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Top 3 Tips From a Birth Doula on Having a VBAC (Vaginal Birth After Cesarean)

  • Writer: Becca
    Becca
  • Jun 30
  • 7 min read

If you are planning to have a VBAC (vaginal birth after cesarean), then this is a great place to learn about some tips - and collect some resources - on how you can prepare yourself for your VBAC.



First, let's get some facts straight!


Once a Cesarean, Always a Cesarean

You may have heard this phrase at some point in your life. It is outdated. It was first coined in 1916 when circumstances around cesareans were very different, mostly due to a pelvic deformity women developed from severe vitamin D deficiency in childhood. This meant that there was a bone structure issue that made birth unsafe for these women, causing them to need cesareans for all their births.


This is not a common cause for cesareans anymore. More often than not, a woman can have a valid reason for needing a cesarean for one pregnancy, and there could be no reason to need one in the next.


If a care provider ever uses this phrase with you, I would recommend asking them why they are saying this to you, and I would definitely recommend getting a second opinion from a provider in a different practice.


VBAC Births are Dangerous and Most Likely Won't Succeed (SPOILER ALERT: this is not true!!)

It is true that VBAC rates in the U.S. are rather low - it was reported by the CDC in 2021 that 14.2% of all births in the United States were VBACs. But the VBAC success rate is actually quite high! Studies have shown that the success rate of a VBAC is between 60%-80% depending on factors such as if a mother has given birth vaginally before, the reason for her first cesarean, and whether or not she had an induction.


Also, while there are risks involved in having a VBAC, there are also risks to having a repeat cesarean. I would argue that it is just as important to talk about the risks of a repeast cesarean as it is to talk about the risks of a VBAC


Placenta accreta is when the placenta gets embedded too deep into the uterine wall. Depending on the severity, it can be managed, or it can cause major complications. After each cesarean, the chances of placenta accreta happening in the next pregnancy goes up.


Just as you should consider the risk of a uterine rupture in a VBAC - when the wall of the uterus tears open - placenta accreta is a risk to consider in a repeat cesarean.


Each person has the right to make an informed decision about what they feel is best for them. If is unfair to claim that one option is always safer than the other because this takes away a person's power to choose based on their own circumstances and their feelings surrounding the matter.


This is your body. This is your birth.


Here are some factors that are often helpful in making an informed decision between a VBAC and a repeat cesarean:

  • the circumstances of your first cesarean

  • how you feel about having a VBAC or a repeat cesarean

  • the type of incision scar you have from your previous cesarean(s)

  • how many previous cesareans you have had

  • and - most importantly - what risks you feel more or less comfortable taking


Now, for my 3 tips!


Tip #1: EDUCATE YOURSELF!

There is a lot to think about when considering if having a VBAC is the right choice for you. But, at the end of the day, that's what it is: a choice.


Knowing the facts will help you make a decision with confidence. (HINT: confidence plays a huge role in how your body will respond in labor!)


This will also help you when looking for a VBAC supportive provider.


In a perfect world, all providers would be VBAC supportive. But this is unfortunately not the case. If it was, the VBAC rates in the United States would be A LOT higher!


By knowing the facts, you can hear red flags in the way your provider talks about VBAC birth. They may contradict what you've learned because they are not practicing evidence based care or because they have their own bias or negative experiences with supporting VBAC. They may also lack the confidence in supporting a VBAC. These are all signs that you may not have the best provider if a VBAC is what you want. And you have the right to shop around!


I also recommend looking into the VBAC calculator. This is a very unpredictable tool that some providers unfortunately rely on. Here is a link to read about why the VBAC calculator is problematic. I suggest proceeding with caution or even changing providers if your care provider is relying on this tool, especially if you are a person of color


And don't forget to ask your care provider about the risks and benefits of a repeat cesarean. It surprises me how often VBAC risks get overplayed and repeat cesarean risks get skimmed over or even skipped. Hearing how your provider confronts this question can tell you a lot about their stance on VBACs, even if they are telling you they are VBAC supportive.


Here are some great resources for learning evidence based information on VBACs:


Tip #2: Process your past birth and prepare your mind for birth


Whether you are having a VBAC or not, the mind plays a HUGE role in labor! You might have some leftover feelings from your last birth experience. By addressing your feelings, you can help prevent them from negatively impacting you during labor and prepare yourself with the tools and support you might need to get through any fears or feelings that might come up.


photo credit to Emily Frank
photo credit to Emily Frank

To process your past birth, you can talk to a therapist or another safe person with experience in listening to birth stories. You want someone who will listen openly and not put any of their own feelings onto you nor dismiss your feelings.


