Many women who want to have a vaginal birth after cesarean (or VBAC, pronounced “vee-back”) in the United States have faced some sort of opposition from their care providers when they have expressed their desire to VBAC.
Sometimes this opposition is blatant (e.g. “I don’t do VBACs. Why would you ever want to risk your baby’s life like that?”). (More on why this is an outrageous statement in a bit.)
Sometimes this opposition becomes obvious only at the end of the third trimester (e.g. “Oh, it looks like your cervix isn’t dilating, so you probably won’t go into labor on your own. Let’s schedule you for a c-section.”) (Many VBAC-ing moms refer to this tactic as a “bait-and-switch” since it involves a supposedly VBAC-supportive care provider rescinding this support once the actual VBAC is imminent.)
Sometimes even a care provider’s “support” of VBAC is instead a conditional, half-hearted, or perhaps sneakily-disguised opposition to VBAC (e.g. “You can only have a VBAC if you deliver before 39 weeks/are dilating and effacing well before your due date/didn’t have a cesarean for failure to progress/etc.”).
These “scare tactics” (as many VBAC-ing moms have come to call them) are often misleading, exaggerated efforts by care providers–and yes, either OB/GYNs or midwives–to discourage women from VBAC and to encourage them to “choose” a repeat cesarean. (Of course, it’s not really a choice if your provider won’t even “let” you VBAC, is it?)
If you find yourself up against a barrage of scare tactics–as I once did–it can be exceedingly difficult to stake your claim and present your case to a care provider who may or may not have your and your baby’s health prioritized higher than medico-legal concerns and who may or may not be insinuating that VBACs are synonymous with driving your child in a car without a car seat. (Yep, some women hear this very analogy.)
If you do find yourself facing such scare tactics, and if you do want to have a VBAC, there are some questions that your care provider should be able to answer when s/he hurls those scary and/or outrageous comments and standards your way. And if s/he refuses to or even cannot answer these questions, then you might want to consider finding an alternative care provider–one who is making medical decisions based on research, evidence, and even respect for your patient autonomy and not on fear, willful ignorance, or even convenience.
Note: these pieces are only as up-to-date as their publication dates OR the dates listed in the editor’s notes. While the questions themselves might be timeless, the research is not. You can search PubMed for the most current research on VBAC, cesarean section, and related topics.