Vaginal Birth After Cesarean 101

One of the most beautiful things about childbirth is no two experiences are the same. 

With that also comes it's fair share of challenges and uncertainties to navigate while you anxiously await the arrival of your second baby. 

If your first birth was a cesarean, or even the first two, a little additional planning and preparation can put you at ease if you're planning for a vaginal birth this time around. 


Preparing for any birth can be intimidating and putting yourself at ease is a great first step. Gather together a good support system and birth team will keep you feeling confident about the process ahead and informed as you move forward. 

Your labor doula can help you with the resources and education you need to prepare and craft your birth plan. Pursuing a vaginal birth after one or a series of cesarean deliveries can be a really emotional decision. Your labor doula will be there every step of the way offering you and your partner both physical and emotional support.  

During labor you should plan comfort strategies with your doula to help you stay as comfortable as possible. Writing your birth plan will be an important part of the process and your team can help you identify what steps will work best for you if you are avoiding medical intervention or cesarean for your next child's birth.

Choosing a Care Provider

As with any birth experience, choosing the right care provider and birth location is important. If you've taken the time to familiarize with your birth center's staff and your team, you'll feel a lot more comfortable. Communication is key and discussing your birth plan with your midwife or physician ahead of time gets everyone on the same page with your expectations and what medical interventions, pain management and delivery strategies you have in mind. From here, your birth team can give you more details about potential tests to avoid or other labor styles that could complicate your vaginal delivery or increase risks. 

Some hospitals don't support VBAC and others have a strict candidacy process to identify whether or not your body can safely deliver your baby vaginally. Choosing the right provider will mean some conversations about your birth goals, your last birth and your current state of health. Safety should be your common ground and different elements on your plan will fall into place. 

The Time Line

How long should you really wait between your cesarean birth, getting pregnant and choosing a vaginal birth (VBAC)? 

Your postpartum doula can help you establish a recovery routine after your cesarean birth and give you some insight about what to expect postpartum. Most care providers would recommend waiting six months to a year of recovery. Remember that a cesarean is a surgical procedure with incisions and muscle trauma that takes some time to completely heal. The more time you allow your body to heal, the stronger you'll be for your next birth. While recovering, pelvic floor strengthening exercises can help your next vaginal birth be more comfortable and even shorter in duration.

With a little preparation and a great support system, your vaginal birth after cesarean can be a successful experience. 


Nitrous Oxide for Labor Pain

When it comes to pain and discomfort during labor, each woman manages pain differently with a wide range of comfort measures and treatments.

One such treatment is the use of Nitrous Oxide to alleviate discomfort during labor. 

Nitrous Oxide use has gathered controversy as more women advocate for drug-free alternatives for comforting labor pains. 

As your due date approaches, our team encourages you and your partner to research different pain management techniques to find what is a right fit for you. 

Like any medical intervention for pain management, Nitrous Oxide has it's share of pros and cons. Nitrous is considered overall a safe way for mothers in labor to manage their discomfort. In high doses, Nitrous Oxide is a fairly weak anesthetic and it is more effective when administered in minimal amounts to the patient. 

Nitrous Oxide is a unique helping hand in the delivery room, offering both an analgesic (pain reliever) and an anxiolytic (anxiety relief). 

Benefits of Nitrous Oxide During Labor

Nitrous Oxide use does not physically injure the mother, fetus or neonate and does not pose harmful health hazards for care givers. This inhaled treatment does not affect the progression of labor and is safe and painless to administer.

Nitrous doesn't affect the levels of oxytocin, therefore does not affect infant alertness, mother and baby bonding or successful breastfeeding. This pain relief does not completely remove the mother from the awareness of labor pain and discomfort, however many women report an easier labor transition and managing their own discomfort. 

Nitrous Oxide is self administered, putting a mother in control of her pain management. It takes between five and ten minutes for the effects of the Nitrous Oxide to minimize, giving mom the opportunity to switch to a different pain relief if necessary.

Risks of Nitrous Oxide During Labor

While safety standards are in place to monitor the levels of Nitrous Oxide, excessive doses may cause symptoms like dizziness, vomiting, and nausea. Health care personnel working with Nitrous Oxide on a regular basis without proper handling procedures in place could begin to notice disruptions in their reproductive health. 

These risks however are in majority associated with recreational Nitrous users that abuse the substance. The percentage of Nitrous Oxide available as a labor pain treatment has too low of a percentage to notice any adverse effects, making this option safe and recommended by birth professionals. 

When it comes to pain management during labor, a mother should feel confident they are receiving the pain relief that they feel completely comfortable using. 

During your pregnancy, visit your hospital or birthing center and ask questions about your options for pain relief and educate yourself on side effects, benefits and risks associated with each. Making an educated decision for your birth will empower you to proceed to your due date confidently. 

Many hospitals in Maine, New Hampshire and MA are utilizing Nitrous Oxide including Maine General, Midcoast, Wentworth Douglas, York and now Maine Medical Center.

Your labor doula is there to ensure your birth plan is carried out according to your family's individual wishes and she is there to answer any questions you have along the way. 

Your birth. Your pain management. Unbiased support.