CBAC – or Caesarean Birth After Caesarean, or RCS – Repeat Caesarean section. The idea can fill a woman with dread if she’s had an unplanned, unwanted, or traumatic caesarean. Women often ask what they can do to prepare themselves for the possibility of CBAC. There are plenty of things you can do, and many you will have already done before you started reading this.
You’re Already 95% Ready!
Even considering a possible CBAC in the lead up to a much anticipated VBAC can feel totally overwhelming. Some women have faced such pain, trauma, and grief after their previous caesarean that they can barely stand to think about it. They can’t fathom actually preparing for it. Other women feel a sense of urgency to prepare themselves for a potential CBAC so that they aren’t caught unawares again.
The good news is that simply acknowledging the possibility, you are preparing. And once you’ve had one caesarean (or more) you are pretty well informed about it being something that could happen. The biggest, most important thing is to simply acknowledge that it might become necessary. You’re going to do everything in your power to avoid it, but you know that birth isn’t always predictable. If you can acknowledge that, you’ve done ninety-five percent of the work already. Congratulations!
Know Your Facts and Figures
It’s a really good idea to know what the VBAC statistics are at the venue where you are planning your birth. Not just VBAC though. You want to know how many women have a CBAC every year. You also want to know how many women have caesareans for their first pregnancy.
Those figures give you a good idea of your care provider’s attitude to birth management in general. All these little things give you more pieces of the puzzle.They help you to figure out how much of a fight you have on your hands. If they won’t give you any figures, or they brush you off with fluff, dig deeper. Interview more providers. You need to remember that VBAC is just a birth, it’s not a super enormous risk that should invoke a sense of mass panic. VBAC is just normal birth, with slight risk of complication.
If there are no other providers, you need to be completely confident in your birth support team (husband, doula, mother / inlaw) and your birth planning skills. If you know what makes a caesarean necessary, and when it’s ok to request more time, you’re setting yourself up to succeed. Knowing that you are consenting to a necessary CBAC can make a big difference in your emotional wellbeing in the months afterwards.
You Got This Far!
You’ve survived one caesarean. You can do this! No matter whether you were incredibly distressed and traumatised, or whether the physical healing was horrible …… you got this far! Talk to your care providers about what happened and why it’s so important to avoid a CBAC. Ask them what they have in place to support you emotionally, how they will manage pain or other complications, if they have a good breastfeeding consultant etc. Use what made your last caesarean rotten, to make a plan just in case.
When making your VBAC birth plan, spend a little time thinking about a plan for CBAC. Keep it on a separate piece of paper, and only bring it out if necessary. Although it might be an idea to discuss your plan in advance, with your care provider. That way you know whether they are able to meet your expectations, and support you adequately through a VBAC. Taking control of an unplanned CBAC by making requests of your medical team, can really help you feel better about the situation.
Know Who You’ll Tell
Have a list of trusted friends, family, or social media support groups that you know will be there for you in the aftermath of a CBAC. Have them all lined up and ready. Know who will say “At least you got a healthy baby” or “I told you to just book the caesarean” and who will hold your hand while you cry out your sadness and disappointment. Consider not telling any of the aforementioned about your VBAC plans, so that if you do have a CBAC you may even avoid flippant, insensitive comments. You can always surprise them after a VBAC, just to enjoy the looks on their faces.
Very few women would claim to enjoy undergoing a caesarean. You aren’t alone if you’d really prefer to avoid having more than one. Ironically women often fear the fear itself. They literally believe that being afraid of a CBAC and preparing for it, could cause it to “manifest”. It can’t. Biology is a powerful force, and it can out manoeuvre absolutely anything your brain can come up. If manifestation is something that concerns you, remember that your baby is also planning something. They’re actively manifesting a VBAC so that they can have a cuddle with their mum. Plan a better CBAC for them in case the birth doesn’t go to plan. Your planning can’t alter things, but a lack of planning could leave you feeling quite distressed.
Take time to really think about what matters to you when you meet your baby. The odds are good, that the more planning you put into it, the more time you spend finding the right care provider, and the right venue for VBAC, the greater your chances are. The only reason CBAC is so common is because care providers are pushing them on us. If we learn what makes vaginal birth happen, what makes a caesarean necessary, if we choose a good support team, and make a plan for all possibilities, the odds are good everything will turn out well.
FOR FURTHER READING
Not While I Still Have A Pulse – a story of CBAC