Our Practice and VBAC
The most recent data available indicates that nearly 1/3 of American women give birth by Cesarean section. In subsequent pregnancies, a birthing person must decide whether to have an elective repeat Cesarean or attempt a Vaginal Birth After Cesarean, or VBAC. Only the individual who has to give birth knows which option is right for them. We encourage everyone to seek out information, find statistics, evaluate their values, and use a mindful, open-minded approach to discovering what option feels most right to them. Deciding how one wants to give birth is a deeply personal decision, and no one should ever make that decision other than the person who will have the baby.
If a woman decides that she wants to have a VBAC (or, as it is referred to before the birth occurs, a TOLAC, which stands for Trial Of Labor After Cesarean), it is essential that she surround herself with supportive family and friends and find a care provider who is enthusiastically supportive of VBAC. The evidence on VBAC demonstrates that the success of having a vaginal birth after a Cesarean depends greatly on whether the care provider truly feels comfortable with the birthing person's decision.
Our practice at Hearth and Home Midwifery firmly believes in VBAC as an option for women with a history of Cesarean birth. We trust the body and its ability to have babies vaginally. Of course, we do a series of risk assessment when considering an individuals risk picture including placental location, history of hemorrhage, location of incision, reason for the surgery, how long ago the surgery was, whether they've ever had a baby vaginally, and a multitude of other factors. We are careful in reviewing a client's chart and in talking with the client about their birth story. We offer individualized care and shared decision-making, and our goal is always to explain risk and management strategies and to let each woman be autonomous in her decision-making. We have seen VBAC be healing, triumphant, and phenomenally empowering. That is not to say that VBAC does not have some inherent risk, as of course all birth does. Our goal as midwives is to be in touch with our own level of comfort and professional boundaries, to communicate them openly with our clients, and to provide a space where women are the decision-makers for their reproductive experiences.
Charli & Sarah