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Vaginal Birth After Cesarean (VBAC)

Vaginal Birth After Cesarean (VBAC)

Many people view the act of giving birth as being just about the baby. But it is not! Childbirth is as much about the new life as it is about you, the mother. Your desires and your wishes do matter. So, if you want to give birth naturally though your previous was a cesarean birth, you have the right to plan and hope for a VBAC.

A c-section can be a lifesaver, but for some people, it can also leave that personal touch out of childbirth. There are many reasons women need surgery to give birth, and none of them are trivial.

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If you had a cesarean but now want to opt for a VBAC, your work is cut out for you! Let us give you all the scoop on VBAC.

Why should you even try for a VBAC?

You had a Cesarean last time, and your baby came out healthy and happy. So, why rock the boat this time around? There are many reasons you and so many other women worldwide contemplate a VBAC. Here are some of the major reasons:

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  • Faster recovery is one of the biggest reasons women opt for VBAC. With a little one at home already and another one about to make their entry into the world, the last thing you need is to hobble around in pain.
  • For many women, a cesarean birth feels impersonal and takes away some of the early chances for bonding with their newborn. If that is how you felt about your previous delivery, VBAC may be right up your alley.
  • Breastfeeding is one of the most beautiful aspects of giving birth. But a c-section can make breastfeeding difficult. A VBAC can help you establish an early breastfeeding bond with your newborn.
  • Once a c-section, always a c-section! For a long time now, a cesarean birth marked the end of any possibility of a natural delivery in the future. If you are planning to have more than two kids, remember that each c-section makes the chance of a VBAC dimmer.
  • It may feel irrational to others, but how you want to give birth is entirely your choice. So, a VBAC is a good idea just because you want to experience a natural birth!

What are the risks associated with VBAC that you should know about?

A natural birth may be your dream, but the ultimate aim of childbirth remains a healthy baby and a healthy mother! That is why it is important that you know about all the risks associated with VBAC before you jump on the bandwagon.

  • The biggest reason doctors are wary of encouraging a VBAC is a uterine rupture. If you had a uterine rupture during your previous delivery, you should not even attempt a VBAC this time around – yes, it is that risky. But if you had a relatively healthy, low transverse (bikini) cut cesarean, your chance of getting a uterine rupture is as low as 0.5% to 1% (depending on other health issues).
  • A uterine rupture can cause infection and brain damage to the baby.
  • In some extreme cases, a uterine rupture can also necessitate a hysterectomy (removal of the uterus). Remember that a partial hysterectomy does not cause immediate menopause but will leave you infertile.
  • In most cases, the worst that can happen during a VBAC is a failed labor process and an emergency c-section.

What different factors determine the success rate of a VBAC?

You’ve seriously considered the risk factors as they relate to your specific circumstances and still want to opt for VBAC? Good for you! In fact, studies show that a good percentage of women (60% to 80%) go on to have a successful vaginal delivery via VBAC. Some of the factors that determine the success rate of a VBAC attempt include:

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  • Check your previous c-section scar. If you had a low transverse uterine incision last time, you have a good chance of having a successful VBAC. But if you have had more than one c-section, your chances will go down.
  • If your pregnancy is progressing smoothly and none of the factors that led to a cesarean last time exist during your current pregnancy, a vaginal birth is no longer a dream for you.
  • If you go into labor without assistance before or on your due date, you are on track for a VBAC. But if you are already past your due date, the chance of a natural delivery will dip.
  • Another factor that can make VBAC difficult is macrosomia; that is, if your child is larger than usual.
  • According to studies, your age too can play a significant role in VBAC. Younger mothers are more likely to come out of a VBAC successful and without complications. But if you are 35 or above, you are 39% more likely to experience complications and a failed labor trial during VBAC.
  • Your race is also a factor that determines the success rate of a VBAC. White women are more likely to have successful VBACs than women of other races. But the good news is that non-white women are 40% less likely to experience uterine rupture during a VBAC.
  • Obese women are 50% more likely to have a failed VBAC when compared to underweight women.

How can you prepare for a successful VBAC?

If your heart is set for a VBAC, start planning for it. There are things you can do to increase your odds of a successful VBAC.

