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Model for Empowered Birth After Cesarean Birth (EBAC)

My work advocating for vaginal birth after cesarean began after my vbac in 1998.  I spent a great deal of time listening to mothers preparing for vbac and sharing the stories of my cesarean birth and my two vaginal births.   I learned quickly that moms need support as they look towards avoiding an unecessary cesarean birth.  Before a mother can plan for something different, we must first understand where the interruption of flow occured in her first birth.  Additionally, we must embrace an understanding of medically necessary cesarean births. 


During my years of work with mothers, I began to develop a model to help mothers put their stories of cesarean birth into context so each mother and her support team could identify barriers to a vaginal birth.  As the model unfolded, my clients and I discovered that when we turned over as many stones as possible we were able to identify where support or change is needed.  Through this process  we seem to increase the chances for a vbac and can embrace cbac (cesarean birth after cesarean) when medically necessary.   The work we do together relies heavily upon:



-an understanding of physiological birth

-our cultural belief about our bodies and birth

-finding a skilled vbac provider

-good labor support

-mother identified personal risk assessment through true informed consent and facts surrounding vbac



What if you want a vbac and a cesarean birth becomes necessary or you feel that vbac is not a good decision based on the context of your situation? What about

cesarean birth after a cesarean birth?  Mamas, your births are important to me no matter the route your baby takes to find his or her way into your arms.  Mamas whose babies are born by cesarean birth are in need of support as well.  I find that most mothers did not have adequate emotional or physical support after their first cesarean birth

The best place to start is through educating yourself so that you are guiding your birth process and you are working with a practitioner and birth team you can trust.



"Melissa was essential to my successful VBAC. From listening to my story (of my first cesarean), to providing invaluable insights into the birth process, to being my human pitocin during labor itself, I couldn't have done it without her. Although in my first labor I had thought I was educated, through Melissa I realized that there was so much I needed to understand about fetal positioning and undoing some of what years of ballet and modern life have done to my body. She guided me to seek help in the ways that I needed it, was a willing ear, and always good for a hug. She called me out when I was making a bad decision regarding my birth team, and most importantly believed in me, my baby and my body. To top it all off, when I started to lose hope in what was turning into another long labor- starting to feel too similar to my first, she showed up on my doorstep and as far as I'm concerned performed magic of the most incredible kind (a formula involving a lot of skill, hard work, passion and love I believe). The body work she did accelerated my labor and an hour later... I was through transition and my midwife was arriving. Later (after much pushing) when I was starting to lose hope of getting my VBAC again, I was able to be at peace with any decision we made, because I felt so strong, and empowered and healed by my labor up until that point. Fortunately, I ended up with the VBAC to boot! I'm never having another baby again without Melissa! (sorry Melissa, you are not allowed to move or retire... EVER )" 

"I am convinced that working with Melissa was one of the most important things I did to safely bring my second child into the world safely and without surgery. After my first child was born via emergency c-section, I found myself wishing I had worked much harder to pay attention to baby's position and advocated more strongly for myself and my baby. When I became pregnant a second time, I immediately began learning about how I could ensure baby's position was optimal, especially since I knew my placenta was in the front once again. Throughout my pregnancy, I saw Melissa for craniosacral sessions which helped control my sciatic pain, center my spirit, and helped me communicate with my baby and body. Since Melissa is also a VBAC mom, she understood exactly what I was dealing with in terms of my spirit and emotional needs, too. Her words of encouragement were as important as the body work she provided. When I began labor, I was fortunate to have Melissa on call to come over to my home where she worked with me during labor. I am certain that it was during this time that baby finally got himself into the right position for birth, enabling me to bring a 10+ pound baby into the world safely. She also was able to come to the hospital to provide a craniosacral session to my child right after his birth and I was astounded to see the mild bruising on his forehead (from his entry into the world) disappear while she worked on his sweet little body. I cannot thank Melissa enough for the gift she has been to our family. She's amazing!"  

"I chose to work with Melissa for my third pregnancy because I wanted to try to deliver my baby via vbac. I also, knew she would be a good source of emotional support that I needed. My first pregnancy was supposed to be a home birth and ended with a c-section due to my baby turning breech at the end. My second pregnancy ended in a miscarriage. Melissa's prenatal body working-knowledge and sincere nature, seemed like a perfect fit. I started early on my pregnancy and received massages from her until my baby was born and after for post natal recovery. I do strongly feel like she kept my body on course for my successful vbac:-). She kept my hips open, corrected and gave me suggestions on posture during pregnancy. She gave me exercises to help direct and keep my baby head down. Melissa also showed me support. Having someone encouraging your success is so helpful. My words cannot truly describe how special Melissa is to me. I will forever be grateful to her for helping and encouraging me to have a successful natural vaginal birth!!! Thank you Melissa.


In 2013 I began to share ideas with colleagues and was encouraged to develop my ideas and present the model at Carol Gray's 2014 Infant & Maternal CST Conference in Portland.   Since the presentation in 2014, I have continued to develop and work with the model.  2015 allowed me to spend several hours working with local bodyworkers and birth professionals.   We are seeing positive results working within the model towards empowered vbac and gentler cbac experiences.   I continue to be available to women who would like to move towards a vaginal birth after cesarean.  2018 finds me working closely with women and birth professionals in our community as I create a workbook for mothers to use within the model.   I am grateful to the following women who have learned to work within the EBAC model in order to deepen the support of women in our community.

The following birth workers and bodyworkers have spent several hours learning to work within the model and help further this paradigm shift:

Ana Arreola Vallow, Professional Doula, Certified Dancing for Birth™ Instructor


Amy Beck, CD(DONA), LCCE

*on sabbatical


Rebeca Greenan, Birth Doula, Certified Dancing for Birth™ Instructor


Susan Krieg, Holistic Doula (Certified, The Matrona), CMT, Reiki Practioner


Molly McDonald, LMT, CST, Founder of TAD


Molly Mendota, LCCE, AdvCD(DONA), CLS
Birth Doula, Doula Trainer, and Childbirth Educator

Julie Mirise, LMT

Maya Abdominal Therapist

Jennifer Moore, CD, SBD

Birth & Bereavement Doula, Placenta Specialist


Jessica Mott, CMT, Certified Monitrice, Birth Doula


Linnea Mugford, CD, LMT

Certified MuTu Pro, Certifed Personal Trainer (ACE)

Lisa Popp, CD(DONA), Reiki Practioner

Songbird Reiki and Prenatal Support 

Lindsey Pyle, Birth and Postpartum Doula

Ashley Seibert, Midwife Assistant and Birth Doula


Jennifer Steinbachs, ND

Claire Woods, CBE, CD



With Carol Gray at the 2014 Infant/Maternal Craniosacral Symposium, Portland, OR

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