Today we will be talking about three common lies about VBAC.
Now I could have said we're gonna talk about three common VBAC myths.
I could have said three VBAC misconceptions, but I said VBAC lies. And that might sound really inflammatory, but I'm calling these three concepts lies for a reason, and that reason is that these concepts are often perpetuated by people who should know better; people who are in a place of authority, or who believe they are in a place of authority, and use that authority to share these lies as if they are facts when they should know better.
So who are these people?
These people are some health care providers, not all, but some.
And these three lies are things you've probably heard when you are you are having the VBAC conversation.
So the first lie we are going to talk about is the idea that if you are planning your feedback, you must spontaneously go into labor by your duty in order to have your VBAC.
The story goes, if you have not had your baby by your due date, then you are going to either have an induction or a repeat C section scheduled and they're gonna schedule that for 39, 40 weeks typically.
Sometimes they don't even want you to go to your due date. They expect you to go into spontaneous labor by 39 weeks.
Well, we have a few issues with this.
The first issue is an understanding of what a due date even is.
What does due date even mean?
We know that only about 5% of babies come on their quote due date and remember pregnancy is not a library book.
It's not an essay.
There's not a date of expiration for your pregnancy.
Even if you were even if your due date is 100% accurate,
accurately calculated based off a very accurate date of conception.
Nobody can insist that your baby is going to come that day for all mammals.
These animals all gestate the amount of time they need to gestate, and
there is no way to predict exactly when anybody of any species will give birth.
Humans are no different.
As humans, we like to have control over everything. So we like to kind of think of our due date as in expiration date or best by date, but it's not.
So when we start putting regulations on VBAC moms based off their due date and their due date alone, we have some problems. We have some really big problems.
And this is a sign that your provider is not necessarily the most supportive VBAC provider if they are requiring you to go into labor spontaneously by a certain time when you and your baby are both healthy.
So in that situation, what can you do? What are your options?
Well, of course you're option is always, I'm going to say run, run run to another doctor,
but I am well aware that in some areas that's not always an option for one reason or another, there may not be other providers in your area. If there are, they may not be accessible due to insurance purposes, et cetera.
Maybe there's no other provider who even sort of supports VBAC. So you have to go with this person who's like kind of supportive but not really.
So what are your options? You can get a new provider if you can't get a new provider,
you've got to start advocating.
So, what kind of things can you ask for or talk about or suggest?
My recommendation would be that if your pregnancy is healthy and you choose to continue your pregnancy and not schedule a repeat C section or an induction,
then you tell your provider, "I am declining your recommendation to schedule this birth.
I trust my body and I trust my baby and I will wait for spontaneous labor to begin.
If it makes you feel better, I am open to getting additional testing. We can do an NST (non stress test) or a BPP (biophysical profile)."
Now you do not have to do that. That's not a requirement.
I'm not telling you you have to or should. But if it's a compromise that you are willing to make and work with your provider on, that might be something that makes them feel a little more comfortable and you a little more comfortable. So, you are both knowing that this decision is being made from a place of information.
Now, maybe you don't want that and that's okay.
You can just say no.
You can just say no.
You can also say, "well, I am not comfortable scheduling my birth at this date.
However, I'm also not comfortable going to this gestation. So let's schedule the induction or repeat cesarean for this date of gestation that I am more comfortable with, so I give my body more of a chance."
There are so many options that you have and if your provider is taking those options away from you, it's up to you to start advocating for them or finding a new provider.
VBAC LIE #2 - Induction is not an option for VBAC/TOLAC
So your provider might say, yeah, you know, I'm comfortable with you going to 41,
weeks. But if you haven't given birth by 42 weeks,
we're scheduling a repeat c section. We will not do an induction.
Why? I know the concern is an increased risk of uterine rupture.
But the truth is that increased risk of uterine rupture is with specific induction methods.
There are induction methods that are considered safe with VBAC.
There are studies that have shown no difference in uterine rupture between the induction group and the spontaneous labor group.
And you know, all these studies have their flaws. None of them are perfectly designed.
But this new study that came out in January 2022...
Basically, the recommendation from the study actually was that all VBACs should be induced at 39 weeks to reduce the risk of hemorrhage, which I mean, again, there were flaws within this study. However, the interesting point was the uterine rupture rate was exactly the same between the induction and the spontaneous labor group.
