WHY LACK OF SUPPORT?

Several years ago, ACOG, American College of Obstetrician and Gynecology stated, that the risk of vaginal birth after cesarean poses a threat of uterine rupture and isn't worth the risk to the fetus or the mother. Since then our hospitals and physicians have changed their views and policies. Larger hospitals with anesthesia coverage around the clock are a little more open to the idea of VBAC. Women aren't given the choice if they are at smaller hospitals. Women who are going forward with their decision for a VBAC may find that the biggest obstacle is lack of support from the medical staff.

PREPARING FOR A VAGINAL BIRTH AFTER CESAREAN

First of all, know why you had a cesarean the first time. Was the cesarean for failure to progress or fetal distress? The reason behind the cesarean makes a difference in trying for a vaginal delivery. Discuss this with your physician. Hiring a labor assistant or Doula will be the most valuable thing you can do. She can help guide you through the entire labor, therefore reducing your chances of a repeat cesarean. Relaxation exercises, a pre-natal yoga class and visualizing a vaginal delivery will also help reduce your chances of a cesarean.

HOW TO COPE DURING LABOR

Being a professional labor assistant, I have been given the opportunity to help many VBACs. The most important thing you can do is keep a positive attitude throughout the entire labor and delivery. Don't give up unless the baby indicates otherwise. Many health care providers do not have faith in a woman's ability to deliver vaginally. It is important to stick to your agenda if the baby and your health are tolerating the labor. Also keep in mind that it will be scary when you reach the point when you had your last cesarean. Change your labor position at least every 30 minutes. Remember your relaxation and visualization exercises to reduce your stress and fear of the unknown. You will get through it one contraction at a time.

Julie L. Johnson is a wife and mother of three who has experienced every pregnancy, childbirth, postpartum and breastfeeding situation there is and has lived to tell about. She is a Certified Lamaze Childbirth Educator, Certified Doula and an International Board Certified Lactation Consultant practicing in Southern California. Her website http://www.birth-angel.com provides services and products to help ease the transition into motherhood.