Maybe I just didn’t trust enough –
a blog post about common feelings for women planning a VBAC

I wish I could offer you a recipe for a smooth and natural birth after caesarean. Then no one would have to manage and cope with difficult feelings of doubt and worry. But unfortunately, I don’t.

Or maybe, it is not so unfortunate after all. The feelings, fears, worries and wishes that come up during pregnancy, are part of the packet of birth, and most certainly of VBAC birth. But if you feel supported and guided through, it can be a recipe for growth, strength and learnings about yourself. Not just for birth, but for life. This is part of what birth is, stretching ourselves in every direction, preparing us for motherhood. It really can be quite exciting

1 in 3 women in Australia birth by caesarean, so VBAC is becoming a very common topic with a lot of varying opinions. If you search for VBAC on the internet, you will find an enormous amount of information. It can be a bit of challenge to navigate.

When I searched on the internet this morning, I found lots of information about the risks of VBAC, and about what a uterine rupture is. I found information about symptoms of rupture, explanations of management, and lots about who the best candidate for a VBAC is. And then I found websites like: 12 steps to a successful VBAC. How good does that sounds, when standing in front of the big unknown of birth?

A lot of this information was really useful and very important, but what was missing was someone talking about the inner journey or the emotional journey a woman, and often her partner as well, go through when deciding and planning for a VBAC. How do you emotionally prepare for a birth after a caesarean, that you probably had really hoped to avoid?

On my search, I didn’t find information about how I might feel and cope, if my VBAC wasn’t successful, and the anguish of even thinking about that possibility.  I didn’t find information about how to feel confident about birth, when you really can’t know, if your VBAC will be successful.

In this blog post I will attempt to touch on some of the most common feelings women can have when planning for a VBAC. Some of these feelings are similar to any birth, but I will be talking mostly about women planning for a VBAC.

Risk
The first issue couples come across when looking at birth after cesarean, is risk. Risk is a very subjective thing. If you asked a 100 different people to rate different risks, some people would consider it much more risky to jump out of an aero plane, than to smoke 20 cigarettes every day. Or much riskier to have sex with a stranger without protection, than driving without a seatbelt, or the other way around. Many people would find it much more risky to swim across a bay in deep water, worrying about sharks, than to drive from Sydney to Brisbane in the holiday season, even though hardly any people die swimming in the bay, and lots of people lose their lives driving a car. My beautiful friend and Midwife, Dr. Rachel Reed often talks about how just like in life, there are no risk free options in birth – only which risks you are prepared to take.

Depending on the caregiver you have chosen, you will be presented with his or her version of VBAC risks. How we present risk can heavily influence whether something feels very risky or not so risky. For instance, you could say that there is a 1 in 200 chance of uterine rupture, or you could say there is a 199 out of 200 chance of things going right. Which one do you like? Read more about risk on Dr. Rachel Reeds page MidwifeThinking

This is also why it is so important to choose your care provider and birth place carefully. They must reflect your values and beliefs. And it is ok to change your mind and find a new care provider, if you realise you no longer match. This can feel difficult and confronting, but is well worth it.

Some of the common feelings women face in this process of choosing, is whether she really is being selfish for wanting this VBAC. ‘Am I putting my baby at risk, for my own needs and wants?
I do agree that the need for a vaginal birth can feel so urgent for a VBAC woman, but never that it is coming from a selfish point of view. I find these urges very valid actually. None the less, it is very common for women to have to go through a time of questioning this in themselves. It is a difficult and quite unsettling feeling that touches those deepest places inside us, of wanting to be good a mother, and wanting to give our babies the best. Most women want VBACs because there are a lot of good and important benefits about birthing vaginally, both for Mums and babies, both physically and hormonally, and this is what they feel would be a good and maybe more gentle start to life for their baby. I have found that this questioning of yourself requires time out and stillness to really feel into and be able to come to your own personal truths about your motivations.

Can I do this? And what if I can’t?

All women, who have experienced a birth that wasn’t smooth, will have some of these feelings. Feelings of doubt about their ability to birth and maybe a worry about whether their body will ‘fail’ again. This might be something really big or something just nagging in the back of the head. It is important to take this feeling seriously whether big or small. If this feeling is not dealt with in an appropriate manner, it can interfere with your decision making, and create a dissatisfaction, before you have even birthed.

