Insider’s Tip on How to Have a Great VBAC

The following is a post I sent to the ICAN (International Cesarean Awareness
Network) list. It is very, very important information for ALL birthing women
and can make all the difference in a VBAC birth. Read it carefully, copy it,
send it to your clients. One of the ICAN women replies to my post at the
end:

Subject: ICAN: Tip for birth

I wanted to write to those of you who are pregnant to tell you something
that has been running through my mind all day about how you can be
successful with your VBAC births. Many births begin in the night…. woman
will get up to pee, feel her membranes release and then an hour later begin
having sensations fifteen minutes apart. Because we think of birth as a
family/couple experience, most women will wake up their husbands to tell
them something’s starting and then, probably because we all hope we’ll be
the 1 in 10,000 women who don’t experience any pain, we start getting the
birth supplies organized, fill up the water tub, etc. I have seen so many
births that take days and days of prodromal (under 3 cms. dilation)
sensations and they usually begin this way. The couple distracts themselves
in that early critical time when the pituitary gland is beginning to put out
oxytocin to dilate the cervix. Turning on the light, causes inhibition of
the oxytocin release. Many couples don’t call their midwives until they have
sensations coming 5 minutes apart at 7:00 a.m. but they’ve been up since
midnight timing every one of the early sensations. If they had called their
midwife at midnight she would have said “Turn off the light and let your
husband sleep as much as possible through the night. You, stay dark and
quiet. Take a bath with a candle if it helps and call me back when you think
I should come over.”

That first night can make all the difference and yet so many couples act
like it’s a party and don’t realize they are sabotaging their births right
at the beginning. Staying up all night in the early part does two things–it
throws off the body clock that controls sleep and waking and confuses the
brain AND it inhibits the release of the very hormone you need to dilate
effectively. You know that it can take days to recover after a night of
partying or after working a graveyard shift. Don’t start your birth with
that kind of stress on your hormone system.

When you begin to have sensations, I urge you to ignore it as long as you
possibly can. Don’t tell anyone. Have a “secret sensation time” with your
unborn baby and get in as dark a space as you can. Minimize what is
happening with your husband, family and the birth attendants. What would you
rather have–a big, long dramatic birth story to tell everyone or a really
smooth birth? You do have a say over your hormone activity. Help your
pituitary gland secrete oxytocin to open your cervix by being in a dark,
quiet room with your eyes closed. Gloria Lemay, Vancouver

Pam wrote:

“I really loved what Gloria had to say here. For me, it’s all about what
went wrong at my first birth (stayed up all night timing
contractions…stupid, stupid, stupid, and was totally wiped out by morning),
and could have been improved at the second, when I lacked a place to stay
dark and quiet. I printed it out for my husband to read, and am putting it in my
file of important things to remember when labor starts, within the next
couple of weeks.”

About gloria

I live and work in Vancouver BC Canada. I've been in the childbirth business for 30 years. I teach midwifery and doula courses both online and in person.
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20 Responses to Insider’s Tip on How to Have a Great VBAC

  1. Sarah says:

    Great tips, Gloria. I am one who has labored prodromally for all three of my births (so far). I do agree with the gist of what you are saying, but at some point, when a woman labors this way, being “dark” and “quiet” doesn’t always solve the exhaustion problem.

    I am thinking specifically of my first birth, where I labored two days and (hard labor) nights (my labor “started” in the morning, though), and even did the things you suggest above both nights (didn’t wake DH, slept through, then between ctx, till it got overwhelming and needed to work with them, still letting DH sleep) yet, I feel as though my being alone so much and downplaying it actually contributed to my emotional exhaustion at the end. And, far from being overly dramatic, the hospital staff had no idea I had been laboring for so long (we arrived a few hours before she was born), and I think the lack of them knowing/believing that (the nurse would not let me say that labor started two days prior) contributed to the difficulty of that labor. To them, I (a primip–lucky!!) just waltzed in at 6 cm and proceeded to push out a baby, only 10 hours from the onset of contractions (again, what the nurse would take as an acceptable time frame–a completely manipulated number).

