5 Questions to Ask Your Doctor When Planning a VBAC
Planning a Vaginal Birth After Cesarean (VBAC)? I’m glad you’re here, in my little corner of the internet. After my own two VBACs and supporting thousands of moms as a Digital Doula, I am passionate AF about preparing women for birth.
Pregnancy after a C-section is… different. The coming months may be some of the most emotionally challenging in your life. I got you.
Let’s begin with one of the most important decisions that you can make in preparing to VBAC - your choice in providers. More specifically, we will discuss questions that can help you determine if they’re VBAC friendly vs. VBAC tolerant.
Why is your provider so important to your VBAC journey?
Here’s an example that I think gives this context. Suppose one day you decide to get a brand new haircut, with a buzzed side. Think badass rocker style. But the hair stylist that you’ve gone to for years has a pile of dust on her clippers. This haircut is SO not her expertise. What would you do? Take your chances with someone that doesn’t specialize in this style? Or make a trip to a different stylist, with someone who has mastered the exact haircut that you want?
Now, let’s apply that concept to your upcoming birth. When it comes to planning a VBAC, the OB that you’ve been seeing since you were 18 may not be the best choice for this birth.
It might make you uncomfortable to think of switching providers at this point, and I can understand that. You might even feel bad, or guilty, for making a switch.
But here’s the thing. What this journey is really about is you taking back your power. It’s you making decisions that are best for YOU and YOUR family, at every step possible along the way.
I want to preface the questions below with a suggestion. Start with researching risks and benefits on the topics behind the questions that are most important to you. This can help you make decisions on what you’re comfortable with for YOUR birth. Then, include them in your birth plan (grab a free template in my Freebie Library).
The next step is to see if your provider is truly supportive of your choices and preferences? Below are questions to ask your doctor, and be sure to pay attention to how they make you feel when responding. Are they listening and holding space for you? Or are they rushing through answering?
Five Questions to Ask Your Doctor When Planning a VBAC:
HOW WILL I BE CARED FOR WHILE LABORING FOR A VBAC?
If you’ve labored before, then you know how important your care is during such an intimate, precious and vulnerable time.
When you ask this question, do you get the feeling that this provider treats all births as dangerous, requiring a lineup of medical interventions? Or, do they appear to approach labor as a normal natural process, that requires medical intervention only when truly necessary?
Refer to your birth preferences and see if this provider is in alignment with your choices.
2. HOW DO YOU PLAN TO MONITOR MY LABOR AND MY BABY?
It’s a good idea to know what type of monitoring you’re most comfortable with as you ask this question. Here are a few things to consider.
If you’re planning on getting an epidural early on, you’ll be confined to the bed and continuous electronic fetal monitoring is necessary. Exception: walking epidural.
However, if you plan to move around during labor (which is great for labor progress btw) and/or delay the epidural, then you might consider alternative monitoring options.
For example, many hospitals have wireless and/or waterproof monitors. These would allow you to move around freely, even get in the tub or shower, while still monitoring the baby’s heart rate.
Another alternative is intermittent monitoring, where nurses manually check the baby’s heart rate.
3. WHAT ARE YOUR THOUGHTS ON WAITING FOR LABOR TO START ON ITS OWN? IS THERE AN ISSUE WITH THAT? (Assuming a healthy pregnancy)
Something that we hear a lot amongst VBAC moms is “my provider is letting me go to x weeks.” If you find yourself using that language, an alternative statement is “I am comfortable waiting until x weeks to make a decision.” Then it’s a matter of finding a provider that’s on board.
Approach this question with your preferences in mind. If you had a crap experience with an induction for your last birth, you may prefer to go into labor on your own this time. How do they feel about that?
And, at what point do you feel comfortable discussing induction… IF you get to that point?
4. WHAT ARE YOUR VIEWS ON ROUTINE INTERVENTIONS DURING LABOR?
To refresh, examples of interventions include pitocin, epidural, episiotomies and forceps (to name a few). How do you feel about interventions being protocol, or standard operating procedure? Or, would you feel more comfortable having interventions available in the event of medical necessity?
Does their approach to labor interventions align with your preferences?
5. HOW DO YOU FEEL ABOUT ME LABORING AS LONG AS I NEED TO? Assuming me and the baby are in stable condition.
If you were told that the reason for your C-section was ‘failure to progress,’ you’re not alone. It’s one of the most debated (and most common) reasons for women being told that they need a Cesarean. Of course there ARE situations where this was a valid reason. But for some, it’s questionable.
Knowing that this birth is a new experience for a new baby, how do you feel about this? So long as everyone is healthy, do you prefer to labor as long as needed?
BONUS QUESTION: IS THE HOSPITAL STAFF SPECIFICALLY TRAINED TO CARE FOR WOMEN LABORING FOR A VBAC?
In addition to interviewing the provider on their practices, it’s important to get a feel for the staff at the hospital where they deliver.
Ideally, the nurses at the hospital are trained in caring for women that are laboring for a VBAC. Laboring after a Cesarean requires a special kind of support, and we want to be supported by nurses that get it.
My suggestion: research the hospital beforehand. What is their reputation for VBAC? And what are their statistics? Local private mom groups on FB and ICAN chapters are a great source of information.
And for further support, be sure to checkout my VBAC Prep Birth Course for expectant couples considering Vaginal Birth After Cesarean (VBAC). We will cover everything from VBAC risks and perspectives to expectations during labor, what to expect during pushing and more to prepare you for delivery.