Westside Doula

Whether or not your doctor or hospital will "allow" a VBAC (Vaginal Birth After Cesarean), depends greatly on the hospital and doctor. 

• Westside hospitals are  MUCH better than Orange County, in that most of our major hospitals do not ban VBAC.

• If you have had multiple cesareans and want a VBAC, make sure your doctor and hospital are on board.  You might have to switch hospitals/doctors.
• Check out the hospital pages, it might say if they are VBAC friendly or not.  Remember, the hospital may be okay with it but your doctor might not--and visa versa
• You do have a right to show up at the hospital and refuse a cesarean.  You will need the support of your partner. He/she should be prepared to take a stand.  YOUR DOULA CANNOT DO THIS FOR YOU (after all, we're non-medical support).
• That said, I can support your family in your choice in every other way possible:  Making sure you are informed and aware of interventions and hospital procedures, comfort measures, moral support and encouragement, etc.
• Most importantly, it's up to you.  If you want a VBAC or another cesarean, you should do the research and be prepared to have an honest discussion with your partner and doctor.

As always, I recommend the UCLA midwives and Kaiser for VBAC.  There are lots of other doctors supportive of VBAC.  I encourage you to please make sure that your doctor (AND HOSPITAL) is not only "okay with" but a "strong advocate for" VBAC.

Here are some questions to ask your care provider:

1.  What percentage of your clients attempt and succeed at VBAC? 70-80% is probably good.

2.  Does the hospital require that the OB be in the hospital for your entire labor?  At a teaching hospital, there is always a doctor around who can catch if your OB isn't around.  Policies at hospitals vary greatly.

3.  How do you feel about us hiring a doula?  "Best way to avoid a cesarean" is a great answer.  "So long as she doesn't get in the way" raises some red flags.

4. What is your cesarean rate for first time moms?  Should be around 8-15%, but realistically under 25% is decent.  Home birth midwives have around 3%.  UCLA Midwives are about 11%.  UCLA Santa Monica (hospital) is 45.5% (2008).  If your OB doesn't know that info off hand--make sure you get it.  Docs with low cesarean rates know what they are.  A low cesarean rate for first time moms means that your OB has more experience with and more likely to trust vaginal births. 

5.  What percentage of your clients get an epidural?  Remember this is maternal choice, so expect this number to be high.  But you should be able to have this conversation. 

6.  What are some good ways to avoid a cesarean?

Interesting Articles:

VBAC Scare Tactics, by BirthingBeautifulIdeas blog.

ACOG Says Yes to Vaginal Births After C-Section , by Aime Newman, Huffington Post.

Dr. Fischbein on VBAC

An personal story of a woman's journey from Cesarean to Home Birth VBAC

My Journey to a VBAC from Lindsey Meehleis on Vimeo .

"This is the story that details the traumatic cesarean birth of my first daughter Dylyn and the journey of becoming a Doula, Childbirth Educator & Midwife in it's aftermath. It ends with the Home Water Birth of my son River."