preparing for VBAC pre-conception?

[mamacolleen]

I had an unwanted c/s last year with my first babe and am starting to think about wanting to get pregnant again and attempt an HBAC this time. I had planned on a home birth with DD and did have a good midwife and did a lot of research ahead of time... but still managed to receive some bad advice during labour and had the "bad luck" to go to 42 weeks with no sign of spontaneous labour. In Ontario, the powers that be have decided that you no longer get to have a home birth at 42 weeks and beyond, so against my better judgment, I agreed to a medical induction and things spiraled downward from there. There are lots that I will be doing differently this time round but I am still really scared that I'll end up with another section and the thought is nearly unbearable.

I'm wondering if there's anything in particular I can or should be doing now, before I get pregnant, to prepare my body and emotions to handle an HBAC. The earliest I would be getting pregnant would be about 16 months post-c/s. Is this a safe enough time frame? I saw a naturopath/accupuncturist during pregnancy and while attempting conception with DD and hope to get to see her again this time, although it's harder to make it to regular appointments with a LO. I'm thinking I should probably start eating healthier again. I'm also concerned, and don't know if I should be, about my abdomen.... the muscles were really stretched out during pregnancy (gained 60lbs) and are still really flabby.... this might be a really stupid question but does that indicate anything about the health of the organs, including uterus?

I plan to see a chiropractor during this pregnancy but should I start seeing her regularly now pre-conception? Are there any books that you would recommend reading to get me emotionally prepared? In ways, I feel as if I haven't healed yet from my c/s and I'm worried that this will be a barrier to a successful VBAC, but I don't know how to heal from the section without having a VBAC.

Also, there is a reasonable likelihood that I might get pregnant with twins next time. I had a really difficult time conceiving DD and she was conceived finally through IVF. We have several frozen embryo's that we plan on transferring to try and get pregnant again. They are frozen in groups of 2 so that is the number we will transfer. I am terrified that both will implant and my chances of VBAC are then nil and the thought of another c/s is really really terrible. Has anyone successfully VBACed with twins? I know it's ahead of the game because I'm not pregnant yet, but I really have to be mentally prepared for the possibility. It feels like I'm caught in a terrible catch-22.

Thanks in advance for your advice.

[AustinMom]

Ok, lots you asked, so I have a feeling this is going to be long....but here it goes....

1) YES, I believe the best thing you can do now is heal from your previous birth. No matter if you have another baby or not, another CS or not, a VBAC or not, HBAC or not, this birth will always be part of your life and part of the mother and woman you are. Trust me, you don't want to work through all this pregnant, hormones don't help much with that. I read the book Rebounding From Childbirth towards Emotional Recovery and it was such a wonderful starting point for my healing. Also, an Easier CHildbirth is good to go over your birth inventory. Maybe see birth therapist as well. JOIN ICAN. Find a local group, and there is tons of support there, advice, and just women to get in contact with to help them heal, and heal together.

2)As far as timing, it's 'recommended' to have 18 months between births for a VBAC. Some care providers prefer a minimum of of 12 months between births. So in your case I wouldn't be worried about that. Even with a stretched uterus and even if you have twins. You may want to look into Arvigo Massage. It's a Mayan Abdominal massage that helps to align your uterus and other organs and your pelvis and ligaments in it as well. Our MW is certified in it, and it's been wonderful learning about it and going through it. Chiro care is always great no matter your sex, health, pregnant or not.

3)don't know much about fertility and twins, except twins are obviously more likely with IVF than without. Personally, I'd still VBAC if I was carrying twins, but I think you may have a hard time finding a CP who supports you openly and fully.

4)You can heal, I can't stress that enough. It's not necessarily about avoiding another CS, but it's more about avoiding another traumatic birth and that can be done with a Cesarean Birth. So, I'd look into interviewing multiple Midwives and Doulas before choosing one and that being a key part in your interview, how do they avoid traumatic births for moms like you.

Much Love!

[MsBlack]

Really, it's a good idea for any woman to prepare herself physically and otherwise for pregnancy and birth. You can think of this for yourself in just the same way as any woman might think of it: being at (or close to) optimum health in all ways is a really good idea! Mother's good health is a strong factor in serving baby's health, and serving a healthy, normal labor/birth.

So, like any other woman planning to have a baby (or twins!), YES, eat right and otherwise get fit--which means, if you don't already exercise regularly then start now. I can't emphasize enough the value of regular exercise in promoting good physical *and* mental health--we were made to move, and regular movement serves the better functioning of every one of our systems, including 'mood and emotional well-being'. You can't exactly 'exercise the uterus', but exercising the rest of your body, with attention to Core/Pelvic Floor, will be very very good for your uterus in 2 main ways: a strong core helps the uterus to gain/maintain proper position along with other pelvic organs. And the enhanced circulation of exercising will have a positive impact on your fullest possible healing of your uterus.

As for emotional healing--well, taking care of yourself with food and exercise will support that. But I strongly recommend that you find ICAN (international cesarian awareness network) and follow their recommendations for healing emotionally and becoming as prepared as possible for vbac emotionally/mentally.

ican-online.org

Good Luck and Healthy CHoices to you!