Preparing for a VBAC: 7 Helpful Tips (2024)
So, you’ve had a cesarean section before, but you’re really wanting to experience a vaginal birth for your next birth. Where do you start? Is a vaginal birth even possible after a cesarean section? Isn’t that dangerous? Are there even any providers who will allow that?
Cesarean sections are done for many different reasons. In the past, most parents were taught “once a cesarean section, always a cesarean section.” Nowadays, we know that’s not the case. Just because you’ve had a cesarean section in the past, does not mean you will only ever be able to deliver your babies via cesarean section.
If you desire a vaginal birth after cesarean section, or a VBAC, there are some steps you may want to take to ensure success. With the help of a supportive provider and birth team, a great birth plan, a doula, and doing things to help strengthen your uterus, preparing for a VBAC is totally possible!
1. Hire a VBAC-supportive care provider
If a VBAC is something that is really important to you, one of the most important things (if not THE most important) you can do while preparing for a VBAC is to hire a provider who is supportive of VBAC births.
It’s really important that you, not only find someone who is supportive of VBACs, but you also want to:
Speak with others who have had successful VBACs with this provider
Interview this provider and ask questions like:
How often are VBACs successful in this practice?
What are your rates of intervention?
In what situations would you recommend we move to a repeat cesarean section?
Just because you see a brochure in an office that states the office is “VBAC friendly”, unfortunately doesn’t always mean there are providers who are truly supportive of VBAC. This is why interviewing your prospective provider(s) is SO important before making a decision.
Thankfully, more and more parents are desiring VBAC nowadays, so finding a VBAC-supportive provider may be easier than it was just a few years ago.
2. Look through your cesarean records
Part of preparing for a VBAC includes learning about your previous birth. Do you know why your last cesarean section happened?
Some of the most common reasons cesarean sections are done include:
Abnormal positioning (i.e. baby is “breech,” or feet/butt down)
Prolonged Labor
Fetal distress
Birth defects
Repeat cesarean section
Chronic health conditions
Umbilical cord prolapse
Cephalopelvic disproportion (CPD, rare condition where baby’s head is too large for the pelvis)
Placenta issues
Pregnant with multiples
Keep in mind that the majority of these things don’t always mean a cesarean section is absolutely necessary. Just as with most things related to pregnancy, labor, and birth, it’s important that you do your own research in order to properly advocate for yourself and your baby.
It’s important to find out as many details as possible about your previous cesarean section because your provider is going to use this information to determine whether or not you’re a good candidate for a VBAC.
What makes a good VBAC candidate?
60-80% of people who attempt a VBAC are successful! That is a HUGE percentage.
Factors that impact VBAC success:
You’ve had a vaginal birth before - For whatever reason you needed a cesarean section, having a vaginal birth a time prior to that simply means your body knows what to do and that it is capable of delivering a baby vaginally.
Age - While we don’t love to use age itself as a “risk factor” or use your age against you, some studies do show that pregnant folks under the age of 35 were more successful having VBACs and they experienced fewer complications. However, this could also be because some care providers treat older birthing folks like they aren’t capable of giving birth and are more likely to rush to cesarean or other interventions.
Incision location - A low transverse incision (one that is horizontally across your lower abdomen) is the optimal area for a VBAC.
Reason for your cesarean section - The chance of your VBAC success increases if your previous cesarean section was performed for reasons related to the baby versus the labor process. For instance, if you needed a cesarean section due to your baby’s positioning or because their heart rate was having some issues throughout labor, that increases your chances for a successful VBAC.
You can also work on strengthening your uterus throughout your pregnancy to help increase your chances of a successful VBAC.
Ways to strengthen your uterus:
Use the help of a pelvic floor therapist
Drink red raspberry leaf tea
Drink lots of water
Stay active
3. Choose a VBAC-friendly place of birth
Finding a VBAC-friendly place of birth coincides with finding a VBAC-friendly provider. Once you find the provider of your choice, you’ll want to start looking at the facility they attend births at.