You can also journal about your previous birth if that is something you find helpful in processing experiences. I personally love journaling, so this is definitely something I would do, but only you know if this a tool that could prove helpful for you.


Here are some tools that you can prepare yourself with in the case that difficult feelings come up in your birth:

  • take some deep breaths - slow and controlled. Try really connecting with your breath and getting into your body in the present moment.

  • find something calming to focus on, like a TV show or a movie, listening to soothing music, or listening to words of affirmation spoken by someone you trust and feel safe with.

  • you can also dive into some comfort measures like massage, aromatherapy, scanning your body to mindfully release tension, and movement!

  • did you know that your neck and hip flexors are nervous system regulators? Doing neck roles or hip movements like lunges, hip circles, or cat-cows can all help you feel more regulated!


I recommend trying these tools before you are in labor. Find which ones help you the most, and practice them regularly. These tools often work like a muscle. The more you use them, the more powerful they are when you really need them.


Tip#3: Hire a doula!

Photo credit to Emily Frank
Photo credit to Emily Frank

Hiring a doula is a great way to increase the liklihood of having a VBAC!


Many doulas know how to help their clients navigate a VBAC. They are able to provide resources, support you in making informed decisions for yourself, and provide compassionate care throughout birth.


They can also help you and support you in building a team that is supportive of your goals and support you in advocating for yourself if the need arises.


And doulas can even help you prepare your mind and body for birth. They may have some mindfulness tools or movements that they can teach you that will help you in labor. Doulas are experienced in providing comfort measures during labor, which on its own can do so much good! And they also have amazing resources at hand to refer you to specialists that might be able to provide even more support, such as pelvic floor physical therapists, chiropractors, therapists, and other specialists.


You deserve to feel supported during your birth!


If you are interested in checking out the services I provide, here is a link to my services page. And here is a link to my about me page if you want to learn more about my mission, who I am, and the education that I have as a birth doula.


If you want to chat over video call to see if I am the right doula for you, here is a link to book a free consultation.


Resources


Here are some great resources if you would like to continue learning about VBAC:


VBAC facts is a great website to explore if you are looking into having a VBAC: https://vbacfacts.com/


Here are some Evidence Based Birth VBAC articles:


Here is an article by Body Ready Method about How to Naturally Induce Labor for VBAC: https://bodyreadymethod.com/learning-center/how-to-naturally-induce-labor-for-vbac/


Here are some resources about the VBAC calculator:


Bibliography


Bruno, Ann M and Allshouse, Amanda A and Metz, Torri D. “Trends in Attempted and Successful Trial of Labor After Cesarean in the U.S. from 2010 to 2020.” PubMed Central, National Library of Medicine. 30, November 2022. https://pmc.ncbi.nlm.nih.gov/articles/PMC10477004/?fbclid=IwZXh0bgNhZW0CMTAAAR3XH9cqtwcRPaYFK8F0LcbTvakBDyBpc65uHtJ-xUG5QBnhzh1ByvSmPE8_aem_Ul0hbCUHelhc4ELcXP458A


Crawford, Karis PhD and Walters, Johanne C BSN RN. “Natural Childbirth After Cesarean, A Practical Guide.” 1996.


Dekker, Rebecca. “EBB 113 - The Evidence on VBAC.” Evidence Based Birth. 28 January, 2020. https://evidencebasedbirth.com/ebb-113-the-evidence-on-vbac/


Dekker, Rebecca. “EBB 209 - Providing Unbiased VBAC Access and Support with VBAC Facts Founder, Jen Kamel.” Evidence Based Birth. 26 January, 2022. https://evidencebasedbirth.com/providing-unbiased-vbac-access-and-support-with-vbac-facts-founder-jen-kamel/?fbclid=IwZXh0bgNhZW0CMTAAAR0eKANWkIz2QxzVB5Rp9C0ZVNRMEcqz6h-Gk_l9SFVRU_jPFipa-Yn-908_aem_yZNlNfia3rXhABM5zBXOVQ


Kamel, Jen. “13 Persistent Myths About Vaginal Birth After Cesarean.” VBAC Facts. https://vbacfacts.com/13-myths/


"Placenta Accreta, A Rising Complication of Pregnancy Associated with Increased Use of Cesarean Section.” VBAC.com an evidence-based resource for birth options after cesarean. 24 September, 2021. https://vbac.com/2021/09/24/https-www-preventaccreta-org-articles-placenta-accreta-a-life-threatening-complication-of-pregnancy-associated-with-the-overuse-of-cesarean-section/



 
 
 

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