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VBAC
What irks me re: VBAC terminology
Why is it that a woman who has had a c/s is always labeled a VBAC candidate/hopeful, even after a successful VBAC? I know rationally that technically any birth after a c/s is, by definition, a VBAC, but why do we lucky ones that a c/s the first time get to have every pg after that labeled as going for a VBAC? Can we never have just a 'normal vaginal birth' (yes, I know this is a label I'm giving it myself).
I understand that you don't get rid of all of your risks of uterine rupture, etc after a successful VBAC, but it's just the mindset. Makes it sound like every birth after a c/s is going to be more of a struggle (with providers, your own belief that you can do it, certain people thinking you're taking undue risks, etc). I wish instead of a lil' bump badge for the first successful VBAC, we could get a clean slate from the VBAC branding, as it were. Be on the same footing as any other mom who has given birth.
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Re: What irks me re: VBAC terminology
M/C Dec 2010 - 5w5d Missing my sweet angel baby.
I totally agree! And even though I have had a "successful VBAC" I still have in my mind that this next birth is a VBAC too.
I think a lot of it comes from the doctors/midwives/hospitals/insurance etc. Here, even if you have had a successful VBAC, only the doctors/midwives who would "let" you VBAC the first time will take you. So, basically, even though I pushed a baby out after my c/s, my choice of care providers is just as limited as it would have been had I not.
I also think, for me, it is because when I was pregnant the first time I sort of figured a c/s wouldn't happen to me. I can rememeber even during the c/s part of our hospital birthing class looking at H and telling him this was the time to go to the bathroom because I wasn't having a c/s. That happened to other women, not to me. Now a c/s is a reality. I know it could happen to me.
Also, I don't like the idea that someone is "attempting" a VBAC or "hopeing for VBAC" or "trying to VBAC". If we hadn't had c/s we wouldn't we trying for a vaginal birth, it would just be assumed, so why do we let it into our minds that we have to try. I feel like it sort of mentally sets us up for failure.
I always say trying or hoping for a VBAC because that is what I am doing. I am hoping I will have one and I am going to do everything in my power to have one. But ultimately, I can't control everything that happens. So I don't think I am setting myself up for failure; I think I am accepting the possibility of another cesarean birth.
Like you, I was sure last time that I was not going to have a c/s. It just wasn't going to happen to me. And then it did and I was completely unprepared. So I don't want to get into the mindset again that a (repeat) c/s won't happen to me, because honestly it might and I need to be prepared for that too, for my own mental health.
I totally agree with those who've said they "weren't going to have a c/s." I distinctly remember our nurse in our birthing class talking about c/s under general anesthesia and saying "but those rarely happen" and me shuddering thinking I do NOT want to be that and feeling certain it wouldn't happen. And wouldn't you know it, I was the general anesthesia c/s through circumstances no one could have prevented.
I don't mind saying hoping/trying for a VBAC. Just like one hopes/tries for a pain med free birth. We all have our plans but there are definitely women out there who end up in the opposite situation than what they planned due to circumstances completely out of their control.
I guess I don't mind always being considered a VBAC. I knew right after having DS that any future children would put me in a VBAC category, whether it was one more pregnancy or multiple ones.
I don't like that either. But the words aren't really the problem; the real issue is acknowledging that there is no guarantee I will get to have the birth I want. I have to make peace with that as much as I can and the rest is just semantics. kwim?
Yeah - I agree.
Papagena - I can see what you're saying. People who haven't had c/s's don't go around saying they hope or are trying to have a vaginal birth. It's just the norm and what is expected to happen unless something changes to require a c/s. But the reality is that those people could speak in those tersm since there is no guarantee that anyone is going to have a vaginal birth. You know? Being VBAC hopefuls does put is in a different category in a lot of ways.
I think Iris hit the issue on the head for me. It's not the language that irks me. It's the deep down fear that my hope won't come true and me having to be prepared for the possibility that all my kids will be born by c/s. I know at least that's more the issue for me than what it's called. And for me, the hope of normalcy during delivery ended with DS's birth.
But here's the thing - especially after having one successful VBAC, why should we continue to be in a category that is different from the average woman? We've (not I, personally as of yet) proven we can, indeed, have a vaginal birth, and I don't think a 1% risk alone should put us in a new category, which besides being semantics with the 'VBAC' label, opens us up to closer watching by many providers, exclusion from birthing centers and/or legal midwife care in certain areas of the country, doctors being able to take you on because of their insurance requirements, etc.
