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Should I have a VBAC or repeat Caesarean?

Look, first off NO ONE can or should tell you what you should do. The birth of your child involves your body and therefore your choice and right to your own decision. The difficulty I find most women have; is they don’t have ALL the information they need to make an informed choice. It feels like most people make a decision based on fear and lack of knowledge. SO, this is exactly why I’m writing this blog today. To provide you with facts and my own personal experience of a c-section, so that you can make an informed decision.

Let’s look firstly, at why many women may choose a repeat caesarean. In a recent study about ‘Do women prefer caesarean sections?’ reported in PLOS ONE Journals, They found women tend to choose a CS for deep rooted fears about the pain of a vaginal birth and injuries to the mother and or the baby, fear of uncertainty over developing a complication during birth, fear of losing control and panicking, fear of losing the tightness of their vagina. They also reported many women chose a CS because they felt they would be more in control, they could plan ahead, women also reported believing that the recovery time was better than a vaginal birth and that they would receive a better form of after care. Many women also reported having a lack of control over their decision and felt that it was a medical decision. you can read the full report here https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0251072

It feels like most people make a decision based on fear and lack of knowledge

All of the above is still very relevant to those considering a repeat CS because people often feel they haven’t experienced a natural birth, so the fear is still there. Other reasons may be because they’re being told they should by their midwife/obstetrician, or they’re worried about the possibility of uterine rupture, stillbirth or maternal death.

Ok, so, now we have covered the majority of the reasons women may choose a repeat caesarean let’s look at whether these reasons require a CS.

FEAR

fear is a big thing, and it really can get in the way of birth. If you are terrified, that fear can lead to tension which can lead to it becoming difficult for your baby to move through the pelvis. Fear could also lead to a rise in adrenaline and a decrease in oxytocin (the very important hormone for physiological birth, orgasms and breastfeeding) that all sounds like fair reasons to opt for a CS, right? Perhaps, but what if you dealt with the fear instead of opting for surgery? Think about that as we continue through, I’ll come to how you can combat fear.

TAKING CONTROL/PLANNING

certainly being able to take control over something that can seem totally out of your control can feel VERY comforting. If a lack of control really scares you then again you could end up with some of the same problems as the fear point. However, birth tends to lead us to a point where our body takes over our mind, in a sense, puts us back in control. Planning ahead is always handy, but what if you went into a labour earlier than planned and you’re not prepared for that? That could create fear in itself, so perhaps preparation is the real key here.

RECOVERY TIME BEING QUICKER

This is most definitely untrue! A truly physiological and uncomplicated vaginal birth has a recovery time of a matter of days! Whereas a CS takes initially 6-12 weeks but for most women can mean YEARS of recovery!

RECEIVING BETTER HEALTH CARE

From my own experience (which is NHS experience) I certainly don’t find this to be true, it seems you get the same care either way and, in my opinion, even less with a CS because medical staff really don’t seem to understand everything that needs to go into recovering from a C-section. There are also many reports from people saying their scar wasn’t even checked after leaving the hospital! (These are reports I have seen people make on birth trauma pages)

LACK OF CHOICE

This is the most common in my experience and this should never be the case, it makes me so so angry that people are led to believe they don’t have a choice! YOU ALWAYS HAVE A CHOICE! Please remember that! A great thing to utilise if this is what is making you think a c-section is necessary, is the BRAIN acronym. You can use this to ask your midwife questions and to ask yourself these questions and research the answers yourself

B – What are the BENEFITS of making this decision

R – What are the RISKS associated with this decision

A – Are there ALTERNATIVES? If so, what are they?

I – INTUITION, what does my gut say?

N – What if I do NOTHING or wait it out?

BEING LED TO BELIEVE YOUR LIFE AND YOUR BABY’S LIFE IS AT RISK

Your body is incredible, it really is made to grow and birth a baby, your body knows what to do but it needs the right environment and time. So why do they recommend a CS then? Because any slight risk is an increase in risk and the medical world, or even the world at large, want to irradicate all risk but this is impossible. This is why it is important to know what the amount of risk is, so that you can decide if it’s a risk you feel comfortable taking. To help you I have linked in this article from Rachel Reed. This goes into detail on the stats for uterine rupture https://midwifethinking.com/2016/06/15/vbac-making-a-mountain-out-of-a-molehill/

In simple terms though, if you have a spontaneous labour (no induction process) then the risk of rupture is much lower but overall the risk is very low, about 1 in 10,000.

WHY YOU MAY WANT TO OPT FOR A VBAC
  1. Recovery time is much quicker! Like years quicker.
  2. Breastfeeding is likely to be far easier due to more oxytocin and no drugs.
  3. Less blood loss because it’s not surgery
  4. Much calmer and nicer experience for your baby and you
  5. You really get to experience your right of passage
  6. Better microbiome cultures for your baby due to passing through the birth canal
Recovery time is much quicker! Like years quicker

Right, so now how can you overcome all of the above if you don’t want a repeat caesarean and have decided you want a VBAC:  PREPARE, LEARN AND PRACTICE!

PREPARE

Preparing your mind and body for birth is imperative. We don’t take part in healthy birth experiences anymore and therefore, most of us only know birth through TV. TV birth is so negative! Our bodies and minds need to be fluid and capable of letting go for a physiological birth to happen easily. You need to prepare physically and mentally. Physical preparation should include releasing scar tissue and regaining core strength. Mental preparation may need to include therapy to deal with past traumas and should also include changing your mindset to feel ready for a VBAC.

LEARN

You almost want to approach learning as if you wanted to be a midwife and wanted to learn everything they know and more. Achieving a VBAC in this current medical system requires knowing all the facts, so that if someone is throwing negativity at you, you can feel confident to say ‘thank you but I know my rights and what the risks are and I am happy making my own decision’. So simply learn all you can about birth. You must go deeper that the usual antenatal courses. Those courses are biased and to be quite frank, not informative enough!

PRACTICE

Embodying the mindfulness practices and practicing labour positions is so helpful. By doing this, you come to understand your own body, so when it comes to it, you will feel confident that you can follow your intuition, and move in ways your body needs to get your baby out safely.

Lastly I would like to touch on recovery. I fear people grossly underestimate caesarean birth recovery! In short, it’s long, it’s tough, it limits your abilities as a woman and new mother, it can impact your breastfeeding success and the repercussions can last a life time (literally)

I hope this article has been useful to you and given you some real things to think about so that you can make an informed decision.

If you want a chance at a VBAC then sign up for my 3 days to pregnancy and birth confidence challenge. This gives you some initial steppingstones to help you grow in confidence to trust your body and provides you with exercises to start doing right away that will prepare your body, mind and soul get ready for everything to come.