 I am so excited to announce GentleBirth: Confident VBAC! As any of you who have read my blog in the past know, VBAC is near and dear to my heart. Women consider or pursue VBAC from a variety of past birth experiences and for a variety of reasons. They make different choices too, and should all be encouraged to make the right choices for their unique situation from a place of information.
There are so many misconceptions out there about vaginal birth after a cesarean, some even perpetuated (either intentionally or unintentionally) by care providers. 70-80% of women who pursue VBAC, will be successful and 99% of moms will have no issue with their scar in labor. The American College of Obstetrics and Gynecology’s, more commonly known as ACOG, guidelines say that VBAC is a reasonable option for most women with one scar and even for many women who have had two cesareans but fears, misinformation, and barriers persist. If you are considering a VBAC, this 4-hour course is for you! It covers recent research, risks/benefits, questions for your care provider, barriers, and how to increase you odds as well as a review of labor and comfort measures and finally, a hypnosis session at the end. But maybe more importantly, it also covers some of the emotional work that needs to happen as women face birth again. A one month subscription to the GentleBirth app to add to your birth toolbox, whether your ultimate decision is VBAC or not, as you prepare is also part of the registration fee. The first class will be offered on July 8th, 1-5pm in Fishers. Subsequent classes dates will be found on Fireweed Doula's class page and on my GentleBirth page where registration is handled. Please, if you or someone you know is considering a VBAC, this is a class not to miss! Next class will be February 3rd, 2018!!
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 I had the opportunity to sit down with a former client of mine, Casey Glassley, who had an amazing VBAC back in January. She was incredible and was willing to share a bit about what helped her prepare. Of particular interest to me was her fitness routine. I've noticed that fit, flexible women tend to, in general, have an easier time with birth. While prenatal yoga is awesome and I don't intend at all to minimize it's impact, pregnant women are capable of much more! (Always talk to your doctor, particularly while pregnant, before starting a new routine!) It was difficult to even find a photograph that showed a pregnant woman doing more than yoga.
You had a successful VBAC back in January, can you tell us a little bit about that? - My first child was born via scheduled c-section due to him being breech. When I was pregnant with my second child, I considered having a repeat c-section. After careful consideration and a lot of praying, I chose to try for a VBAC. I'm happy to say I had a successful VBAC with my daughter. My labor lasted over 24 hours and was the most mentally and physically challenged I have ever felt. However, with the help of my amazing husband, doula, and hospital staff, I was able to give birth to a beautiful, healthy baby girl without any medication. The recovery process was so much easier after the VBAC than it was after the c-section. I am so grateful I chose to try for the VBAC and feel blessed for such an amazing and empowering experience. How did you prepare? - The process for preparing for my VBAC involved a few different steps. I did a lot of research about child birth in general, including reading articles about VBAC vs.repeat c-sections and understanding the benefits and risks involved with each process. I attended a couple of meetings through ICAN of Greater Indianapolis to talk to others about their experiences. I also had a doula who provided support while I was pregnant and during labor and delivery. My physical preparation involved trying my best to eat a healthy diet and exercised consistently throughout my pregnancy. I enjoyed taking brisk walks, chasing after my active toddler, and attending barre classes a couple times per week. You did a barre class throughout your pregnancy, correct? What was it about that class that appealed to you? - Yes, I began taking barre classes back in 2013 and continued to take classes during both of my pregnancies. A variety of classes are offered where I attend. They range anywhere from high intensity intervals to toning to fun, dance-inspired cardio. All classes are both physically and mentally challenging. I love group exercise classes in general, but especially enjoy the atmosphere created in the barre classes. Instructors lead clients throughout the 50 minute class by providing guidance on proper form and motivating everyone to push themselves to their full potential. The combination of the upbeat music playing over the speakers and the dimly lit rooms create the perfect space for getting the best work out. It really allows you to get in the right mindset to connect with your body and mind while pushing out all other distractions from daily life. Where was it? Who was the instructor, etc? - The barre classes I take are offered at The Barre Code Indianapolis. It is located in Fishers, just off of Cumberland Road and 121st Street. The studio owner is Danielle Hacker. Not only does she run the studio while being a mom to a toddler and a baby, but she also instructs quite a few of the classes. Most of the class formats I was able to attend during my pregnancy were the Barre Code or Barre-dio classes offered during my lunch hour. The lovely ladies that instruct these classes are Lily Slonaker, Heather Pohland, Kimberly Moore, and Sarah Hetrick. These are just a few of the instructors I've had throughout the years. Each has their own personality and vibe that shines through in each class. What kind of modifications did you need to make as your pregnancy progressed? - I had to modify ab-work once I was no longer allowed to lay flat on my back in my second trimester. As my pregnancy progressed, I had to stop doing push ups and planks on the ground and just did them at the barre. The