Archive for February, 2019

Coaching towards a Successful VBAC

Tuesday, February 19th, 2019

While the coaching strategies are valuable in supporting and leading every expectant woman who would like to give birth healthily and experience high levels of satisfaction, they are even more crucial when supporting and leading a mother who wishes for a VBAC, because of the additional elements, or challenges, she faces :

  • Environmental challenges: The external constraints this expectant woman needs to react to and overcome are much bigger than a woman who did not undergo a cesarean. Medical providers aren’t supportive of her VBAC decision, and even when she finds a caregiver that will agree to a TOLAC (Trial of Labor After Cesarean), Agreeing to a VBAC doesn’t mean Supporting it. The difference is being manifested by the medical imposition and restrictions that aren’t supportive of her vision for her birth.
  • Behavioral factors: These are the specific action steps taken in order to reach success. The client who desires a VBAC not only has to find a caregiver that will agree to take her on, but she must learn what the biggest hurdles are to achieving her desired goal, such as the need for induction or any other medical intervention, including an epidural. Once this TOLAC is medically managed, the chances of achieving a VBAC meaningfully decrease. Therefore, your client needs to be well informed about this, and take the right steps to be successful.
  • Capabilities: These have to do with the mental maps or strategies that lead to success. It obviously takes a mental strategy to go through nine months of pregnancy and to complete all the action-steps in order to achieve a VBAC while all along being told by family, relatives and your caregivers that it is dangerous. Advocating for yourself is another mental capability, and coping with pain is another.
  • Beliefs and values: These relate to why a particular path is taken and the deeper motivations which drive people to act. My experience has been that this is one of the most important steps towards achieving a successful VBAC. Clarifying the woman’s motivation in a coherent manner that is also aligned with all her other beliefs is crucial for the actualization of her desired VBAC. Additionally, as her doula, you will be able to tap in her motivation during moments of crisis during her journey and empower her.

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A series of prenatal coaching sessions is therefore essential in order to successfully achieve a VBAC. Here are some of the most important steps I have successfully used in coaching my VBAC clients:

  1. Clarifying the mother’s motivation for having a VBAC: Please ask questions such as: ” Why is it so important for you to have a successful VBAC?”, or: “What do you think will be different in your life when you will achieve your goals?”. Listen to the direction of the motivation – is she choosing a VBAC in order to avoid something (away from) or to have something (moving towards)? Taking actions toward something desired is a stronger motivation than running away from.
  2. Protect the positive mindset of your client: She already chose to have a VBAC knowing all the risks and objections. Help her adopt strategies to block the environmental ‘noise’ and continue with confidence toward her goal.
  3. Work with Affirmations: Affirmations are word pictures that can engage the mind and attract what we desire. After having an unplanned and unwanted cesarean, your client holds a negative memory of her first birth. Writing and regularly reciting her affirmation is one of the best coaching strategies to get her mind focused on what she wants rather than what she fears. You can learn more about the rules and process of writing a strong affirmation HERE.
  4. Emphasize cultivating new coping skills: Since one of the most important actions towards achieving a VBAC is to avoid taking pain medication, you’ll want your clients to practice labor support tools until these become her habitual responses to labor strains.
  5. Help the mother avoid an induction: Your clients can’t appreciate the importance of avoiding an induction for their successful VBAC. Help them be proactive in inviting the birth to take place spontaneously. Discuss with your clients all the proactive actions they can take in order to avoid an induction such as acupuncture, homeopathic tinctures, chiropractor’s adjustment, prenatal massage, herbs, sex, and more.
    Provide spiritual support: Have faith in your client – trust her body and her process, and trust her caregiver (until proven otherwise). Coaching from a positive mindset while expressing your full trust in her ability to achieve her goal is one of the keys to her success.
  6. Provide spiritual support: Have faith in your client – trust her body and her process, and trust her caregiver (until proven otherwise). Coaching from a positive mindset while expressing your full trust in her ability to achieve her goal is one of the keys to her success.