Sensitive Midwifery - Issue 44 - October 2019

Birth fear) to work through, and tend to need a lot of reassurance and guidance to overcome mental blocks. Building a relationship before birth, and helping her to prepare are paramount, so you cannot whisk through a VBAC appointment. During antenatal consultations, I make a point to gather information, set the safety parameters, and address emotional as well as physical concerns. Here are nine ways I recommend doing this: 1. Get the records; get the FULL story. You will be surprised what you might find out. Clients mostly don’t understand medical terminology. Be sure to discuss their medical history with them in easy-to-understand language. 2. Address her fears head-on. Fear can be self-defeating, so you need to address every fear she might have. Give the fear or emotion a name. 3. Work with the VBAC dad – he might be the stressor. Men often want the ‘easy’ way out, and feel helpless seeing their partners in labour. Ask him to name and discuss his fears with you too. Very often, men just do not get why their partners want a vaginal birth. Midwives can facilitate insight and support. 4. Bust fear with facts. Educate your clients with evidence-based facts, demonstrate labour techniques, and create a learning environment where they feel safe and acknowledged. 5. Listen carefully, especially to what’s NOT said. Sometimes fears are expressed without words. For example, when she says, ‘My labour did not progress after the induction and my baby went into distress,’ she may mean, ‘I feel my body was not ready and my birth was forced. I almost lost my baby.’ You can interpret this for her, saying, ‘Your body is not broken; you are designed to give birth at the given time. Your baby is strong and will follow your body as soon as the time is right.’ Words like these are very helpful: ‘You fear to fail, but you are stronger than you think. You can do this. I am with you all the way.’ 6. Suggest art therapy. Drawing or painting her previous birth experience and/or her expectations for the next birth can be a wonderful way to process things. 7. Advise that she sees a chiropractor at least three times during pregnancy. They need to know they have done everything they can to improve their VBAC success, and body alignment helps free energy pathways in many women. 8. Emphasise that VBAC clients will need to be relatively fit for birth. Any birth requires stamina, but VBAC moms-to-be need even more. Encourage her to keep up her physical activity, even if it’s only walking. 9. Explain that mental preparation is key. She may be fit enough to carry her baby, but her mind must also be strong. If she is prepared for the healing birth she is seeking, she is more likely to achieve it. Midwives need to explain to clients during pregnancy that successful VBACs are often based on a positive mindset. You need to remind her constantly that her body has not failed her; it is designed to do what her heart and womanhood are seeking. Guiding her through A client who seeks your support and guidance for VBAC needs to trust you. Part of preparing her for the birth will involve developing a relationship with her, so that she can use you, if necessary, as her anchor during birth. Even if she doesn’t realise it, you may unexpectedly become her focus point. You need to be able to guide her into the unknown – to be able to surrender to the power of birth. Women who seek VBACs are usually doing so because they dread the idea of the previous birth experience recurring. It may have been traumatic – and this is all she knows of birth. While this is not her first baby, it is her first vaginal birth and she needs to know that it can be di ff erent this time. "I believe that VBAC women have longer, gentler births because nature is compensating for the scar." Hopefully, she will have addressed most of her fears during her antenatal appointments with you, but they may resurface during birth, and it will be up to you to dispel these. Fear can be a great enemy, withholding women from empowering birth experiences. Never forget that fears are busted by facts. Continued on page 26 25 eSensitive Midwifery Magazine Issue 44