may or may not be supportive of VBAC, switch care providers!!!
a Even if you found one provider in a big practice who is sincerely supportive of VBAC, it is often the case that this provider will need to induce you in order to make certain that he/she is “on call” during your birth. This decreases your chance of successful VBAC while also increasing your risk of uterine rupture AND repeat c-section. It’s a LOSE LOSE LOSE!!!
b If you are allowed to go into labor spontaneously you run the chance of your supportive provider NOT being on call and ending up with Dr. C-section who hates VBACs and refuses to support them.
2 If your care provider is unable or unwilling to give you his/her exact stats, switch care providers!!!
a C-section rate? VBAC success rate? How many VBACs attended? If your provider is really supportive of your VBAC, you can expect him/her to easily and willingly share exact stats.
b Look for a provider who is very experienced and comfortable with VBAC and has assisted in many VBAC deliveries. You should look for a provider with at least a 75% success rate with VBAC deliveries. I’ve actually seen some providers with a 95% or higher rate!
c This bears repeating. Find a provider who is very experienced and supportive of VBAC deliveries. This person should not just be “willing” to “let you try” as a VBAC mom, but also be excited and happy for you and clearly EXPECT you to be successful!
3 If your care provider keeps using language that indicates he/she may be skeptical of your ability to give birth vaginally, switch care providers!!!
a Look for key phrases like…
i “Birth is unpredictable so we’ll see what happens.”
ii “I’ll let you try, but I require certain things just in case…”
iii “IF you go into labor by (set deadline) and IF you progress at (set rate of labor progression), then you MIGHT be able to have a VBAC.”
4 If your care provider does not give accurate and up-to-date evidence based statistics, birth practices, or information in general, switch care providers!!!
a This puts some of the responsibility on you to look up the current practice bulletins, know the latest VBAC research, rupture stats, induction stats, best birth practices, etc. So do your homework so that you will know if your provider is feeding you BS or even just their own personal biases against VBAC.
5 If your care provider at any point has an anecdotal horror story involving a VBAC that he/she feels compelled to share with you, switch care providers!!!
a Any care provider that has clearly been “scared” by VBAC is not ultimately going to be supportive even if he/she says “I’m willing to let you try.”
6 If your care provider says he/she is supportive of VBAC, but is discouraging of your taking an independent childbirth class and/or hiring a doula switch care providers!!!
a This may be a sign of the classic “bait and switch.” Unfortunately, it is very common. A mom may feel very supported in her desire to VBAC…. until 36 weeks when suddenly the doctor starts saying things like, “Are you still sure you want to attempt a VBAC?” (Add possible random scare tactics thrown about haphazardly to make mom feel intimidated. Maybe a scary anecdote from the past thrown in for good measure.) Run, do not walk, AWAY from this care provider. It is never too late to fire your provider until you have given birth!
7 If you genuinely LIKE your care provider but are unsure of their ability to support your VBAC, but are also afraid to “hurt their feelings” by switching care providers, GET OVER IT AND switch care providers!!!
a Even if you “click” with this person and just love him/her to pieces. Even if you are best buds and have warm fuzzies every time you are together. Even if you have every single thing in the world in common. Warm fuzzies will not support your VBAC!!!!
b It does not matter if you have organic gardening in common and love knitting together, this will not get you your VBAC.
c Even if you are afraid to switch, it is actually unlikely that you’ll hurt anyone’s feelings. We’ve even seen moms switch and the OB didn’t even notice. They see so many moms, this is often the case. Do not EVER be afraid to switch at any point in your pregnancy.
d You are just one person out of hundreds of patients your provider is likely seeing. You are not going to be the one to change his/her mind about VBAC. Nor should you be. Do not put yourself into that position!
e We are talking about the health and well being of you and your baby here, it is not worth risking over fear of hurting feelings or fear of leaving someone you “get along” with. You need a provider who practices evidence based birth and believes in your ability to give birth, not a buddy with whom you can chat comfortably.
8 If your care provider does not clearly love VBAC, switch care providers!!!
a Care providers with the best VBAC success rates honestly enjoy supporting VBAC moms and have a solid belief in the moms’ abilities to give birth normally!
b Your provider should understand that VBAC is supported by the evidence as the option that is in the best interest of you and your baby! It will be clear from the beginning that this provider wants you to get the birth you want and will do everything possible to support you in achieving that birth.
c If your care provider does not actually want you to be successful with VBAC in the end, you most likely won’t be.
9 If you have missed the “bait and switch” signs until the very end it is not too late to switch care providers!!!
a If your provider is all the sudden throwing around scary stories, scary stats, or obvious scare tactics, it is still not too late to switch!
b If your provider does a late term ultrasound and cries “LOW FLUID!” or “BIG BABY!” or even mentions that maybe you’re a little overweight and might not be able to give birth (say it with me!), switch care providers!!!
10 If you are not 100% sure that your care provider is the most VBAC supportive care provider you can find, switch care providers!!!
a I cannot emphasize enough that just being “comfortable” with a certain care provider IS NOT ENOUGH. You may feel very trusting of this person, but if this person does not 100% believe in YOUR BODY and YOUR ABILITY to birth your baby, all the comfort and trust in the world will not get you the safest and healthiest birth for you and your baby!
b A care provider that is genuinely supportive of your VBAC will not only say, “I will support you.” but also may (hopefully!) say encouraging things like, “You are a great candidate for VBAC! I see no reason why you shouldn’t be able to give birth vaginally!” This provider not only will support you, but WANTS this right alongside you and will go the distance to support every measure to get you that VBAC. This provider is practicing evidence-based medicine rather than fear-based! This is your best chance for a safe and healthy birth!