May 6-12, 2017 is National Nurses Week, a time to recognize, appreciate, and celebrate the important work that nurses do. In particular, maternity care nurses play a significant role in helping mothers who want to labor for a VBAC.
Women laboring for a VBAC may have some anxiety about their prior cesarean and may need additional support. They are grateful for the encouragement, validation, and labor progress suggestions that nurses can provide. Many times mothers have said, “My nurse was wonderful. Just when I wanted to quit and ask for another cesarean, she told me things were going just as they should be. I couldn’t have done it without her.”
Nurses, midwives, childbirth educators, and doulas who have experience working with mothers who want a VBAC have learned that a mother with a prior cesarean may need additional support, time, and encouragement to have a rewarding and satisfying birth. She needs to feel self-confident and strong. Here are some valuable suggestions that they have shared:
- When meeting a mother for the first time, try to find out how she experienced her cesarean? Can you suggest how she can do things differently this time? Ask her how she wants to labor. What is important to her? Help her to create the birth environment she prefers so she can feel safe and supported.
- Ask her partner or family how they feel about a VBAC? What concerns do they have?
- Remind parents that 3 out of 4 women who labor for a VBAC have a safe birth.
- Some mothers may have anxious moments and flashbacks of their prior birth. Disturbing memories of fetal distress or of laboring “for ever” and not getting anywhere. Help mothers to overcome these difficult moments and remind them that this is a different labor for a different baby and that they are strong enough to move through it.
- Mothers who may have experienced a prior birth as traumatic will especially need understanding, encouragement, and the freedom to give birth as she wishes.
- Some mothers know when they have gone as far as they can and that they will probably need to adjust to the idea of having a cesarean birth. Give a mother time, if circumstances allow it, to think about what she would like for this cesarean birth. Does she want her doula to be at her birth? Does she want her baby skin-to-skin after birth? Does she want her family to visit her in recovery? Does your hospital support a “gentle cesarean?” Let her know that your team wants her to have a good experience and will do their best to welcome her baby.
For additional information on how maternity care professionals can support mothers who want to labor for a VBACs see VBAC for Educators: A Teaching Guide.
Maternity care professionals who are interested in establishing “skin-to-skin after a cesarean” clinical guidelines or developing mother-centered VBAC education guides can freely use the hospital-developed forms included in Hospital Policies that Support VBAC, Family-Centered Cesarean, and Informed Choice, both are part of the VBAC Education Project.
A nurse’s support, guidance, compassion, and respect for a mother’s individual birth preferences will give both, mother and baby their best start together.
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