Birth After Birth Trauma

This is a question that we hear often. How can I have another baby?

Firstly, whether you’ve experienced psychological trauma or birth injuries or both ,spending time on your mental well-being is important.

Are you or your partner experiencing fear of being pregnant again?
Thinking about or being pregnant again after a negative or traumatic birth experience affects everyone differently. The decision around having another baby is yours to make and it doesn’t need to be rushed – well-meaning people may question and comment but ultimately only you and your partner can make the decision on whether or when to have another baby.
It is absolutely understandable that you may be feeling fearful about getting, or being, pregnant again or about a birth that may happen.
We often hear other women share experiences where they or their partner may wish to have more children but the previous birth experience has left them feeling like that might never be an option. Processing your previous negative or traumatic birth experience may well reduce your fear around getting or being pregnant again or the birth of another baby.
Birth after birth trauma

What we want you to know

  • No two births are the same but whether or not you chose to have more children is up to you and your partner.
  • Some women and families choose to have further children and work through their previous experience.
  • Some women and families choose not to have further children.
  • Some women may have wanted to have babies close together and now feel like they can’t. Equally, you may be ready to try again for another baby but your partner may not be. Together, you might be able to find strategies to help mange your fears and create support networks.
  • We encourage open and honest communication, this may involve the support of a couples counsellor.
  • Talking openly and honestly about your previous experience means you know where the other is coming from and what your fears and needs are.
  • Allow time to process your trauma. Often we hear of external pressures, not necessarily from partners but well-meaning family members or friends.
 
 

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I’m pregnant and now terrified of the thought of giving birth!

Finding a recommended mental health practitioner can support you in this process. This could be a social worker, a counsellor, a psychologist or a psychiatrist. For more information about pregnancy support counselling, visit COPE’s website.

How do I decide my model of care?

 Eg. Private, public, Private OB, Midwife Group practice
 
ABTA advocates for a multidisciplinary approach to birth. You can read why in our Position Statements.  Ideally, your support team would consist of a midwife, a doctor, a pelvic health physio and a mental health clinician. At this stage, this model of care isn’t readily available through public services.
 
Choosing a care provider that treats each woman as in individual, with specific values and desires and is supportive of your choices whatever they may look like, may give you the best chance for a positive outcome.
 
In being clear, and on the same page as your support team you can make plans around possible situations and outcomes. For example, “if X happens, we’ll try our best to do Y”s

What If I’ve had Birth Injuries?

It’s not uncommon for women to feel fearful of making current symptoms of physical trauma worse. Seek advice from your trusted health professional about the risks of another vaginal birth.
 
We asked Pelvic Health Physiotherapist, Sally Ely her thoughts about the key considerations when birthing after birth trauma, which you can read here.
 
Ultimately, you know what is best for you and your baby and your birth support team needs to be supportive of your choice.
 
If you’ve experienced a perineal tear you may find the information here useful.

What if I’d like a VBAC (vaginal birth after caesarean)?

Perhaps you’ve previously has a c-section and wish to opt for a VBAC. Finding a list of recommended providers may help.  Word of mouth can be hugely powerful in identifying who may be the best person to support you. You can get recommendations from feedback in community groups etc.

As mentioned, we recommend asking your health professional about the pros and cons of both modes of delivery so that you can make informed choices.
 
If available to you, we also recommend seeing a pelvic health physio during pregnancy, they may be able to support you in preparation for a vaginal birth.
 
Once you’ve selected your care provider, you might like to share this Discussion Guide with them so that you are both aware of the things to be discussed at each stage of pregnancy and post-birth. This is just a general guide, and you can add topics you would like discussed at each stage.

What women say about having another baby after birth trauma

Alex’s Story

Alex, was under the care of a private obstetrician, she ended up with a vacuum delivery with her first child and experienced pelvic floor muscle trauma resulting in prolapse.

How long was it before you felt ready to try for a second child?

We originally wanted our kids very close together and had planned on trying before when our son turned one, however due to how my sons birth went and the injuries I was left with we waited for 2 years before trying again.

Was it a tough decision to try again?

It was a very tough decision, there was a long time where I thought I couldn’t do it again. The fear of going through it all again and making my injuries worse, I just couldn’t imagine. I also couldn’t imagine only having one child as we always wanted a big family. It was a really tough time mentally and physically for a good 18 months. After almost 2 years in constant physical therapy with my women’s health physio, I felt my body could maybe handle another pregnancy.

