Sensitive Midwifery - Issue 44 - October 2019

She has never birthed naturally before, so the various birthing positions she can use might not be obvious to her, especially if she previously laboured in a hospital environment where she was made to lie on her back. She may not know that vomiting is normal during labour. As her midwife, you need to reassure her and her family that nothing is wrong, and that physiological birth is not to be feared. Having had a previous C-section, which makes walking di ffi cult at first, she may not realise that she can walk upright immediately after her vaginal birth. The midwife can lead her and her family gently through this journey. Five other ways to build the best VBAC birth environment 1. If you have a gut feeling, trust it! Be honest with yourself and your clients. 2. Identify the psychological hurdle and keep her focused until it’s passed. If she only progressed to 5cm previously, she may hold back until then, for instance. 3. Ensure privacy and quiet. This is important for any birth but for a successful VBAC it’s high priority: this might be her ONLY hope to have more children and no more C-sections. 4. Encourage her ways of striving for success. A ffi rmations, birth balls, snacks, a resting place, music… 5. Your vocabulary is an important part of success. Your client needs to hear that she is brave, courageous, educated, built to birth. She needs to hear you saying: ‘I believe you can. Your body did not fail you last time. The system did.’ She needs to know that you know she is not broken, and that you have faith in her. Be especially careful with the birth of the placenta in a VBAC because there is a slightly increased chance that the placenta might be adhered to the C-section scar, and uterine prolapse can be caused by pulling on the umbilical cord. Ultimately, though very important, a midwife’s job is not as simple as just keeping clients safe. A midwife needs to be a cheerleader, and to be able to read what her VBAC client needs — skills which aren’t taught but will be honed by experience, insight and compassion. Birth 26 eSensitive Midwifery Magazine Issue 44