I love working with seasoned moms. The ones have been around the block already and are gearing up to take it on all over again. Perhaps it's because I became a second time mom a little less than a year ago myself. I remember sometimes thinking, "I must be MAD to do this all over again. How in the world am I supposed to juggle the responsibility of taking care of two children?" Somehow it all seemed to work out.
A lot of second time/plus mothers I come across in doula work are those seeking a different birthing experience than last time. Many had a cesarean birth with their first child. It could have been planned or unplanned, sett off all the bells and whistles emergency delivery or a failure to progress. These women are generally disappointed with some aspect of their previous birth for a variety of reasons and are hoping to have a vaginal birthing experience this time around. We in the birthing world call them VBAC mothers, which most know stands for Vaginal Birth After Cesarean.
We listen to their birthing stories. Sometimes they are frustrating, scary, or sad. Sometimes it wasn't necessarily a negative experience. Having a vaginal birth just wasn't in the cards but believe it can this time around. Statistically speaking a large percentage women who plan a VBAC can go on to have a vaginal birth if they are in a practice that is up-to-date on best medical practices and following ACOG's (The American Congress of Obstetricians and Gynecologists) guidelines, in a VBAC friendly hospital, and are surrounded by the right support team.
But what if you did all these things and you didn't have your VBAC? What if you did everything right and it just didn't pan out?
We congratulate and celebrate our mothers who go on and have a VBAC but does that mean if we don't have a vaginal birth we weren't successful? Is having another cesarean a failure? Is having a first time cesarean a failure? No, a cesarean birth is not less-than or inferior than a vaginal delivery. Our VBAC mothers should be absolutely proud of the vaginal birth they planned for and got but we should remind ourselves to be sensitive to those who gave it their all but for whatever reason it was not in the cards this time around again.
If you are a mother who is striving for a VBAC and are nervous that if you need a c-section it will be the same experience as last time it shouldn't and most likely will not. Families that make a VBAC as a high priority in their birth vision will often take the time to become very well educated, prepared, and are a lot less afraid to take charge of their care this time around. They generally have learned how to surround themselves with the right people and their experience can be strikingly different than before even in the end they have a cesarean delivery.
I recently attended a birth at Magee Women's Hospital in Pittsburgh, PA in which my client did everything right but ended up needing another cesarean in the end. Her provider was VBAC friendly, the hospital and staff were very supportive, and she had all the right support, including me as a doula. Even though her birth wasn't as she had planned with me she was able to have a remarkably different cesarean experience the second time around. It was an incredibly family centered cesarean birth.
Remember that birth is unpredictable but you can still have a positive birth even if a VBAC is not possible the second or third or forth time around. We doulas hold a special place in our hearts for our VBAC moms and hope that more and more hospitals and practices will get-with-the-times sooner than later so we can bring down our overwhelmingly high cesarean and birth mortality rate here in the United States.
Never ever dismiss her feelings if she is disappointed in her birthing experience, even when baby and mom were perfectly healthy. Remind her that her birth counts just as much and that there was no failure or shame in the way baby was born. If she tries again, give her the confidence that it is possible.
A Couple Ways to Have a Family Centered Cesarean:
- Request skin-to-skin immediately after birth (Dad can fill in if needed)
- Request to breastfeed with nurse assistance while in OR
- Ask if your hospital has clear drapes so you can see the birth
- Request that you have your doula there with your family in the OR
- Ask if doula or dad can take photos and video of your family and baby in OR
- Baby stays with parents at all times (unless there is a concern about something)