Planning for a Possible CBAC: Making the Best of a Difficult Situation
All VBAC hopefuls should have a plan in case another c-section should become necessary. Although most women who try for a VBAC do have a VBAC, not all do. Sometimes another cesarean becomes necessary or prudent under the circumstances.
Some women avoid making a CBAC plan because they are afraid that acknowledging the possibility of CBAC will doom them to actually having one. Others studiously avoid listening to or reading the stories of CBAC mothers while they are planning a VBAC.
It can be very emotional to think about the possibility of another cesarean, but remember, planning for the possibility doesn't make it come true. Rather, it helps quiet the fear by actively addressing it, so then you can set it aside and focus on other things. Many women have found that making a CBAC plan and addressing the fears brought up via that process helped them on the path to their VBAC. Those that did have a CBAC found that having a CBAC plan in place helped them take control and have a better experience.
If you found your previous cesarean traumatic, remember that you never have the same cesarean twice. You might have a much different experience if another one was needed. Planning can help make it as optimal as possible under the circumstances.
Many women lessen the trauma of a CBAC by making plans to keep as much autonomy and input into the process as possible. This seems to be the biggest lesson shared by CBAC mothers who have had an "Empowered CBAC." It's not that they were happy to have another cesarean, but rather that by having more input into the process, they were less devastated by it. The goal is to be able to integrate a challenging experience more smoothly.
Think about the things that happened during your c-section last time. What things went well, and what things could have been better? What helped you heal physically? What helped you emotionally? What helped you bond with baby more easily? What did you need for your recovery?
Develop a plan to improve things if a c-section was needed again. Be as specific and proactive as possible, and don't be afraid to ask for what you want. Think about the things that would help you have the most positive experience possible. Common things that many women find helpful include:
- Listening to your own music in the O.R.
- Taking pictures or video in the O.R.
- No casual chit-chat from the staff during the surgery
- Minimizing separation from the baby immediately after birth
- Allowing your partner to hold the baby after birth
- Having a second support person in the O.R. with you (midwife, doula, or other family member) so your partner can accompany the baby, if needed, to the N.I.C.U.
- Nursing and bonding with your baby in recovery
- Avoiding formula unless medically indicated
- Delaying certain procedures (weighing, vaccinations, baby bath) until you have had bonding time with your baby
In your plan, focus on the things that would make you feel the most empowered or that would help bonding. As one CBAC mother said about her CBAC:
“While I am still sad to have lost the opportunity to birth my baby naturally, the ways we were able to maintain a certain level
of empowerment on how the rest of the story went made things a little easier to handle.” -- Amanda Taplin Milberry
A CBAC is not the end of the world. It can be very difficult, emotionally and physically, but it is also possible to integrate the experience into your life as just another disappointing -- but not devastating -- moment of your life. Having a good plan in place in case another cesarean were needed can be a first step towards the best experience possible under the circumstances, and towards being able to integrate the outcome, whatever that is.
A Family-Centered Cesarean - link from ICAN's website
Having a Cesarean-In-Awareness - link from Birthing From Within website