The Tarrant County Birth Network and International Cesarean Awareness Network (ICAN) of North Texas co-hosted a meeting last night in Fort Worth about birthing outside a hospital after a cesarean. Since around 1 in 3 women in Texas have a c-section, birth after cesarean is a hot topic. The old saying of “once a cesarean always a cesarean” is more myth than truth, and even the American College of Obstetricians and Gynecologists (ACOG) recommends vaginal birth as a “reasonable and safe” option after a previous c-section. (Read ACOG’s VBAC practice bulletin here.)
What options does a woman have when planning her next birth after a previous cesarean? For some women, planning a repeat cesarean may be the best option because of health indications for baby, or for their own physical and emotion health and well being. This is ok! DFWdoula supports all types of birth, and can help you plan a family centered cesarean if desired.
According to ACOG– “most women with one previous cesarean delivery with a low-transverse incision are candidates for and should be counseled about VBAC and offered TOLAC.” (TOLAC stands for trial of labor after a cesarean, which is the language some providers will use.)
When planning a VBAC, the most important component is a VBAC supportive provider. In Dallas Fort Worth we are lucky enough to have amazing provider options, from nurse midwives or OBs in a hospital to home birth midwives.
The VBAC panel discussion included area midwives and was led by a local ICAN leader. They discussed the reasons for planning a birth center or home birth after cesarean (HBAC), factors to consider, and experiences catching VBAC babies. Some highlights from their discussion-
“Our first job is to rephrase the way we speak about these women and the way they speak about themselves. You are not a VBAC. You are not a c-section. You’re not your birth. You are a mom. When we label these women as their births they can feel like failures if things don’t go according to plan. They are mothers planning a birth like any other mom.” – Kristine Tawater, CPM, LM
“We are more hands off, we aren’t interfering with bonding.” –Terry Gyde, CPM, LM
“The best collaborative care in the nation is happening right here in Tarrant County. I have great relationships I can utilize if things come up. We work together.” – Jenee Ohrvall, CPM, LM
-Birth is a physiological process, we trust that it’s going to work instead of planning that it won’t.
-Moms should be an active partner in their own health and prenatal care; nutrition, exercise, chiropractic care.
-Look at operative report and overall overall health, consider additional risk factors- blood pressure, blood sugar, health history, etc.
-Discussed transport, monitoring and signs of uterine rupture.
The meeting overall was really informative and empowering! I loved hearing about the collaboration happening between providers when risk factors or complications indicate it, and these midwives’ passion for helping women reach their goals was so evident.
If you need more help to plan your birth after cesarean, contact me! Whether hospital or home, it’s a special passion of mine since I walked the same journey too.
Did you have a cesarean? A VBAC? Where were you babies born?
– DFWdoula- Fort Worth – Dallas – VBAC – Cesarean -Natural Birth – Epidural – Twins –