    Though I think it’s generally great advice to downplay/not pay attention too soon and the like, in my second and third births, I found it reaffirming to acknowledge that labor was happening. To give myself permission to take comfort measures I would have otherwise saved for “active labor” if I were trying to ignore it. My second birth was so much “easier” than my first, and I believe some of that had to do with my state of mind, acknowledging that my body really was doing something in those weeks of pre-labor, and just letting it do its crazy thing.

    Is it your opinion that prodromal (or prolonged) labor is always a result of adrenaline or fear? I know many people believe that, but my labors are an exeption to that idea, because I truly enjoy birth and am not an over-excited laboring type (I can really relax, and am very low-key on the drama). I really think my body just needs to warm up that way, and I’m okay with it.

    Again, I agree with you about 99%. So true what you’re saying. But part of me wonders what my problem was–like I did something wrong to make myself have prodromal labor. Then I think by that standard, all the precipitous laborers must be doing the “right” stuff, and that just seems like too much of a generality.

    My providers do not necessarily know I labor this way, since we now call my home birth midwife when I am HAVING the baby. I wouldn’t know when to call otherwise–it could be days or weeks before labor becomes birth.

    I’d really like to know more of your thoughts on this subject, with your years of experience. Please expound on what you’ve found!

    P.S. Sorry so long; I plan to bookmark this post for my students!

  2. Christine says:

    This makes so much sense! With my last baby, I had prodormal labor for two weeks. I practice hynobirthing and finally determined that I could either be in a relaxed state OR time my contrax. So I decided to quit worrying if THIS was it, and just let things happen. My body labored through the night — while I slept. And the next day we BARELY made it to the hospital.

  3. Jennifer says:

    Iam so thrilled to have read your article!!! I’m now pregnant with my 5th baby. I’m planning a home birth, low lights, tub /water tub. I have had 4 c-sections all truly not needed. Due to exhaustion/light drama during the night, going to a very medically interventive hospital and I gave into the staff out of sheer exhaustion.
    In regards to woman laboring at night (so dead on), all of my labors but one proceeded at night. Thank you and please continue to post articles for VBAC’ING MAMMAS!!! More articles greatly needed to wake up our population!

  4. Saylor says:

    Thank you so much for the VBAC advice! I never would have done this if you had not suggested it. At the first twinge, I would have been so excited and woken up my husband to start timing them. I didn’t realize darkness prevented oxytocin release. Even after we get to the birthing center, I’ll make sure they keep the lights low. Keep the VBAC advice coming!

  5. Jerri says:

    I just wanted to say the tips make a lot of sense. I remember at my second hbac (after four sections) how I thought I must be so far along only to find out I did not even dilate. After the midwife check and inform me how far I really was…I almost got upset but then I stopped and said to myself “Im going to bed.” I went to bed and I woke up the next morning in transition and had the baby within two hours of waking up. I was so caught off guard I ended up having the baby on the bathroom floor instead of the birth pool. I really thought I had all day to hunker down and wait for the baby to come. I realize resting well really made a big difference. As for the missed water birth…I wouldnt change it if I had a choice.
    —Jerri

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  7. Van says:

    Great post Gloria.
    It seems that birth stories that include “natural” induction, lots of energy expended early with long walks, lots of excitement & getting others involved quickly often travel a harder road.
    Rest, conserve energy, & get as comfortable as possible always seems to be the best course.

    • Cepot says:

      Ever notice how much emphasis our society places on weddings and everything that goes into them? Same with all the material objects that every baby needs? I wonder how much things would change if the media placed more emphasis on the good it would do children and families to have a good start in life by investing in birth? Then again, that wouldn’t bring in much advertising revenue.[]

      Twitter: Reply:May 2nd, 2011 at 10:59 You’re right, sadly money seems to be the motivation.[]

  8. Amy Gow says:

    Great post Gloria….I find, especially with first time moms, this can be hard advice to follow. I’ll be sharing this with all my clients, thanks!

