VBAC Rules

Hi Lullaby,

I am also a VBAC hopeful, currently 31 weeks.

Here is what my midwife had to say about your doctors' rules in my situation:

1. I will be allowed to go up to 42 weeks if mother and baby is doing well.

2. Baby shouldn't be predicted to be bigger than 4,2 kg

3. Active labour should progress as per textbook, I think that is about 1 cm per hour.

4. Baby should be head down.

I can understand why doctors/midwives do put in certain measures in place. There is a certain amount of risk involved for them and it makes sense to play it safe.

My midwife said she is not a "cowboy midwife" meaning that certain midwives will put almost no rules in place for a VBAC. I respect that each doctor/midwives decides what they feel comfortable with.

However I can't lie to you - I am nervous about active labour not progressing, I am not the type of person that likes to be put on a clock. But that is my only chance in this case to have a VBAC so I will have to livve with that.

Hope that you will be joining us here:

www.moomie.co.za/71-labour-and-birth/225...ac-support?start=585

Hi there Lullaby,

Is your pregnancy still high risk or did the problems from the first trimester resolve? If you are not having problems anymore, you could go back to your midwife and rather give birth with her at Genesis.

With regards to his rules:

1. You have to go into labour naturally with a VBAC as augmentation increases your risk for a uterine rupture. You can however use acupuncture, reflexology and other natural means of helping labour to get started. 40 weeks is a bit strict on a final date as a normal pregnancy can last for 42 weeks, so I would be wary of putting a 40 week "deadline" on a pregnancy.

2. Baby's birth weight can only be determined after birth, sonars are not accurate at measuring a baby's weight after 20 weeks.

3. If he means active labour, then 12 hours should be ok, early labour or pre-labour can take days or weeks, the new guidelines says that active labour starts more or less at 6 cm. So if you can wait till you feel you are sure you are in active labour before you go into hospital and your get to hospital between 4 and 6 cm, then 12 hours can be enough if you labour without an epidural and you are allowed to be free of monitors so that you can roll your hips around on a ball, walk, squat etc to help labour progress.

4. Very few gynies / midwives if any will assist you with a breach birth these days, so I would say that this one is fair. Remember to visit a chiropractor during pregnancy to help you get baby into an optimal position. Also visit www.spinningbabies.com if your baby is not lying in the "right" position.

In addition to that, please take a good antenatal class that concentrates on natural birth, something like HypnoBirthing, I know I teach it, so obviously I am not objective, but I have had a lot of clients who had successful VBACs after the course.
And get a doula to assist you during labour. You need that support and guidance especially with a hospital birth. Someone who knows when to suggest different labour positions, to help your husband support your with squats, counter pressure etc, all things that will increase the chance of having a natural birth.

Hi Ladies

Hope you will be able to assist me..

My first one will be 5 in June, had a c-section since she was breach at about 38+ weeks.

I am currently 29wks with my 2nd one and wanted to go the VBAC route so I consulted with a midwife at Genesis but I encountered problems in my 1st trimester. Midwife then referred me to one of the back up gynaes she uses and I have been with him ever since. He says he is pro VBAC however has a few rules I/we need to abide by and I am wondering if these are really "true" or this is just another way to conveniently do a c-section. His rules are


1. Nature needs to take its course, ie baby must come on his own before the 40wks mark with no medical intervention

2. Baby's birth weight must not be bigger than 1st baby. Currently we are at 1.75kg as opposed to the expected 1kg he said and this is likely to mean he will be big.

3. Labour must be over within 12hours, ie progress atleast 1cm every hour

4. Baby must be head down.

Can you please help and advise if these rules would really prevent a successful VBAC. So confused..

Thanks