For many women who have experienced a traumatic birth, contemplating a subsequent pregnancy is fraught. This can be true for those who have experienced continued post-traumatic symptoms, as well as for those who’ve felt relatively at peace for some time. In my experience, with a lot of planning and proper supports, it is possible to have a positive birth experience after a traumatic one. Of course, as pregnancy and birth are unpredictable, it may not be the birth you envisioned, but it could still be a reparative and healing experience.
My 10 tips on having another baby after a traumatic birth experience are below.
- Work with a trauma therapist: I highly recommend that you work with a therapist trained in treating trauma to make sure you have adequately processed your experience. Many women who have experienced traumatic births do not share their birth stories or avoid thinking about the experience. They think they are fine because they don’t think about the experience often, and are caught off guard by trauma symptoms that emerge during a subsequent pregnancy. A trauma therapist will help you process your experience and teach you techniques to manage trauma symptoms such as anxiety or flashbacks.
- Identify the “stickiest” parts of your birth trauma: When I work with client’s who have experienced a traumatic birth, we work to identify the moment or moments which felt most scary or difficult about their first experience. These “sticky” moments often hold the weight of the trauma. For example, for one client it was the memory of having the anesthesiologist start her epidural. For another, it was the moment when her baby did not cry after birth. Focusing in on these moments will help you to process the cognitive and somatic memories attached. This is essential to moving through the trauma, as well as planning for what could be the more anxiety provoking elements of a subsequent birth.
- Exposure: Exposure exercises are an important part of trauma treatment. However, please only do this work under guidance of a mental health professional who can make sure you are doing it safely. Exposure exercises are way of confronting a feared experience either imaginally (thinking about the experience) or in vivo (exposing yourself to real life places or scenarios). I generally work with clients in a gradual way, building up from less scary memories to ones that are more intense. For example, one of my clients was afraid of returning to the hospital where she had a traumatic experience. We worked first with having her imagine different aspects of the memory. We then moved into in vivo exposure where she first practiced walking around neighborhood near the hospital, then around the block, then into the lobby, and finally up to the labor and delivery floor.
- Anxiety management techniques: Before starting any exposure or trauma processing, I work with clients on strategies to help them feel emotionally safe. These strategies can be used in therapy, at home, or during labor and delivery. I often use grounding techniques which help to move someone out of a traumatic memory and in to the safety of the present moment. I find it helpful to work with strategies that connect clients to their breath and their senses. For example, naming five things they can see or hear in the therapy room, or focusing on their breathing and a neutral sensation in the body.
- Get Educated: Once you have some solid strategies to help you cope with difficult memories, I highly recommend that you educate yourself on what happened during your previous birth. I suggest reviewing your experience with your medical providers and perhaps looking over your records. I’d also discuss what happened with any members of your birth support team (partners, doulas) who were there during the previous birth. Having a more complete understanding of what happened is helpful in processing the traumatic experience, feeling empowered for your next birth, and finding points of intervention to make the experience different.
- Remind yourself the ways it will be different: It can helpful to review all the ways in which a subsequent birth experience can be different. Perhaps you have chosen a different medical provider, or are working with a doula the second time around. Or maybe you have a better grasp on techniques to help you cope with anxiety or pain. This will help you to feel more empowered and in greater control over your next experience.
- Manage expectations: That said, birth is unpredictable and there are no shortage of reasons why things may not go as planned. It is important that you manage your expectations about the experience so you don’t set yourself up to feel disappointed or re-traumatized. In often work with clients to help boil down their birth plans/preferences into what feels most important. For one client that was recognizing that underneath her desire for an un-medicated VBAC, was a need to feel empowered and listened to during her labor and delivery. For another, it was to feel like she was doing the best for her baby regardless of medical intervention.
- Get your team together: Take the time to make sure you are working with a medical team who you feel is sensitive to your experience. This may mean finding a different OB or midwife, or it could mean having a conversation with your past medical team about your birth trauma. Many of my clients have found it helpful when possible to work with a smaller OB/Midwifery practice.
- Tell your story: Tell everyone involved in your next pregnancy and labor that you experienced trauma with your previous birth. Put it on your birth plan, tell the nurses, the anesthesiologists, the medical assistants. Repeat it over and over until you find someone who will listen. Maybe that is an L&D nurse or a sensitive OB in your practice. Enlist this person as your advocate.
- Hire a doula: I highly recommend working with a doula following a traumatic birth. A doula can serve as an extra advocate and a steady presence during labor and delivery. I often encourage clients who have experienced trauma to connect with a doula early in their next pregnancy so they can truly get to know one another, and make sure the doula understands their previous birth experience.
Stay tuned next week for some suggestions on supporting a friend or loved one after a traumatic birth, as well some ideas for how medical providers can offer more compassionate trauma informed care.