Getting a VBAC in China

You may have heard the old saying, “Once a cesarean, always a cesarean.”

This was common practice for decades. However, new studies and care providers are now finding that many women CAN and DO safely birth their babies vaginally after a previous cesarean.

A vaginal birth after cesarean, or VBAC, is decided on by the birthing person for a variety of reasons. Maybe your first cesarean birth was unplanned, and you want to achieve the vaginal birth you originally planned for with your first.

A trial of labor after cesarean, or TOLAC, is another term you will come across when planning your VBAC. This is when a birthing person labors before deciding with their medical providers to repeat a cesarean birth.

You may be thinking about going for a VBAC for a number of reasons.

Maybe your doctor is telling you that it is the best choice for you and your future family plans.

Or perhaps you just want to see what all the fuss is about regarding vaginal delivery.

But type “VBAC” into a search engine, and you may get a lot of conflicting or confusing information about the safety and availability of VBAC birth. If you’re having your baby here in China, you may get even more confusing information.

Today I’m going to break down what seeking out a VBAC in Shanghai or China can look like, as well as offer some practical information to help along your way.

Why choose a VBAC?

Your reasons around choosing a VBAC for your upcoming birth are often personal to you. People choose VBACs for different reasons, and whatever your reason, it is valid.

We also know that there are many benefits to VBAC, both for the mother and baby.

Benefits include:

Avoiding major abdominal surgery. Cesarean birth is common, but shouldn’t be considered the “easy way out” for those who give birth this way. Recovery takes time, patience with yourself, and pain medications.
Shorter recovery and hospital stay. Compared to a cesarean birth, you will be up and moving around sooner and more comfortably if you birth your baby vaginally.
Lower risk of infection, blood loss, and blood clots. These risks are common with any major surgery.
Reduced risk of bladder or bowel injury. These injuries can happen during any major abdominal surgery.
Lower risk of maternal mortality. Studies show that more most healthy people, giving birth vaginally shows statistically significant reduction in the material mortality rate.
And last but not least, YOU HAVE A GOOD CHANCE OF SUCCESS! Observational data suggests that those who try for a VBAC succeed 60-80% of the time. A successful VBAC is no longer the unicorn of birth, and is now being embraced by more and more care providers as a safe and viable choice for birthing your baby.

What are the risks of a VBAC?

Every birth carries with it risks, whether that’s a post-due-date induction, planned cesarean, or unmedicated vaginal birth.

We also know that every person and pregnancy is different, so it’s important to talk to your doctor about any risks that may be specific to you and your pregnancy.

Risks for VBAC include:

Uterine Rupture. This is the big, bad wolf of VBACs, the one that providers may want to avoid by scheduling a repeat cesarean. Fortunately, the rate of uterine rupture is low, occurring in about 1 in 5000 births.
Your provider may not want to induce or augment your labor with Pitocin (synthetic oxytocin). This is to reduce the risk of uterine rupture.
Possibility of vaginal tearing or episiotomy. This is a risk with any vaginal birth, but one that you may be able to minimize. Talk to your doctor or doula to learn more about what you can do to prepare for vaginal delivery.

Now that we’ve gotten the risks and benefits out of the way, let’s talk about how you go about getting your VBAC in China.

1. Know your “why”

Getting a VBAC may come with challenges or opposition from some friends, family, or even some medical providers. Knowing why you want your VBAC and surrounding yourself with supportive people, like a VBAC doula, can help you feel more confident in your decision.

2. Find a provider who supports your decision

This can be a more challenging task in China than some other countries. Most Chinese hospitals have high cesarean rates and some medical providers may be more comfortable with a repeat cesarean than VBAC. You may want to talk to several medical providers to find one who will support your VBAC.

When choosing your provider, you can ask the following questions:

- What is your professional opinion regarding VBAC?

- Do your on-call partners share a similar philosophy?

- What is your hospital policy regarding VBAC beyond 40 weeks’ pregnancy?

- What methods of induction would you use if labor does not begin on its own?

- What is your policy regarding augmentation of labor during a TOLAC?

- How about walking and fetal monitoring during a TOLAC?

- What is your policy about rupture of membranes?

Answers to these questions will be helpful when making a decision about your provider and birth facility.

3. Take a childbirth education class!

Learning more about what to expect during a vaginal delivery and comfort measures available to you will SIGNIFICANTLY improve your chance for a successful vaginal delivery.

Doulas of Shanghai offers one of the most comprehensive childbirth education classes available in China. Holly, the founder, is the only certified Evidence Based Birth Instructor in China. This six-week course includes with small group zoom classes and an online platform with instructional videos, workbook, and supplementary information and videos.

Don’t want a group class? Schedule your private childbirth education course today to be held on days and times that are convenient for you.

4. Hire a doula

Study after study show that having a doula present at your birth will increase your chance for a vaginal delivery. The American College of Obstetricians and Gynecologists (ACOG) state, “one of the most effective tools to improve labor and delivery outcomes in the continuous presence of support personnel, such as a doula.”

Women who have a doula attending tend to have births that are shorter, easier, request less pain medication, and more. Babies born to moms with a doula attending are statistically healthier and breastfeed more easily.

Your doula will also help your partner to feel more involved and safer during your labor.

VBACs can bring with them an array of feelings, including fear and emotional baggage from previous experiences. She is here to help you feel safer, calmer, and improve communication with your medical providers. She will help you know the questions to ask and may even be able to help with translation.

Don’t leave your birth up to chance.

Schedule a one-hour private consult to talk more about your birth plans and how to get what you want.

Preparing for your VBAC is exciting, but also brings with it fears and anxieties that are unique to this type of birth. Contact Doulas of Shanghai to learn more about more resources in your community, and how we can help you to relieve anxiety, talk about your fears, and help you prepare for a more confident birth.

WeChat: DoulasofShanghai

Website: https://doulasofshanghai.com