The cesarean rate in Alberta and even in Canada, at the moment, is around 15% higher than the WHO (World Health Organization) recommends. I can’t say I am surprised at this statement, since so many of the people I talk to lately have had cesareans. I’m included in this population, so I know how valuable they are when needed. At the same time, as a doula in Edmonton and an instructor of childbirth classes in Edmonton, I can’t help but feel sad that cesarean rates are so high and not really budging at the moment. Honestly, it’s likely due to the fact that most of the cesareans performed (76.1% in Alberta to be exact*) are repeat cesareans. WE NEED MORE VBACS!
Are VBACs actually safe?
VBAC is an abbreviation for Vaginal Birth After Cesarean, and contrary to many beliefs VBACs are actually more safe than cesareans. A cesarean carries the risk that any major surgery would carry – risk of blood clots, infection, nerve damage, damage to other organs, etc, and this is just the list of risks to the mother. In comparison, a vaginal birth only carries minor risks to the birthing person like perineal or pelvic floor trauma, and in a low-risk situation there are minimal risks to baby (I want to acknowledge that in some circumstances a vaginal birth is far more risky for the baby than a cesarean. Be sure to take a prenatal class to learn which situations these might be). The only added risk that comes with VBACs is an increased risk of uterine rupture (notice how I say increased… yes a uterus can rupture even without a scar from a previous surgery!). This risk, according to ACOG, is about a 0.2 to 1.5% chance. If you were to make a list of all of the risks of each, the surgery’s list would far outweigh the VBAC’s!
A trial of labour is valuable
When a woman attempts a vaginal birth, regardless of if she’s successful or not, it is called a trial of labour. When you think of what happens during a labour that is brought on naturally and is allowed to proceed even for a few hours, it makes sense why there are benefits to even trying for a VBAC. That hormone oxytocin which starts your labour and keeps it going is also responsible for the loving bond you develop with your baby and for letting down your breast milk when it comes time to feed. Additionally, natural oxytocin (the kind your own body produces, not the synthetic kind you get by the drip in a hospital) is linked to a lowered chance of postpartum mood disorders as it helps with stress and overall mental well-being. So, even a little bit of labour before a cesarean will get the natural oxytocin flowing and benefit you for years to come!
The added reward of finally getting your “big moment”
As a mother who has experienced cesarean birth personally, and a doula in Edmonton who has attended both cesarean and vaginal births, I know just as well as many that the moment you meet your baby isn’t quite the same in both scenarios. Some mothers are lucky to have care providers who are open to making their cesareans more “mother friendly” (allowing immediate skin-to-skin, breastfeeding in the OR, even dropping the drape to allow mom to watch the birth), but many of us experience the usual trends of not being able to have the Golden Hour and being separated from baby during the first moments of their life. Not gonna lie… this part really sucks. One beautiful part I’ve witness in vaginal births is that moment that baby comes out and immediately is placed on mom’s chest – the relief from mom that her hard work is over, the incredible sense of joy in getting to hold her little one for the first time, the pure, abundant love that the two share already. And if you think this is powerful with a mom who’s never had a cesarean, you should see what it’s like for a VBAC mom! Understanding how different the two moments are, the VBAC moms are just so proud of their happy ending. Witnessing this has moved me in ways that I’ve never before experienced.
So I’m obviously pro-VBAC, but I also understand that sometimes they aren’t the safest choice and sometimes your attempts don’t end up the way you plan. However, if you are a good candidate for a VBAC, even if it is unsuccessful, the attempt is a great choice for both you and your bundle. So if it’s an option for you, why not explore it?!
*Examining Caesarean Section Rates in Canada Using the Robson Classification System, www.semanticscholar.org