We share a lot of content about preparing for your VBAC – educating yourself, finding the right provider, using products that will support you and so much more – but when it really comes down to the wire… how do you actually avoid another c-section?

Whether you’re early in your VBAC journey and planning ahead or you’re at (or past) your due date and feeling pressure from your provider to “just get a c-section date on the schedule,” these tips are for you. 

Read on to find out what you can do as your due date approaches and even during labor to help yourself avoid a repeat c-section (RCS).

Third Trimester

Here are a few things to focus on during your last few weeks of pregnancy that can help you pave the way for a VBAC.

Aim for alignment

Getting your body and your baby aligned plays a major role on when labor starts and how smoothly it goes. Incorporate these things in your third trimester to make sure your body is aligned and baby is in the optimal position:

• Spinning Babies Daily Activities, especially forward-leaning inversions
• Chiropractic care, be sure to see someone who is Webster-certified
• Check your posture (This can be difficult to do late in pregnancy, but try to sit up straight rather than slouching in your chair or on the couch. Use a birth ball when sitting at the desk or even during meal times. Good posture helps you stay aligned and makes room for baby.)

Walk… a lot

Walking is so, so good for you AND your baby! There is evidence to suggest that regular walking, especially late in pregnancy, can actually increase your chances of having spontaneous labor and decrease your chances of needing induction or a c-section! Plus, we all know that walking can help clear your mind, strengthen and lengthen muscles you’ll use in labor and help baby get in the right position – all really helpful things for a smooth vaginal birth.

Minimize cervical checks

Most providers start asking if you want a cervical exam around 37 weeks to check for dilation. Unless there’s a medical reason for a pending induction, try to avoid these. Dilation does not tell the whole story – you could be dilated to a three and walk around for weeks before labor starts, or you could not be dilated at all and end up having your babe the next day. 

Getting a cervical exam early or getting them done at every appointment can cause you frustration and possibly give you doubts, or cause your provider to become doubtful. Cervical checks can have their time and place, but use them wisely. It is also important to note that some people don’t ever have a cervical exam and still go on to have a vaginal birth without any issues.

Wait for spontaneous labor

Giving your body the time and space it needs to go into labor on its own provides you the best chance of having a VBAC. If your body isn’t ready for labor, inducing may cause challenges that need to be overcome with additional interventions, including a repeat c-section. While VBAC is still possible with induction (read more here), your best chance of having your VBAC is to wait until your body spontaneously goes into labor. We understand this can be hard, especially in the end when you are SO done and uncomfortable (and people may be encouraging induction), but mama, YOU HAVE GOT THIS.

Encourage labor to start

Yes, I know, I just told you to wait for spontaneous labor, but… sometimes you’re ready to get labor started because you’re past your due date or just feeling like you are being pressured to get a medical induction. You may consider some more naturally-minded forms of encouraging labor. 

Nipple and / or breast stimulation can produce oxytocin which is the hormone that causes uterine contractions. Studies have shown those who perform nipple stimulation may go into labor sooner, could progress labor and may have lower rates of c-sections (Evidence Based Birth, April 2020). Because the release of oxytocin is uncontrolled, you should always discuss nipple stimulation with your provider before performing during pregnancy or during labor.

Now, research isn’t exactly conclusive on the correlation between having sex and the imminence of labor, but most of the evidence available suggests that having sex can’t hurt. Especially if it includes semen in contact with the cervix, nipple stimulation and orgasm… there’s a chance that sex could be effective at moving you closer to starting labor (Evidence Based Birth, Sept 2020).

Consult an expert

Meagan, the owner and founder of The VBAC Link (plus a doula and VBAC mama herself) is a wealth of information, support and SO MUCH encouragement. If you listen to The VBAC Link Podcast, you already know what a genuine, knowledgeable woman she is. If you’re looking for some extra direction, schedule a one-on-one with Meagan. You won’t regret it!