What care model did you choose and how did you come to that decision?

I met with several private obstetricians before we decided to go ahead and try again, as I wanted someone who knew my concerns and fears and supported me the whole way through. I needed this in place before I was pregnant! I had fears over both types of births, I wasn’t looking for a healing birth, I was looking for a supportive birth.

How did you decide on the type of birth you’d like?

I was unsure on what way I wanted to birth, logically I thought a c section was the way to go but my heart so wanted that natural birth. My obstetrician talked through both options with my and gave me her medical opinion but supported me in which ever way I chose. Finally at about 32 weeks pregnant I chose the c section, as I have a partial avulsion I just didn’t want to risk making it a full avulsion, that’s ultimately what lead to my decision the risk was far to great.

What are 2 things you would tell to a family thinking about having another child after a traumatic birth?

I would highly recommend if you are able to, to get your team in place before hand. It mentally helps so much and don’t be afraid to look around for your team until you find someone you are comfortable and happy with but also trust

Try not to focus on the what if’s, it’s hard it really is but focus on what you can control, not on what you can’t.

Sophie’s Story

In 2017, Sophie laboured at home with baby exposed long term to meconium. (This was only revealed once we trusted our instinct and ignored advice to labour longer at home and went to hospital). Their son was delivered unexpectedly via emergency cs. Unfortunately their son passed away days later due to severe irreversible brain damage. Needless to say the physical, emotional and psychological birth trauma for this couple is complex and ongoing.

How long was it before you felt ready to try for a second child? Was it a tough decision to try again?

For us, we knew we wanted to try for another baby. We weren’t preventing but we were also not obsessively trying(like we did with our first!) After we had follow up with the hospital and had assurance that there were no genetic disorders that would put us in a high risk group, we decided to ‘see what happens’ and fell pregnant with our second child 5 months after the birth/death of our first son. For us we were glad we fell when we did, as we felt if we had of left it much longer, we might not have had the confidence to try again out of fear of history repeating itself.

In theory it was a a neutral decision to try again. We did have many moments when we would be ‘pendulums’ being decisive one moment and then totally indecisive another. For us being in a different situation – it definitely was a ‘leapof faith’ as there’s no doubt that the ‘what ifs’ and ‘could this happen again’ plagued our minds. However having the peace of mind knowing that we would be heard and closely monitored by the hospital helped make the decision and no doubtfully got us through and we finally got to bring a healthy baby home.

What care model did you choose and how did you come to that decision?

We chose to stay with the hospital where the birth trauma happened with the birth of our first child – mainly because they had all of our medical history. We were offered to go through the PALC (Pregnancy After Loss Clinic) which is public. We were advised that we would be under the care of a qualified Bereavement Midwife which we felt would be a benefit to us and our future baby. Also, because we were automatically deemed high risk (since we had previously lost a full term baby), we were going to be monitored more closely, have access to more regular scans by a Maternal Fetal Medicine unit after 20 weeks.

How did you decide on the type of birth you’d like?

I was in labour with my first son for just over 12 hours. I was unaware that he was in the posterior position and was in severe distress for the entire time. I ended up having an Emergency Cesarean section. Consequently, I developed an anal fissure a few weeks postpartum which added to my physical, mental and emotional trauma. I had corrective surgery a few months later and then fell pregnant, I naturally had many fears of adding to this already weakened area giving birth again . I was adamant that I did not want to risk further long term damage having a vaginal delivery so I elected to have another cesarean. I wanted the assurance that if I did happen to go into spontaneous labour before my scheduled cs date, that I would have a cs and not have to explain, justify and plead with hospital staff my reasons for not attempting a VBAC (it was on my hospital file to have a cesarean – scheduled or emergency).

What are 2 things you would tell to a family thinking about having another child after a traumatic birth?

 

  1. Definitely make sure you have an active support network around you. Trusted people who can help you out when you are mentally/physically/emotionally exhausted. Including having psychological support (social worker, doctor etc).
  2. Don’t be afraid to question and query the medical professionals on their decisions or advice – make sure you do your own research and trust your instincts and push if you have to (eg: we were adamant due to old tissue damage that I wanted to eliminate further complications or issues and therefore it was marked on my hospital file to have a cs whether it was scheduled or emergency and not a VBAC which was supported).

Support Services