Keep in mind that, when giving birth in a hospital, it’s not uncommon for the nurses to be caring for you up until you’re ready to push; then the provider is called. In this case, you’ll want to make sure the hospital is also VBAC-friendly.
Some questions you can ask regarding the facility include:
Does your hospital support VBACs?
How often do you have patients who desire a VBAC?
How often are VBACs successful?
What does the VBAC consent process look like?
Are there anesthesiologists readily available?
Does this hospital support uninterrupted, physiologic birth?
Do they have telemetry units allowing you to walk around and still be monitored?
4. Create a VBAC birth plan
With any birth, you should create a birth plan. A birth plan is essentially a guide for everyone on your birth team that helps to make sure everyone is on the same page.
Preparing for a VBAC-specific birth plan will ensure all of the members of your birth team are working toward your goal of a VBAC.
Not only is a birth plan a great tool to ensure everyone on your birth team is on the same page, but it also requires you to educate yourself before choosing your birth preferences.
Over at Motherboard, we’ve made making a birth plan super easy. You don’t need to overwhelm yourself with researching articles full of medical jargon. You can read through each labor/birth preference, read all of the up-to-date, unbiased, evidence, and select your preference for your birth plan all in one place!
5. Hire a doula
Hiring a doula is a great option, especially if you are wanting a specific birth. While there are a ton of reasons why you should hire a doula, here are some of the top reasons:
You’re statistically less likely to be medically induced
You’re statistically less likely to need a cesarean section
You’re statistically less likely to request pain medication during labor
You’re statistically more likely to establish a good breastfeeding/chestfeeding relationship
A doula can help you find your voice during labor when it may be challenging to speak up
Doulas often can come to your home and labor with you there, getting you comfortable, coping with contractions, and helping you decide when to call your provider or head into your hospital or birth center
6. Learn about the best fetal positions
The optimal fetal position for a vaginal birth is called: left occiput anterior, or LOA.
This is when the baby is on their left side with their back against the pregnant person’s belly.
When the baby is in this optimal position, it creates balance within the pelvis. This balance helps to dilate the cervix faster and also helps the baby descend down the birth canal more efficiently.
Not only can ideal positioning help with labor and birth, but it can also help with comfort at the end of pregnancy. There are some exercises and positions you can do to help your baby get into this position.
Tips to make sure your baby is in a good position for birth:
Walking
Bouncing/swaying/figure 8s on a medicine ball
Curb Walking
Lunges
Squats (you can use a chair, partner, or a friend for help)
Pelvis tilts
Captain Morgan position
7. Have a backup plan
When planning for a VBAC, it’s likely that you’re going to have the thought of a repeat cesarean birth in your head; and that’s okay. While your body is totally capable of having a successful VBAC, if it makes you feel more in control, have a back up plan!
Remember, this is your labor and your birth. Although birth can be unpredictable, being educated, empowered, and having a plan helps us to feel in control of our birth and our bodies.
Maybe you want to do everything in your power to have a VBAC. Maybe you have some previous birth traumas and if “x,y,z,” occurs, you’d rather just have a planned cesarean birth. If this is something you’d like to do, you may want to explore a “family-centered cesarean” as part of your backup birth plan.
Either way, make a plan, or two, and get your birth team on board!
The Takeaway
In the past, the thought used to be (and may still be for some), “once a cesarean, always a cesarean”. That’s not the case anymore! Just because you’ve had a cesarean birth does not mean you can never experience a vaginal birth if you want to.
There are some factors that may work in your favor of being a good VBAC candidate. There are also some things you’ll want to do while planning a successful VBAC, like finding a provider who is not only experienced with VBAC births, but who is supportive and will encourage you to have a successful VBAC.
It’s also important to educate yourself and create a birth plan when preparing for a VBAC. Having a birth plan ensures everyone on your birth team is on board with your preferences. Feeling empowered, educated, and supported is the key to success!
🤍 The Motherboard Team
