Comfort Birth

You need to do your research on this topic. Don’t blindly take your OB’s word on if it is the right choice for you. OB’s are often motivated by insurance companies and hospital policies. I think it is horrible that in some areas it is nearly impossible to find a care provider who will support VBAC’s. This is often due to insurance companies, hospital policies and misinformation. (Click here for a story of an OB who was pressured by her hospital to “up” her cesarean rate). It is important to find a care provider who will support your decision.

I did research for myself and found that elective repeat cesareans have risks of their own.
You have the right to make the best decision for YOU and your baby. As I said before it is your body and your birth. There are risks with both VBAC’s and Elective Cesareans… study and choose for yourself the path you want to take. If you decide to have a VBAC find support to help you on your path. If you decide you want a repeat cesarean I am gathering information to help moms have more positive cesarean births.

• Hypnosis: I feel that hypnosis really helped me with my births and to develop a positive I can-do it attitude. I felt very confident that I would be successful birthing my baby, I was able to trust that my body could carry a baby and have a vaginal birth. And I wasn’t even going for a vbac or hbac (homebirth after cesearean)
It also helped me to be calmer during my pregnancy and stay relaxed and positive when things came up that could have freaked me out.
During the birth, hypnosis helped me to stay calm and in control allowing me to make good choices. I also was able to stay comfortable and mobile which helped my baby to descend and get into his birthing position.
Hypnobabies now has supplemental CD’s just for VBAC moms!

• Supportive Care Providers: My husband was supportive, my midwife was supportive. This helped immensely in my success.

• Doula Support: I think this can be invaluable. I didn’t have a professional doula my first birth, however I had a large support team counting two friends, 3 midwives, my mother and husband. It was really wonderful to have an extra person *or 3* to give me support, my husband loved it too! With our second birth we did have a doula and she was absolutely wonderful!

Comfort Birth offers the following for VBAC moms:
• emotional support
• references to supportive care providers
• Hypnobabies childbirth classes: I love teaching the Hypnobabies program because it has a fear release CD you can listen to as many times as you need as well as SO many tools and so MUCH empowering information that can empower you to have the best birth possible. Hypnobabies now also has supplemental CD’s especially for VBAC moms!
• Doula services: We understand that your needs are different than other birthing moms. We want you to have the most positive experience with your birth and we are here to help you.

• We suggest you read:
Ina May’s Guide to Childbirth by Ina May Gaskin and
The Thinking Women’s Guide to a Better Birth by Henci Goer.
They both have VBAC chapters in them as well as other empowering information on pregnancy and birth.

LINKS for VBAC information:
• ICAN is a great resource for information about VBAC’s and support if you feel you are being forced into having a repeat cesarean.
http://www.ican-online.org/

• I like this website for their straight forward information about VBAC’s and their risks.
http://www.childbirthconnection.org

• also check out
www.vbac.com

• Think hospitals have something to do with the crazy rise of C-section rates? You are right… here is an article about an OB who left a hospital because she was being pressured to increase her c-section rates.
http://www.earthybirthymama.com/articles/sandlandarticle.html

Also here are some good questions to ask an OB/Midwife you are interviewing for a VBAC

- How many VBACs have they attended? (Word spreads fast on pro-VBAC OBs.)

- Of the last 10 women seeking VBAC from them, how many had a VBAC?
(If it’s less than 7 or 8, I would ask what happened in those 2-3 labors
that ended in CS. This would give you a great idea of how they operate… so to speak!)

- Do they have any standard VBAC protocols that differ from a non-VBAC mom?
(If so, this could be a red flag, because if they start viewing you as a uterus waiting to explode, rather than a laboring mom, they may not really support VBAC.)

- Do they induce a VBAC?
(This is dangerous and should not be done unless there is some serious medical condition requires immediate birth and vaginal birth is still an option. “Big baby” and “after your due date” are not valid, medical reasons. Before 42 weeks, induction should not be performed. At 42 weeks, I would request a ultrasound to check on baby and as long as baby and mom are fine, I would wait for labor to start instead of inducing/CS.)

- If so, what methods do they use?
(If they use Cytotec, find another provider FAST. According to Dr. Wagner’s “Born in the USA,” uterine
rupture rates in VBACing women is 28 times higher when Cytotec is used. Gonen 2006 found that very low amounts of Pit were safe.)

- What is their philosophy on going past 40 weeks?
(If they want to schedule a CS at 40 weeks, run fast. They should be fine going to 42
weeks as long as you and baby are fine.)

- What is their philosophy on “big babies?”
(ACOG has found no value in inducing for “big baby” since it simply doubles the CS rate and does not prevent shoulder dystocia or newborn morbidity. Nor do they support cesarean section for “big babies:” “While the risk of birth trauma with vaginal delivery is higher with increased birth weight, cesarean delivery reduces, but does not eliminate, this risk. In addition, randomized clinical trial results have not shown the clinical effectiveness of prophylactic cesarean delivery when any specific estimated fetal weight is unknown. Results from large cohort and case-control studies reveal that it is safe to allow a trial of labor for estimated fetal weight of more than 4,000 g. Nonetheless, the results of these reports, along with published cost-effectiveness data, do not support prophylactic cesarean delivery for suspected fetal macrosomia with estimated weights of less than 5,000 g (11 lb), although some authors agree that cesarean delivery in these situations should be considered.” http://www.aafp.org/afp/20010701/practice.html

- How many uterine ruptures have they witnessed?
(This can be an indicator of their induction rates.)

- What kind of monitoring do they require?
(For me, if it’s continuous fetal monitoring, that’s enough reason to find another provider because I’m not down for staying in bed the whole labor. I want to move! I personally think that 15 minutes of monitoring per hour is reasonable.)

- What is their CS rate?
(If it’s greater than the World Health Org’s recommendation of 10-15%, this is a huge red flag. How can they support VBAC if they are performing unnecessary primary CSs?)

- Do they perform an automatic CS if waters have been broken for more than 24 hours, even if there is no evidence of infection and mom and baby are fine?
(If they say yes, huge red flag. Find another provider.)

- Do they have a time-limit on how long your labor can be before they c-section you?
(There should be no limit as long as baby and you are fine.)

- Do they require epidurals for VBAC?
(Strangely, some providers do.)

- Do they require an IV or heplock?
(IV restricts your movement, heplock means they put the part in your arm, but it isn’t connected to a bag. Heplock can be annoying and get you into the “patient” rather than “healthy, birthing mom” mindset.

- Are you permitted to move and deliver in whatever position you want?
(Laying on your back or the “on the edge of the bed with your knees by your ears” are great for their viewing, but may not be where you want to be. In addition, especially if you have a big baby, you might want to deliver on your hands and knees.” 7 - 8 pounds is considered average size for a baby. 9 - 10 pounds, is just a little above the norm. 11 - 12 pounds, THAT is what should be considered as a “big baby”. But REMEMBER, baby fat squishes. Pushing from different positions and moving around can work even the biggest of babies through mom’s pelvis. =)
In fact, here is a great page that a mother wrote about the natural outdoor birth of her fairly large baby