After going through an emergency c-section with my first child, I was determined to have a successful VBAC (vaginal birth after caesarean) with my second. The experience I had with my first birth was a little terrifying. I wanted to do whatever I could to put myself in a position to be able to attempt having a non-surgical birth the second time around. Finding a “VBAC-friendly” doctor was not easy.
I moved to Florida when I was six months pregnant and quickly realized pursuing a VBAC wasn’t going to be as easy as I had hoped. My midwives in New York were supportive, but moving somewhere where you have to find a doctor who will support your desire to try for a VBAC is hard. VBAC’s are considered more dangerous than repeat c-sections -an idea that is not supported by facts – and are more of an insurance liability. For this reason, doctors and hospitals are cautious when deciding whether they will allow one or not.
45% of American women are interested in the option of VBAC (14), yet 92% have a RCS (15). Some women chose their RCS or it was medically necessary. Others felt like they didn’t have much of a choice for numerous reasons including hospital VBAC bans (16); immense social pressure; or the misrepresentation of VBAC risks (17).
In 1999, the ACOG made a recommendation that a doctor be “immediately available” to perform a cesarean, which means in some states (like Florida) in order to be assured of a trial of labor after cesarean, you have to find a physician willing to attend your entire labor. The doctor couldn’t just waltz in the last half hour like many OB’s are known to do. This is why it is increasingly more difficult to find a physician who is willing to be supportive. They may reference things like uterine rupture, but catastrophic uterine rupture – which is what doctors are usually referencing when they talk about how “dangerous” VBACs are, happen in less than one percent of women who VBAC. Basically, insurance companies have made it very hard for women in a lot of states to have successful VBACs if they do not find the right doctor/hospital fit.
So how do you find that fit? A lot of questions. I am going to go over some of the ones that I asked when I pursued my VBAC. I fundamentally believe in a woman’s right to choose what happens with her body, which also applies to how she decides to approach labor. I’m listing these questions as a guide – I am not a doctor. Nor do I believe that if your doctor gives you compelling evidence as to why you should not try for a VBAC should you ignore her. I hate to be one of those annoying people who says A healthy baby and mother is the most important outcome! But hey – a healthy baby and mother is the most important outcome. That being said, here are some tips to help you in your search for a VBAC-friendly doctor.