Hi my name is Amy, and I’m a student midwife. Growing up I often spent a lot of time on my grandparent’s farm in a country town, surrounded by animals and their young.  With my mother being a nurse, and my father a social worker, my four siblings and I were almost was handed the passion to care for others. It wasn’t until I was eight years old when I was granted the newfound responsibility of an aunt to twins that my fascination of pregnancy and birth was sparked. It is now my passion, to support women in any aspect of their journey through labour, birth and motherhood.  And being a student, my head is constantly filled with information, and I love sharing it with people who want to hear it.  That is why I created this Instagram page, in the hope that I will touch the lives of any more women than I do in the clinic, birth unit and postnatally throughout my career. 

What is a VBAC?

A VBAC is a vaginal birth after cesarean. This is almost the same as any other vaginal brith, expect for the fact that doctors and midwives will monitor your progress much more closely. This is because of the relatively small risk (1 in 200) that your previous cesarean scar will tear or your uterus will rupture. Despite this risk there are many benefits of a VBAC, including faster recovery, shorter hospital stay, higher chance of skin-to-skin after birth, more physically mobile and able to care for their baby (and other children), better chance of breastfeeding initiation and less complications in future pregnancies. 

What is a CSECTION?

 A C- section or cesarean is a surgical procedure in which they make a low horizontal incision into your abdomen and uterus to deliver your baby. Depending on the reason to deliver via cesarean, pain relief is administered normally by epidural block or spinal block - general anaesthetic in emergencies. Delivery by cesarean is safe, and normally carried out due to precaution or necessity. However, it is major surgery and it does carry risks. These include, risk of infection, future pregnancy complications and breathing difficulties for baby. Disadvantages include longer recovery time, extended hospital stay, monitoring and less mobility. 

Do you agree that a lot of Cesareans which are occurring are not necessary, and if so, why?

Unfortunately, yes. We now live in a world where the normality of birth has been tainted with fear and apprehension due to the newfound necessity to medically intervene. This includes anything from restricting the woman to a bed with a CTG, to breaking her waters to an unnecessary cesarean. And as grateful as we are that emergency caesareans and instrumental births are available, the accessibility has become of ease and has narrowed the mind of obstetrics into allowing for a natural birth. Keep in mind obstetricians are only in the room if they perceive something is not right, they do not deliver normal births on a daily basis like midwives. And that is why in most cases, they are out of their comfort zone and respond with the idea that they need to do something – and that is intervention, whether or not it is needed or beneficial for the woman or baby. 

In a lot of cases, woman like myself feel cheated if the cesarean is not necessary. Why do you believe doctors and midwives are throwing the prolonged labour and the big baby card around so lightly? 

I can completely respect that is how you feel, and as midwives we feel just as cheated. We are the last people in the room that want you to have to experience intervention if it is not necessary. Cesareans do need to occur in obstetric emergencies or if babies heart rate is decreasing after contractions – often due to the baby getting tired or stressed.  If however it is not one of these things, and you have just been in labour for a long time, there is no concern. Early labour, especially for first time mothers can take up to 20 plus hours, established labour can take up to 8-12 hours and they say an hour maximum for pushing. But in the end, prolonged labour and the big baby card comes down to fear and fear of the unknown. Doctors’ would much rather have the baby out faster and their head spared than wait another few hours for you to achieve your optimum birth. Midwives however, do try and advocate for you as best they can to prevent this intervention, it just depends on the day, the doctor, the midwife, the situation and unfortunately, the hospital.

Three things you can do in pregnancy or labour to increase VBAC chances and avoid a cesarean? 

1. Care - Choose an obstetrician who is supportive of VBAC's and perhaps attempt to have shared care with a caseload midwife or midwifery student (as they can follow you through your whole pregnancy and birth and be your advocate).

2. Preparation - Go to special VBAC classes and birth classes so you know what to expect - and hear advice from other mothers who have had a VBAC. Do also try to keep active and healthy during pregnancy, this will help prepare your body for birth and increase your chances.

3. Birth - Make your birth environment optimal for a normal birth, so that you are comfortable and relaxed. This includes having the constant support of your partner/support person to increase the likelihood of a VBAC. 

Advice for women who are planning on having a VBAC or cesarean? 

Be confident in your choice but try not to go in with a closed mind, as birth alone is an unpredictable event and despite our efforts to make things go normally and smoothly, it's not always the case. Despite my feelings towards intervention, there is no 'right' or 'wrong' way to give birth, just a hope that whatever way your baby is born into this world, that it is a positive experience for you.