Doula Care for VBAC Clients

Many women in the United States have the misconception of “once a c-section, always a c-section”; in reality the rate of VBACs are in the rise and many women are candidates for a vaginal birth after cesarean.[1] The choice to have a VBAC is very personal for a birthing person and having a doula is another choice to help their chances for successful VBAC. Many parents feel out of control after their cesareans and there are so many decisions to be made when planning a VBAC. Having a doula for a VBAC is helpful by offering a prenatal space to set goals and to go over their feelings and facts of their cesarean, by having continuous labor support by a birthing professional, and allows birthing parents feel in control of their labor, delivery, and postpartum period.

A VBAC is a vaginal birth after a cesarean. Women choose to VBAC for many different reasons including: a shorter recovery time, more options for their birth, less complications if they decide to have a large family, and and fewer complications since they probably won’t surgery. [2] When choosing to pursue a VBAC, birthing parents may seek out a doula, which is a professional birth partner that supports the parents emotionally and physically during pregnancy, labor and delivery, and postpartum. Having a doula has been shown to lower c-section rates, lower the rate of interventions, have a shorter birth, and twice as likely to be breastfeeding at 6 weeks. [3]

During pregnancy, the birthing person meets with their doula 2-3 times. During those visits, the birthing parents have a space to talk about their previous cesarean. They may not have been able to tell their story in a safe space or been able to fully process their cesarean. Often parents come to a decision of “not a cesarean” however there is much more to a Birth including accessing a supportive provider, knowing where they want to give birth, and the many different aspects of labor and delivery. They may have certain times or situations in their first labor that they never experience and feel that is a place of relief to get past. A doula can lend their experience and resources with parents so they can come to their own decision regarding their birth.

During labor, most hospitals do not want birthing persons to come in until they are at the 5-1-1 rule, meaning contractions 5 minutes lasting 1 minute for 1 hour. Before that, mothers labor at home and they may need more support than a partner may be able to offer. They may need advice about how to handle the discomfort of early labor. Once arriving at the hospital, the birthing parents may not realize that while a nurse can offer some support, they may have other patients. Nurses are also tasked with the medical side of births and even if are with the client the entire time will have to split their focus between labor support and a client and client baby’s healthcare needs. Nurses also have shifts. If a birthing person comes in at the end of a nurse’s shift or their labor lasts longer than a shift, they would have to acclimate to another person, another personality in their birthing space. Another nurse also has to learn about a birthing person and their preferences during a time that they are also being updated on the birthing person’s medical information. [4] While if a birthing person has a doula, then there is a professional birth partner who is knowledgeable of the birth preferences, can help the birthing person advocate for themselves, and offer continuous support as long as they are needed.

Other providers will be there for the medical aspects of birth, but undeniably there is more to the birthing process than cervical checks and timing of contractions. Statistics show better outcomes when a birthing person has continuous labor support with the best outcomes being birthing person’s who have a doula as their continuous support. Having a doula is beneficial with any type of birth, but with a VBAC birth the knowledge and experience a doula can bring to to the table can be invaluable for parents who are looking for a more satisfying birth experience.

[1] https://www.contemporaryobgyn.net/pregnancy-and-birth/cdc-vbac-rates-increasing [2] https://www.mayoclinic.org/tests-procedures/vbac/about/pac-20395249 [3] http://www.birtharts.com/what-is-a-doula-4/ [4] https://www.happiestdoulas.com/doulasupport/nurse-cannot-be-your-doula