The 'try' and 'hope' thing I can be ok with - especially when you're using it to explain your choices - I don't think it is a good idea to 100% believe you will have a VBAC, but again, at this point I don't think it's healthy for any woman to 100% believe they'll have a vaginal birth. However, I think if we are really in a place where we want to encourage women to have supportive options to VBACs, I think it can be very important to watch the semantics to a degree, and at least the 'VBACer for life' label does, IMO, put up some barriers both for the individuals mentally and sometimes in the system.
I think it probably depends on why the mother ended up with a c/s in the first place. For me, I consider myself a potential VBAC for life because I had HELLP and so I know that my chances of getting some kind of PIH is 25%. If that happens, it's an automatic c/s for me and every pregnancy is going to have to be closely monitored regardless of any successful VBAC attempt. So that's probably why I'm coming at it from the direction I am.
But if a woman had a c/s because of a breech baby or some other reason that is unlikely to recur, I can see why they would be more insistent of shedding that VBAC label and what that would mean for birthing choices. I just don't think it would ever be possible for me given the circumstances of DS's birth. So that's probably where I'm coming from.
Understood. I guess in those cases, I don't see it so much as a VBAC issue as the underlying medical issue. There can be various issues during pg that can put you in need of further monitoring, but, again, that wouldn't be because of the VBAC attempt.
T&P that you don't have to deal with HELLP or any PIH with any other pregnancy.
I agree. IMO there is no need for VBAC to be its own category or have so many restrictions placed on it, or be banned. There are many other conditions in pregnancy that have as much or more risk as a prior cesarean and those births do not get their own label or outright banned across the country.
I want every pregnant woman to run around saying "I'm a VB hopeful" and see how long it takes before their confidence in their ability to birth comes crashing down.
We need to find a better way to verbalize our goal without saying out loud that we might fail. You can know it in your head, but I don't always agree that you should say it out loud. It's not a positive affirmation, which is what EVERY pregnant woman needs. She needs to be confident in her body. When you start doubting, your subconcious starts doubting and then things don't happen.
Just my 2 cents. Although, I don't feel bad calling myself a VBAC. I feel like it makes me a warrior! Makes me that much more determined to prove I can do it. Because I KNOW I can. I just hate phrases like "trial of labor", "hopeful", "attempting", etc. It just sets you up mentally for failure. Mind over matter, ladies.
You are holding every woman here to your own standards though. Some of us find it helpful to verbally acknowledge the possibility of c/s and prepare for it. I plan to make a c/s birth plan too. It's not saying I might fail because giving birth by cesarean is not a failure. Birth is never a failure. It's saying that I might have another cesarean, which is true, and by facing that directly, I can come to terms with my fears about another c/s. That may not be what works for you, but everyone is different.
If you view another cesarean birth as a failure, that is the real issue. Not the words you are using. It's ridiculous to imply that a woman is setting herself up for failure simply because she verbalizes the possibility of a repeat c/s, and it's insulting to imply that a c/s birth is a failure.
If anything I think the success/failure rhetoric that I see on this board is a lot more harmful that words like "hope" and "try." Since when is the word hope a negative word? How can we honestly tell women not feel like failures if our VBACs don't work out, if this is the way we speak?
Not everyone on this board is going to have their VBAC work out. Is this board going to support those women too? Or are we just going to harp on about how people are setting themselves up for "failure," implying that they should feel bad about the way they gave birth and blame themselves for it?
For me, personally, I agree - I had a doula candidate say "when you have your VBAC!" She meant to be empowering and supportive, and I didn't take offense at all - it didn't bother me, but I did tell her 'if'. I personally can't imagine setting myself up to be that positive about my chances for a VBAC - I feel like if I focus on that too much I'm setting myself up to have the same disappointment and sense of my body failing that I did after my first c/s, and above all, that is what I want to avoid!
I'm not saying I love that I have to announce my plans with any qualifier, but personally I think it is safer for me to think that the c/s is a possibility, but a possibility that I can help be in control of and have a voice in, even if it is only in my prep, as it may be in an emergency situation.
That said, I have heard and understand the power of truly believing without a doubt that you can do it and using your words to emphasize that - I wish I had fewer doubts, honestly. In the grand scheme of things, though, I don't think it is what is ideal for me.
This is what I was saying. I didn't say don't think about it, I said don't agree with verbalizing it. (I also said it was my 2 cents, and therefore, just my opinion.)
I am going to make a birth plan for every possibility. I am scared sh*tless that this isn't going to happen (the way I hope) b/c I don't have a plan B. I am doing my best in a state that doesn't offer me the legal option to have a CPM attend my homebirth, so my wonderful MWs are working under the radar. This means if I walk into a hospital I will be treated like an uneducated person who received no prenatal care instead of the person who did hours of research, soul searching, and whatever else to come to the point of making the best decision for my family. I HAVE to make this work. I will be writing a birth plan for about 5 different situations. I want to know that I have in writing what I wanted (when my brain was in a better place than it is in labor/birthing time) things to be like. But I know that if I personally sit and dwell on the "what-ifs" I can't focus on the specific "what-if" I should : What IF everything just happens the way it should?
