Although down from a high of 32.9% in 2009, cesarean births in the United States have risen from 5% in 1970 to 31.9% in 2016, which was the last year of national statistics posted by the CDC.
With this rise has also come the increase in mothers with previous cesareans educating themselves about TOLAC (trial of labor after cesarean) and VBAC (vaginal birth after cesarean delivery). While every trial of labor after cesarean won’t end in a vaginal delivery, the success rates for VBAC, according to the ACOG Practice Bulletin published in November 2017, are 60-80%.
Renee Bradfield, HPCE, of The Birth Space, is a certified hypnobirthing teacher and postnatal doula in Australia. She is the mother of two, the second of which was delivered during a TOLOC that resulted in a successful VBAC. Renee and I connected via Instagram where I stumbled upon a link to her moving VBAC birth story.
Here, she shares some tips for preparing for a successful VBAC, as well as how she utilized Hynpobirthing during her own pregnancy and delivery.
Choosing a VBAC
I’ve known many moms who would like to try for a VBAC and get overwhelmed with all of the planning, especially conflicting information. Once you made the decision to have a VBAC, what did you do next?
Once I had read all the current evidence and decided a VBAC was the safest option, I joined support groups online and read every birth story, I read books (Juju Sundin, Ina May, Grantly Dick-Read) and started to prepare my mind with self-hypnosis tracks.
Making Peace
You have a really wonderful article on your blog called, “10 tips for a successful VBAC,” one of the tips is debrief your previous birth, which I think is necessary and wonderful. I know one huge aspect of the debriefing is to understand what happened during a previous pregnancy or birth and release the fear and trauma related to that experience before heading into a TOLAC. Is there a particular time during a VBAC pregnancy one should debrief? What do you recommend for mothers who have a more challenging time releasing a previous birth experience?
I recommend my clients debrief all their births if they get the opportunity. In an ideal world a VBAC client would have debriefed their caesarean birth before they’re pregnant so any lingering questions or doubts they have can be resolved however this isn’t usually the case. For most women, it’s not until they’re pregnant again that these questions, the “what if’s,” may arise.
I highly recommend women getting a copy of their medical records from their previous birth and reviewing these with an independent party (a Private Midwife, a new Obstetrician, Doula or Childbirth Educator). You can identify areas in your previous labor where things may have deviated from your original preferences or where the start of a string of interventions occurred. Its then using this information, you’re able to identify what you can do differently in your next birth. Its not a time to chastise yourself for decisions you made in that birth because we all do the best we can with the circumstances on that particular day rather it’s a time to educate ourselves further.
I also encourage the birth partner to attend the debrief as we quite often forget that our births have a big impact on them and it may be the only time someone has actually asked them how they were affected by the birth.
Hypnobirthing
I know you’re a Hypnobirthing teacher and utilized Hypnobirthing during your own VBAC. How did the guided meditations and breathing benefit you throughout your pregnancy? Is there one thing unique to Hypnobirthing that really helped you make it through your labor that you wouldn’t have known otherwise?
Learning some great breathing techniques is so beneficial and can help from early labor right through to breathing your baby down. It’s the quickest and easiest way to bring yourself back to calm. I still sometimes use relaxation breathing in my day-to-day life. I also loved visualizations. While I struggled to practice these during my pregnancy and felt they weren’t for me, it felt quite easy in labor and I used various visualizations at points when I felt I needed to get into the zone and tune into my body.
Do you cover interventions and cesarean births in your classes?
I teach the Hypnobirthing Australia™ program and we discuss common interventions and caesareans. We even have a Positive Caesarean Birth course for those women planning an elective caesarean or having a change of circumstances later in their pregnancy.
Choosing a Care Provider
When choosing a care provider, should a mother be looking for specific qualities, statistics, etc? Will choosing a midwife over an obstetrician (or vice versa) denote increased odds of VBAC success?
Evidence shows continuity of care has much better outcomes for mothers and babies and statistically you have a higher chance of a vaginal birth. Ask around in your area and see if there are any Private Midwifes or a Community Midwifery Program (CMP) at your local hospital. You can also ask around in your area for recommendations. If you want to see an Obstetrician, have a meeting with them before you commit and ask them their personal VBAC statistics as well as the hospital policies and see if they align with your preferences.
Hiring a Birth Doula
Will a birth doula increase the chance of having a successful VBAC? For mothers who choose to have a birth doula, is it important for them to find someone who has experience with VBAC?
Yes. Studies have shown women with birth doulas have a higher chance of a vaginal birth so that would translate to VBACs also. They don’t necessarily have to have experience with VBACs however it would be advantageous if they have knowledge of current VBAC evidence and experience with previous clients at the hospital or birth center you are going to.
Estimated Guess Date
I know a huge part of VBAC success can be going into labor on your own, for moms who start to feel anxiety as they near their due date and/or pass their due date, do you have any tips or words of wisdom?
Absolutely! Going into spontaneous labor will increase your chances of a successful VBAC.
I think the biggest thing to remember is that your body isn’t broken. You will go into labor and your body is doing exactly what it is supposed to be doing until the time your body and baby are ready to be born. I always encourage my clients to not focus on their estimated due date rather think of an approximate time ‘mid-April’ or ‘late September’ for example. It’s a nice sneaky trick for your brain to try and keep any anxiety at bay or feelings of impatience (it also helps stop those pesky ‘have you had your baby yet’ calls and text messages).
Fourth Trimester
Your VBAC birth story was so moving; the part that stuck with me the most was your obvious elation after your baby girl was in your arms. You did it! How did your VBAC fourth trimester differ if any, from your previous fourth trimester after your cesarean birth?
I can still remember that feeling of just wanting to get up and high-five everyone and walk down the corridor with my baby straight after she was born – I felt great, just as birth is supposed to be when those amazing hormones take over. I was able to get up and shower on my own, get dressed on my own and then my Husband and I FaceTimed our families together – all of which I couldn’t do after my emergency caesarean. Having a vaginal birth also meant I was able to pick up my son for cuddles and play with him like normal, which was great as he was only 21 months when our daughter was born.
Do you have a favorite affirmation or mantra you used during your labor or share with your clients? If yes, would you be willing to share?
I can’t choose just one! But I always try and emphasize to my clients to remember that your body and baby are working in unison during labor. Your uterus is a working muscle and its doing its job perfectly. You just need to relax and let go.