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The Secret to VBAC Success

by meggf (follow)
vbac (46)     
ďWhat should I do to prepare myself for VBAC?Ē women ask, and in response they are given advice about nutrition, fitness, chiropractic care, fudging conception dates, and hiring doulas. Those things can undoubtedly improve any birth, but the secret to success with VBAC is much simpler.

WHO you hire to attend your birth and WHERE you plan to give birth will determine more VBAC success than any other factors, even health.

Itís a sad day when women feel they should take more care of themselves during pregnancy than they do normally, but here we are. Eating well and pursuing fitness are ALWAYS important. You can not suddenly make yourself healthy enough to give birth during pregnancy, and if you can conceive and carry a pregnancy then the odds are good that you are healthy enough to give birth anyway.

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Hiring a doula and seeing a chiropractor are great, but if your labour care isnít genuinely VBAC supportive (Genuine VBAC Support Predictor) then you are wasting your money. Lying to a care provider about your due date is pointless because they normally determine their own EDD for you via ultrasound or fundal height anyway.

Lying to your provider is problematic for a couple of reasons. Firstly you arenít going to get care based on your actual health, and secondly, you probably arenít the sort of person who is comfortable refusing the routine testing they use to determine EDD. A doula can not fight off pressure to induce or undergo repeat surgery, and a chiropractor can help with your babyís position but not your care providerís attitude.

It pays to be honest with yourself about why you are hiring a care provider. If you think you need to cheat them then maybe you should take your business elsewhere. Itís somewhat unfair to hire someone to do a job and yet give them false information. Maybe you are hiring them because of social conditioning. Maybe your expectations of them and the service they provide are unrealistic. Think it through carefully.

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This is not to suggest that itís easy to switch, because we all know finding someone and somewhere to give birth after a caesarean is hard! However itís important to be honest with yourself about what sort of care you want. If you are hiring someone to keep you safe, lying, and hoping other people will protect you from them Ö. then you obviously donít FEEL safe. Hire someone else, donít hire anyone, or have realistic expectations for this provider, realistic being that VBAC is unlikely on their watch.

Choosing a venue for birth is hard because we are socially conditioned to choose a hospital. For a small number of women that is the safest place, but for the majority it isnít. When one in three of us gives birth via major abdominal surgery we have to start questioning the hospital sales pitch - that their venue and the care they provide is superior to all others. When we look at the number of women who successfully VBAC and see that itís quite negligible we have to further question that. We know from the scientific evidence shows VBAC is safest and yet so few women VBAC in hospitals. Why is that?

Itís surprisingly simple really. With VBAC the surgeon assumes the risk of legal liability. With a repeat caesarean the woman and her baby assume the risks. Thereís a saying in the obstetric world ďno one ever sues for the caesareans you do, only the one you didnítĒ. Unfortunately, the way you give birth is more commonly determined by businessmen in suits, than it is by your health.

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The saying ďOnce a caesarean always a caesareanĒ was coined by an obstetrician in 1916. Almost a century later women are still held hostage by it despite the phenomenal advances in anaesthetic, and surgical techniques. What we see currently is that the caesarean rate is rising, the VBAC rate is plummeting, and maternal and foetal outcomes are going along for the ride.

And so now you know the Secret to VBAC Success. It isnít hidden in diet, or exercise tricks. The Secret is WHERE you give birth and WHO you hire. If you go to a hospital with an extremely low VBAC rate your odds are poor, no amount of Positive Thinking can cheat statistics. If you plan a homebirth or a birth centre birth your odds are good. If you hire a surgeon your odds of getting surgery are very good! If you hire an independent midwife your odds of birth increase greatly.

Donít leave it to chance, choose wisely because you only get one shot at birth, and the more scars you acquire, the more risks you carry, the harder it becomes to opt out of the high risk options. The more risks you have, the more decisions are taken out of your hands and into a boardroom.

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