Have you just found out you’re pregnant, but every time you think about birthing this baby your heart sinks?
Are you excited about the pregnancy, but terrified about giving birth?
If your previous birth was difficult or traumatic – and probably still fresh in your mind like it was yesterday – it isn’t uncommon to feel this way. Many women feel frightened about birthing again after a difficult experience. You might have so many questions: Will it be like last time? Should I just do the same thing again, with the same care-provider, and hope it will be better?
Or do I want something different?
Perhaps you push those thoughts away altogether because it is simply too frightening and overwhelming to contemplate. Maybe you haven’t even given yourself the space to think about your previous birth, because you’ve been urged so many times to be grateful for your baby.
The majority of women I work with have previously had unwelcome birth outcomes or traumatic experiences. They come to me because they decide that this time, they want something different. They want to discuss and understand what happened in their previous birth. For this pregnancy, they have chosen to seek knowledge, confidence and loving support. They want someone who understands that they both love their baby and feel disappointed about their birth. They want to know that if they ever feel like giving up, there will be someone there for them, reminding them they are worth it.
During your pregnancy, preparation and clarity takes work – but it isn’t work you have to do alone. It is done over time, and through conversations and sharing, questions and discussion, your understanding of your last birth and your desires and plans for your next one unfold naturally.
So what might it feel like, to have a positive birth experience next time? Well, there’s no one right way; it is different for each woman. But one thing that is true of any woman who feels great about her birth is that she always felt that the choices were hers to make, no matter what happened – and that she was respected and believed in at all times. But not only that – by the end of her pregnancy, she also trusted and felt confident in her body:
“You helped me find healing around my previous experience, and a deep, intuitive level of trust in my own body and my baby to birth … you supported me to find my own strength so that I was never too afraid to go on.” – Heather
“It was from this position of knowledge, strength and determination that we were able to gently, calmly and beautifully bring our second born into our lives; a moment that we will treasure forever.” – Kay
When you tell me the story of your previous birth, I will listen. If you felt unsupported or scared, I believe you. When you want to know what options are available for you this time, I will talk about them with you. And if you are worried or afraid, I will comfort and support you.
If you have had a previously difficult birth and are pregnant again, and are ready to take the first step towards a better birth, get in touch and let’s talk about it.
Did you know that the biggest reason for having a baby via caesarean, is having had a previous caesarean? And did you know after having had a caesarean, only about 15% of women will go on to have a vaginal birth for their next baby?
Because of these high rates of surgical birth, it can be easy to assume that repeat caesareans must be necessary and safe. And for some women, this will be the case. Some – but not all.
Attention is being drawn to rising caesarean rates. While the World Health Organization recently stated that caesarean rates over 10% are not associated with reductions in maternal and newborn mortality rates, countries such as Australia and the United States have some of the highest rates of surgical birth in the world. In Australia, more than one in three births now happen via caesarean, at 33% of all deliveries.
But what does this mean for an individual woman?
Sometimes, women find it isn’t as simple as a choice between a repeat caesarean, or a vaginal birth. If it was, we wouldn’t have a vaginal birth after caesarean (VBAC) rate of only 15%.
I spoke to Ana, who gave birth to her third baby after two prior caesareans. Of her second caesarean, Ana explained, “After being disappointed when my first birth ended in a caesarean, in my second pregnancy I sought a care-provider who would support my plan to have a VBAC. Although this care-provider offered one-to-one care, they didn’t listen to my needs or wants, and spent the entire time convincing me that my only option was a scheduled repeat caesarean.”
Pregnancy and birth is a time of personally nuanced and complex feelings and needs. Yet planning for a birth after caesarean, however, can also often feel like an exercise in statistics. Risks of this, chances of that, a certain-times increase or decrease in something else. It can be confusing to make sense of the presented statistics and to work out how they can inform your decision making.
Often, women might feel talked at, rather than listened to. She might feel differently to her partner, or her friends or family. She might have one care-provider tell her one thing, only to have a different care-provider tell her something else. She may also find that her feelings change as her pregnancy goes on, and she may wish to make different decisions or change her plans. It can be of enormous benefit to a women to learn to communicate her own desires and needs to those who will be supporting her – for instance her partner, and her maternity care-providers.
When planning a birth after a caesarean, it can be helpful for women to remember that their choices are individual, and that risk analysis is subjective. What feels like a risk for one may not feel so for another. What is important to one woman, may not be for someone else. Consider, for instance, a woman who may have previous birth trauma centred around not being given enough time during labour, and feeling coerced into interventions. It may be vitally important to her that this does not happen again, that for her next birth, she feels supported to labour uninterrupted and without pressure. Yet another woman may have felt alone or out of control in her previous birth, and for her next birth she needs strong, consistent support and explanation from care-providers at all times.
As Ana went on to tell me, “It wasn’t until I found myself unexpectedly pregnant with my third child that feelings from the previous experiences surfaced … this time I would not settle for a care-provider or any model of care that did not put my needs as the highest priority. So I went on a mission to find support for my plan for a physiological and natural birth after two caesareans. This was not readily available. I quickly concluded that I would need to develop my own team, made up of personal support for myself and my husband … My doula offered us unbiased information when exploring our needs for this birth. I also sought a care-provider who respected our decisions, as well as independent birth education to provide us with useful information and tools that raised our confidence in preparation for the labour and birth. Finally we worked on restoring our belief that women’s bodies are designed to birth, that my body could birth this baby physiologically and naturally. Anyone in our social network who offered a different opinion was reminded to keep that to themselves.”
Even though a wealth of evidence demonstrates that birthing after caesarean carries minimal extra risk, women may choose not to consider a VBAC for many reasons: fear (of pain, of complications, of birth itself), care-provider preference or policy, lack of support from family, or feelings about risk.
A planned repeat caesarean will be right for some women, and a planned VBAC a must for others. Each woman’s needs, choices and situations are different and unique. The important point is that every woman deserves to make birth choices with all the information, and with the full support of those around her.
Ana’s story demonstrates this importance, as she finishes, “I am proud to say that this preparation and determination is what made the difference in our third birth. I birthed my third baby – my biggest baby, and my longest labour – naturally as planned.”
* For more support for birthing after caesarean, please click here.