While there are care providers who may mislead you about your risks, benefits, and options, this article is written assuming that you are meeting with an ethical care provider who supports the option of VBAC. Read more on how to find a providers like this.
If you are a good candidate for VBAC, the single most important decision you can make that will have the greatest impact on your chances of VBAC success is who you hire to attend your birth. This is why it’s important to interview several care providers and ask specific questions.
You will often receive different information when speaking to the doctor or midwife directly than you would from the people who answer their phones. When calling their office, be sure to state that you want to have a consultation. Ideally, you want to meet in an office, not in an exam room.
Questions You Should Ask
These questions are relevant to all birthing people, VBAC or not.
I think the most important ones relate to going overdue and suspecting a big baby, so I recommend asking those first.
If you want to learn more, check out my workshop “The Truth About VBAC.” There, I translate the evidence on each question so you know how to decode the provider’s response as well as red flags to avoid. In the workshop, I also provide an extensive list of questions for out-of-hospital providers.
What is your philosophy on planned VBACs?
What is your philosophy on planned VBACs going past 40 weeks?
What is your philosophy on suspected “big babies” (macrosomia) among planned VBACs?
How many VBACs have you attended?
Of the last 10 planned VBACs you attended, how many had a VBAC?
What is your philosophy on inducing VBACs?
What is your philosophy on monitoring planned VBACs?
Does your hospital have telemetry (wireless monitoring)? How often is it used?
What is your philosophy on waters being broken for more than 24 hours?
How long do you think it’s safe for VBACs to labor?
What is your philosophy on epidurals in planned VBACs?
What are your standing orders for planned VBACs and do they differ from your standing orders for first time parents?
How does your on-call schedule work?
What is your cesarean rate?
What are their thoughts on movement during labor and delivery positions?
What is your philosophy on IV or saline lock?
Do you offer family-friendly cesareans?
In the event that the baby isn’t head down, do they manually turn babies? (This is called an external cephalic version or ECV.)
Do they attend vaginal breech births? If not, can they refer you to a provider who does?
Do they attend vaginal twin VBACs?
Do you attend VBAC after 2 cesareans?
Do they attend VBACs with a classical (high vertical), T, or J scar?
Do they attend VBACs with a low vertical or unknown scar?
You might have to interview several providers until you find one who is truly supportive of VBAC.
If you do find such a provider, refer all your friends, VBAC or not, to this provider so that they can reap the benefit of someone who supports non-interventive birth!
I really think that true change won’t occur in the medical community in terms of supporting natural non-interventive birth and VBAC until the OBs and hospitals see their revenue decrease.
For this reason, we all need to support OBs, midwives, and hospitals that support VBAC.