How can I increase my chances of having a successful VBAC?
I’m hoping to have a vaginal delivery after having had a c-section. I’ve been told I’m a “good candidate" for a vaginal birth, but I’m worried about ending up with a repeat cesarean. How can I increase my chances of having a successful VBAC? #askingforafriend
Dear Cautious Candidate,
First off, congratulations on your decision to birth vaginally and avoid a repeat cesarean. Even though you’re still pregnant, or maybe even just considering pregnancy at this point, the decision in itself can feel enormous.
Vaginal delivery after a cesarean holds fewer risks than having repeat surgery for most individuals. Let’s explore the best ways to support having a successful vaginal birth after having had a prior cesarean delivery (VBAC) with the below tips.
The single most important thing you can do to support your VBAC journey is simply to bolster your own confidence. We’ve also outlined five additional and instrumental steps to help you increase your chances for a successful VBAC.
1. Be your own advocate
There’s a lot of undoing and relearning that needs to be done after you’ve had a previous cesarean. Many people hold onto fears of what their bodies are not capable of. They’re left wondering if their body failed them last time or if they can physically or mentally handle a vaginal birth this time.
Begin preparing for your VBAC by educating yourself on your prior birth and all of the circumstances surrounding it.
You can begin to better prepare for VBAC by taking the below steps:
Revisit your last labor and delivery story
Review your labor records with a provider
Find a midwife or doula who will debrief with you
Confirm you are a good candidate for a VBAC
Chat with a therapist about any fears you may have
Join your local ICAN (International Cesarean Awareness Network) chapter.
It’s essential to name any fears or concerns you may have going into this next birth and remind yourself how powerful you are. Make sure to share these fears with your selected provider and learn more about the power of self-advocacy during pregnancy.
As you begin to find your voice, it’s imperative that you also find a supportive birth team. This includes your provider, partner, friends, or doula if you’ve got one, and anyone else who is walking alongside you during this pregnancy. It pays to have everyone on board with your plan for a VBAC. Focus on surrounding yourself with a team of people to rally you through this pregnancy and labor and who will remind you of your own strength every step of the way.
2. Reconnect with your body
Your body has brought you this far in life. It even got you through that wild cesarean surgery. It’s a pretty phenomenal thing and should be honored for all of its capabilities. Become your body’s loudest and proudest cheerleader.
If you’re curious about how to prepare your body for a VBAC, start by finding ways to get in tune with it. This can look like meditation, massage, breathwork, acupuncture, yoga, etc. — really anything that brings you into direct communication and harmony with your own body.
3. Find a VBAC-supportive provider
The rate of cesareans in the United States is somewhere around 32%. With such high rates and regularity of this surgery happening today, you’ve got to get to know your individual provider and what their personal VBAC rates are.
The success rates of a VBAC by the provider can vary as widely as 0.5%-87%, so ask questions and do your research. Interview your local PCPs, OBs, CNMs, and Licensed Midwives. Consider finding out how often the births they attend to result in induction, cesarean, or successful VBACs.
The provider you choose can help increase your chances of a successful VBAC.
Birth after having had a cesarean is pretty similar to giving birth for the first time, but there are some clinical nuances that can significantly affect your care and the success rates.
Make sure your chosen provider has a rich history of supporting people through this kind of labor. Just because a provider says they will “let you try” doesn’t mean they’re going to guide you through the process and preserve your chances of a vaginal delivery. In fact, if anyone says they’ll “let” you do something with your own body, it’s probably safe to move onto the next available provider.
You’re the expert in your own body, and you’re looking for someone to safeguard and support you through a regular physiologic event. Find a provider proudly supporting people through VBAC, not one who is just okay with it.
4. Pick the perfect place to give birth
Don’t forget to consider where you are planning on having your VBAC, as well. Where you give birth matters! It’s the same deal as interviewing providers — you’ve got to do a bit of research on the sites you may deliver in. Even if you’ve picked the best provider in the world, be sure the institution or group they practice in supports their VBAC ethos.
Will your provider be able to provide the VBAC care you desire, or will their hands be tied by institutional or practice protocols?
It’s so important to be comfortable in labor and feel confident and in control. Our pain receptors change depending on the environment we’re in, so be sure to tour hospitals and birth centers. Even consider your own home and suss out where you feel best.
Wherever you feel safe and in control is where you’re going to labor best. Trust your gut on this decision. For some people, that’s in the hospital’s labor ward, while for others, it’s a freestanding birth center or in their own bedroom.
5. Create a simple birth plan
Another critical thing to consider when aiming for a VBAC is how to keep your birth plan as simplified as possible to help lower the rate of intervention. We know the fewer interventions that occur at birth, the higher your chance of a successful VBAC.
The goal here is a normal, un-intervened physiologic birth. That may be easier said than done, though. While you may end up needing some interventions along the ride (and that’s totally okay!), starting with a team specialized in supporting you through an un-intervened birth journey can make a world of difference.
Midwives in particular specialize is in this type of birth and may be worth considering as a part of your team. If giving birth in a hospital, many interventions are quite readily available and regularly used. Also, think about hiring a doula who is familiar with physiologic birth and can help avoid the unnecessary use of those interventions.
Consider taking a childbirth education course geared toward physiologic birth. You’ll learn about different positions in labor that can aid in progress and comfort. You’ll also discover various foods and drinks that can keep you satiated while keeping energy levels stable throughout labor.
By keeping your birth plan focused on simple things like movement, nourishment, and support, you can significantly decrease your likelihood of certain interventions like IV fluids, epidurals, induction therapies, etc.
More on preparing for a successful VBAC
As we mentioned earlier, the rate of cesareans in the United States is somewhere around 32%. There is a whole slew of reasons your previous birth may have resulted in a surgical delivery, but the World Health Organization states there are no maternal or neonatal benefits associated with national cesarean rates higher than 10%.
It is worth considering why the United States rate is so high in the first place, but we’ll save that complicated topic for another day.
While VBAC is typically the safest option after having had a cesarean, our national statistics prove that the medical model doesn’t support them. It takes diligence, perseverance, and determination to have a successful VBAC within this system, but you absolutely can do it.
You are amazing, so find amazing people to support you. Find an amazing place to give birth. And keep that birth as sweet and straightforward as you want it to be.