  • Research, research, and research some more! If you are going for a VBAC, make sure you know the ins and outs of it. You can even take VBAC childbirth classes along with your partner.
  • Talk to your doctor about your wish for a vaginal delivery and discuss your complete medical history with him. Many doctors try to talk women out of a VBAC. But unless there is a good reason, hold your ground. If your health care provider is not supportive of a VBAC, look for someone who is!
  • Look for a hospital that is not just supportive of a VBAC but also has a high success rate in it. The hospital should also be well-equipped to handle any emergency situation.
  • Despite popular belief, your doctor can induce labor during a VBAC. But it will be best if things kick-start naturally. So, allow your body to go into labor naturally.
  • If you are obese, talk to your doctor about the risks while opting for a VBAC. In fact, it will be a great idea to lose some weight before you become pregnant!
  • Eat well and exercise regularly. A healthy pregnancy is surely a plus if you are trying for a VBAC.
  • Most importantly, be ready for a c-section! No matter how perfect everything is moving, the slightest of problems may warrant an emergency cesarean.

“Birth is not only about making a baby. Birth is also about making mothers – strong, capable, competent mothers who trust themselves and know their inner strength”. Barbara Katz Rothman

Remember this beautiful quote whenever you find yourself doubting your body. Trust your body and your doctor.

A VBAC can make you feel powerful and strong, reaffirming your inner warrior! But even if you do end up with another cesarean, remember, being a mother itself is a victory. Giving birth is only the first step, you have a whole battle lined up. So, plan a VBAC if it’s right for you but don’t let it take over your life.

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Featured photo credit: VBAC via flickr.com

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Published on August 15, 2019

15 Tips for an Overwhelmed Working Mom to Feel Better

15 Tips for an Overwhelmed Working Mom to Feel Better

As an overwhelmed working mom, you get a lot of intelligent ideas from magazines, friends and the internet about how to manage work, children, and a household.

Unfortunately, you may still feel exhausted and insufficient at work and home despite the advice to organize, cook efficiently and pamper yourself .

How great would it be to wake up tomorrow knowing that you can begin to feel better without all of those overwhelmed feelings?

The sensation of feeling overwhelmed when you wear a lot of hats: mom, professional, household manager, partner, friend, etc. has its roots in reality. You are absolutely doing a lot of important jobs. But here’s the thing:

If feeling overwhelmed has become your knee-jerk or chronic reaction, this emotion is now literally a part of you that needs your attention so that you can move forward more confidently.

If helping yourself sounds too difficult, never fear. These tips come straight from therapy and neuroscience to hack into your nervous system. You will learn deeper ways to calm down and feel more confident about yourself, your life and your choices.

1. Breathe and Notice What Your Body Feels like Inside and Out

By using body-centered therapy techniques, you can better understand your overwhelmed feelings and offer accurate and practical help.

As you’ll learn, when you feel stressed out, your thinking brain is not your best resource. In fact, simply thinking about and bolstering your efforts to “get rid” of overwhelmed feelings might actually make them worse.

The first step to help when you feel overwhelmed is to simply slow down and breathe. This does not mean that you should suddenly take in huge gulps of air or breathe rapidly. That will send you into panic!

Breathe normally and naturally. Make your breath comfortably slow, extending the exhale. Count 5 to 10 breaths.

2. Get a Little Curious

Ask yourself: How do I know I’m overwhelmed? Close your eyes or soften your gaze if you are able. Imagine shifting your awareness from your outside world and sending it into your body along with your breath.

You might notice the signals right away. For example: My chest is tight, my heart is beating rapidly and there’s a sense of frustrated energy in my legs and arms. Or you might just hear some words like: I’m freaking out, failing or cannot do it!

If it’s possible, get a little curious about this sensation. Consider that while it may be a big feeling, you probably have other parts of you that feel differently.

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3. Offer Some Loving Care to Stressed-Out Parts of You

Richard Schwartz, developer of Internal Family Systems Therapy defines our personalities as made up of sub-parts that interact within us. This explains why a “part” of you can feel one way and yet, you have another part that feels differently.[1]

Gently acknowledging the part of you that feels overwhelmed and offering it some support and compassion (as you would a frightened child) can soothe your body and mind. “I’ve got you,” is a great mantra to breathe in when you’re overwhelmed.

