As a doula, I support you through your birth choices, no matter what they are. I support your right to education and autonomy. However, I am particularly passionate about supporting VBAC (Vaginal Birth After Cesarean) moms. Why, you ask? Well, that's because I am a VBAC mother myself. New Jersey has some of the highest cesarean rates in the country, and some of the poorest birth outcomes in the country. This needs to change. Many doulas are working tirelessly to facilitate changes that will improve birth experiences and outcomes for New Jersey mothers. What are some tips for VBAC? 1. Find a VBAC supportive provider... not a VBAC tolerant provider.
VBAC supportive = Respects your choice to VBAC, follows evidence for VBAC "policies", follow ACOG guidelines for supporting VBAC VBAC Tolerant = Says they allow VBAC, imposes arbitrary guidelines on gestation, labor progression, etc., does not follow ACOG guidelines for VBAC management
2. Educate yourself. There are two main things you need to focus your education energy on: Physiological Birth and ACOG Guidelines. I personally printed out well done studies and the ACOG guidelines and brought them to appointments with me. If the provider set a limit that I was uncomfortable with, I referenced the research and guidelines and they always backed down. You can't be autonomous if you aren't well informed. And unfortunately in our society's medical culture, you won't be taken seriously without solid backup and proof of that education. 3. Remember your rights versus hospital policies. This one is self explanatory. Hospital policies are not laws. I'm not suggesting you go in guns blazing and shake the place up, writing your own rules. But keep in mind you have rights and you can exercise them, even if it is unpopular with the staff. 4. Build a supportive team. Start by finding a CNM, CPM, or OB that you respect that respects you. Interview a few until you find one that is VBAC Supportive. Then hire a doula. A doula will be able to support you through all of the mixed emotions that accompany a VBAC, point you toward educational resources, and help you focus on achieving your goals.
Educate your partner. Whoever is going to be your support person through labor needs to be on the same page as you. Even if they have their own fears, they need to be informed and educated, and understand that VBAC is typically safe, and that you need unwavering support, not doubt and negativity. If someone is unable to be supportive and respectful, I suggest you find a way to ask them for their support after the birth as opposed to during. 5. Tune out the negative. This is so much easier said than done. But there will be so many people who try to instill doubt in you, who look negatively upon VBAC, or who don't trust in a woman's body, and they can all project their issues on to you. Ignore them. Focus on you and your baby. 6. Remember that your body was made for birth. Your body was designed to give birth. Yes, there are some circumstances where some women simply can not deliver vaginally safely. However, the vast majority of women who are told they "will never dilate enough" or "are too small to deliver vaginally" or "Cant have a natural birth" are lied to.... Most of the time the interventions, limits, and psychological warfare (intentional or not), hinders labor. Most unhindered labors will progress with patience and support. Sometimes intervention is needed. But why pull out all the tricks before seeing what the mother and baby can do on their own? 7. Prepare for a Repeat Cesarean. I don't really like telling people to "plan for the best, prepare for the worst". I'm someone who prefers the phrase, "planning a VBAC" or "having a VBAC" over "trying for a VBAC". I hate the term "Trial of Labor after Cesarean". But realistically, a repeat cesarean is a possibility. Preparing for that to some degree is important. Discuss the options for a "gentle cesarean" with your provider. Work with your doula and OB to figure out how you can make a cesarean as minimally traumatic as possible if your VBAC doesn't go as planned. Having these conversations may allow you to feel a sense of peace and control. 8. Take care of your body physically and nutritionally. This is important for any pregnancy, of course, but I fully believe that have quality nutrition and remaining physically active during pregnancy increases your chances of a vaginal delivery. Utilize chiropractic care if you're interested to help promote optimal alignment for your body, and optimal positioning for your baby.
Jaimie is a proud mother and wife, Certified Breastfeeding Specialist, Birth Doula and Postpartum Doula. Jaimie would be honored to support you through your VBAC journey in South Jersey. Schedule an interview with Jaimie today to see if she is the right fit for your family and your birth!
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