VBAC – Should You Have One Or Not?

"VBAC takes planning, it takes good support, it takes knowledge and commitment, VBAC can be a gruelling journey, and it can also be a remarkable one"

VBAC – Should You Have One Or Not?

After a traumatic, or unwanted caesarean women often set out planning a VBAC (Vaginal Birth After Caesarean) to avoid further trauma. This reason can seem like the best reason there is to pursue vaginal birth, but we should take a closer look at it, and perhaps some of the other reasons, to see if VBAC is really being chosen by women whose eyes are wide open.

DON’T VBAC TO HEAL YOURSELF: A vaginal birth after a caesarean can not change history. It can not take you back in time and give you those moments you long for with your older child. It can give you those moments with a new child, but some women find themselves grieving even more once they know what they missed out on. A VBAC can definitely leave you feeling like you have achieved something great, but it isn’t a time machine.

DOES THIS MEAN YOU SHOULDN’T VBAC? No! All it means is that you should be aware of this in advance. If VBAC is a healing experience for you that’s awesome, if it isn’t, you have a plan in place to survive while you recover. 

DON’T VBAC BECAUSE IT’S EMPOWERING: Many women speak about their VBAC as an empowering experience, but choosing an unpredictable activity and setting your heart on it in the vain hopes of finding empowerment isn’t always going to work in your favour. If you find, after your VBAC that it was an empowering experience that’s brilliant, but don’t expect that it will be because you just can’t predict how you will feel or what will happen.

DOES THIS MEAN YOU SHOULDN’T VBAC? No, it means you should plan for all outcomes. Plan for healing after a repeat caesarean in case it becomes necessary, and plan for healing after a VBAC as well.

DON’T VBAC BECAUSE YOU THINK IT WILL BE EASIER THAN SURGERY: Healing after a caesarean is no walk in the park for many of us. Many women want to have an easy recovery after birth, so that they are more physically competent mothering a new baby, and older children too. Some women have easy vaginal births, others have difficult ones. Healing from a tear, from stitches, from a dreaded episiotomy, can be difficult both physically and emotionally. 

DOES THIS MEAN YOU SHOULDN’T VBAC? No, it means you should talk to lots of other women about what made their postpartum period manageable. Be realistic about it all, it can be physically challenging no matter how you welcome your baby.

TO PROVE SOMEONE WRONG: Maybe your mother in law, your sister, or a maternity care provider has said something dismissive to you about your caesarean or your ability to give birth. Maybe they’ve told you you aren’t meant to give birth vaginally, maybe they told you that you couldn’t hack it, maybe they’ve told you that you don’t want to give birth vaginally – as if you’re somehow clueless about what it entails. That’s pretty insensitive isn’t it! For some reason people love to say that stuff to women who want to VBAC. Choosing vaginal birth for this reason is foolhardy because for one reason or another you may well find yourself having a repeat caesarean, and you won’t have proved anything.

Woman with blue eyes thinking
Credit: Julia Freeman-Woolpert, FREE IMAGES, CC0

DOES THIS MEAN YOU SHOULDN’T VBAC? No, it just means that you shouldn’t talk it up to the doubters until afterwards. If you end up with a CBAC you really don’t need them saying “I told you so”.

DON’T VBAC TO AVOID TRAUMA: The reality of birth is that no matter how it happens, it can turn into a traumatic experience. Some women find themselves MORE traumatised by their vaginal birth than they were by their unpleasant, unwanted caesarean.

DOES THIS MEAN YOU SHOULDN’T VBAC? No, it just means you should be incredibly careful in planning your birth and hiring your attendant, ensuring that you are both on the same page, and that they are very clear about how you would like your birth to play out whether you remain healthy, or whether you require interventions.

DON’T VBAC BECAUSE YOU WANT TO GIVE BIRTH: Depending on where you live, who you hire, and in what venue you plan to welcome your baby, the odds of giving birth vaginally after a previous caesarean vary significantly. Birth can be amazing, but unless you really truly want to add a new family member to your household, be wary of pregnancy. If it’s possible it’s a good idea to find the right care provider before trying to conceive.

DOES THIS MEAN YOU SHOULDN’T VBAC: No! It means that you should plan your family carefully and choose where and with whom you give birth even more carefully.

DON’T VBAC BECAUSE YOUR CARE PROVIDER SAYS THEY WILL LET YOU: Your care provider isn’t in charge. Furthermore, many care providers (if not the majority of them when we look closely at VBAC statistics) don’t actually support birth after caesareans. They might say they do, but there’s a giant chasm between a genuinely supportive provider, and one who merely “doesn’t mind if you give it a shot” but also has no aversion to repeat caesareans. Then there’s the other type who doesn’t mind them under very strict conditions which make it all but impossible to labour successfully until you give birth vaginally. Furthermore many will say they support VBAC simply to get your business, then spend your entire pregnancy stealing your confidence and making you fearful of birth so that by the end you skip willingly into an operating theatre carrying your catheter bag and feeling like you are being saved from impending doom.

DOES THIS MEAN YOU SHOULDN’T VBAC? No! It means that you should research everything about VBAC and interview multiple care providers thoroughly before settling on one. Remember that if you hire them, you set the rules. They get paid to offer advice, but not to make rules. It’s your body, it’s your baby, YOU make all the rules. The law says so.

There are a million reasons to give birth vaginally after a caesarean, and those above aren’t really reasons NOT to, they’re just things that you really should be aware of. VBAC takes planning, it takes good support, it takes knowledge and commitment, VBAC can be a gruelling journey, and it can also be a remarkable one. If you decide you’d like to give it a shot, the very best reason to do it is because birth is the default setting. Major surgery is a medical miracle if you need it, or if there’s an emergency, but vaginal birth is the normal, healthy way for normal healthy pregnancies to conclude.

Bold yellow text, YES, NO
Decision making!
License: Creative Commons CC0.

And last but not least:

DON’T VBAC IF YOU NEED A CAESAREAN: This is pretty obvious right? The reason it’s included here is because if it isn’t included we’ll receive forty comments telling us that some women need caesareans. Consider your comment posted already. Thanks for that, it was highly insightful.

DOES THIS MEAN YOU SHOULDN’T VBAC? Yes. It also means you shouldn’t make painfully obvious comments on the internet.

FOR FURTHER READING:

“Go In Pushing” isn’t a birth plan

What To Ask A Care Provider

Birth Trauma Explained For Fathers

Giving Birth After Birth Trauma

Making a Birth Plan For V.B.A.C.

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