Relax & enjoy your family

Lastly, try to be in the moment with your sweet family just as you are. Planning a VBAC and waiting to TOLAC is not easy, but we do believe there is a strong correlation between your mental state and how your labor progresses. If you feel stressed, anxious or fearful about something, consider working through that using talk therapy, journaling, meditation or doing a fear release. Trust that your body and your baby know the right time for labor to begin.

During Labor

If labor has already started but maybe isn’t progressing or you’re feeling nervous about things pointing toward a RCS, here are a few things to consider.

Minimize cervical checks

Again, cervical checks can be helpful to assess how labor is progressing and where baby is positioned in your pelvis, but they can also cause mental stress. Even during labor, your dilation just doesn’t tell the whole story. It’s possible to sit at a couple centimeters for hours and then suddenly jump to fully dilated. Furthermore, being checked frequently can be uncomfortable for you, increase your chances of infection and could certainly cause labor stalls. Plus, your provider may be more likely to pressure you to try some type of augmentation if they feel like your labor isn’t progressing.

Bottom line: you can always refuse a cervical exam.

Rest until you can no longer rest

I remember it vividly – when I was planning my first VBAC (a pregnancy that went to 42 weeks), I worked so hard to “naturally” start labor. Once it finally started, I did everything I could to keep it going. And when it lasted for hours turned into days, I was absolutely exhausted and found myself with a RCS.

Oftentimes, long labors can stall out because our minds and bodies run out of gas. Whether it’s in early labor or in active labor in between contractions, rest when you can. If you are able to sleep, sleep. If you can get comfortable and rest your eyes, do that. Conserve your energy every opportunity you have so you can run the marathon your birth experience may be.

Move frequently

Movement is key to both coping with any pain you might be experiencing and progressing labor. You’ll be surprised how the slightest of movements can make the biggest difference in helping your labor along. When labor becomes active, we recommend changing positions every three to five contractions. Movements as simple as shifting from one side to the other in a side-lying position or propping up one leg and then the other with a peanut ball can help you dilate and make space for baby to descend. 

Try nipple stimulation

We mentioned it before, but it’s worth mentioning again. Nipple stimulation during labor could be an effective way to start or progress contractions. Nipple stimulation releases oxytocin, so when a provider suggests starting a pitocin drip (the artificial form of oxytocin), a natural alternative could be nipple stimulation. Always consult your provider before starting.

Use your BRAIN

Sometimes we can feel unprepared, uncertain or even pressured into making decisions while in labor. Non-emergent things can often feel like emergent things, and we make rash decisions that we otherwise might not (rightfully so). Practice using your BRAIN when faced with decisions…

• B – what are the Benefits of doing this?
• R – what are the Risks of doing this?
• A – are there any Alternatives to this?
• I – what does my Intuition say?
• N – what if I do Nothing at all / can this wait?

Be comfortable saying “NO, THANK YOU“

These are words that don’t always come easily, especially in labor, but always know that you have the option to say “NO.” Jot down these phrases to have close by in case you need them. You can always say things like…

• No, thank you
• I will think about it
• Maybe later
• Thank you for going over that with me, I will respectfully decline at the moment

Remember that although these providers may have a lot of knowledge, your intuition and feelings matter more than anyone else’s. If something is not feeling right or you do not want to do something, you can always say no.

Make one decision at a time

Last, but certainly not least, try to make one decision at a time. Having a birth plan is wise, but holding on so tightly to that plan could be detrimental to your overall experience. You may be faced with a choice or intervention that isn’t ideal early on, but it doesn’t mean you can’t still get the outcome you’re hoping for. Do one thing at a time, stay present and make informed choices as you go. You’ve got this.

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I know, mama… your yearning for this VBAC is so great. You’ve worked for and longed for this. You deserve this. I hope these tips to avoid another c-section are helpful in planning your best birth experience yet.

As always, I’ll leave you with this affirmation and reminder…

Sources

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8395880

https://evidencebasedbirth.com/ebb-125-evidence-on-acupressure-acupuncture-and-breast-stimulation

https://evidencebasedbirth.com/evidence-on-pineapple-and-sex-for-natural-labor-induction