The Statistics Queen: VBACs
I was chatting with another doula today about VBACs and CBACs. There are so many factors to a woman who has had a previous cesarean to getting a vaginal birth the next time. Factors include the choice of care provider, the reason for her first cesarean (I do believe most of my clients have either had failed inductions- ie- their baby was not ready to be born and was being forced out, or had impatient care providers), the team she has with her and how deeply they believe in her ability to have this vaginal birth, and the preparation she puts into this birth being a different outcome.
She called me the “Statistics Queen” when I shared that I think in the 75 women who have taken our BOLD/Fear to Freedom Method Childbirth class, we had 2 or 3 primary cesareans and I think maybe 1 cbac in our whole group. And we have a lot of VBAC moms attend our weekends. Now I am not going to say it was just our class- that would be too BOLD for sure to make that statement. But I do think that they were more careful about those factors I mentioned earlier. And I do think that the type of preparation we offer is so different, that women really process their fears and the baggage we could all take to our births.
Sometimes there are hidden fears deep inside of us that do not come out until someone or we ourselves probe deeply to find them- to bring them to the surface and process them. If they are not brought to the surface, then they are likely to come out during labor and inhibit a woman from being able to release and open up to giving birth. That is why when I hear a mom who had a previous cesarean tell me she took classes before and does not need to do so again, I cringe.
All classes are not equal. Some classes teach you how to be a compliant patient and others are great at conveying information and even allowing some hidden concerns to come out. But you need to have more than those concerns and fears revealed, you need to have to have tools to process them and tools to develop a plan to resolve them.
I went through my most current stats spreadsheet when I started being even more detailed- since 2009, 116 births later, I have had 18 women attempt a VBAC- vaginal birth after a previous cesarean. Of those 18, 16 went on to have vaginal births. What has made the most difference in helping women get those vaginal births- choosing wisely where they are birthing and who they are birthing with- but yes I do think the way I help them process things does make a difference. And those factors keep those primary cesareans reduced as well. I have an 87% vaginal birth rate- that means a 13% cesarean rate overall in my 600 births. 10% is optimal per the World Health Organization. And keep in mind our area has more like a 40% rate in our metro area at the larger, busier hospitals.
So make sure you really do the work prior to your labor so you improve your chances to have the birth you desire.