What are the real barriers to VBAC, and are they evidence-based or built on fear and bias? In Part 2 of this powerful two-part series, Dr. Kathleen Kendall-Tackett continues her conversation with Australian midwife, researcher, and author Dr. Hazel Keedle. They dive deeper into the systemic, emotional, and clinical roadblocks that women face when planning a vaginal birth after cesarean (VBAC).
From BMI bias to short interpregnancy intervals, big babies to special scars, Dr. Keedle unpacks the often-coercive medical narratives and exposes the power imbalances that still plague maternity care. She shares groundbreaking insights from her research and emphasizes how control, trust, and informed choice are key to transforming birth trauma into empowered birth experiences, whether or not a VBAC is achieved.
If you care about evidence-based, respectful, trauma-informed maternity care, this episode isa must listen.
In This Episode:
(00:00) Introduction to The Science Chick Report
(00:29) Concerns about inductions and VBAC barriers
(01:01) Body mass index and VBAC calculators
(01:28) Fat shaming in maternity care
(06:07) Impact of birth experience on mothers
(06:52) Challenges with big babies and VBAC
(09:16) Interpregnancy interval and VBAC
(12:07) Multiple cesareans and VBAC support
(16:30) Breech birth and ECV options
(18:07) Hospital policy changes and breech births
(19:28) Understanding special scars
(22:45) Birthplace choices: hospital, birth center, or home
(27:15) The importance of control during birth
(29:39) Positive birth experiences: beyond the outcome
(35:58) Final thoughts and resources
Notable Quotes:
(01:45) "A higher score was more chance of a VBAC the thinner you were. And it really went to quite a ridiculous weight." – Dr. Hazel Keedle
(04:24) "What annoys me is that this is about the baby and not the woman. We want to get the baby out of this woman who's larger and, you know, if she has complications afterwards, whatever, that's her fault." – Dr. Hazel Keedle
(05:31) "A live mother may well have a pulse. However, she can be traumatized." – Dr. Hazel Keedle
(12:15) "The data is very supportive for two. One or two cesareans…potentially the more caesareans you've had, the higher chance you've got of a uterine rupture." – Dr. Hazel Keedle
(22:58) "Sometimes being in a hospital doesn't feel safe for women, especially when they've had previous birth trauma." – Dr. Hazel Keedle
(25:58) "We're treating them like terrorists and they just wanted to have a natural birth.” – Dr. Hazel Keedle
(31:56) "You can have a cesarean and feel amazing. You can have a cesarean and feel bad, you can have a VBAC and feel amazing. You can have a VBAC and feel bad." – Dr. Hazel Keedle
(35:37) “There were women who had cesareans that felt okay about them, women who had vaginal births that described them as rapes.”– Dr. Hazel Keedle
Our Guest
Dr. Hazel Keedle is a Senior Lecturer of Midwifery at the School of Nursing and Midwifery, Western Sydney University. With over 25 years of midwifery experience, she completed her PhD in 2021, focusing on vaginal birth after cesarean (VBAC). Hazel is the author of Birth After Caesarean and The VBAC Clinician’s Guide. Her work blends research and lived experience to promote trauma-informed, evidence-based maternity care.
Resource and Links
Podcast
The Science Chick Report
Dr. Hazel Keedle
Dr. Kathleen Kendall-Tackett
Mentioned
INOSS Study – Largest European data on uterine rupture (0.22% rate)
Sarah Wickham – Plus Size Pregnancy
Interpregnancy Interval Study (Australia)
Special Scar Research Project (Qualitative study on uterine rupture)