There’s no doubt that anticipating birth in the midst of a pandemic can be fraught. This may be exacerbated when you may have additional risks, or complicating factors. If you have had a previous surgical birth and are pregnant again, know that you still have choices for this birth during this time.
The choice of a Vaginal Birth after Cesarean Birth (VBAC) or a Cesarean Birth after Cesarean Birth (CBAC), is one that each birthing person who has experienced surgical birth must make for themselves — based on evidence and intuition.
If you are choosing a TOLAC (Trial of Labor after Cesarean Birth), it’s important that both your provider and your place of birth is truly supportive of this path. And while the American College of Obstetricians and Gynecologists says that a VBAC is a safe and appropriate option for many birthing people, hospital or provider policies do not always reflect the evidence. If you are planning a VBAC, here are three tips that can help support your intention.
Our friends at ICAN have a great description of what that means. Consider talking to different types of providers to see what feels best for you. Obstetricians, Family Practice Doctors and Midwives (who can provide care at a hospital, a free-standing birth center or your home), can all provide full prenatal care plus support your birth. Practices and policies vary widely. Is your provider VBAC tolerant or VBAC supportive/friendly?
There is a difference between the two, and this can affect your outcome. Some signs your provider may be merely VBAC tolerant:
We’re pretty research obsessed at Mina. Some of our favorite resources for VBAC research are:
What can doulas do? They can help you find evidence-based information, clarify your birth preferences, and amplify your voice as you advocate for your needs. They can help with comfort measures and positioning that can support you during birth. And multiple studies have shown that having continuous labor support has a host of benefits – including lessening your chances for a surgical birth – up to a 39% decrease.
It’s true that hospital policies are changing rapidly right now, in terms of the number of people can be present at your birth. However, doulas can provide prenatal and postpartum support, be with you in early labor at home, and be present virtually. Depending on your birthplace, they may be able to offer in-person support as well.
This is your birth. Here’s the thing — beautiful births are ones where the birthing family feels safe, empowered, informed and supported. Whether that’s an operating suite, your living room, or somewhere in between, that is for you to decide.
Whatever you choose, we want you to have the information and the support to feel confident in your decisions. You’ve got this. We believe in you.