The VBAC Companion: The Expectant Mother's Guide to Vaginal Birth After Cesarean

November 7, 2011

by Diana Korte (The Harvard Common Press, 1997. PB: ISBN :1558321292, HB ISBN: 1558321284)

This book is a joy to read, and I recommend it highly to all women, especially those seeking a Vaginal Birth After a Cesarean (VBAC). With the ongoing discussions and research about the safety of VBACs, this book becomes a current, up to date and valuable resource. Korte starts out with a historical perspective of cesarean birth and the changing yet sometimes conflicting viewpoints in this area, and then proceeds into an excellent decision-making format, including addressing particular concerns such as the rupture of a uterine scar, and other risks associated with Cesarean Birth.

Information is presented in a sequential and logical manner. Having worked with women and families desiring VBAC birth I have seen parallels in problem solving and thoughts women go through to accomplish their goal of a vaginal birth. Questions are always raised about safety, and the most obvious: Can I do it? I feel this book gives good guidance and very detailed tools for decision making.

The titles of the three sections summarize the complete focus of the book:

  • Understanding Why and Overcoming Fears
  • Planning
  • Giving Birth

The Appendix is a wealth of resources and references which help to put VBAC in perspective with what is happening elsewhere. Especially helpful is a section with a discussion of VBACs, Cesareans and Infant Mortality Around the World providing fascinating statistics about infant mortality rates and cesarean and VBAC rate. There were several aspects of The VBAC Companion that I especially think women will like. The first was the personal narratives sprinkled throughout the book, related to the topic being discussed. The author wasn't just telling us her opinion. She shared personal viewpoints from a wide range of women in each chapter especially surrounding decisions making and implementation. The positive tone of the book with questions and where to go for more information helps encourage the confidence women are seeking when planning a VBAC. The Planning Section is especially helpful for a variety of reasons. Korte starts out with good guidelines for seeking a supportive environment and provider for a VBAC, and gives reasons why a women might even choose a home birth for a VBAC. I appreciated that she was very supportive of midwives, and strongly encouraged their use for women wishing a VBAC. Some of the recommendations are very new and current, such as the prevention of herpes at term. Lots of 'tricks of the trade' are presented in a variety of formats. I found her section discussing the impact of sexual abuse on pregnancy, labor and birth especially valuable, and an area not commonly addressed in books such as this.

Two excellent chapters are especially useful and practical: "Work with Your Other VBAC Helpers" clearly delineates the types of support that can be given to a woman in labor, both by her partner, and by others the mother chooses to have around her. The author adds many tips for turning breeches, posterior babies and maintaining a calm approach. The chapter "Experience a VBAC labor" gives a realistic view of what a women can expect, and also provides guidelines for a woman to ask her hospital and provider ahead of time about the process of labor and birth.

The final chapter, "Appreciate Your Birth Experience," pulls everything together, and again affirms that a woman can work through and learn to live with whatever the outcome of her plans. The author's viewpoint promotes what is healthiest for mother and baby, both mentally and physically, and attempts to decrease the guilt and grief sometimes associated with a birth experience. Should a women need or want a cesarean birth, there are suggestions for making a cesarean birth more of a birth and less of a surgical event. This book would be a welcome addition to the library of every childbirth educator, and a wonderful basic text for a VBAC preparation course.

References:

Pat Sonnenstuhl, BSN, CNM, ARNP, RH

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