Your Destination: Is ‘a healthy baby out of your vagina’ all that matters?

As I mention in ‘Empowered Birth is Not In The Eyes of the Beholder’, one of the most disempowering assumptions to be made during a planned VBAC is that ‘a healthy baby out of my vagina’ is all that matters – this is a great and logical foundation for a bigger goal, but the process of planning a VBAC should not only be about babies and vaginas.

Here’s where I’m going with this… What if that baby comes out of your vagina, but you have to have an assisted delivery? What if that baby comes out of your vagina, but you are coached to push? What if that baby comes out of your vagina, but you feel totally out of control because your body takes over? (Google ‘foetal ejection reflex’ if you haven’t already.) And, what if you unexpectedly decide that you want to have a repeat Caesarean?

The passage of your next child through the birth canal is not automatically a passport to empowerment. Sometimes women ‘get their VBAC’ and yet still report feeling disempowered for various reasons. Conversely, others end up with unplanned repeat Caesareans and yet feel perfectly empowered during their birth. These are some of The Grey Zones of Empowerment.

Instead of focusing solely on the mode of delivery of your planned VBAC baby, have a think about how you want this birth to feel from your perspective. Yes, by all means plan to birth your baby vaginally – there are, after all, many benefits associated with vaginal delivery! But, don’t stop there – also plan to be empowered.

If you plan to be empowered, the fear of ‘What if I don’t get my VBAC?’ can disspate. Reducing fear ahead of a planned VBAC is actually an integral step towards VBACing! And, if you can say – I know what it feels like to be empowered, then, congratulations! This is about as close as you will possibly get to guaranteeing yourself a positive birth experience next time, which is right where we want you!

The Empowerment Ride Doesn’t Stop Here!!

The awesome thing about the VBAC journey is that it does not have to end with the birth of your baby. The things which we learn through the process of actively planning an empowered birth are, like many of the lessons of motherhood, transferable and applicable to many aspects of ‘Life After VBAC’. Empowerment during birth is the same as empowerment in life – once you’ve discovered your portable power, you can use it to make good decisions about anything.

VBAC By Numbers

Stop Two – VBAC By Numbers

Because we are not taught to cope well with ‘unknowns’ in life (and because the VBAC journey is full of them), it can be tempting to look for a ‘VBAC by numbers’ solution thinking also that a VBAC will automatically be an empowering experience in and of itself. And, I totally understand why this shortcut is so tempting, especially when we all have small children, minimal research time and a craving for VBAC Hacks which will make life easier!

The ‘VBAC By Numbers’ set of instructions for empowered birth often looks like this:

  • Consider choosing to birth in a birthing centre or at home
  • Employ the services of a VBAC-friendly care provider
  • Do a lot of research and read a lot of stories
  • Gather stats – lots of stats
  • Find professional support and assemble a birth team
  • Keep your physical body fit and healthy
  • Face your personal demons re ‘What Happened Last Time’ (and any others)

All of these steps are absolutely important and integral to planning an empowered VBAC. Everyone who is serious about planning a VBAC is well-advised to work through these things (plus a few extras which I will cover in a separate post!). So, please do go forth and consider doing at least one, some or all of these things.

However, here’s the harsh reality check… Ticking off all of these things and then assuming this will guarantee a VBAC outcome and/or an empowered birth is, unfortunately, ironic. Whilst a VBAC preparation list is something you can google and work through without any personal reflection at all, if you miss that opportunity for personal reflection, you have also missed a chance to practise being empowered.

The other problem with the ‘VBAC by numbers’ mentality is the danger of switching one form of outsourced responsibility for another – if you blindly follow a ‘How to Plan a VBAC’ list, you are not necessarily any better off than you are when blindly following the advice of a care provider. If you want to be empowered, you must question everything (including this blog post!) and come to your own conclusions. The second you stop thinking for yourself is the second you risk becoming disempowered.

Working through any list of dot points (like the one above) is totally fine as part of an ongoing process – a work in progress which is your own journey to empowerment. But, once you’ve exhausted the ‘How to Plan a VBAC’ list, keep going! Stay open to the possibility that, with every layer you work through, you get closer and closer to an empowered birth.

>> Your destination: Is ‘a healthy baby out of your vagina’ all that matters?

The Grey Zone of Empowered Birth

<< Greetings! You are now entering The Grey Zone of Empowered Birth. We hope you enjoy your stay!! >>

Hi, I’m Tessa. I’ll be your tour guide today. I have had one unplanned Caesarean, and two planned VBACs. I run VBAC workshops and am passionate about consumers having access to balanced information.

You may be here because you’re making choices about repeat Caesarean versus VBAC. Perhaps you’re here because you’re supporting someone to make this decision. I hope everyone is here because our shared destination is personal empowerment.

