The numbers are astounding: Nearly 90 percent of American women have repeat cesarean births; a third of U.S. hospitals don’t support vaginal births after cesareans (VBACs); and half of all obstetricians don’t “do” VBACs.’
When working with a doula, women are overall less likely to need a C-section, labor-inducing drugs, pain-relief drugs like epidurals, or forceps or vacuum extraction.
But also 90 percent of women who have had a cesarean are good candidates for VBAC, and there’s a growing movement to support women who want them. So, if you want to labor for a VBAC, there are two things to keep in mind:
- Understand your birth environment’s policies, and
- Consider a doula, who can be a fantastic asset.
Because doulas act as emotional, mental, and physical aides throughout the pregnancy and birth process, studies have shown that doulas help reduce risk of C-section and other medical interventions. That means hiring a doula can be tremendously helpful if you want to labor vaginally after a cesarean.
The benefits of working with a doula to plan for VBAC
Doulas are great support for any birth
Doulas can be game-changers for any birth. They bring evidence- and experience-based expertise, training, and insight to support and prepare pregnant women so they can have an uplifting and empowering birth experience—and stick to their birth preferences as best they can.
When working with a doula, women are overall less likely to need a C-section, labor-inducing drugs, pain-relief drugs like epidurals, or forceps or vacuum extraction. They also experience shorter labors and fewer complications and are more satisfied with their overall birth experience because of the mental, physical, and emotional support doulas provide.
Women wanting a VBAC can turn to doulas for reassurance, support, and knowledge. Doulas are well versed in and educated about VBACs: that it’s not actually a high-risk delivery method (as many medical professionals push), that it can be done smoothly and safely, and that medical evidence supports the often successful VBAC process. Many doulas can relate firsthand success stories and can share their experiences and insights about the process, possible complications, and medical providers and facilities that support VBACs.
Doulas can help you find the right birth location and provider
As we’ve covered elsewhere on Motherfigure, the choice of birth location and provider can have a major impact on whether a woman will have a cesarean or not. Some locations have higher-than-average C-section rates, and researching the rates ahead of time can provide additional insight into the habits and practices of the birth center you’re considering.
Many providers indicate that they will support a VBAC, but in practice they are not supportive in a way that is conducive to a mother’s goals. Doulas often have the inside scoop and can supplement insight from Motherfigure’s directory on hospital and birth center maternal outcomes.
OB-GYNs and their support staff don’t always have the time or skills necessary to help progress labor. After all, their job is to deliver babies, not wait it out and trust the process.
Doulas are experienced with birth and have likely supported women giving birth in all types of environments. Your doula may have worked at the exact hospital you’re considering! When researching hospitals, it doesn’t hurt to ask your doula for advice.
Doulas can help support you so that labor continues to progress
One reason why many women receive a cesarean is for “failure to progress” (FTP), or labor dystocia. In fact, nearly one-third of American women receive their first cesarean due to FTP. But some doulas claim that failure to progress is really just “failure to wait.”
Handling labor and delivery can be complex, even scary, especially for first-time moms. Women and their partners typically put their full trust in their OB-GYN, but OB-GYNs and their support staff don’t always have the time or skills necessary to help progress labor. After all, their job is to deliver babies, not wait it out and trust the process.
It’s your doula’s job not only to know your desires but to communicate them to the rest of your birthing team too.
Fortunately, doulas are typically trained in understanding fetal positioning and helping your baby rotate. They’ll push for a vaginal birth, as long as they believe it’s possible for you to have one. Of course, even doulas understand that sometimes C-sections are medically necessary, so listen to them if they encourage you to go through with it.
Doulas can help with the coercion that can happen in a birthing space
No matter how clear women are in their birth plans, coercion can be difficult to avoid during labor. Whether it’s encouraging you to allow your mom into the delivery room or ignoring your desires for items that provide comfort, someone in your birthing space might try to talk you into something you’re not completely into.
Your doula and birth partner are your biggest advocates in the delivery room, but your birth partner may be too preoccupied to remember everything you listed in your birth plan. This is one area where your doula can really help. It’s your doula’s job not only to know your desires but to communicate them to the rest of your birthing team too.
Are you convinced you need a doula? Find one using our directory, and brush up on some questions you should be asking during the interview!
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