When speaking with prospective clients, our doulas may be asked, “What is your VBAC success rate,” or, “How often do your clients get epidurals?” We understand these questions. You want to feel like they you are choosing a doula who a) has experience with the type of birth you are hoping to have, and b) who can help you achieve it. The thing is, doulas cannot guarantee outcomes. We just can’t. Our role is to provide our clients with physical, emotional, and informational support. The clients we work with feel supported and empowered by what we offer them. We can help normalize what occurs during labor, and help you navigate the options your medical care team may suggest, so you can make the best decision for you and your family.
Doulas, by definition, are not medical professionals, and therefore we cannot specialize in or have a “success rate” of any certain type of birth, intervention, or outcome. Many medical and personal factors are involved in determining whether a client has a VBAC (Vaginal Birth After Cesarean) or a repeat cesarean. The same is true with clients having a unmedicated or medicated birth. We can guarantee we will support you in every way possible as you welcome your child into the world. We absolutely love our job and take the care and support of your family very seriously.
Our Doulas and VBAC Deliveries
Our doulas are experienced in working with families hoping to VBAC. But we do not document our “rates” because the fact is, the rates are not ours to claim. With a VBAC, there are far too many medical factors that go into the decision of whether or not a client is a good candidate, or if the labor is progressing in a safe manner for mom and baby. While studies show that the presence of a support person (ie a doula) can reduce the chances of a mother having a cesarean, the doula herself is not the deciding factor, nor is she the responsible party in that decision being made.
Doulas are not medical professionals. And even if we were, nobody can promise that you will achieve your birthing goals. The complexities of birth, and of the medical care you will receive, are largely influenced by your own anatomy and previous birth history; your baby, their health, and their position; how your labor is progressing; and your care provider’s approach to birth management. None of these factors are under the control of your doula. Therefore doulas cannot claim “success” if a woman has a vaginal birth vs repeat cesarean. And, quite frankly, doing so is misleading. The best advice we can give potential clients hoping for a vaginal delivery after a cesarean delivery is to seek out a provider who is truly supportive of vaginal births after cesarean.
Furthermore, we find claiming success rates as doulas (whether for VBACs or any intervention) harmful to the culture of birth. Doulas are not saviors. We do not swoop in and “save” our clients from their doctors, the hospital, or interventions. For us to keep track of who does or does not have a vaginal birth, or an epidural, or an induction, or any such factor, puts our clients into “successful” versus “unsuccessful” categories, which places judgment on those choices or outcomes.
Judgment is the antithesis of doula support. Choosing or requiring interventions is not a failure, and the opposite is not a success. Everyone’s birth is unique. The choices you make about your birth are not intrinsically positive or negative. Placing these value judgments on certain ways of birthing do nothing but divide and degrade. Our doulas work hard to provide nonjudgmental, unbiased support to our clients, regardless of how they give birth. We also empower our clients to take ownership of their birth experience. The outcomes are theirs to claim, not ours.
When choosing a doula, we encourage you to frame your questions in such a way that highlight whether the doula has an energy and personality that will set you at ease. You should not focus on how many of a doula’s clients have had a particular birth outcome because, as you see, doulas provide support. They can’t guarantee outcomes.
What if we switched the terminology? Instead of saying you had a “successful VBAC” we started saying that you “completed your VBAC” or “had a VBAC”? This can work because if your baby is born vaginally, you have completed your goal. While I realize there are limitations to this language as well, the opposite of completed, “incomplete,” is much less harsh than the opposite of “successful.” Language is powerful and it can shift how we ourselves, and others, view VBAC.
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This article is for informational purposes only. It does not take the place of speaking with your healthcare provider.