4. Get Smart About Your Wise Nervous System

You may have heard of the “gut” brain or “body” brain. The science of Polyvagal Theory shows that the entire nervous system impacts how you think and feel – not just your thinking mind.

In fact, did you know that your wise nervous system generally picks up information from your environment before your brain can interpret it?[2]

When you feel overwhelmed, just one tiny cue of “danger” felt in your nervous system is often the unconscious trigger that tips you from busy but competent to feeling freaked out and exhausted.

This cue could be as simple as a song on the radio that feels overly-stimulating, a child’s bad mood (even if it has nothing to do with you) or your spouse forgetting an unimportant errand.

5. Remind Yourself That a Feeling Can Just Be a Feeling

When you’re feeling agitated, your physical body is naturally on high alert. Any information or stimulation you receive at these times will feel overwhelming.

This is not your fault, but it is helpful to understand that usually, when you feel like you’re not good enough, it is not objectively true. Your mind may just be creating a reason for the signals of danger coming from your body.

Allow your body to feel without making a negative judgement about yourself or your life. This technique will help you break the cycle of feeling overwhelmed, then creating negative thought about the feeling resulting in overwhelming yourself even more.

6. Learn Your Most Common Unconscious Responses to Stress

Why is this important? When you feel stressed, you probably respond unconsciously in the same ways throughout your life.

For some, too much stress will quickly create a numb, hopeless sensation. For others, the thought that life is just “too much” leads to bouts of panic or anger. Still, others might freeze completely, feeling highly anxious but not able to do much at all.

From a biological perspective, all of these experiences are pretty normal. When you recognize that your body’s reactions are not faulty or foolish, it’s much easier to reassure yourself and move forward confidently.

7. Exercise the Part of Your Nervous System That Provides Wellbeing and Social Connection

Did you know that you can actually tone your ventral vagal nerve, the nerve responsible for feelings of safety and social connection?[3]

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As often as you are able, allow yourself to linger on your favorite memories that invoke feelings of wellbeing, connection to loved ones, times of beauty in nature or your favorite memories of pets or places. Use all of your sense to really feel the experience in your body.

By doing this, you’re activating and toning your ventral vagus nerve as you might tone your muscles. Make a kind of “body bookmark” of these purely content sensations to which you can return when stressed.

This practice may feel silly, like an indulgence or even a fantasy. But it is supported by science and is important for you to create a strong and healthy response to stressors.

8. Give Baby Parts a Break

No part of you is trying to hurt you. But parts of us do feel extreme feelings and carry burdens from our past.

For example, if you are feeling overworked in the present, it may activate parts of your personality that felt similarly earlier in life. Deep anger, fear, resentment or sadness provide a signal to you that something from your past could benefit from your attention.

I know this may sound strange, but the next time you feel very overwhelmed, take a breath and notice if you feel like a child trying to do an adult’s job. If so, spend a moment calmly and compassionately reminding all of your inner child parts that you are indeed grown, capable and doing something appropriate.

9. Address Critical Messages You Give Yourself

What do you hear yourself saying to yourself when you feel overwhelmed? You may notice parts of you that sound critical or even cruel.

Statements like “I’ll never catch up,” “Why do I try,” or “I can’t do anything right,” are very common to hear when you’re under stress. Believe it or not, these inner messages are likely misguided protective parts of your personality.

These parts are normal and try to help you by “whipping you into shape” so you won’t fail, alerting you about scared feelings inside, or avoiding shock or disappointment by anticipating how others might criticize you.

If it’s possible, acknowledge these parts as protective. Maybe express a bit of gratitude. Notice how the critical voices inside you, even though they likely mean well, cause exhaustion and even more stress.

When you acknowledge these messages inside, letting them know they are part of you and you see their positive intention, the critical messages calm.

10. Take Small Moments to Express Gratitude

Everyone is talking about gratitude, I know. But there are good reasons for this trend.

