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VBAC tips
- Cathy Williams
- 6 days ago
- 4 min read
My reflection on over 10 years of supporting people planning a VBAC (vaginal birth after a previous caesarean birth).
This is one of my clients. She is so radiant. A home water birth after a previous caesarean birth. She found it healing. There was an amazing atmosphere. The NHS midwives were calm, reassuring, supportive, and obviously delighted to be there. Baby's arrival was gentle: welcomed into the world by the soft voices of his parents.
It has been a real privilege to work with clients planning VBACs. I think that they are really underserved by the NHS.
If you’ve had a previous caesarean birth, you are not given options. You are told what will happen: hospital birth, stuck to monitors, no eating or drinking, go to hospital early in labour. None of these has any research to back it up.
If you put a list of standard hospital policy for vbac next to all the factors that increase your chance of ending up with a caesarean, they almost match, which means women are set up to fail from the start.
For example, there is no research to back the recommendation for continual ctg monitoring in labour for vbac. It is not better at identifying a uterine rupture than intermittent monitoring with a handheld device, such as a doppler or sonic aid. Someone contacted me after I had posted on social media about VBAC to say that she had had a vbac in hospital, attached to the ctg monitor. She felt something was wrong, but the midwives and doctors wouldn't listen because the monitor showed the baby was fine, until, two hours later, the baby showed signs of distress. Her uterus had ruptured. Fortunately both were fine.
If you have had more than one caesarean birth, you are bluntly told you must have a caesarean, despite the national guidelines saying otherwise.
Navigating your way through the evidence, the options, the meetings, and working out what you want, is just part of preparing for a VBAC.
You are also dealing with understandable emotions, hopes and fears. You know that birth doesn't always go to plan. You can have feelings that your body might not work, or that fears around any trauma, or actual trauma, may arise.
Working with a doula, even if it is just a one-off antenatal session, can really help you to work through these feelings, understand what happened last time, and have a plan that works for you, puts you in control, and helps you to relax, whatever happens.
"I just wanted to let you know that I had an amazing HBAC at 42 weeks. It was a very speedy birth, much in contrast to my labour the first time around. Thank you for the workshop as it really helped give me confidence to go for it!"
What are my tips for planning a VBAC?
Understand and heal from the last birth. Learn about how birth works (hormones etc).
If your baby was in an awkward position and that affected the birth, see a physiotherapist, osteopath, or chiropractor, to check if you pelvis is a bit wonky. (Though this can be less of a problem with subsequent births.)
Explore your options. Consider a home birth. You don't have to accept what is presented to you.
Consider hiring a doula or independent midwife, or both.
Or book a one-off session with one.
Don’t compromise in the expectation of compromise back.
Don’t expect your baby to come before x weeks and build you hopes of VBAC around that. If you want a VBAC, plan for that.
Build confidence in your body and your instinct, especially around the reasons for the caesarean, or sticking points from the previous birth. Learn birth skills.
Put yourself in the best position you can for all to go well, whatever you decide, whatever happens Have a plan A, B, C.
Be kind to yourself whatever happens.
And, of course, - do my VBAC and HBAC courses!
"I got the midwives and consultant on board for the HBAC using calm assertiveness backed up by cold hard statistics from the vbac handbook and pointed, but casually posed, questions to help these professionals question their own assumptions about HBAC. Cathy leant me some wonderful books which helped me prepare myself emotionally and spiritually for the birth. And then we did it.
Everybody worked together wonderfully. Me, my partner, Cathy and the midwives. It was a lovely safe, warm, supportive atmosphere and my baby was born at home in the birth pool. It was the best thing I've ever done."
Over the last 10 years most of my antenatal clients have had previous caesareans, including my doula clients. All but one of the later having HBACs (home birth after previous caesarean birth).
The clients I have worked with who’ve planned VBACs have had really positive experiences. I’ve put some of their birth stories into a document to inform and inspire others. If you’ve had a birth after caesarean, and would like to share your story, however it turned out, I'd love to add it to this collection.
I am still offering VBAC webinars and workshops. My online HBAC course has been accessed by almost 900 people.
"I was given more information tonight than in the whole of the rest of my pregnancy. It has been so useful."
Final words from one of my clients:
"We had loosely agreed a plan that if I hadn't started labour at 10 days over I would be induced. I knew I could refuse this from the VBAC course but I was happy to be guided by consultant on this.
Induction happened with a balloon catheter. It was uncomfortable but absolutely fine. Then the drip used very, very slowly. I used the tens machine, gas & air, diamorphine and the epidural. Required an episiotomy in the end. Baby born 9 pounds 11 ounces.
It was a medicated and hospitalised birth but it didn't feel like that. Felt like it was just my husband and I, being held, to safely have our baby. We were walking on air.
Recovery was seamless and uncomplicated.
Was a particularly healing experience which I am so glad I persevered for."
If you would like to have a chat with me, send me a message or book a time (see home page).