Book Review

The VBAC companion is exactly what it's title portrays. A book that will encourage women, seeking a VBAC, to pursue their desire for an empowered birth experience. The presence and encouragement of the author can be felt emanating out of the pages - within her words and thoughts.

This book outlines the steps a woman needs to think about, and plan toward, to improve her chances of achieving a VBAC birth. To do this the VBAC companion begins by looking at the issues that may have arisen during a past birth experience, or contributed to an unnecessary caesarean birth experience. It takes the reader through the psychological aspects that may have been present, as well as the actual physical factors that may have contributed to the unfolding of each of our personal experiences of birth.

Diana Korte expresses her findings by using the personal stories of women's birth experiences (VBAC and caesarean), by collating worldwide statistics (available in the reference section) and by researching the many studies and reports that have been produced in regard to VBAC/caesarean birth (all included in a detailed bibliographical reference section within the book). She also contacted, and researched the aims and philosophies of, the many support groups and childbirth professionals that advocate VBAC as a valid choice for most women who have previously experienced caesarean birth (many of whose contact details are found in a 'Resource Directory' at the rear of the book).

The personal anecdotes are particularly valuable, as they allow women to realise that they aren't alone in feeling emotional, or physical, trauma in relation to a past experience. And the words of wisdom shared in these anecdotes are priceless. One example is: "Needless to say, while I was delighted with my baby, and would have gone through the whole experience again if I had to just to have him, I could not help but wonder if all that trauma to my body and my spirit could have been avoided..." (Page 16)

Diana touches on the consequences of caesarean birth, and 'caesarean depression' in particular. This is a phenomenon that I, personally, believe is often overlooked when women contemplate the possible ramifications of birthing by caesarean. I was very happy to see it discussed and the likely reasons for this condition explored in some detail.

Another section ponders the misconception that VBAC is a 'self-indulgent' choice that women make, risking the safety of their child to achieve a higher ideal of how their birth should be. Somehow society believes that caesarean birth is the safer option, and that women have the right to choose to birth their babies surgically, with drugs, etc, and that this choice is the more reasonable alternative. Diana seeks to inform women that VBAC is usually the safer option, not a selfish one, and that their wish to birth naturally is generally the best option for both mother and child.

Diana acknowledges that not all VBAC's will be successful, and spends some time recounting women's personal thoughts on how they felt should their VBAC attempt be perceived as a failure. Again, and again, women related that, though they grieved for the loss of a natural birth experience, they did not regret attempting VBAC and experiencing labour itself. The women may have been angry at any factors that may have prevented their VBAC from success, especially if these contributing factors were not necessary, but they were generally aware that they experienced some part of birth and, in doing so, they prepared their child for it's entry into the world.

"The VBAC Companion" is a wonderful collation of hard-won experiences and research-based suggestions that aim to help women explore the birthing choices available to them after experiencing a caesarean/s. It is a pro-VBAC book, but it acknowledges that some women will still choose to birth by c/section - either because it IS the safer alternative in their particular situation, or because of psychological fears to do with birthing naturally. For women choosing this alternative the book closes with suggestions of how to improve the caesarean experience, making it more acceptable to both mother and child.

I highly recommend this book to all women attempting VBAC birth. I found it to be extremely enjoyable to read, and full of commonsense advice as well as up-to-date woman-centred, evidence-based findings in regard to both VBAC and caesarean birth.

It would make a valuable contribution to all libraries related to birth (ie, in midwifery centres, hospitals, etc) as advice on future birth choices is one positive way to reduce unnecessary future elective c/sections.

All childbirth professionals (Ob's, GP's, midwives, etc) will gain much insight into the emotional consequences, and challenges, of both c/section and VBAC birth by reading this book. It could only benefit their clients and will provide a more understanding relationship in regard to negotiating the care of women who have experienced caesarean birth in a previous situation.

I believe that Diana's final words show her great understanding of the emotions surrounding birth, and the expectations that we hold as we aim towards an EBAC (Empowered Birth After Caesarean). She encourages us to recognise our efforts, and forgive ourselves, and others involved, if we don't always manage to achieve our ideals. She says: "Kiss your partner, and that new baby. They need reassurance, too. Have confidence that you did the best you could."

Jackie Mawson
Convenor of Birthrites: Healing After Caesarean Inc.