Why I Wrote
the VEP
Nicette Jukelevics, MA, ICCE
My goal as a childbirth educator has always been to provide expectant parents with evidence-based information, support, and guidance to achieve the birth they hoped for. Every family is unique, and although ultimately everyone wishes for a healthy mother and baby, every family reflects its own values, cultural and spiritual beliefs, and strong views about what a “safe” birth means to them. The current practice of performing routine repeat cesareans for the majority of women with a prior cesarean birth is contrary to their right to choose how they want to give birth.
Vaginal birth after cesarean (VBAC) is a safe alternative to a routine repeat cesarean and is recommended as an option by the world’s leading professional associations of obstetricians and gynecologists. Evidence tells us that about 70 to 75 percent of women who labor for a VBAC give birth safely and avoid the complications of a repeat operation yet the majority of mothers in the United States who want to labor for a VBAC are not given a choice.
Many maternity care hospitals do not support VBAC and only provide care for mothers and birthing families with a prior cesarean if they “consent” to a repeat operation. Ultimately expectant parents with a prior cesarean birth agree to a repeat operation they don’t want or need.
Women and birthing families have the right to choose how, where, and with whom they want to give birth. It is a human right.
To make informed decisions about laboring for a VBAC or choosing a repeat cesarean expectant families need accurate information on the choices available to them and the benefits and risks of those choices. Unfortunately, the American College of Obstetricians and Gynecologists (ACOG) tells us that physicians are not having these conversations with their patients during prenatal care. Instead, the information physicians provide reflects their values, priorities, and culture.
The VBAC Education Project (VEP) is a resource that provides hard-to-access, evidence-based information on birth options available to mothers and birthing families with a prior cesarean birth. First published online in 2015, the VEP is the culmination of over 40 years of experience as a hospital- and community-based childbirth and perinatal educator.
The VBAC Education Project (VEP) was designed to provide transparency, clarity, support, and guidance regarding your birth options after a cesarean. Ultimately, it gives you a voice, helps you to advocate for yourself, and empowers you to determine what’s best for you. When you actively participate in your care you have better health outcomes.
If you choose to plan a VBAC you will find important guidance about how to improve your odds of safely having a vaginal birth.
Educating yourself about your options for caregivers and place of birth can help you avoid a repeat cesarean if that is your choice. If after reading about the benefits and risks of both VBAC and repeat cesarean, you choose to have a cesarean you will find information that can help you have a meaningful and empowering birth that supports mother-infant bonding and breastfeeding.
Reproductive rights for the majority of women in the United States have been severely restricted or completely denied in many parts of the country. I believe denying medical care to eligible women and birthing families who want to labor for a VBAC and avoid the complications associated with a surgical birth is also a violation of their reproductive rights.
My Wish for All Expectant Mothers and Birthing Families
Whether you ultimately choose a hospital, birth center, home-based VBAC, or repeat cesarean, VBAC – A Safe Alternative to a Repeat Cesarean provides you with evidence-based information, helpful strategies, and trustworthy resources that will help you to make your own decisions about how you want to give birth this time.
When I was pregnant with each of my two children, I knew I wanted to labor without drugs and with my husband at my side. I had the blessing and fortune to have had two safe, empowering, and healthy births. It was my choice. My wish for all mothers and birthing families is to have the understanding, respect, and support of their caregivers so they can make their own choice and experience their own empowering best birth.
When women and birthing families are treated with kindness and respect, have access to accurate information about the choices available to them, and understand the policies and practices of their caregivers they can make the decisions that best meet their needs.