How to Have a Good VBAC
What is a VBAC?
Understanding Birth Terms
CB: Cesarean Birth
VBAC: Vaginal Birth After Cesarean
TOLAC: Trial of Labor after Cesarean
Stats of Safety
Women with prior CB are at higher risk of uterine rupture. The reported incidence of uterine rupture among women with prior CB ranged from 0.22% to 0.5% (Motomura, et al).
The World Health Organization Multicountry Survey (WHOMCS) collected data on pregnant women who had a previous cesarean in facilities across 29 countries. The incidence of uterine rupture was 0.5%, meaning out of 37,366 women, 170 experienced uterine rupture. Though the risk is low, there are some risk factors you should speak with your doctor about while you are deciding if a VBAC is right for you.
Reasons for a cesarean birth:
The most common indications for primary cesarean birth include, in order of frequency:
- Labor dystocia
- Abnormal fetal heart rate tracing
- Fetal malpresentation (any fetal position other than vertex, or head down, for example: breeches presentation)
- Multiple gestation
- Suspected fetal macrosomia (large baby)
The reason I mention these indications, is because I want to bring to your attention the number one reason, labor dystocia. Labor dystocia in the second stage of labor is characterized by prolonged duration or arrested descent where the baby does is unable to navigate through the pelvis for birth. This may be caused if the baby is not a position that can fit through the pelvis, inadequate contractions, poor maternal efforts, or true cephalopelvic disproportion when the pelvis is too small for the size of the baby.
Through the stresses of life, particularly physical or emotional trauma, our bodies can become imbalanced and misaligned. This can interfere with the labor process, and it can rob you of the mobility and flexibility that assist in vaginal birth.
This is why receiving bodywork during your pregnancy is a PRIORITY for a successful VBAC. (Read more about How To Avoid A Cesarean Section)! There are a variety of bodywork modalities that can help you improve your alignment, mobility, and restore proper function to avoid a labor dystocia in your next birth. I recommend therapists who are trained in releasing fascial restrictions. Fascia is a connective tissue that weaves through the body. Through muscle fibers, through organs, and over bones, it connects the skeletal system to the muscular system. Fascia literally holds us together with gluey proteins that bind cells all together in their proper placement. When there is restriction to the fascia in one area of the body, the whole body is affected. Trauma, injury, inflammatory responses, postural patterns and/or SURGICAL procedures create fascia restrictions and RESTRICT mobility and function.
Fascia is a VERY BIG DEAL THAT NO ONE REALLY TALKS ABOUT IN PREGNANCY!!!!!!
So, I am here to change that. I love fascia, I work with fascia, and I see the magic that happens when fascial restrictions are released in pregnancy and in labor. My clients that receive fascial work with me have smoother, easier, and faster births than they thought possible.
So much of birth relies on alignment and balance in your body- first to help the baby (the passenger) find an optimal position to travel through the birth canal, but to also allow your body (the passage) to open and create the space needed for you to have a successful vaginal birth.
Here are my top 2 favorite bodywork modalities: structural integration (some may have heard it called Rolfing) and chiropractic alignment. I find blending soft tissue work and the work of a chiropractor to be very synergistic when used together. This is because the soft tissues control whether our bones move, and the pelvis has to move in ways never seen other than in vaginal birth. Your soft tissues (muscles, ligaments, tendons, fascia etc…) must be healthy and supple to be able to function in the capacity needed in labor and for vaginal birth.
Other modalities include Craniosacral Therapy, Acupuncture, energy work such as Reiki, and if you can- a pelvic floor physical therapist! I am surprised at how many women don’t know about the importance of the pelvic floor physical therapist PFPT)… I mean a baby is about to introduce itself to those tissues- they should be prepared! If your previous cesarean birth was because your baby could not descend, or you had to push for hours but still had a cesarean birth, then you are a great candidate for the PFPT. If you have difficulty finding one in your area, look up Dr. Kelly Sadauckas, DPT, OCS, ITPT at www.pelvicfloored.com or Lynne Schulte, PT, Pelvic Health Physical Therapist at www.instituteforbirthhealing.com. They offer a few online courses for birth healing and birth preparing.
With a previous cesarean birth, this means you have an abdominal scar. Did you know your scar can cause fascial adhesions? I emphasized it in the paragraph above for this very reason. Scar work is an important part of preparing your body for a VBAC. If the bodyworker you go to doesn’t do scar work, here is a video by Lynn Schulte on how to massage your scar https://youtu.be/p-VfUJ6JcWo. But if you have other scars, this would be good to use on them as well.
Speaking of the previous cesarean birth, it is important to take the time to go inward and explore your feelings toward it. Since there are different reasons why you may have had a cesarean birth, such as a breech presentation, or the ever so scary non-reassuring heart tones of the baby. Or perhaps you DIDN’T have to have it after it turned out that the 10 pound baby your provider predicted ended up being only 6 pounds after all. Or maybe you were among the many whose cervix just refused to dilate to 10cm despite every effort, and cesarean birth was your only option. Whatever the reason, most women who are deciding to attempt to have a VBAC carry some type of fear or trauma inside them. The idea of a “healthy baby” and “we should be thankful” plays over and over and over in some women’s minds. Often they try to ignore these feelings of fear when they bubble up because they feel they don’t have the right to be upset about the “lifesaving cesarean birth”. However, in reality, it is imperative to acknowledge the experience that they had during their cesarean birth so that they can go into their TOLAC open, present, and emotionally prepared.
