Anyone who knows me, knows that I love preparation and planning. And that I'm a strong advocate for starting to prepare for your VBAC journey BEFORE you get those pretty pink lines. In fact my "zone of genius" is supporting women to get started before they get pregnant.
Yet many women are still waiting until they are pregnant, until they are past 12 weeks (or another arbitrary gestation), or until they have been given "permission" by their care provider to "try" for a VBAC.
The reasons for this avoidance is varied. Some women don't want to jinx themselves or the pregnancy; some don't want to feel like they've wasted time, money and energy preparing if they experience infertility; some don't realise how few VBAC friendly care providers are out there. And, of course, some pregnancies are a complete surprise or women didn't expect to become pregnant so quickly.
But it can be really useful to start preparing for a VBAC as soon as you decide that you want one in your future. And the big reasons for this are:
Ensuring that you have as many options open to you as possible when you do become pregnant.
Many women don't realise just how many options there could be for them, or how quickly some of them book out. If you are interested in a model of care other than whatever is standard in your community (usually either GP shared care or hospital based obstetric led care with some midwifery appointments) it can pay to look into them as early as possible.
Many women start looking into their local midwifery group programs once they've passed the 12 week mark only to find them booked out. Or they start looking into homebirth with an independent midwife only to find that they have either booked out or that they are out of their price range. Or they don't feel comfortable starting a conversation with their partner (or GP, or mother, or friend) about homebirth once they are pregnant and hormones are wreaking havoc with their emotions. Or the local private Ob who comes highly recommended for VBAC has booked out by the time you start making enquiries.
Sometimes new options pop up, like a new midwifery program, new private OBs, change of policies at hospitals regarding VBAC, or new independent midwives come to town. Keeping your finger on the maternity care pulse of your local community ensures that you will know your options, and know as much as possible about which of those options may be best for you when it comes time to engage them.
Which leads to...
Lowering the risk of being subject to bait and switch.
If you have less options (due to either not knowing your options or being too late to book in with your preferred option) the chances of you ending up with a care provider who is truly VBAC supportive and truly supports your goals go down.
Considering how many women want VBACs and how many care providers say that they are willing to allow VBACs, it seems crazy to think how many care providers out there aren't truly VBAC supportive. But if you get in late you have less time to talk about your birth goals, ask them how they will support your birth goals, find out what VBAC and physiological birth means to them, find out how they feel about caesareans and the reasons why they would recommend one, check out their policies, decide which you will and won't consent to, and find a new care provider if this one turns out to be truly unsupportive.
Often bait and switch is completely unavoidable, but by taking the time (and starting before you are pregnant increases the amount of time available to you) to thoroughly research possible care providers, their VBAC stats, and their policies, creating a shortlist, and then interviewing those on your shortlist you increase the chances that the care provider you choose is a good match for your birth journey.
You can read more about the signs of bait and switch here.
Giving you a chance to learn about VBAC and the things that can increase or decrease your chances of achieving one.
Before you can start really analysing your potential care providers and their policies you really need to know how VBAC works and the things that increase and decrease your chances of achieving one.
I see so many women who don't realise that growth scans are not evidence based or supportive of VBAC until AFTER they have had one. Or they don't learn that induction increases the chances of caesarean until after their care provider has told them that they must have an induction at 38/39/40/41 weeks gestation.
Learning about what increases and decreases the chances of a VBAC (and how you feel about those things) means that you can interview potential care providers more thoroughly and get a better feel for whether their VBAC philosophy matches yours.
To give you a chance to work through your previous birth and lower its impact on your decision making for this one.
Fear is a completely normal part of pregnancy and birth. And it's also normal for those fears to have some impact on our decisions. But it's also useful to look at our fears and to critically examine how much they are based in fact and come up with strategies to help us move forward without our fears having significantly negative impacts on our VBAC journeys.
For many women a fear of recurring physiological complications is a big issue or a fear of having another unplanned caesarean and needing general anaesthetic. Some women also fear a repeat of trauma caused by coercion or bullying from care providers.
These can all have a huge impact on the decisions that we make for birth.
A great starting point is to get a copy of your file from your previous birth. The full file. And then go through it thoroughly. Often doing this, even just doing it alone, will raise many questions about what happened from a physiological perspective. And often many fears will be quelled simply by knowing what happened and the possible causes of that. For example many women fear a repeat of foetal distress, but feel more reassured when they learn that things like induction or maternal position during labour can increase the chances of distress as they now have a strategy to lower the chances of a repeat of the circumstances.
Working through your previous birth also gives you a great opportunity to explore what birth means to you.
From your previous birth - What was good? What was bad?
And then - What are you wanting from this journey? What would you like to do differently?
Preparing for a VBAC usually involves exploring some big concepts - political, physiological, relationships, psychological, and philosophical concepts all come out to play.
There are many opportunities for deep exploration of yourself. And it always helps if you have a little more time to do this work thoroughly without feeling like you are on a strict deadline.
I don't know anyone who has regretted starting to prepare just that little bit earlier!
Please feel free to pop into the comments and let me know a bit about when you started preparing for your VBAC journey? Did you start before you were pregnant? Leave it until you got the all clear at 36 weeks? Somewhere in between?
And for those of you who are ready to start preparing for your journeys, but would love some help structuring that preparation, please get in touch. I offer VBAC mentoring packages that are designed to help you get REALLY clear on what you want from your VBAC journey and the pathways to get you closer to your goal. Just send me an email at firstname.lastname@example.org (or send me a message on Facebook) and we can discuss how I can help you create a VBAC journey that is as unique and powerful as you are.
Much love, Lizzie. x
Powerful, political and personalised pregnancy & birth services.