I have a client who is currently 36 weeks pregnant and this amazing woman is going for a VBAC! So far, her pregnancy has been complication free. She is fit, healthy and baby is growing beautifully.
Sadly at her 36 week appointment , Mum and I both felt she was being manipulatively coerced into having another c-section by the doctor. He threw comments around of “a healthy baby and Mum is success to us”.
Of course, a safe and healthy Mum and bubs is most certainly a goal of any parent and good health care provider, but an interesting article written in 2013 by Cristen Pascucci is “A Healthy Baby Is All That Matters” is one to read:
"We can start by educating ourselves to know what great care looks like— respectful, evidence-based care. In my opinion, hearing something like “A healthy baby is all that matters” during prenatal care says to me, “Whatever happens in Labor & Delivery, you have no room to complain. If we present you with a live baby, we’ve done our job.”
The Doctor on duty also said, “you should come to terms with the fact that your may have a c-section”, “there are risks of complications with a VBAC” and “your baby is quite big”. He rolled his eyes at her frequently, crossed his arms and deeply sighed whenever Mum asked a question.
He continued with advice that Mum should present straight to hospital within 4 hours of her waters breaking or once she has her first contraction. But let’s think here:
In research by Landon (2005) it was shown that women who presented at hospital in active labour (so their cervix had dilated to 4cm-6cm or more) had an 84% chance of a successful VBAC.
And for women who presented at hospital less than 4cm dilated had a 67% chance of a successful VBAC. Ideally, we want to keep Mum away from the hospital (yes, providing there are no medical issues) until she is in active labour to help increase her chance of a VBAC. So why encourage her to go to hospital straight away!? I mean, she is aiming for a VBAC!
He followed on with, “if you get to 40 weeks, we will look at inducing you”. Again, WHY? A study by Coassolo (2005) “Safety & Efficacy of VBAC attempts at or beyond 40 weeks gestation” concluded that women beyond 40 weeks of gestation can safety attempt VBAC, although the risk of VBAC failure was increased. He didn’t explain the risks involved of going beyond 40 weeks or the RATES of those risks.
During the appointment there was a lot fear inducing words that can definitely set any VBAC Mum up for a decreased chance of VBAC success.
Of course, the medical professionals should be stating all areas of risks and concerns, particularly with the possibility of uterine rupture but they need to be followed up with supporting information, explanations and evidence. And showing care, respect and encouragement.
As we do know, the greatest fear of having a VBAC is the risk of uterine rupture. The data consistently shows a uterine rupture rate of 0.4% to 1% so it is important to acknowledge that 99.5% of women will not have a uterine rupture, and uterine rupture is extremely rare.
Were these facts given to Mum during the appointment? Nope! Only words of discouragement and fear-instilling.
So as her Doula, I have collected an intensive amount of research, facts and studies to continue to support, educate and encourage Mum on her VBAC. I am here to provide her with as much support and confidence to help her achieve what she is aiming for!
If you are thinking about having a Doula and would like to connect to learn more about how I can support you to achieve your birth goals, please DM me! I’d love to chat with you!
My name is Shereen Nielsen and I am a certified infant and child sleep coach and Birth and Postpartum Doula. I am also a lecturer and mentor for students on their journey towards becoming a Sleep Consultant, through my on-line internationally recognised sleep consultants course.
If you would like more information about my services please contact me:
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