Why do women feel fear from the past pregnancy if there was no obvious traumatic event? Well, let’s start with how some women have a vision for their birth, only to be told the baby is breech, won’t turn, and she was not confident to take the risk of a breech birth, or her provider was not skilled enough to offer her the option of a vaginal breech birth. This can be very disheartening, and the woman can feel like their dream was stolen. The way they help themselves feel better is to say, “It’s ok, I will VBAC next time.” However, when the next pregnancy comes along, this mother holds the fear her baby will be breech again.
There are also those who experience an unexpected cesarean birth. Perhaps it was emergent, and the baby’s life was at risk, such as with an abruption (where the placenta detaches from the uterine wall causing life-threatening bleeding), or with a cord prolapse (the baby’s umbilical cord slips past the head and becomes the presenting organ, which may become pinched from the pressure of the baby’s head). These situations are extremely scary, and the thought of losing their baby or their life is a memory not easily forgotten. The fear of it happening again in the next pregnancy is very real, and it can hover around her all the time.
Then there are the women who experience labor, and for some reason, the labor does not progress. Even if they were fully dilated and tried to push, their baby would not be born vaginally. These women relive that experience, and they can get very scared that in their TOLAC, they won’t get past the furthest dilation their cervix achieved previously, or when it is time to push, they will “fail” again. That is the unfortunate side of birth: feelings of failure. It may not make sense to someone who has not shared in this experience, but some women do hold themselves responsible for something their body “failed” to do. However, many women instinctively feel the need to have a vaginal birth, and this is partly because there is an unseen and instinctual part of birthing and bonding that is very natural and important to occur. Read more about this in my blog, The Invisible Process At Birth.
Fear is a very powerful force. It is vitally important to clear your body of this energy when going into your next pregnancy in order to decrease your worry, doubt, and anxiety that not only rob you of a happy pregnancy, but could also set you up to relive the experience again. The reason for this is because of “Manifestation”. Your thoughts become reality. When your dominant thought is “I’m scared this will happen again,” then your thoughts are all on the vision of what you don’t want.
Did you know your subconscious mind is where all your actions and behaviors come from? Our subconscious mind is what drives our behavior, not our conscious mind. Our subconscious mind is our emotional mind, and whatever this emotional mind feels or believes, the body will act accordingly. So, if your thoughts and feelings are of fear, worry, doubt and all about what you “DON’T” want to happen, then that is what you will attract and that is what can happen.
Changing your mindset is the most important thing you can do to create new feelings, new beliefs, and new beginnings. This is why I created my program The Natural Birth & Beyond Method at www.maryaeddaifi.com. The mind is the most powerful tool we have, and birth is all about the mind. How we feel about birth, how we feel about ourselves, and how we feel about our abilities. Our paradigms run deep in our subconscious, and even though we know that we want to have a VBAC, we can’t seem to shake the fear of repeating the past. Even though we know our bodies were made to give birth vaginally, and we are equipped with what we need courtesy of mother nature, we still can’t seem to shake the fear. That is because of our paradigms. Shifting your paradigm takes special work! It is more than affirmations, and it is more than just saying out loud “I am born for this”. Those are just words, and they mean nothing if they don’t resonate inside of you enough to get you to believe deeply and to feel at the core of your being that YOU are CAPABLE of ANYTHING. If you work to heal and clear yourself of these paradigms… if you take the time to REALLY explore your feelings, to put the work in everyday to build your confidence, YOU can have the VBAC you so desire.
And this, my dear readers, is why I believe so passionately about bringing the body, emotions, and mindset together for success. This is why body work is important: not only does it truly free restrictions that could physically hold labor progress back, but also releases trauma from your tissues. Soft tissue bodywork will help you feel more confident and prepared from a physical, mental, and emotional perspective. As you emotionally clear your fears, you have space to bring in feelings that are energetically strong like joy, love, enlightenment. You will put your body in a higher state of vibration, which is the vibrational strength that will attract the birth you desire, the birth you dream about, the birth you deserve!
Thoughts create feelings
Feelings create actions
Actions cause a reaction
That reaction causes a result…..
So, MAKE IT THE RESULT YOU WANT!
THINKING INTO RESULTS
It’s just that simple.
Caughey, A. B., Cahill, A. G., Guise, J.-M., & Rouse, D. J. (2014). Safe prevention of the primary cesarean delivery. Obstetrical & Gynecological Survey, 69(7), 381–383. https://doi.org/10.1097/ogx.0000000000000083
Motomura, K. et al. Incidence and outcomes of uterine rupture among women with prior caesarean section: WHO Multicountry Survey on Maternal and Newborn Health. Sci. Rep. 7, 44093; doi: 10.1038/srep44093 (2017).
Hi, I'm Marya Eddaifi
I was only 22 when I had my son. It wasn't the best experience but I didn't know better.
It wasn’t until after I became a Labor and Delivery nurse did I realize how badly I was treated and grieved over my birth. Did I tell you this was 15 years later?
After realizing how nurses and medical providers impact such a huge life event, it became my mission to change the world through beautiful birth experiences!