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Aiming for a VBAC

My first workshop in the UK was once again in Hull. It was primarily intended for the incoming group of doulas who have joined the very successful team of volunteer doulas that are matched with vulnerable women for support during pregnancy, labour and the post partum period. This is my third trip for this program and they are achieving some excellent results. It is a very good example of how social support can improve birth outcomes, especially amongst the disadvantaged.

There were two pregnant women in the group as well and a number of midwives from various hospitals in the area and from further afield. One of the pregnant women was hoping for a VBAC so I had a chat with her about how she might achieve her goal. Changing consultants to a known advocate of VBAC would be an important first step - the vague support offered by the Registrar in the clinic that her wishes would be respected is too tenuous to rely on. When a VBAC is planned, the most important step towards achieving this outcome is, I believe, finding a support team who are positive and enthusiastic for vaginal birth after previous caesarean. Many women are paid lip service on this issue during pregnancy only to find, when it is to late to change doctors easily, that they are being carefully and inexorably pushed towards a repeat caesarean. A few scary words, a hint of a problem with the baby, a throwaway line about the size of the baby and all too soon women find they are back on the operating theatre table with another incision being made. I encouraged the woman in my workshop to shop around and keep her options open. Trust in her own body and belief in her ability to give birth well is important as well. I hope she succeeds, and as a result lays to rest some of the doubts about her capacity to give birth.

Several of the doulas in the group recounted their own birth experiences, which were not always positive. One said that she had now realised that she must deal with her own disappointment with birth before she could properly support another woman through the birth experience - she realised that this had to be the woman’s journey and not her own. I was impressed by the degree of insight and maturity in this comment, and I feel sure that now she recognises her own vulnerability and needs she will take the appropriate steps her help resolve her own issues before she works with other women.

I wish that health professionals (midwives and doctors) would adopt this approach and acknowledge that many of their management strategies and behaviours for labouring women have their roots in their own personal disappointments and griefs about birth.

I’ve moved on to Huddersfield now and will have the opportunity to work with midwives in this area over the coming weekend. But first, another Essential Educator presentation for CBEs in this area.....

Posted by andrea at February 17, 2007 05:14 AM