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  10. Melissa Cline says:

    I let my husband sleep! But I did stay up timing sensations, and I did call the midwife as soon as it was 7am. I guess that’s a universal “decent time” to start calling, eh? Ha ha! 18 hours later I was about out of gas and wishing for that sleep I should have gotten! Plus I’d have had a lot more pleasant 2nd stage if I’d have read pushing for primips before labor.
    I’ll have so many more good ideas for this next birth (and same midwife, loved your thoughts about the midwife who does the first hard birth, gets me tickled that my lovely Mary Anne will get to be at the 2nd–she worked so hard at my first) :) Thanks for sharing the hard-won wisdom of experience.

  11. Jessiebella says:

    Wish I had’ve followed this advice for my two births

  12. Pingback: Insider’s Tip on How to have a Great VBAC | Blessed be the Belly

  13. Courtney says:

    This is awesome! I just had an “accidentally”-unassisted home VBAC with an inverted-t incision. I kind of instinctively did exactly what’s written in this article when I felt contractions begin at midnight new year’s eve… didn’t tell a…nyone until 9am when my water broke. Baby came a half hour later, in my bathroom, caught by my husband and I. It was amazing! And I know it would not have gone nearly as well had I told anyone something was starting to happen at midnight. And this birth was SO much more than just an amazing birth… it has already, three days later, helped me to see my son’s upcoming fourth birthday (in four days, the anniversary of my inverted-t, extremely traumatic c-section) in a very positive way, for the first time since his birth. I feel I had to experience the trauma in order to truly and fully appreciate how empowering and beyond amazing birth CAN be. My son’s c-section lead me to research, obsessively, birth, infant health, and when I became pregnant again, pregnancy and all that I could do, within my control, to lead to a physically and emotionally healthy full term pregnancy and delivery. I feel so incredibly empowered and completely healed, emotionally and physically, from my traumatic birth experience. My birthing experience is complete, after three very different births, and it would not have felt complete or resolved without achieving my unassisted-home VBAC!

  14. Sound and wise advice for all births Gloria.
    Many blessings to you.

  15. KeeKee says:

    This is awesome! I knew I was in labor around 5am and continued to go about my regular day: I went to work.
    I told a few people I was in labor, but I just went on about my regular business as usual. I should have kept this up instead of going ot the doc and expecting the medical “experts” to tell me what I already knew. For the next birth, I’ll know what to do.

  16. Veronica Clouse says:

    I do so love the ladies who come into the hospital 6-10 cm and just needing help to ensure a healthy delivery and to have the safety of nursing staff for babies or if the mother needs help. I have assisted physicians with vaginal deliveries and c/section deliveries. Most go great/ and by great I mean a healthy mom and a healthy baby go home from the hospital. I have seen VBAC deliveries go great. I have also assisted on a few cases where during a c/section the previous scar was so thin that you could see the baby. I have also seen when the only thing holding the baby in the uterus was the bag of water. How do we know ahead of time who needs the repeat c/section and who can safely VBAC******I truly believe that God has his hands and eyes on us, protecting both patients and the medical staff. We really do want you to have the very best experience that you can and a safe delivery. I can tell you stories that are awful and sad that are very happy and healthy, from every kind of delivery. If we did not have to worry about being to blame in a lawsuit years down the road we could be more free to use less or no monitoring, but since we have it and know how to use it we have to do so. If a baby came out deprived of oxygen with problems that we would have seen with monitoring that was available to us and we had the knowledge to use, we would be held liable.(not only legally but emotionally, working with women who are loosing a child or loses a child in delivery really has a great stress that we take home with us and we live with that)

    This is why I believe if you really want to have a baby naturally, please hire someone to be at home with you, someone to help make the decisions. But coming to the hospital and asking us to not use all the precautions that we know to do and are trained to do is putting us in a very hard place. The hospital has protocols for every thing we do from the moment you walk in to the moment you leave. I hope you all understand what I mean. Like you would not take your child to the doctor and they tell you he needs an antibiotic and you say no i think tylenol and motrin will fix it…..no you would have already tried motrin and tylenol and you would be going to them for additional help. Thats what I see the hospital doing for labor and delivery. I do love seeing all the happy stories and I am friends with many of my families that I have helped deliver. I hope to help with thousands more mommas and babies before Im finished, God willing.
    Veronica Clouse RN Labor and Delivery Nurse

