Nurses play a significant role in helping women complete their VBAC labors. Women laboring for a VBAC may have more anxiety than women having first babies, and may need extra support. They are grateful for all 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.”
The following is a list of suggestions to help nurses support women laboring for a VBAC:
- During labor, while collaborating with her caregiver avoid formally admitting mothers to the L & D unit until they have a strong active labor pattern.
- Encourage mothers to continue taking in clear liquids and light carbohydrate snacks in the early phase of labor and liquids in the active phase.
- Support physiologic birth. Remind mothers to use a variety of positions and ambulate during labor as long as they are comfortable.
- Suggest that the mother and her partner use a variety of comfort measures, such as heat or cold packs, lunging motions, a birth ball, a rocking chair, or hydrotherapy.
- When meeting the mother for the first time, find out how she wants to labor this time. How does her partner or family feel about a VBAC? What concerns does she have? Why did she have a cesarean? Teach her how she can do things differently this time. Verbal support and encouragement are extremely helpful, especially when nurses help to identify signs of labor progress. Remind parents that 3 out of 4 women who labor for a VBAC have a safe birth. Help her to create the birth environment she prefers (low lighting, quiet, music, no visitors).
- When laboring for a VBAC, some mothers may have anxious moments and flashbacks to their prior birth. Distressing 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. Most nurses know when a mother has gone as far as she can and that she needs to adjust to the idea of having a cesarean birth.
- Give her time to think about what she would like for this birth. Does she want the baby skin-to-skin after birth? Does she want her partner to go with the baby to the nursery if it becomes necessary or stay by her side? Does she want her family to visit her in recovery? Involving mothers in their care and honoring their wishes will go a long way to help them adjust to the loss of the birth they may have planned for and anticipated for months.
- Many mothers have said that they were left alone after the birth while their partner went with the baby to the nursery (when medically necessary). If a mother does not have a doula and if you can provide one-on-one care for this period of time and talk to the mother about how she is feeling, or how the baby might be doing, she is more likely not to feel abandoned.
- Mothers, just like their newborns, need to adjust to their new life. Your support, guidance, and compassion will give mothers and babies their best start together.
To find out more about laboring for a VBAC download the VBAC Education Project