Vaginal Birth After Cesarean Checklist
Read, read, read.
Get in training. Labor is the hardest work you'll ever do, but it's worth it! Focus on good nutrition and exercise.
* Make a daily checklist to ensure you are getting essential nutrients.
* Daily exercise: swim, walk, yoga, prenatal fitness class -- whatever feels good.
Prenatal classes. Be sure to register early for VBAC, refresher or any other quality prenatal program Even though you may have taken classes in a previous pregnancy, an evening out together with your partner will help to prepare you both, promote discussion, give you ideas on coping with labor and focusing on this baby and its birth.
Supportive care provider. Find someone who believes in VBACs, has a VBAC success rate over 75% and a cesarean rate that is lower than community average. If you are unsure about anything, get a second opinion. Read "Working with Your Birth Attendant".
Hire a midwife/labor assistant/monitrice/support person. If you are worried or are anxious about labor, it is worthy every penny to be reassured during labor by someone who believes birth is a natural function. One suggestion is to stay home under the observation of this person until labor is well established. This support person will be your advocate in the hospital to help you have the birth you want. Some childbirth educators are willing to give labor support too.
Write a Birth Plan (hospital request list). See "Planning Your Baby's Birth" (available from ICEA). Include what is important to you and that which you have discussed with your care provider. Give a copy to all labor attendants on hospital admission to be put on your chart. Know your hospital's VBAC policies and negotiate well before the birth for anything different. Here are some ideas to consider when writing your birth plan:
* Establish a safe supportive birth environment to facilitate labor.
* Try a variety of positions. Standing or walking instead of lying down facilitates labor and squatting to push can be most effective. Try sitting on the toilet.
* Continue calorie and fluid intake. Labor is hard work and takes a lot of energy. Far from eliminating the risk of aspiration with general anesthesia, total fasting (NPO) may increase the risk by raising the acidity of the stomach contents. Fasting may also make it harder for the uterus to work.
* Throughout pregnancy practice relaxation and visualization with exercises, tapes, massage, affirmation and touch. During labor, warm water (bath, shower, hot compresses) helps you relax and open up.
* Avoid medical intervention whenever possible. Continuous electronic fetal monitoring may restrict your movement and artificial induction such as rupture of the membranes can usually be avoided. Ask for more time to try non-medical methods to stimulate labor if your doctor thinks labor is not progressing. These include: change of position, walking, nipple stimulation, warm water, relaxation. Time limits are unrealistic as every labor is different. Unless you dilated 5-6 cm during a previous labor, consider this one your first labor.
Believe in yourself, your body, and the process of birth. Say affirmations silently to yourself or write them down or tape them and play them back over and over. Examples of affirmations include:
* "This is what I want. I can do it!"
* "My body knows how to give birth and I will let it!"
* "My contractions are massaging my baby and hugging it."
* "My cervix ix opening with each contraction."
* "I accept the healthy pain of labor if and when it is here."
* "The power of birth strengthens me, my child and my partner."
Read from the hundreds of natural birth stories related in books listed in "VBAC Materials" (available from the Online Bookstore).
Work on those emotions! Work through "leftover" negative feelings (guilt, disappointment, anger) from previous cesarean birth(s). Facing fears will help you let go" of this baby.
Work through fears. Accept the pain of birth as a sign of how strong and well your body is.
Learn to trust, cooperate with and listen to your body and your own unique labor pattern.
Feel good about yourself and your relationship as a couple and keep a positive outlook.
Reassure family and friends. Remember that according to medical studies VBAC is usually safer for both you and your baby than a repeat cesarean. Read and make available to your friends and relatives "Yes, I'm Having a VBAC."
Attend VBAC support meetings or, if there are none in your area, join national organizations. Through meetings and newsletters you'll hear from others who've "been there" and will share their VBAC experiences.
Having a VBAC takes a lot of hard work but in talking with others, you'll learn that it really is worth it! Good Luck!
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