Skip to main content

I believe in VBAC- thoughts from a midwife

“Once a cesarean, always a cesarean.”  That often-heard adage does not reflect the reality of birth today.  While it can seem astoundingly easy to end up with a cesarean surgery for the birth of a baby (roughly 1 in 3 babies in the United States are born this way), finding a provider to support a TOLAC (trial of labor after cesarean) and VBAC (vaginal birth after cesarean) can seem astoundingly hard, depending on the part of the country you live in. 
                There’s always things out of our control that contribute to cesarean section being the choice way to have a safe birth for mom and baby: a baby coming breech, a pregnancy of twins where the first baby is coming breech, baby’s heart rate in labor becoming abnormal, placenta over the cervix, mother having certain active infections, some medical conditions of mother or baby.  Despite all this, the World Health Organization says the number of women birthing by cesarean should be closer to 10-15%.  I am happy to be part of a group that overall tries to help women achieve vaginal birth rather than cesarean in the first place, but that also supports women when they desire a VBAC. 
As midwives, we work together with our pregnant women to help them stay as healthy as possible through healthy diet and regular exercise.  Moms can’t change genetics, but they can make  good decision prior to and in pregnancy to be healthy and grow a healthy baby and placenta.  These seemingly simple things can impact mom’s health and stamina, which impact her risk of cesarean; they impact growth of a healthy placenta, which supports the baby through pregnancy and during labor to help the baby’s heart rate stay in a normal range; they help grow a healthy baby.
Another aspect of care that midwives are attuned to is the baby’s position in the third trimester.  At 28 weeks, about 75% of babies have figured out that down is out, are head-down, and stay that way.  The other 25% are still figuring it out, and by birth, only about 3-4% of babies are still breech (not head-down).  We start checking the baby’s position around 30 weeks, and if baby is not head-down, we work with moms to do things that encourage the baby to flip.  We are able to help with external cephalic versions for those babies who insist on staying breech despite our other efforts. 
When we feel the belly to find if the baby is head-down, we are also feeling the position the baby is in, and we suggest positioning and exercises to help babies be not just head-down, but also in the most ideal position for birth.  I feel like I have seen more cesareans done because the head-down baby came into the pelvis in a not-ideal position, and then was not able to change positions or fit to get out.  We work really hard with our moms to have babies start out in good positions or get there during labor to prevent cesareans. Chiropractic can be especially valuable for this.   
Despite all the prevention measures we take, sometimes women do end up with cesareans.  It is our pleasure to be able to work with those women in all the same ways to prevent a repeat cesarean. When it comes to labor, we know women can be apprehensive about reaching the same point in labor as when the cesarean happened the first time. Sometimes women pass that point with no problem, but other times women need extra encouragement to get through that point mentally. We stay with laboring women to be physical and mental support especially through that challenging point. 
It is so rewarding to help a mom work through labor after a previous cesarean, to have a vaginal birth, and for her to know her body is not broken.  I truly believe women are strong, their bodies are powerful, and given the right support, most women will be able to birth vaginally after a cesarean.

Betsy McCanse CNM is finishing her 4th year at the birth center.
When she isn't catching babies she enjoys traveling and dancing.
Follow her hasttag on Insta and Facebook #gbconthego.


Popular posts from this blog

A Deep Calling by Lauren Cox CNM

Lauren is the newest member of the midwife team here at the birth center. She is a recent graduate of the school of nurse midwifery at Frontier Nursing University.  In her spare time, Lauren enjoys spending time with family and friends, being outdoors, international travel, playing piano, Latin dancing, and being a member of St. Joseph County Right to Life.

Why midwifery?This is often asked when I share with others what I have been pursuing the past few years.  I suppose the answer is summed up as this: When you feel a calling deep within your soul, you cannot always explain or understand why, but because you are known by a God who knows your heart’s deepest dreams and desires, you respond and trust. As I reflect on my desires as a child, I never imagined this journey of life would bring me to such a sacred place of caring for new families and being the first to hold a precious new life in my hands. I distinctly remember as a young girl, learning about the immense poverty that was so p…
When The Midwife Gives Birth…
When a midwife is pregnant she gets lots of questions about her own preferences surrounding her own pregnancy and birth.


Morgan De Kleine CNM, a midwife at Fairhaven OBGYN graciously answered some of those questions for us to share with you.
Which midwife did deliver your baby?
Our son was delivered by Anne, under the supervision of Beverly. They both did a great job taking care of us, and we were happy that we got two midwives for the price of one! Sara and Julia were working at Fairhaven that day, so they came by to visit us at the end of their office day. We also had a wonderful team of nurses caring for us. Diana assisted during our birth, and Charlene cared for us after the birth. Elizabeth and Charlene did our home visits at 24 and 48 hours after the birth.
What is your birth story? This is the short version! I woke up at 3:30 am with contractions. Within an hour, they were 2-3 minutes apart, and I was working hard to breathe through …

Betsy: Mother, Teacher, Doula, and Midwife

I took a very circuitous route to becoming a midwife.  When I first went to college I didn’t have a strong pull toward any profession, but I did like to do art, so that became my major.  At one point, my grandfather pulled me aside and said, “Your grandmother was a teacher, your mother was a teacher and you should be a teacher, too.”  I know he meant well, but as a typical teen, I didn’t really like to follow unsolicited advice, so not only did I stick with art, I made sure not to become an art teacher. 
Fast forward to several years after graduation.  I was pregnant and knew the people to see when pregnant were midwives.  I sought out a group of midwives and saw them for my prenatal care.  At one point they asked if I planned to take a birth class, and steered me toward Bradley classes.  Within minutes of the start of the first class, I knew it was the right class for me, and I thought maybe someday I should teach it.  So when my daughter was 2 years old, I became a Bradley Method …