So it just goes to show that induction can be an option. So if your provider says it's not an option,
ask them why not ask them if it's because they had a bad experience and they just don't feel comfortable doing it again or because they prefer to just get keep options from you.
Ask them which one of ACOG's guidelines they choose to follow and which ones they choose not to follow and how they make that decision.
ACOG supports offering an induction after C-section.
I think it's important to have the pros-cons conversation.
For some people, the idea of an induction is an automatic no go because they had an emergency C-section after a failed induction and they never want to go through that stress again.
For others they will do anything to avoid a repeat C section and would feel better at least trying with an induction if it was medically indicated.
So you need to really sit with yourself, figure out what is the best decision for you and then learn how to communicate that with your provider using evidence and information and trying to talk with them in a way that respects their concerns, respects their "policies", but also makes it clear you're going to demand better from them because they should know better.
The third lie about VBAC is that you cannot have a vaginal birth if you've had more than one cesarean
I'm sure you've heard this one and I know I have talked to a lot of mamas who kind of have this issue where they had their first C-Section for one reason or another and then their second C.
Section, they weren't even given the option to VBAC.
By their third pregnancy they're like "wait I was totally a good candidate for VBAC. I would have done that if somebody offered it but nobody offered that. Nobody supported that. Nobody informed me about that and I really want to have this vaginal delivery. Can I have a bad back after two C sections?"
Doctors will say whoa I support VBAC with one c section, I do not support feedback with two C sections. Heck No.
And to that answer I say hold your horses there doc If you support back After one C section There is no reason not to support back after two C sections.
ACOG guidelines support vaginal birth after two C sections.
The data is clear that the increased risk of uterine rupture with two previous c sections is low enough that it's a reasonable option when you compare it with the alternative of a planned repeat C section.
If you are planning on having more babies more births, more pregnancies, having a VBAC after two C sections can be really important, and it can be critical for reducing the risks for your future pregnancies. So if you want to have a VBAC after two C sections I am going to tell you that it is a reasonable decision.
It is a reasonable choice and it is an option.
However it may be an option that you have to fight hard for.
I have supported one VBAC after two c-sections in person, and it was the most amazing experience I think I've ever had. I think it's one of those births that there was nothing super special or unique about that birth itself aside from the fact that mom had had two previous C sections, she was almost 42 weeks. But she was soooo determined that it became a favorite.
They ended up kind of inducing her because of her high blood pressure but she didn't actually have high blood pressure.
It was like a whole it was the whole thing.
But she was also like in early labor but not like super labor if that makes sense.
Like pre early labor.
She had a lot of medical history that could have stacked the odds against her, and even when she was at the hospital admitted, and starting her labor they tried to prep her for a C-Section even though her midwife team was well aware and well on board with a VBA2C.
The attending at the hospital, the nursing staff at the hospital... they were not used to this and they just like started trying to prep her for a C-Section and everybody kind of like got like what the heck confused and crazy when we were like no that's not what we're doing.
But she did it and it was so amazing to witness it.
It was so such an amazing energy to feel to be in that room and witness it.
And I love hearing women tell me their VBAC after two c-section stories because for so many of them, even though they had great support from certain people, there were people they did not have support from and they really did have to fight for that.
There are some that I know I had to just say I'm sorry I'm not coming to this scheduled C section and just show up at the hospital in labor and refuse a C-Section. And that's hard.
That is a hard state of mind to be in because it gets very difficult to settle into a safety cycle but it's doable. And this is a reminder that I am not recommending anybody goes against medical advice. However, I think it is important to always question medical advice and have good conversations where a lot of information is brought to the table and people are clear about their fears versus the facts. The data and the truth.
So that is my spiel for today.
You do not have to give birth by your due date in order to achieve your feedback
Induction is an option for VBAC mamas
Vaginal birth after two c-sections IS an option,
There might be times where certain medical conditions or medical history things kind of make that risk higher, but it doesn't mean you don't still have the right to have the discussion.
It doesn't mean you shouldn't have the option.
So if you have been told one of these three lies, I would love it if you could reach out and let me know which one of those three lives you were told, how you handled it, how you plan to handle in the future.
DM me on instagram! Let me know what your thoughts are, what your plans are for this birth, what your concerns are, and if you need any help advocating for yourself.
Like you're being told these lies, you know they're wrong, but you are just having a hard time pushing back... I am happy to help you with that.
Go listen to this conversation and MORE on theVBACpodcast!