  17. Kirsty MacDonald says:

    Hi Gloria,

    My question is how do you know when it’s just a long labour and when there is a problem. I never thought I would have a cesarean. First child, very informed, very capable Homebirth midwives. I went into labour, regular contractions every four minutes or so at 4.30 am. Woke my hubby to help me with my tens machine then sent him back to bed. Called my midwife at 5.30 because I had some bleeding and wanted to know if it was normal. She said she would come over. Also called my mother because she had to come from an hour away. Room was dark, everything ready, was just labouring away quite happily. When my midwife got there I expected she would tell me it was still early days and say she would go home and to get some rest but now, she stayed. She didn’t mention prodromal labour at all and I knew what that was so I must have been in active labour. She recommended I get into the birth pool. It was warm and quiet, I breathed, moved instinctually , relaxed between contractions. Things slowed down so I got out of the pool and slept for half an hour. then things got going again. I was experiencing a persistent pain in my right hip which would get worse on a contraction, baby’s heart rate was great throughout though and this continued more
    or less till the next morning, throughout the day and into the next night. By the second night at 4.30 am I was barely two cm dilated. My choice was then to transfer for pain relief and sleep and try for a vagunal birth in hospital or go it alone. Basically no choice at all really. I felt ok still, was still working with contractions and handling it ok, conserving energy but did not want to be left with no medical support. The midwives thought I would not be able to push if I did eventually dilate. Well after a smooth transfer, waters broken, failed epidural, pain I could no longer handle and with my little angel pooing and his heart rate starting to deviate from normal i was examined and no
    further dilation. So that meant now a cesarean. The surgeon found out his head was coming through sideways and was very jammed . This had not shown up in ultrasound on arrival. There had been fluid at the top of his head and they thought this was what was preventing dilation so they ruptured my membranes. I now know that the only chance he had to right himself was that pocket of fluid and possibly some spinning babies techniques from me but how was I to know what to do when the people around me didn’t know he was in that position? I didn’t know? So I guess my question Gloria is how do you know when it’s just a long labour and when something is wrong? My midwives could fell my boy was head down and anterior but he was really too low in my pelvis to see what position his head was in and the ultrasound didn’t pick it up. I had also been labouring so long there was free fluid in my abdomen which they tell me is a bad sign that my uterus was getting exhausted although I can’t seem to find any information on it. I was fortunate, I had a gentle cesarean, low lights, delayed cord clamping, our own music, immediate skin to skin contact and he was either with me or my husband for the whole day until later that night when the nurse took him because he was bringing up fluid and choking and I couldn’t lift him up to help him breath. That was a mixture of fortuitous pre planning on my part and good decisions at the time of transfer as we decided not to go to the hospital I had originally been put with as well as a bit of luck that the OB does gentle. C sections as a matter of course. Thankfully it never got to an emergency situation because we transferred in good time. The only thing I would change if I could was the ARM because I didn’t want it. My instinct was not to but they said I could not have an epidural unless I had it and my midwife who came with me and I trusted, said it looked like the pocket of fluid was what was preventing his head engaging and dilation from happening. She said my best chance of a vaginal delivery was rupturing the membranes to see if that would get me to dilate. I could see the logic so I agreed reluctantly. I had no idea that his head could be malpresented and that this wouldn’t show up on an ultrasound? I agree Gloria that by keeping your early labour signs to yourself you could be buying yourself more time and if contractions are all over the place, not in. A rhythm or not particularly strong then I can see the sense, but in my case, would more time have helped or put myself and my baby in danger? I walked, squatted, relaxed in the birth pool, spent lots of time, leaning forward, hands and knees. I worked with my labour, ate, slept. I have wracked my brains for what I could have done differently to have prevented this but the fact is, my baby had a problem coming out that no one knew about until he came out, until he was cut out, and yet I still want to cry when I think about how it turned out, how I couldn’t birth my baby the way I wanted to, gently, into water, into my waiting hands. I have now lost faith in my body’s ability to birth and I am fearful of the risks of a HBAC if I have another baby. How do I get that faith back? As much as I desperately want to experience birth the way I wanted to, the way I thought I would, I am afraid I may not be capable of it. what advice do you have for me Gloria assuming I go ahead and plan a HBAC?

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