What Does Trial of Labor Really Mean?

Here is an email conversation I had this week:

I am very interested in hiring a doula to support me and help me VBAC (Vaginal Birth after previous Cesarean) in *************.”

I asked a few questions about her due date and location for her birth.

I am birthing at *************, and am looking for someone who have assisted in VBACs before. I was ten days early, spontaneous labor with my first.”

Well if any doula has been doulaing for very long she has experience with VBACs. I was curious if she was setting herself up for a real chance for a VBAC. So I asked a few more questions about who she had chosen for a care provider and what preparations she was taking this time and the reasons for her previous cesarean.

I have seen Dr. ****** for two appointments thus far and have another one next week. Is there a certain Dr/practice that you are familiar with that are VBAC friendly? I am still early and have not had an in-depth discussion about VBAC, but was told from the first appointment that there should be no reason not to allow me a TOL. (Trial of Labor)”

I have to be honest. I was quite shocked at the practice she was with offering her support in having a VBAC. This practice is not known for natural births nor supporting VBACs as of the last I had heard. I told her she needed to have some really frank conversations early on to make sure they had changed their policies. Ask them how many VBACs are successful within the practice. I also found out that her first labor was where her water had broken- no labor started- and yes she had recently had a vaginal exam- and then the augmentation had failed to have her give birth vaginally. She then shared this with me:

I was starting to get this feeling that maybe they would try to bait and switch me at the end. I have an appointment on Wednesday of next week and will discuss in detail the likelihood that they will really support my VBAC wish. My water did break and it was four days after an exam. I progressed to a ten, but baby was “sunny side up” and after 4 hours or pushing he was not fitting through my birth canal. I ended up needing a blood transfusion  from the cesarean and just had a hard recovery, and would like the chance to have a positive birthing experience (either vbac or cesarean). You have definitely enlightened me on taking more action now and not waiting.

So the baby being OP was the issue. Not the size of the baby. She is a perfect candidate for a vaginal birth. And her intuitive voice had already led her to believe the practice was not really being fully supportive of her desires. I suggested she take our Aligned and Ready workshop to help her have an optimally positioned baby this time. I also encouraged her to ask more questions and question their evasive answers.  I encouraged her to do a bit more research of her options.

“I called my current hospital and they stated they could not give out which doctors perform VBACs, but to call around to the providers and ask. So I just called my current practice without revealing who I was and she stated that no doctore there who was VBAC friendly. Definitely an eye opener.”

bait and switch

She is doing her research. She is aware that the Trial of Labor was not really going to be a true trial of labor at all with her current practice.  A few days later I received this email from her:

 I just wanted to update you since you have been such a blessing thus far. I have officially switched to Dr. ****’s office. I will officially be his patient in May. I researched and just loved everything I read about him. At what week would you suggest coming to your workshop “aligned and ready”? Also, at how far along should I book one of your doula’s? Thanks a million times over.”

I was happy she had done her research after I offered her a few names of practices that were truly supportive of VBACs. I encouraged her to take the class at her earliest chance. And it is great she is hiring a doula- hopefully a Labor of Love one and encouraged her to do so sooner than later!

I am often still shocked -although I see it a lot- when practices lie or lead a woman to believe she has their support in the type of birth she desires. There are no excuses for a bait and switch mentality ever.