It is a very personal question; can I do this? But maybe the question on the flip side is actually what is more aggravating: what if I can’t? What will it mean about me, if I can’t do what I set out to do? It is a crucial part of preparation to come to a place of realising what it is we are telling ourselves about ourselves, when things don’t go to plan. Being prepared on this level can help us out of that stuck feeling a birth with some negative leftovers can have. Coming to terms with those beliefs inside yourself, can help you feel really encouraged and ready to take on birth, even though you do not have control over how your journey will unfold.
Trust

Birth Connection VBAC blog

In my search on google I found lots of websites talking about trust. It has become a bit of a catch phrase in modern birth preparation; just trust in your body, your body is meant to do this.
But what happens to the women, who clearly then didn’t trust enough? Did the VBAC woman not trust enough the first time? How do you suddenly start to trust, if you feel like your body failed you last time?

Being positive and trusting is important both in life and in birth. But it can be a superficial thing, or it can be a quest for something deeper and more meaningful. It is about daring to explore how you might trust birth and feel positive and confident, even if you find yourself in situations you had really hoped to avoid. Or dare to feel disappointed without it tainting your whole birth experience. You might ask yourself: What do I actually trust about birth? And even: What does trusting birth or my body look like and mean to me? Does it mean not looking at the things that doesn’t feel good and positive? Or does it mean trusting that you will manage, even if your birth is not what you are hoping it will be?

I know the feeling that ‘trusting your body’ can create. It is a nice feeling, but it is more useful, if it has a deeper meaning to it.

Pam England, founder of Birthing From Within has a great quote in her book ‘Labyrinths of Birth’:

There is an expectation or ideal that women should trust labor, with the implication that if they trust their body and the process enough, they will be calm and labor will be normal. I suggest that this idea of Trust be expanded to include trusting even crazy thoughts and emotions, which come and go during labor and postpartum, because this is a normal response to being in the Unknown”..

There is also a fear, in particular for women trying hard to trust, that to think about and explore things other than what they are hoping for, will make them happen. Exploring and learning about ourselves in connection to our fears or worries, will not make bad things happen. Not having dealt with these issues or looked those worries in the eyes, on the other hand, can create this false sense of security and trust, and leave women very stranded during labour and birth, which might not look anything like they had hoped and trusted. Using your fears and worries to guide your preparation is incredibly effective in my experience and opinion. And the only way you can feel truly ready and confident about birth.

What if the same thing happens again?

Most VBAC women, and other women having experienced difficulties of any sort in a previous labour and birth, often have a point in labour where they felt it all went wrong. This could be at a certain point of dilation, or when they said yes to that epidural, or something completely different. Many women find that getting through that point in their next labour, can be a bit of a struggle for them emotionally.
Overcoming this issue might mean practising asking for help. It might mean searching within about what it is you will need, if you find yourself struggling at ‘your point’ too. It means accepting that difficult feelings can arise in your labour, and that that would be quite normal as well. Labour does not necessarily have to be all bad, even if there are difficult or even negative moments.

Knowing and accepting that it is normal to go through lots of emotional stuff through labour, can minimise the effect of that, and spare you from the agonising beliefs and doubt that there is something wrong with me, or that I just can’t do this properly and so on.


Birth as a Rite of Passage

We are preparing for a journey or a Rite of Passage, when we prepare for birth. In a Rite of Passage there are bound to be challenges. It is getting through these challenges, whether they are physical or emotional that helps us come out on the other side, feeling like we can do anything. And that is the best place to start Motherhood from.
Feeling prepared for the unknown and for challenges is a big part of preparing for birth to be the best experience possible.

Preparing for a VBAC birth or any birth, really is a huge emotional journey. There is much inner work to do that is as important, as the outer work of risks and birth management. I find that this is where lots of magic can be found. Birth doesn’t have to be natural, calm and collected or with candle lights to be healing and empowering, though it is lovely when it is. But it does need self-love, acceptance of who we are and what we bring with us in our life experience , it needs having made peace with a previous tricky or difficult birth, and an honouring of our womanhood and mothering.

Birth Connection VBAC blog

Next Birthing From Within VBAC course is starting on the 24th of June. Click here to get more information and to book your spot.

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Birth Connection is the online presence of Childbirth Educator, Advanced Doula, Birth Story Healer, & Birthing From Within mentor, Pernille Powell. Pernille is based on the Sunshine Coast in Queensland.

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