instructors were available before and after class to discuss ideas on different modifications I could use to help with anything I felt uncomfortable doing. During classes, they also give instructions on modifications that can be used if something just doesn't feel right. It is important to listen to your body and don't push yourself too hard. Have you started back? If so, what has it been like after? - Yes, I started back about ten weeks postpartum. I have only gone to a couple of classes and have been easing myself back into it. Since I took a few months off, my body needs some time to build back up to what it was once able to do. I continue to make modifications depending on how I feel that day. Ab exercises are probably the most difficult. I still feel a little sore where my scar is from my c-section with my first child. Overall, it feels great to be back taking classes and gives me more energy, which is needed now that I have two little ones who need me! Do you have any advice for women considering VBAC or looking at exercise options during pregnancy? - My advice is to make exercise a priority, especially while pregnant. It will make labor, delivery, and recovery much more manageable. Find something that you enjoy and you will be more likely to stick with it. For women considering VBAC, I encourage them to have a great support system, whether that be their husband, family member, doula, etc., who can provide encouragement while they are in labor.  If you first baby was a cesarean (or your second or third) and you are expecting again, you might find yourself faced with the decision to plan for a vaginal birth after a cesarean (VBAC) or schedule a repeat cesarean. For many women, whatever your choice, it’s an easy decision. For others, it might take more thought. Often a repeat cesarean is the default but it doesn’t have to be. Here are 5 reasons to plan a VBAC.
If you do choose to plan a VBAC, pick your care provider and place of birth carefully. Hire a doula like me! ETA: I serve Spokane, Coeur d'Alene, and the North Idaho area ;). Find a support group like ICAN. Know you aren’t alone and go for it!  I thought I'd try something new here. I've been reading so much for GentleBirth certification and now for the VBAC class I'm taking too, I thought I'd pass on my take on a valuable book available here.
Birth after Cesarean by Jenny Lesley and published by the volunteer group Association for improvements in the Maternity Services is a very encouraging and positive book about normal birth. It’s full of snippets from women and beautiful birth stories. It’s truly a book that understand the emotional reasons why women choose VBAC and fits with the GentleBirth philosophy. After an introductory chapter about why women choose VBAC and really why women should be encouraged in that direction, the rest of the book is all about the numbers and dispelling myths surrounding VBAC. Chapter 2 focuses on risks of cesareans and how those risks go up with each cesarean. Our maternity system seems to focus on the risk of VBAC and gloss over the risks of cesarean. This happens for a variety of reasons not the least of which is because doctors often feel more in control of a surgery than they do in a normal birth. The risk that’s most often talked about in VBAC is a uterine rupture. This is the focus of Chapter 3. This is a real risk but as is pointed out, a small one even with multiple scars and it’s not limited to women with surgical history. Some women wonder if they should even bother trying for a VBAC. They fear that they will just end up back in surgery. Chapter 4 addresses this. Most women who try for a VBAC get their VBAC. There are some situations where that doesn’t happen, of course, but even then, the repeat cesarean is often less traumatic because the birth woman knows what to expect and she was part of that decision. Chapter 5 weighs the risks and benefits of VBAC vs. an elective repeat cesarean. This is important. Risks on both side of this equation are low. There is not a black and white right answer for every woman. Every one needs to make a decision based on information and their own particular situation. There are real risks and benefits on both sides. Chapter 6 dispels the myths that are often brought up about why women might be told they “can’t” have a VBAC. As a mom who has had more than one cesarean, I particularly appreciated the positive portrayal of vaginal births after more than on cesarean. But really, even if you are told your baby is too big, you are too old, your baby is breech, it’s too soon, you have the wrong kind of scar, you’re having multiples, the numbers are still in your favor. Women have options! Chapters 7 & 8 are about planning for and making VBAC more likely and include beautiful birth stories including the author’s own HWBA3C (home water birth after 3 cesareans). Choosing care providers and birthing locations carefully and making sure the necessary support is in place increase women’s chances significantly. To birth normally, women need to be comfortable and relaxed in their chosen place of birth. No book on VBAC would be complete without information about repeat cesareans and this is the topic of Chapter 9. They are a reality and sometimes the solution. A positive birth is possible even in the event that a cesarean becomes the best option. I really enjoyed this book and I’ll be recommending it to women who are making decisions about future births after a cesarean. The one limitation is has is that it’s written primarily for the UK and the medical system there. The process of transferring care and moving from home to hospital just isn’t as fluid here as it is there and that needs to mentioned. |
Adina Nelson, CD(DONA)I am a birth & postpartum doula and chlidbirth educator practicing in North Idaho. 
She was there every step of the way for me and my husband...I thank Adina for everything she helped us with. She truly is a special person and we will be forever grateful for her! ~Erin Categories
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