Birth After a Previous Cesarean
Are you sorting out your two options for your next baby after having a cesarean for a previous birth? Choosing a course to walk will reflect your values and also your physiology. Read on to better educate yourself on your options and for important information on preparing for a VBAC.
Which are you comfortable with?
We make the best decisions we can given the situation we live in, personally and in our group. The best decision for you might be different for your friend, your mother, your Le Leche League group leader, or for me. That’s more than ok, that is you!
Is a cesarean the expected choice?
Personal preference for a cesarean may reflect expectations. If someone wants to avoid a vaginal birth, then major surgery is the obvious option. If the choice is about fear, though, then changing the story to let your body be less scary to you is a third option. People have different reasons for which they choose.
Some people find few options in their area. Current care rests heavily on the convenience of a repeat cesarean and therefore a repeat cesarean is the most common “choice.” Another cesarean would be familiar to both mother and medical team. Knowing what to expect can be reassuring to everyone. The birth can be scheduled, the nearly routine challenges of major surgery feel manageable to surgical staff. While there are risks to major surgery, these risks are those the medical-legal culture deals with on a regular basis and while serious, are part of today’s status quo. Is this the birth that fits your personality and that you want to shape your life?
Some pregnant people have undeniable medical reasons for having their babies by cesarean section. Others experience cesarean for “reasons of the day.” They may not have had a cesarean with different knowledge on the day (or night!) that the birth was happening. Options were limited that day. Let’s be open to compassion for ourselves and for others. Let’s expand knowledge about birth so more options are actually available for your next birth.
Is vaginal birth your choice?
I encourage you to prepare for a birth not just getting into labor! Since vaginal birth is not 100% guaranteed to be possible, this choice is actually a decision to go into labor with the intention of vaginal birth. That’s the last I’ll say of calling your body’s function a Trial of Labor.
Vaginal birth after one or two previous cesareans is supported by the American College of Obstetricians and Gynecologists. Some women have vaginal births after 4 or 5 cesareans. The risk of uterine rupture after two cesareans is at least as unlikely as complications of a repeat cesarean and potential damage in future pregnancies. VBAC, Vaginal Birth After Cesarean is a safe choice after two cesareans and a reasonable choice after more cesareans for many families.
If I were to make it an equation, I’d say your determination for a vaginal birth equals wishes minus the power of your fears plus the skills of your birth team plus the “balance” of your body.
Want to push my baby out – fear of tearing + education on breath awareness and skilled midwife who can help me avoid tearing + balanced pelvis and better circulation to my perineum which makes tearing less likely = determination to overcome obstacles to vaginal birth.
Your level of desire for having a planned cesarean or planning a vaginal birth may be the most important factor in decision making. Penny Simkin has a useful scale to help in decision making.
Enjoy the miracle hidden within both options. Joy can be found in every birth. A bit of preparation and communication can brighten your baby’s and your own personal experiences in either a surgical or a vaginal birth. More mother-baby centered care is possible when you talk with your birth team with your goal in everyone’s mind.
Find your way to “Yes!”
Give yourself the gift of envisioning wholeness. If your pelvis didn’t get smashed in an accident, then you aren’t broken. Many broken pelvises can be repaired, however. See yourself as whole and able – even when you face other people’s doubts. Speak your vision and help them sweep their horror stories away with new stories of what is really possible and likely – a strong, powerful birth experience.
There will be providers and maybe family that worry about your upcoming birth. You don’t have to take their worries into your body and mind. The high rates of today’s cesarean section mean understanding how to protect and support vaginal birth is often missing. This lack can even occur among providers. If your provider is an expert at surgery but inexperienced at spontaneous, natural birth, consider changing providers to someone who also has the skills to support vaginal birth. Get a doula for the times you need one.
Informed consent is factual. Informed refusal is your right. You can refuse certain aspects of your care. Being aware of risk doesn’t have to equal being afraid of the risks. Let go of ideology and ask yourself and your baby what is best for the two of you. You two are working together and what benefits one usually benefits the other. Resiliency is being able to have the flexibility to go with the unexpected. Whether or not you want to go entirely “natural” or not, a VBAC provider needs to know natural birth to know if your labor is normal or needs a cesarean, and how to help keep things normal. That is where Spinning Babies comes in.
How does Spinning Babies support VBAC?
- Spinning Babies approach uses daily activities to support a supple birthing body – sacrum and pelvis, ligaments, muscles – all move more freely when exercised for a full range of motion.
- Spinning Babies asks “Where’s Baby?” and suggests body balancing techniques and maternal movements in pregnancy and especially in labor to help the longer labor, the painful labor, or the stuck baby.
- So, Spinning Babies is about prevention and pro-active preparation in pregnancy. Spinning Babies offers intelligent solutions for the long labor by addressing the anatomy where the baby waits when labor is long or stuck.
These skills can help avoid the stress of a long labor for many users. (We don’t promise perfection.) Is it possible to reduce the risk of a ruptured uterus? Some ruptures happen before labor, so good nutrition and body balancing may help protect the function of the uterus even with a scar. By far, most uteri heal amazingly well! We don’t have data on rupture reduction, but we have lots of happy birth stories!
The Spinning Babies Parent Class shows you the techniques that will help avoid the most common unexpected causes of cesarean (for healthy singleton pregnancies) in our modern times. Our video is physiological birth-specific and doesn’t address the epidural. But you can do anything you don’t need to be vertical for in these techniques while using an epidural.
Childbirth pain or cesarean surgery can be lessened. Enjoying birth can be possible now. Download our Daily Essentials Video today for comfort tonight!
Self-care activities begin making space for the baby. VBAC parents use Spinning Babies to sort out previous births, prepare for the birth of their dreams and avoid another cesarean. You could be one of these parents.
The Sidelying Release is taught to a partner on the Parent video and is available to read about on this website. Use this now and at the time to reduce pain during childbirth. Use before labor regularly, and once in early labor or if labor gets challenging or slow. The SLR smooths labor from start to finish and may help women decide an epidural is no longer needed or desirable.
Explore the website to find the gems. Learn the different things to do when baby is high above the pelvis, deep inside the pelvis or low and almost visible. The Lunge is a great move to overcome “transverse arrest,” a regular cause of cesarean when baby is deep in the pelvis. Use the Lunge and other maternal positioning techniques after Sidelying Release. Learn how in the Parent Class video, which you can stream. Download it on your device for your upcoming birth in case you want to refer to it in labor.
A VBAC is a powerful way to shape your future sense of self. If you have the health to give vaginal birth a chance, then gather the support to explore birthing through your own ability.
Spinning Babies® partnered with the Mommy Labor Nurse Podcast by sponsoring Episode 15: Carly’s VBAC After Having Two C-Sections. Hear a mom discuss her VBAC experience after having two c-sections, and finding a great provider who was supportive of her wishes!