All women should write a birth plan. Your plan expresses your wishes for your labor, birth and the time immediately following the birth. Having a well written plan makes it easier for your support people and medical personnel to carry out your wishes. There are special considerations in a VBAC birth that make a good plan even more valuable.
Medical interventions are sometimes instituted sooner in a VBAC situation than in a typical vaginal delivery. The concern for complications can cause some doctors to jump the gun in suggesting interventions or a repeat c section. A well thought out plan can help prevent this from happening.
Consider each phase of labor, from early labor until the beginning of the pushing stage. What do you want in each part of labor? Spell out your wishes for natural pain relief methods. Include information about your preferences for pain relief medications or your desire to avoid them.
Consider the medical interventions typically used in hospital birth settings. One to consider is continuous fetal monitoring. Some doctors like to do this as a matter of standard procedure. They feel more comfortable with a clear picture of the baby that continuous monitoring offers.
While this method may be most convenient for the doctor, it is not always what is best for you. The freedom of movement in labor can help keep your labor progressing. Gravity helps the baby move into position and make the trip through the birth canal. The flat on your back while strapped to monitors position can interfere with your progress. Ask for intermittent monitoring at certain intervals.
A large number of hospitals hook all pregnant women up to an IV as soon as they walk in the door. Like continuous monitoring, the IV can restrict the movement and make the mother more uncomfortable. Talk to your doctor about skipping or at least delaying the IV. One reason given for use of an IV is dehydration. Stay well hydrated in the early stages of labor if you want to try to avoid an IV.
While your overall plan will be written with a vaginal delivery in mind, it is a good idea to include a section on your wishes should you need a c section. The majority of women who attempt a VBAC delivery are successful, but this is not always the case. In a certain number of cases, a repeat c section may be needed. It is a good idea to prepare for that possibility.
Include a statement spelling out your desire to avoid a repeat c section. You can request a second opinion should the doctor decide that a c section would be in the best interests of you and the baby.
Other things to include would be your desire to have your support people present for the c section, having the curtain lowered for the actual birth and having the baby handed to your partner immediately after the birth.
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