Almost all VBACers have heard the term “bait and switch”. While it certainly happens in non VBAC births (perhaps it’s how you became a VBACer in the first place…) it is alarmingly commonplace in VBAC pregnancies. So much so that many women miss the signs that their care provider may not be totally on board with their plans because the things they say are so “normal” that women believe that this is just how it goes.
A bait and switch is where your care provider starts out “supporting” your VBAC and, usually at around 36 – 38 weeks, ends up recommending a caesarean for non medical reasons (such as big baby or if you reach a certain date). Sometimes women are completely blindsided by this. Sometimes they don’t realise it’s a bait and switch because their care provider had been “so supportive” during pregnancy that they figure this must be a genuine need for caesarean. Sometimes they try to fight it or change providers.
Sometimes it breaks a woman’s trust in the maternity care system for good.
There are a few signs that your care provider may not be completely on board with your plan to VBAC or that they are trying really hard to find a reason to suggest a caesarean.
Here are my top 4 signs your care provider isn’t keen on your VBAC plans:
Fobbing off birth plan discussions.
It’s amazing how many care providers shy away from birth plan discussions until 36 weeks. A common comment seems to be “It’s far too early to discuss how you will birth – things could change between now and your due date”.
But, you know, things can change very dramatically after 36 weeks (or whenever the birth planning conversation does take place) as well. The health of mum and / or bub can change right up until baby is born. And if your health status changes between the signing off of your birth plan and the actual birth then you can change your plan! But it’s never too early to start ensuring that your care provider is on board with supporting your birth goal.
I always suggest to women that it is a really good idea to start the birth planning conversation early so that you can get a good idea of whether your care provider is on board. And it’s a good idea to get it all in writing so that conversations can’t be “forgotten” down the track. This can be one of the earliest signs as to whether your care provider plans to support your birth goal.
Avoiding your requests for statistics.
Another common tactic suggested to women planning a VBAC is to get the stats for your care provider before you sign up. Knowing their caesarean, VBAC and intervention rates can be very useful for determining whether they are truly supportive of VBAC or not. Many care providers either fob this one off as “I can’t possibly remember these numbers” or they pull out their “success rate”.
It’s much better for you to know how many actual women have VBACed with your provider. For example: If they have a 100% “success rate” this sounds awesome – once you find out that only 10 women even attempted a VBAC with them last year it sounds less awesome.
And they know that.
They use a VBAC calculator.
Yes, there is actually a calculator designed to calculate your chances of a VBAC. Funny enough a really good indicator that you have a lower chance of achieving a VBAC is if your care provider uses one of these calculators. Yes – some things can increase or decrease the chances of you achieving your VBAC. But these calculators are the equivalent of pulling a number out of your….um…hat.
Routine sizing scans.
Many women out there are terrified of birthing a “big baby” and the kind of damage that can do. Given our cultural conditioning around all things birth and vaginas this isn’t surprising. And OBs know that women hold this fear. They also know that sizing scans can be off by as much as 20% (making them, essentially, a guess), that babies heads mould and pelvises stretch open and that birthing in water and moving instinctively can reduce damage. There can be genuine reasons to have ultrasounds during pregnancy but if your care provider does an ultrasound at every appointment and constantly mentions the size of baby chances are that they are setting you up to want a caesarean. And the one at 36 weeks? The sole purpose of that is to guess how big baby will be at birth and if they guess baby will be bigger than whatever they "allow" - you'll be heavily pressured into induction or caesarean.
There are many many other signs that you care provider is planning a bait and switch but these are my top ones. If you find yourself feeling like, perhaps, your care provider is planning to withdraw their support of your VBAC you do still have options. Start with open and respectful communication – ask them all the questions that you need answered in order to feel confident.
And if this doesn’t get you any satisfaction then let them know how unacceptable this is by firing them.
You deserve strong SUPPORT for your goals. Not just tolerance while your care provider tries to find something to talk you out of them.
PS: If you'd like help navigating the system and preparing for VBAC in a truly powerful way please contact me or book in a coffee chat and lets get you started on reclaiming and re-igniting your power.
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