I am a new doula and have just met with my first Mom. This is a third baby and a scheduled c sec. This will be her third c sec. In speaking with her ,she decided to ask her O.B. for a VBAC. I thought that I would just be supportive of a repeat c sec. I did not try to change her mind at all. What kind of advice should I offer? , besides telling to speak withher O.B. Also what kind of support can I offer if she is to deliver by c sec. Remember this is my first actual delivery. Thanx Linda

-- Linda (Hulktuna@aol.com), March 21, 1999

Answers

A VBAC sounds like a wonderful idea! Statistically they are quite safe and you can feel comfortable supporting this woman 100% in her move towards a VBAC. I've supported women having a VBAC and you can be assured that it is very moving. Talk about a feeling of success! Suggestions, how about getting some books on VBAC for both you to read and her to borrow. You will feel more comfortable and knowledgeable and you can help her to feel that way too. Two books would be Silent Knife (you need to understand her before you loan her this book because it can seem a bit harsh) and the VBAC Companion. These are just 2 among quite a few good books on VBACs.

If she does have a c-section you can be with her as much as possible. Talk to her about her options during a c-section. If you don't know what these are do some asking and help her to feel like she will have some control. A c-section is still a birth and with your help it can be quite positive. With any luck you would be allowed in the OR and you could talk to her about what is happening. If she has a partner who will be going with the baby you can remain with her. This will comfort the partner as well as help the mom.

Have fun! This birth will be just like it's supposed to be. Your support will be a great help.

-- Kirsten Gerrish (kirsten@doula.net), March 23, 1999.

Does this mom really want to give birth vaginally? How do you feel about supporting her 100% in that endeavor if that's her deisre? Do you feel confident that she can do it? As doulas, we need to believe wholeheartedly in the safety of birth and the power of birthing women. I sense some uneasiness on your part. Help yourself get clear, read anything by Nancy Weiner-Cohen, and the book Reclaiming Birth. You're going to do wonderful, but it helps going into it feeling confident. As a doula, I try not to give advice. I really want the mother to find her own best answers. Ask her how she feels, what she wants, what she feels her chances are in achieving her goals, and how she percieves you in helping her. With love, Lesley

-- Lesley Nelson (lesley@doula.net), March 27, 1999.

I am about to go through doula training after hiring a wonderful doula for my third baby, born 3 months ago. My first two children were born by c sec, after very long, difficult labors. My memories of the surgeries still haunt me...I have never felt so out of control in my whole life. I desparately wanted a VBAC for this baby. I read Silent Knife, The Thinking Woman's Guide to a Better Birth, Active Birth and every article I could find. I went into labor 5 weeks early, labored for 30 hours with virtually no progress, and ended up with another c sec. But I do not feel the slightest bit disappointed, nor am I discouraged from trying a VBAC with the next baby, because I know I did everything possible. I know that simply having our doula in the room during the labor and the surgery gave me the confidence and support I needed to be able to look back positively on the whole birth experience.

She did not offer advice, even though I kept asking. She didn't say much, but I knew she was there. She held my hand and cried with me when I received news during labor that my grandfather had died. She filmed the c sec for us. She continually told me what a wonderful job I was doing and completely supported every decision we made. She brought me soft Kleenex to use instead of the cardboard stuff the hospital gives you. She cried happy tears with us after our daughter arrived safely. She was terrific, but she felt as though she didn't do anything. I am hopeful that I can become as helpful to women as she was to me.

I would advise your client to read, read, read. The more informed she feels, the easier it will be to make decisions, and to live with those decisions later. Make sure her birth plan includes detailed information about what she does and does NOT want if a c sec becomes necessary and that she discusses this fully with her doctor/midwife. And the sooner, the better...since I delvered 5 weeks early, I had not yet had the chance to go over my birth plan with my doctor. Luckily, the hospital was outstanding! They didn't strap my arms down and someone was right by my head telling me exactly what was going on though the entire surgery (two things I would demand if I had to have another c sec). Most importantly, believe in your ability to help her emotionally as well as physically. She will sense your confidence and it will give her strength. I would be happy to answer any other questions that come up as you work with this mom...good luck!

-- Melissa (missa0213@earthlink.net), September 05, 2000.

I would first look at the reason for her previous abdominal births (cesareans) and whether or not they were justified medically. My first daughter was born all naturally, but my second daughter was born thru my abdomen as I had placenta previa and had a severe hemmhorage. I of course would like an a non-interventive VBAC next time, but if there is a serious medical concern, it may not be possible. Of course, many cesareans are not justified and are done out of fear or convenience. Just do a lot of homework yourself and find out exactly why the surgery was performed and how it can be avoided. Good luck!!

-- Angie C (supportingu@canoemail.com), July 22, 2001.