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. There are too many medical and personal factors involved in whether a client has a VBAC (Vaginal Birth After Cesarean) or a repeat cesarean, or whether a client has an unmedicated or medicated birth. What we can guarantee is that 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
While we are experienced in working with families hoping to VBAC, 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. Studies do show that the presence of a doula (or other support person) can reduce the chances of a mother having a cesarean, however, the doula themselves is not the deciding factor or the responsible party in that call being made.
Since we are not licensed medical professionals, we cannot promise our clients that they will achieve their birthing goals just because we are there. 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, and therefore doulas cannot and should not claim “success” if a woman has a vaginal birth vs repeat cesarean. 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) to be harmful to the overall culture of birth. Doulas are not saviors and 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, and the choices you make about your birth do not hold positive or negative value. 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, and know that the outcomes are theirs to claim, not ours.
We encourage you, when seeking your doula, to reframe your questions in such a way that highlight whether the doula has the energy and personality that will set you at ease. Don’t get hung up on how many of their clients have had X kind of birth because, as you see, doulas provide support and don’t guarantee outcomes.
This article is meant for informational purposes only. It is not meant to diagnose, treat, cure, or prevent any disease.