Quick Tip 6: VBAC Supportive Provider

In Katie’s interview this week, she talked about finding a supportive provider if you are looking to have a VBAC, that is a Vaginal Birth After Cesarean. For today’s quick tip, I am going to share some ways that you can tell if your provider is VBAC supportive. 

I talked about this in episode 3, but today I’m just going to do a brief recap. The first thing you want to look at in finding a VBAC supportive provider is their c-section rate, their repeat c-section rate, and their VBAC rate, as well as as those rates for the hospital that you will birth at. 

Now you should be able to find the rates for the hospital online. Cesareanrates.org is a good place to start. I live in PA, and to find the hospital rates in PA I use health.pa.gov. It’s sorted by counties. I will leave the link in the show notes for my friends that live in PA. A quick google for your state should also provide some results. 

For your provider’s rates, you will most likely have to ask, and they may not give them to you. Which could be a red flag, but not necessarily. So when I was going for my VBAC, I did not have the rates for my OB, but I did for my midwife. My midwife had a 90% VBAC rate, and a 9% total c-section rate. To give you a point of reference, the national c-section rate is about 32%, and the VBAC rate is about 14%. So my midwife’s stats were WAY better than any hospital and most likely any OB rate that you’ll find. Which was enough to convince me that I would be fully supported in having a VBAC. 

But before I had those rates, I based my OB’s supportiveness on whether or not they placed certain conditions on my labor and delivery. And this is where you can really tell if your provider is VBAC supportive. 

Do they tell you that you need to go into labor by 39-40 weeks, and they won’t induce you? Do they require certain interventions, like an epidural “just in case”? Do they want you to put a c-section on the calendar by 37 weeks, “just in case”?  Do they place an acceptable birth weight limit on your baby? This might look like “as long as your baby isn’t over 8 lbs”, based on an ultrasound. Do they tell you that your baby might be “too big” or your pelvis is “too small”? Do they skip over the risks of a repeat c-section, yet emphasize the risks of a uterine rupture with a VBAC? Do they require you to progress at a certain rate, for instance “you need to dilate 1 cm every hour”?  And this is a big one: Do they use a VBAC calculator to determine your odds for success? 

If you answered yes to these questions, then your provider is not VBAC supportive, and may be tolerant at best. If your provider is truly VBAC supportive, this is what it should look like for you:

There is no limit on the length of your pregnancy, and they will offer you a “gentle” or “soft” induction before a repeat c-section. They will consider the need for interventions based off of how your labor is progressing and how you and your baby are tolerating labor. They wait until 39-40 weeks before they ask you to schedule a c-section, if at all. There are no restrictions for a vaginal birth based off of an ultrasound estimate of weight of your baby. They present the risks of a VBAC and a RCS equally. They allow your labor to progress naturally if you and your baby are doing well. They can guarantee that you will be supported by whatever provider from their practice is present at your birth. And they will look at your previous pregnancy and delivery and current pregnancy to help determine your success of VBAC. And at the end of the day, if all looks well, a truly supportive provider will do what they can to help you have a VBAC. 

Asking your provider questions about how they feel about and what their policies are around VBACs are a great start to figuring out if your provider is supportive. If you’re looking for personalized recommendations for providers, this way you KNOW your provider is supportive, I recommend your local ICAN group. ICAN stands for International Cesarean Awareness Network. Your local group that meets in person, or your local Facebook group members can give you recommendations for great providers in your area, and may also be able to tell you if your current provider is supportive or not. 

Thanks for joining me for Friday’s quick tip. If you know someone who could benefit from this episode, please pass it along to them. Thanks for listening.