What Questions to Ask Your Provider to See if They Are VBAC-Friendly
If you’re considering a Vaginal Birth After Cesarean (VBAC), one of the most important decisions you’ll make is choosing a healthcare provider who is supportive and knowledgeable about VBAC. Not all providers are comfortable with or supportive of VBAC, so it’s essential to ask the right questions during your prenatal appointments to ensure you’re working with someone who aligns with your birth preferences and values. In this blog, we’ll cover key questions to ask your provider to determine if they are VBAC-friendly and how to evaluate their responses.
1. “What is your experience with VBACs?”
Why This Question Matters:
Experience matters when it comes to VBAC. Providers with experience in supporting VBACs are more likely to have a clear understanding of the process, the risks, and the support required for a successful vaginal birth after a C-section. You want a provider who is confident and knowledgeable about VBAC and has experience with successful outcomes.
What to Look For:
• Providers should be comfortable discussing their VBAC success rates and have positive experiences with VBAC.
• If they have supported multiple VBACs and are familiar with handling the potential complications, that’s a good sign.
• Look for a provider who is open to discussing your specific situation and who will take your personal health history into account.
2. “What are the criteria for being a good candidate for VBAC?”
Why This Question Matters:
Not every woman is a candidate for VBAC, so it’s important to understand the factors that affect your eligibility. Providers who are VBAC-friendly will have a clear understanding of the factors that increase the chances of a successful VBAC.
What to Look For:
• A VBAC-friendly provider will discuss factors such as the type of incision from your previous C-section (e.g., low transverse vs. classical), your overall health, the reason for your previous C-section, and how far apart your pregnancies are.
• They should also take into account your current health, your baby’s health, and your mental readiness for a VBAC attempt.
3. “What are the risks of VBAC and how do you manage them?”
Why This Question Matters:
Understanding the risks associated with VBAC is crucial, and a supportive provider will be transparent about the potential complications while offering solutions and strategies for managing them. Uterine rupture, while rare, is the most serious risk associated with VBAC, and it’s essential to have a provider who is proactive in mitigating risks.
What to Look For:
• A VBAC-friendly provider will openly discuss the risks, including uterine rupture, but will also provide statistics and evidence-based information.
• They should have a clear plan in place to monitor you during labor (e.g., continuous fetal monitoring, careful observation of contractions) and how to handle potential complications.
• Providers should make you feel informed and empowered, not fearful, about the potential risks.
4. “How do you support laboring women who are attempting a VBAC?”
Why This Question Matters:
A VBAC-friendly provider should be committed to supporting your birth preferences, especially during labor. This question helps determine if your provider’s approach aligns with your birth goals, whether that includes the freedom to move around during labor, the use of natural pain relief methods, or minimal medical interventions.
What to Look For:
• A provider who supports VBAC should be open to working with you to develop a birth plan that includes your preferences for labor, such as staying active, using natural pain management, and avoiding unnecessary interventions.
• They should be willing to allow labor to progress naturally, avoiding artificial methods like Pitocin unless medically necessary.
• A VBAC-friendly provider should encourage a supportive birth environment, including a team that understands your goals and provides emotional support.
5. “What is your policy on continuous fetal monitoring during labor?”
Why This Question Matters:
Continuous fetal monitoring is often recommended for VBAC patients to monitor the baby’s heart rate and detect potential complications early. However, some women feel that continuous monitoring limits their mobility during labor. It’s important to understand how your provider plans to balance safety with your desire for an active labor experience.
What to Look For:
• A VBAC-friendly provider should discuss how fetal monitoring will be used to ensure your baby’s safety, but should also respect your preferences regarding mobility during labor.
• Some providers may offer intermittent monitoring as an alternative to continuous monitoring, allowing for more freedom during labor.
6. “What is your policy on repeat C-sections?”
Why This Question Matters:
Some providers may recommend a repeat C-section without fully discussing your options or providing a clear understanding of the risks and benefits. It’s important to know whether your provider is truly supportive of VBAC or if they are more likely to recommend a repeat C-section at the first sign of complications.
What to Look For:
• A VBAC-friendly provider will discuss VBAC as a viable option, but will not pressure you into a repeat C-section unless it is medically necessary.
• They should emphasize the importance of patient autonomy and support your decision if you choose to attempt a VBAC, while providing you with all the relevant information.
7. “What happens if I go into labor and it doesn’t progress as expected?”
Why This Question Matters:
Labor can be unpredictable, and one of the main concerns with VBAC is whether labor will progress as expected. If labor stalls or complications arise, it’s essential to know how your provider will handle the situation.
What to Look For:
• A supportive provider will have a clear plan in place if labor doesn’t progress, whether that includes offering interventions that are in line with your preferences or recommending a C-section only when it is absolutely necessary.
• They should be willing to work with you on different options to help labor progress naturally (e.g., walking, changing positions, water immersion).
8. “How do you feel about doulas and midwives being involved in the birth process?”
Why This Question Matters:
The support of a doula or midwife can be invaluable during a VBAC, especially in terms of emotional support and helping you navigate the challenges of labor. A VBAC-friendly provider should be open to working with other professionals, including doulas and midwives, to provide comprehensive care.
What to Look For:
• A VBAC-friendly provider will be open to having a doula or midwife as part of your birth team and will work with them to ensure a supportive and positive birth experience.
• They should understand the value of additional support and be willing to collaborate with your chosen team.
9. “What is your VBAC success rate?”
Why This Question Matters:
Understanding the provider’s success rate with VBAC can give you an idea of their experience and expertise in supporting women through the process. A high success rate may indicate a provider who is confident in managing VBACs and who has developed strategies for minimizing risks.
What to Look For:
• Keep in mind that VBAC success rates can vary based on your health history, the type of C-section incision, and other factors. However, a VBAC-friendly provider should be willing to share their success rate and discuss the factors that influence it.
• They should also explain that individual outcomes may differ, and their goal is to help you have the safest, most positive experience possible.
10. “How do you handle emergencies during VBAC labor?”
Why This Question Matters:
In rare cases, VBAC can lead to complications like uterine rupture. It’s important to know that your provider has a plan for emergencies and is prepared to act quickly to ensure the safety of both you and your baby.
What to Look For:
• A VBAC-friendly provider should be prepared for emergencies and have a protocol in place for handling any complications that may arise, including quick access to a C-section if necessary.
• They should make you feel confident that, while they support VBAC, they have the experience and resources to manage any emergencies that occur during labor.
Conclusion: Finding the Right VBAC Provider
Choosing the right healthcare provider is crucial when planning a VBAC. The questions outlined above will help you evaluate whether your provider is truly VBAC-friendly and whether their approach aligns with your birth goals. Ultimately, a VBAC-friendly provider should be supportive, knowledgeable, and committed to providing the best possible care while respecting your preferences. Be sure to take your time, ask plenty of questions, and choose a provider who will empower you to make the best decisions for your health and your baby’s health.
-Dr.SA
