Women who are planning a vaginal birth after one (or more) previous caesareans (VBAC) are often strongly motivated to avoid similar experiences to what happened in their caesarean birth (Keedle et al, 2015). Negative experiences relating to CTG monitoring are among these. These include feeling trapped and restricted by the monitoring equipment, being told there was no choice about what monitoring equipment “needed” to be used, or being rushed into interventions including caesarean section on the basis of the fetal heart rate pattern.
The desire to make do without CTG monitoring in order to avoid repeat experiences is counterbalanced by anxiety about the possibility of a poor outcome during the planned birth. Care providers (Keedle et al., 2022) and family members can reinforce this fear by overstating risks of perinatal loss or uterine rupture relating to VBAC. CTG monitoring is typically proposed as a solution to preventing these poor outcomes, but does it actually help? How is anyone meant to balance all this?
While some women planning VBAC are well supported by maternity professionals and doulas, others struggle to access reliable information to support their decisions about their birth. If no one tells you that you have choices about what type of fetal monitoring you can use during your next birth, you are really going to be stuck when it comes to getting the kind of birth you are planning for.
Several years ago, I wrote a blog post about VBAC and fetal monitoring, and it has been read by over 8,000 people. It was getting out of date and needed a do-over. I realised there was so much more that I wanted to put into it than would fit into a single blog post. So – I created a mini-course instead!
The course is called I’m having a VBAC. Do I need fetal monitoring?. Inside it you will find lessons about:
- What are the things that CTG monitoring was designed to prevent?
- Do these really happen more often with VBAC – and just how likely are they?
- What researchers found in studies that compared CTG use with intermittent auscultation during VBAC
- The risks of CTG use
- And more…
The information is supported by research – and the list of sources I used is there for you to download so you can fact-check it all. There are useful tips on how to communicate your decision with your care providers in a way that maximises your chances of getting what you ask for. And there’s a workbook, and a fetal monitoring birth planning document that are yours to download and keep. I’m there too – you can ask me questions as you learn.
The course will remain open for you to join whenever you want to, and once you sign up, you have access to the information for as long as the course exists. Right now, there is an early bird discount offer – so you can sign up for half price (it’s only $17 AUD!). The discount ends on Wednesday March 12 at midnight AEST.
[If paying for information simply isn’t an option right now – you might enjoy listening to Dr Hazel Keedle – midwife, researcher, and VBAC expert – and I chat about VBACs and the CTG. Register here to get free access to the recording. ]
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References
Keedle, H., Schmied, V., Burns, E., & Dahlen, H. G. (2015). Women’s reasons for, and experiences of, choosing a homebirth following a caesarean section. BMC pregnancy and childbirth, 15, 1-12. https://doi.org/10.1186/s12884-015-0639-4
Keedle, H., Schmied, V., Burns, E. & Dahlen, H. G. (2022). From coercion to respectful care: women’s interactions with health care providers when planning a VBAC. BMC Pregnancy Childbirth, 22, 70. https://doi.org/10.1186/s12884-022-04407-6
Tags: caesarean section, Courses, VBAC
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