More and more studies about gratitude show valid connections between gratitude and lowered stress and mental health. A 2018 multi-university research study concluded that gratitude not only has direct effects on quality of life, but also has indirect effects through perceived stress and mental health.[4]

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There are many reasons that gratitude impacts our nervous systems in positive ways, but the best way to discover this impact is to simply try it yourself.

Take a minute each day to write down one to three things for which you feel grateful. These can be large or small, important or trivial, but they must be true. Make this a habit and watch your stress-relief grow.

Or you can try some of these 40 Simple Ways To Practice Gratitude.

11. Play with Time

In Gay Hendrick’s 2010 book The Big Leap, he talks about the concept of Einstein time vs. Newtonian time.

Newtonian time is the clock time we all watch all day. Einstein time is more about what you make with your moments, realizing that your perception can slow or speed time up.

For example, if you are spending time with someone you love and doing something you enjoy, time moves very quickly. Conversely, if you are doing a miserable job in uncomfortable weather, each second can feel like an eternity.

The next time you feel stressed for time, take a slow breath and remind yourself that you make time. Time belongs to you. Then, enjoy the pace and do what you need to do. With practice, this little tool will become valuable for overcoming the mental pressure of time.

12. Don’t Be Tricked by Perfection

When you’re in the thick of raising children and working, sometimes nervous energy presents as perfectionism. In an effort to feel in control, you may make arbitrary but unreasonable goals for yourself that feel like they are necessary or true.

Make a quick inventory of every job you are expecting of yourself and your family. Now question it all. What is really important and what is just preferable? What jobs can be left to someone else’s discretion, done well-enough by the children or dropped completely?

Keep any jobs that give you joy and do them joyfully. Let go of jobs that feel like standards or expectations with little or no payoff. Save them for retirement if you like.

13. Give Yourself Credit for Quality Time with Your Kids

Think of the time you spend relaxing with and enjoying your children as a $100,000 per hour job. Very small amounts are still incredibly valuable.

Showing your children that they are important is just as likely to happen in a ten-minute game of catch as in a whole day at the water park. A shared snack time, a book before bed, a half hour away from your phone to allow loving eye contact with your babes adds up to a lifetime of security and wonderful memories.

Imagine your child someday saying, “Mom worked hard, but she always had time to hug me, to hear about my day, and to offer me guidance. I always knew that I mattered to her.”

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14. Meditate for One Minute a Day

Yes, you may do more. But if you can’t afford any more than one minute, go ahead and sit comfortably, breathe and be in your body for this time. It’s such a simple but powerful exercise and the kids can do it too.

While you meditate, notice your loving heart. What does it need from you today — patience, compassion, creativity, caring, play? Remember to show up for yourself and you will show up for your work and your family as well.

15. Guard and Celebrate Sleep

From tinies to teens, there are many unavoidable reasons that kids interrupt your sleep.

Here’s the thing: Unexpected sleeplessness due to childhood growth or illness is normal and not easy to control. If you are feeling overwhelmed, though, sleep is crucial.

There are two things you can do to improve your mindset toward sleep so that you set yourself up for confidence rather than collapse.

One, prioritize and protect your sleep time. If you tend to wait until the kids go to sleep to complete work or finally relax, that’s okay. But don’t let these activities cut into your sleep time.

Given the choice between another load of laundry, Words With Friends, binge watching Game of Thrones or eight hours of sleep, consistently choose sleep.

Two, appreciate and express gratitude for any sleep you get. Sometimes, it’s impossible to get seven or eight hours of sleep. However, allow yourself to enjoy any time when you are laying in a comfy space allowing your body to rest and repair.

When you wake up saying “I didn’t get enough sleep last night,” you put your mind on alert that there is something lacking. This thinking alone can trigger feelings of overwhelm.

Set your nervous system up for success by appreciating any amount of rest.

Final Thoughts

Life as a working mom is not an easy one. Overwhelmed feelings are natural and normal but, they can take over and cause chronic stress and dissatisfaction.

Allow yourself just a few moments a day to reorganize your thoughts and feelings using the steps above. You’ll soon discover your calm and capable self.

Take a lesson from your growing children: small changes create big results now and in the future.

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Featured photo credit: Bruno Nascimento via unsplash.com

Reference

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