The trip I’m about to take you on will freak you out – it will sound like I’m not advocating for VBAC at all. But, please bear with me – it all makes sense in the end! Here we go…

First Stop: Making Assumptions about What Empowerment Is

Making external judgements about birth choices and their effect on inner empowerment is fraught with danger. If you intend to seek/provide woman-centred, individualised care, it is important to reserve such judgement, whether you are the woman planning a VBAC or a birth professional attending her, because:

Sometimes, women who elect for repeat Caesareans do not want to own their own births. However, it is also possible that someone who elects for a repeat Caearean may, in fact, be taking responsibility for their own birth. Don’t declare they have been coerced, bullied or duped into this decision by default.
Sometimes, women who choose to VBAC want to own their own births. However, it is also possible that someone who chooses to plan a VBAC is not making a conscious, active and informed decision. 

Let’s talk about the two possibilities which do not fit the stereotypes found in some parts of the birth community.

It is dangerous to believe that all elective repeat Caesareans are disempowering and a sign of an ill-informed consumer. One must not assume that, because this mother lies prostrate and ‘inactive’ to birth her baby, she must also be disempowered. (An aside: A Caesarean birth does not have to be a passive experience, either – care practitioners who perform woman-centred Caesareans can make a huge difference here.)

Whilst some women birthing by Caesarean may indeed be victims of a system which prefers ‘controllable risk’ to chance, there are also other women who do access good quality, balanced information about their birth options after Caesarean, and – of these women – some will make a conscious, well-considered decision (which is not influenced by the agenda of a care provider or system) to have a repeat Caesarean. It must also be said that opting for a repeat Caesarean does not mean a woman is opting out of personal responsibility for the safe delivery of her baby – consciously handing over control of your birth to another human being is one of the bravest choices a mother can make.

On the other hand, though the choice to VBAC is a deviation from the norm (‘previous Caesarean’ is the leading reason for all Caesareans performed both in South Australia and nationally), it is not intrinsically an enlightened one.

While the VBAC choice is more likely to be made by someone who naturally questions the status quo, if a care provider or centre systematically pushes a VBAC agenda (whether out of personal bias or an external system ‘push’), it is also quite possible that some women might go along with this unquestioningly, never being suitably informed of this choice (and thus of the support she may actually need). Furthermore, whilst it appears to observers that the birthing woman in this case assumes responsibility for this birth (because she has chosen to physically birth her own baby), this is deceptive – if she is not well-informed and an active decision maker, this woman has possibly invested all of her power in her care provider (or the system). This is obviously counterproductive to the ‘empowerment cause’ (even if you think that VBACing is by nature an ‘empowered’ or ‘empowering’ choice), because empowerment lies within.

CONCLUSION?

Personal empowerment is highly individual. Many women I work with through VBAC workshops decide that their route to ‘birth after Caesarean’ empowerment comes in the form of planning a VBAC. My point with this post is to highlight the fact that empowerment is not ‘one size fits all’ – as long as you are making active, informed decisions you’re doing a great job of working towards empowerment. And, if you decide that planning a VBAC is an empowering process for you, I do hope I might see you at one of my upcoming VBAC workshops! 🙂

>> STOP TWO: VBAC BY NUMBERS

Empowered Birth is Not In the Eyes of the Beholder

It can be really tempting to make assumptions that certain sets of birth choices are more empowering than others. A common image of ’empowered birth’ often features a birthing woman who, supremely fit and healthy, labours like brave, primal warrior whilst being attended by her ‘sisters’ and a patient, strong partner. This is, indeed, a picture of empowerment which resonates with many of us and it is something to which we aspire. Images of women dressed in hospital gowns, attended by doctors and placed under the bright lights of a typical hospital room are far less appealing to the heart strings.

But, what if empowered birth can actually happen in a hospital gown? What if it’s possible that a birth among ‘sisters’ might feel disempowering? Are we doing women a disservice when we present one version of empowered birth as the only version of empowered birth?

The thing is, no single image will ever universally capture what it is to be empowered in birth because personal empowerment comes from within.

Personal empowerment can definitely be influenced (for better or worse) by a range of external factors. A doula can be a good ‘empowerment coach’, a traditional midwife can facilitate empowerment by simply holding the space, a partner can support empowerment by advocating for you when you cannot do it for yourself…

But, much like birth, the act of becoming empowered, whilst aided by all of these external factors, is essentially a task one must complete alone. This might sound a little scary, and it certainly takes some practice (like any new skill), but don’t let this put you off – learning the art of self-sufficient empowerment gives you the gift of portable power. Once you know what personal empowerment feels like, you can pack it into your birth bag and take it anywhere, regardless of your destination.

For women, this concept of portable power is an important one to understand. You need to know that your birth choices do not automatically empower you. A woman-centred doctor or midwife cannot empower you, a nice, ‘homely’ hospital room cannot empower you and making what is considered by others to be ‘empowered decisions’ does not empower you. And, why not? Because you empower yourself.

For those attending birthing women, we need to remind ourselves of the internal nature of empowerment and the goal of portable power which lies at woman-centred care – just because a woman has made the set of choices which an empowered woman generally makes, this does not mean she is herself empowered. Judging external factors as evidence of a woman’s personal empowerment (or disempowerment) ironically robs the birthing woman of the opportunity to find and define her own power (and thereby become empowered). Why? Because only she alone can empower herself.

Now, in the interests of maintaining my portable power metaphor above, I invite you to pack your bags and take a short trip with me into The Grey Zone.