VBAC Scare Tactics
Many women who want to have a vaginal birth after cesarean (or VBAC, pronounced “vee-back”) in this country 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 having your uterus explode and ending up with a dead baby?”). (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 OBs (and yes, even 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?)
And 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 argue against the doctor (again, or midwife) 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 hurling phrases like “catastrophic uterine rupture” and “dead baby” your way.
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.
VBAC scare tactics (1): VBAC = uterine rupture = catastrophic outcome
VBAC scare tactics (2): When bad outcomes in the past affect patient options in the future
VBAC scare tactics (3): An early eviction date
VBAC scare tactics (4): No pre-labor dilatation = no VBAC
VBAC scare tactics (5): VBACs aren’t as safe as we thought they were
VBAC scare tactics (6): CPD or FTP = no VBAC
VBAC scare tactics (7): Playing the epidural card
VBAC scare tactics (8): The MD trump card
VBAC scare tactics (9): You have *how many* scars on your uterus?
I don’t know if I’ve ever thanked you enough for writing these! I swear that my CNM’s supervising OB has told me EVERY SINGLE ONE OF THESE THINGS to try to get me to schedule a c/s.
I’m so, so glad they’ve helped you, Bethany! As sad as it makes me that there is even a REASON to write them, I’m just thrilled to know that they have made a difference for women out there like you.
Thank you for your awesome post. I’ve bookmarked this for my upcoming prenatal appointments – I’m currently 33 weeks, seeking a VBAC.
One of the scare tactics I’ve gotten the most is the “big baby” tactic, like I’m going to “grow” a baby I can’t push out.
Can you speak to that tactic too?
Thank you! And congratulations!
You know, I’ve had a “big baby scare tactic” draft in my queue for a while. You’ve given me the impetus to get working on it in the next week or so!
This is a fantastic series of posts! I am going to send the link to the listserv I just joined for my local ICAN group.
Hello, first I want to say how all of the information you’ve provided here has helped me in my decision to VBAC with this baby. I would love to share my story with you but it is a touch lengthy and I’m not sure you want it here. However, I have a question that I fully trust you will have an accurate answer to. According to the surgical report for my c-section, I was closed with a single-layer suture. Yes, the single-layer vs double-layer debate. I have already surmised from prior research that there really is no difference in the sutures when it comes to my ability to VBAC. However, and this is the irritating part, the OB I thought was proVBAC has thrown out such things as I must deliver by 38wks and absolutely NO single layer sutures or else no VBAC. (I’m currently searching for a new doctor!) I did my research and figured out the truth. Unfortunately, my husband (who is still apprehensive about my choice to VBAC) works in the same medical office as a computer tech. Today, they tried another tactic to scare us away from VBACing by saying that it was strange that my previous doc did a single layer suture on me but that it could be because my uterus was “too thin” and therefor VBAC would be too dangerous for me to risk. It really ticks me off that they targeted him with this “info” because it has only freaked him out more so. I swear I saw research opposing that info but heck if I can remember where. So, I thought I’d ask YOU because I trust that I’ll get an accurate answer. Thanks in advance, sorry if that was long-winded and thank you again for providing all of this fantastic info for us VBAC hopefuls.
I did respond to Kaite via email, but if anyone else would like to take a look at it, ICAN has a fabulous and well-researched article on the single-layer and double-layer suture issue. Check it out if you’re interested! (www.ican-online.org/vbac/the-suture-debate)