It is not me that views it this way, but society. Ever heard anyone called a successful repeat CS after trial of labor? No....they are called "failed VBAC".....FTP is another term that comes to mind. Obstetrics needs to re-term their diagnoses so that the mental and emotional state of women all over the world doesn't suffer. My first birth was labeled a failure (FTP) and when you hear those words, or see them in writing, after a while it really starts to hit you. Negative wording tends to stick a lot easier than positive.
It is not me that views it this way, but society. Ever heard anyone called a successful repeat CS after trial of labor? No....they are called "failed VBAC".....FTP is another term that comes to mind. Obstetrics needs to re-term their diagnoses so that the mental and emotional state of women all over the world doesn't suffer. My first birth was labeled a failure (FTP) and when you hear those words, or see them in writing, after a while it really starts to hit you. Negative wording tends to stick a lot easier than positive.
Right but my point was that if you post that saying "try for a VBAC" is setting yourself up for failure, you are perpetuating that same success/fail dichotomy that you say you are against. If you don't see a repeat c/s as a failure, then you can't say that any VBAC mom is setting herself up for failure, because there is no failure. There is only giving birth.
I would like to say that this post has helped me a lot. I wasn't planning on having anymore children mainly for the fact that I was scared to death of being pregnant/giving birth after having a c/s with my last child. Now that I am blissfully albeit unexpectedly pregnant I know I want to have a natural childbirth with this one. I also know that having another c/s is a very real possibility simply because of the "old school" thought that hospitals and doctors have about c/s.
I also know that at my first OB appt tomorrow that I will be very very clear on my desires to "try" for a natural birth. And by clear I mean, no monitors unless absolutely necessary, no iv's unless absolutely necessary, no strapping down and laying on my back, that i have my doctor's direct consent that he and his staff will do everything they can to ensure that i have all my wishes fulfilled. But, I would also like to be monitored as closely as possible without being too invasive to ensure I have no problems of rupture. I don't have an answer as how this will work out as I am not a medical professional but I am a woman who knows what she wants and does not want done to her body and child.
I enjoyed reading the different perspectives. I agree with encouraging words but I am not so offended by being called a "VBAC", but I don't like the term "Trying for VBAC". I am no more or less trying than the woman who has or has not had a c/s. Personal perspectives only. If this one ends in another c/s i will of course be saddened but also know that (just like with the last one and every other labor/birth before that) that i did all that i could to make sure my baby, myself and my family are safe and taken care of.
I wish everyone lots of good luck and hope that all our wishes come true and also hope that you cut yourself some slack if for any reason it doesn't go the way we hope it does.
I don't disagree with all that you're saying because I think it's good for women to think positively about their birth. But when you say things like "mind over matter ladies" it makes it seem like if only women thought better about their births, then things would go their way.
And I think that kind of attitude perpetuates the failure women feel when they don't get the VBAC or birth experience of their choice. I faced this with some people when my DS was breech. Some people told me if I just imagined him turning he would. And trust me, I visualized him turning. I tried everything I could, no matter how crazy, to get him to turn. And you know what? All my positive thinking didn't do jack squat. Granted, I got HELLP at 37 weeks so I still hold out hope that he would have turned if he had been given the chance. But that's just an example that positive thinking doesn't make things happen. I was not as jaded then and I remember back then truly believing he would turn and I would get my natural birth. I really felt like I did everything to get him to turn and felt such a letdown when nothing worked. It was more frustrating to me that I couldn't control the situation no matter how positively I thought about it.
I would just hate that if I don't ever get a VBAC that someone would be thinking that if only I had thought more positively about it, that it would have happened. It just seems to perpetuate an emphasis of blame on the mother for not doing something that could have helped her achieve the birth she wants.
I am not saying women should go into birth assuming that they're going to have a c/s but I do think it's important to be prepared for one. Acknowledging that there's a possibility of not getting a VBAC doesn't set someone up for failure.
This 100%
I think my issues are not so much with the VBACing woman saying she is hopeful or trying, but other people putting that on her (or me).
The other day I saw a friend who didn't know I was pregnant until then and she said "oh, are you going to try to go natural again?" It just rubbed me the wrong way. Like she didn't think I could do it or something.
I think it is a good idea to prepare for a c/s (I had a c/s birth plan with DD's birth), but I still want positve VBACing thoughts in my head when I am pregnant.