A
Bit About VBAC
by Annemarie van Oploo, BScN, CD (DONA)
In 1990, Judy Cochrane, the founder of
the Edmonton VBAC (vaginal birth after Caesarean) Support
Association, came to speak at a seminar during my BScN student
days. Her talk, along with my clinical experiences, greatly
influenced my decision to birth both my children at home
with midwives. This was during a time of very high Caesarean
rates, and a time when VBAC was not yet as accepted as it
is today. Since then, we have seen the Caesarean rate drop
and VBAC become more popular. Unfortunately, the Caesarean
rate is on the rise again. In 2001, almost 22% of births
were by Caesarean section, whereas in 1999, just under 19%
were Caesareans in Edmonton hospitals. Moreover, there is
still a persistent view in the medical community that having
a VBAC is high-risk. The VBAC success rate in the Edmonton
hospitals continues to hover around 75%. All this despite
medical evidence that VBAC is safer than Caesarean, and that
an overall Caesarean section rate of over 7% shows no better
outcomes for mothers or babies.
Caesarean section rates are lower and VBAC
success under midwifery care is substantially higher than
under medical care; why is that? Perhaps it is because the
care given by midwives is more wholistic, taking into account
not just the physiological, but also the psychological and
spiritual aspects of birth, recognizing it as a rite of passage
and a good outcome to be more than a live mom and baby. Midwives
also treat birth as a natural process, not a medical condition
and their philosophy fosters trust in the birthing process.
The women who choose midwifery care tend to be more motivated
(they must be because they pay for the care out-of-pocket!),
and they get the support from their midwife to build greater
confidence and trust in themselves, rather than in technological
interventions. For women planning VBAC this is extremely
important.
The Edmonton VBAC Support Association is
another resource where women planning a VBAC will find valuable
information and the kind of support to become more confident,
gain trust in themselves and in birth. In November this year,
I attended my first meeting of the Edmonton VBAC Support
Association as a certified doula to see what the group could
offer my VBAC clients. The group is facilitated by Cathy
Pearson and meets at her home monthly (phone 4697840 for
more info). The meetings are fairly informal, allowing participants
to voice their needs and get support from others in the group.
There were experienced VBAC moms, expectant moms planning
VBAC, and doulas in attendance the night I went. The association
also has a library of books, journals, and research on Caesareans
and VBAC, does telephone counselling, and mails out information
packages. The conversation in the room on the evening I attended
provided much validation of midwifery care as a safe alternative
to medical care. Many of the women in attendance had had
successful VBAC outcomes with midwifery care after having
one or more Caesareans under medical care, and one of the
expectant moms had just hired a midwife for her planned VBAC.
I encourage not only those who are planning VBAC (under either
midwifery or medical care), or those who have had a VBAC
to attend, but all women and their partners who have experienced
a Caesarean, and anyone working with expectant parents to
sit in on a meeting. You will be glad you did.
Article from Fall 2003 issue of Birth
Issues , published by ASAC in Edmonton .
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