VBACs (Vaginal Birth After Cesarean) in Korea

VBACs are relatively new since at one time there was the belief that "once a C-section, always a C-section". Thankfully this has changed in recent years. However, not everyone is a good candidate for a VBAC. Here are some things you can do to increase your chances of trying for a VBAC. If you already know you need to have a C-section, make sure that your doctor allows you to do these things so that you can try for a VBAC for your next birth.

• Double stitching, not single stitching
• A low, transverse incision (bikini line cut) 
• Being allowed to labor prior to getting your previous C-section can greatly help
• Time between births should be at least 18-24 months
• Many doctors will not allow you to try for a VBAC if you've already had two C-sections.
• A healthy pregnancy, not being over or underweight, eating properly, and exercising. No diabetes,  pre-eclampsia, or high blood pressure
• Being under 35
• No issues with the placenta or danger of uterine rupture
• Do your research and find out about natural childbirth vs. the cascade of interventions

C-sections in Korea
I recently blogged about signs that your doctor might perform an unnecessary C section. Unfortunately, C-sections are very common here in Korea. The rate is around 30%. Korean culture has something to do with it. Husbands rarely get days off (even though legally they're allowed 5 days paternity leave), auspicious days are chosen for the baby's birth, and the lack of education makes women believe that C-sections are easier: they're not. Most Korean hospitals will keep you for 3 days after a vaginal birth and 5 days after a C-section. Some women believe that you'll be wheeled in, cut open, sewn shut and ta-da it'll be over. It's not. Recovery takes weeks, sometimes months, sometimes women are left with permanent nerve damage and are numb.

A C-section is major abdominal surgery. Many C-sections can be avoided, especially the "emergency" C-sections. The number one, top, best ever way to avoid an unnecessary C-section (or unnecesarean) is to choose a hospital or clinic that supports VBACs (Vaginal Birth After Cesarean). It's hard enough to recover from major surgery let alone have to care for a newborn on top of it.

Where to get a VBAC in Korea
Here's a list of hospitals and clinics in Korea. Not all of them may support VBACs. Birthing centers and hospitals focused on natural birth should. Always ask a place what their view on VBACs are and what their success rate is. I can't stress it enough for you to get information. Even at the same hospital you may find some doctors who support them and some who don't. Get your doctor to sign your birth plan so that if your doctor isn't on call your wishes will still be respected. These are some VBAC friendly places in Gyeonggi-do and Seoul.

• Agitanseun Natural Birth Center (김옥진조산원) Kim Ok Jin (Rosa)
• GM Cheil Women's Clinic
• Lee Myung Hwa (행복한이명화조산원) they used to be Happy Birth  
• Mamas' Birth Center
• Medi Flower
• Soonchunhyang Hospital (SCH)
• Yeon and Nature

Getting the Birth You Want
There are many things you can do to get the birth you want. The number one thing you can do is to choose a caregiver wisely. You should also ask questions and see how likely it is that you will be able to try for a VBAC. Here are some things to consider asking:

• How far past your due date will they allow you to go? (Remember that there are different ways to calculate due dates. Add to that gestation age can vary up to 5 weeks and due dates can be up to 5 weeks off means that your due date isn't that accurate at all so doctors can get your due date wrong. Don't forget that first time moms are 8 days late on average.) The ACOG (American College of Obstetricians recommends not inteferring with a health pregnancy before 42 weeks.
• What's their C-section rate?
• What's their VBAC rate?
• Do they try to convince you to have a C section?
• Will they try to induce you if you go past your due date or automatically schedule a C-section? (Even if you need a C-section, being allowed to go into labor is beneficial for both the mom and the baby. Among other things, it allows the natural flow of hormones as well as squeezes the liquid out of the baby's lung so that it's easier to breath.)

Resources
If you're interested about learning more about VBAcs and C-sections, check out the links below. 

• American Pregnancy's info on VBACs
• C-Section: How to Avoid, Prepare for, and Recover From Your Cesarean 
• The Essential C-Section Guide
• How to Plan your VBAC
• ICAN (The International Cesarean Awareness Network). They have a section on VBACs.
• The Thinking Woman's Guide to a Better Birth by Henri Goer
• The Unnecesarean
• The VBAC Companion
• The VBAC Forum on Mothering.com 
• VBAC Facts. Check out their 13 Myths about VBACs.
• VBAC.com

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Tender Embrace Birthing offers childbirth, breastfeeding, and newborn care classes and support.