• Stephanie Lecker

5 steps to achieving the best VBAC outcome!

Okay, you've been down this birth road before.

Maybe you desired a straightforward vaginal birth with or without interventions, or a home birth that ended up in a transfer, or maybe you opted to have a C-Section the first time around. WHATEVER your birth outcome last time, you are here because you want a successful vaginal birth after a Cesarean - correct?

Well, great job finding this blog because we are all about birth and shaping your birth outcome! Today you will learn about the 5 steps to having the best VBAC outcome you can!

Let me first say that having the best outcome does not mean that you will have a VBAC. This is birth and birth is unpredictable. As in all my approaches to birth plans, we work toward the desired outcome with flexibility and dignity in mind. The goal is not just VBAC, but it is also that your dignity is upheld throughout the whole process and because of that layer of respect, you naturally become flexible with what happens in the end. With that said, let's jump in!

Step One: Choosing the right Care Provider for your goals!

This is step number one for a reason. If you are uncomfortable with your care provider's viewpoint on VBAC, then please seek another provider's opinion. Just because they delivered your first baby, does not mean they should deliver the next one. If they do not practice VBAC on a regular basis, then they will not be willing to coach you through yours just because you desire it.

Harsh? Maybe, but this blog isn't about changing your provider's mind. This is about getting you the best outcome possible. That starts with your birth team...a.k.a. your doctor or midwife.

Step two: Incision and length of time.

Ask your care provider what kind of incision you have from your previous Cesarean. This is important because the type of incision will determine your risk of uterine rupture. I know this one is a bit scary, but it is necessary to know if you want a successful VBAC. A horizontal incision has the best success rate while vertical incisions are not recommended to attempt VBAC. Also, consider the length of time between pregnancies. It is considered favorable to have at least 18 months between pregnancies to allow your scar tissue to heal properly. Does that mean you can't have a VBAC because it has only been a year, no. However, it is something to include when you move on to step three.

Step Three: Do your research.

From the American Congress of Obstetrics and Gynecologists (ACOG), 2017, "Currently, women who attempted trial of labor after cesarean delivery (TOLAC) have a 60-70% SUCCESS RATE of achieving a vaginal birth." THAT"S A LOT!!!

This means there ARE providers having successful VBACs in hospitals and ACOG is backing it up! This research is just one piece of the puzzle. Do your own research and decide based on evidence if you want to proceed with your VBAC. There are risks to consider, BUT 60-70% of women are having positive outcomes!

Step Four: Take a birth class.

That last bit of research was just one piece of evidenced-based knowledge taken directly from the field manual for Birth Boot Camp's Comprehensive Birth Class. I whole-heartedly believe taking a birth class (even though this is not your first time through pregnancy and birth) will provide you with so much more knowledge and confidence going into your VBAC that you'll notice the difference right away!! You'll have more confidence, less anxiety and so will your birth partner!

Step Five: Hire a doula!

It is SOOOOO important to have someone there to help you through labor on a fundamental level. A doula will be able to reinforce your wishes and help you advocate for your desires. She will be able to give you hands-on pain relief and reaffirm your choice to have a VBAC. A doula is also there for your birth partner. They will need a break from labor because it is intense! Your doula can step in and help you and them the whole step of the way!

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