Why do women want a VBAC? To understand VBAC we have to understand the change in cesarean rates over the past 40 years. Until the early 1980s when ‘the bikini cut incisions’ became the norm, women ONLY had a cesarean for severe medical risks to the MOTHER not her baby! Having a cesarean was very serious back then.
Below is a very short, short history because everything really is about your VBAC and about how you can best achieve one! We just need you to get your head clear. VBAC is not just about ‘choice’, finding a midwife or obstetrician who will support you, where you birth, what happens or even whether you feel respected. Your VBAC is about you and giving birth to your baby!
Very short history of cesarean
Prior to the late 1970s, a cesarean was major abdominal surgery … a woman was unconscious throughout and her uterus and belly was cut up and down. There was truth that a subsequent labor could cause the scar tissue to separate which could endanger a woman’s life. Back then there were no ‘unnecessary’ cesareans and women were not yet seeking to have a VBAC.
Close your eyes
What if there was a problem with the baby?
This might be very hard to understand and appreciate, if a baby was at risk of dying prior to the late 1970s that was not a reason for a cesarean. Back in your grandmother’s generation there was no electronic foetal monitoring! Forceps were used. There was no vacuum extraction. Some obstetricians actually tried putting their hands inside a woman’s uterus coming up inside through your vagina to turn her baby … internal version.
Instead a woman labored until the baby delivered dead, damaged or alive. If a baby did die before birth, prior to the 1970s, a woman just labored and delivered a still birth.
What if a woman couldn’t cope with labor pains?
Back then if a woman couldn’t cope with labor pains she was either knocked out or she just kept going no matter how long it took. ‘Suffering in childbirth’ was an often used term. You would think many women felt traumatised by their births but they didn’t as they do today. Certainly birth could be very traumatic for both mothers and babies prior to the early 1980s. What was the difference from your grandmother’s generation to yours?
- Back then women had no ‘choices’ so they accepted their birth
- You have ‘choices’ and expect those choices to be given to you
- Throughout Time Women have accepted Birth because world wide people know ‘There’s no way to know what your birth will be like’
- There has been an incredible change in how the medical profession deals with cesareans since the 1980s.
Here are statistics: ‘In 1970, the cesarean section rate was about 5%; by 1988, it had peaked at 24.7%. In 1990, it had decreased slightly to 23.5%, primarily because more women were attempting vaginal births after cesarean deliveries’ https://www.nlm.nih.gov
AND in 2015 in US
- Number of vaginal deliveries: 2,703,504
- Number of Cesarean deliveries: 1,272,503
- Percent of all deliveries by Cesarean: 32.0%
You might also like to read this history of cesarean
How did VBAC start?
Birthing Better skills started to develop right at the time when two things happened:
- Women wanted to try to have a vaginal birth for subsequent births that didn’t appear to have risks as the initial cause for cesarean.Sometimes women wanted more children then was advised. In other words, women wanted to challenge the belief ‘once a cesarean, always a cesarean’.
- The medical profession began to find ways to make cesareans safer, less intrusive with women awake and participating in the birth of their baby: bikini cut incision, epidural, fathers coming into surgery
Both women and obstetricians wanted cesareans to change. Yes, obstetricians knew the real risks to a woman’s uterine muscles if she attempted to labor because of the ‘classical’ incision. This meant the obstetrical profession has fear around VBAC. Be compassionate to them. They see what you don’t! So you have to stand out and show your midwife or obstetrician that you are not putting yourself or baby at risk.
A cesarean was major, major abdominal surgery with a number of high risks to the mother. Consider this, penicillin was not in common usage until after WW2 so women could die from an infection after having major abdominal surgery!
Here’s the VBAC conversation today
Given 32% of births were a cesarean in 2015, we are faced with two conclusions:
- Women can no longer labor and give birth vaginally for some reason/s … more obesity? bigger babies? older women?
- There are many ‘unnecessary’ cesareans but what does that mean?
In this mess there is YOU. You want a VBAC for your own personal reason so how can you achieve what you want? First you have to change the word used for what you want .. VBAC
VBAC should be LBAC
You and all of us have a problem with the acronym … VBAC. This simple acronym problem has a huge impact on you and your supporting partner/other. YOU want a vaginal birth but to get to the vaginal part of birth you have to do the labor part of birth. 99.9% of all cesareans now and prior to mid1970s and today are performed during LABOR and not during the vaginal part!
Was your cesarean done during your labor or the vaginal part?
What if we called it a LBAC … labor birth after a caesarean? Would you or other women be so keen to try one? This is not a silly question. Your understanding of simple language choice is crucial to your success and how you approach your coming birth. In other words you have to get through the longer and harder labor part to get to the shorter and more exciting vaginal part.
How to get from LBAC to VBAC?
We know why both obstetricians and women wanted to labor and have a vaginal birth after a previous cesarean as mentioned above. In order for VBAC/LBAC to become realistic, there were pioneers … and Birthing Better skills were being developed by some of these families. These women had classical cesarean incisions! They were at risk. Some had more than one classical cesarean. They were at greater risk. You are not at much risk today because you have had a ‘bikini cut’ which does not put as much stress on the muscle fibres of your uterus.
This means Birthing Better families had to do two things to reduce the risks of problems that could arise from attempting to labor and have a vaginal birth.
- We had to learn how to prepare a pregnant body to let out this big object called our baby.
- We had to learn to labor effectively and not have long labors or delays in 2nd stage
We’ve achieved these two goals and you get all the skills to achieve a safe and successful LBAC/VBAC
Think about it. Whether you believe your cesarean was necessary or not, you need to get through labor first before your baby can come out of your vagina. In order for your baby to come out of your vagina you have to make that easy for your baby as well as cope and manage the natural occurring pain of labor contractions. When you have those two areas covered you are much more likely to achieve your birth goal.
What’s your birth goal?
Birthing Better families went further. They actually had to think about how they felt about ‘types’ of birth. Did they actually feel their cesarean was less than a labor and vaginal birth? If that were true then we’d value our babies differently and that goes against something very profound in ourselves. This means we had to elevate every type of birth! Birthing Better families really thought this out. Instead of having skills ONLY for a LBAC/VBAC, we had to develop skills for whatever birth we experienced.
We achieved so much more.
- We prepared our pregnant body for birth.
- We learned birth and birth-coaching skills
- We committed to using our skills to birth our baby no matter where the birth took place, no matter who was present AND no matter what actually happened to or around us. That included having a non-laboring cesarean, an unplanned one after labor as well as having heaps and heaps of medical ‘interventions’.
- We committed to birthing our baby with our skills!
This means in Skills Specific For VBAC you are given this huge gift of skills for use no matter how you birth your baby. You too have a choice about how you work through your baby’s birth. Either birth is all about YOU or it’s about you and your baby!
You can focus entirely on a goal … having your baby come out your vagina. If that doesn’t happen do you want to be plagued with shame, blame and guilt that deprives yourself and family of your joy?
You can focus entirely on the process … how you do the activity of giving birth as you help your baby do the activity of being born … and live with the empowerment based on the skills you and your partner used. This leaves you empowered, closer as a family, connected to your baby and finally full of understanding … we need another term instead of VBAC.
You want to have a vaginal birth after a Caesarean but you have to absolutely need to want to get through the natural occurring pain of contractions. You do that best by becoming a skilled birthing woman.