VBAC Book Review

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.

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