Pregnancy After Birth Trauma

One of the Focus topics for the #MatExp campaign this week is Pregnancy After Birth Trauma. Here, a member of my private Facebook group discusses her experience of this.  Please note, this mother is not a healthcare professional, so some of what she says may be standard practice.

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With my first birth I had a major obstetric haemorrhage resulting in 4l blood loss due to a retained placenta.  This was despite having a low risk pregnancy and a low risk birth (spontaneous onset of labour, ~5 hours of established labour, delivered in birthing pool).  To this day we still don’t know why I bled so much from a retained placenta nor why it was so quick…it’s just one of those things.

I had a debrief when in hospital and also a further debrief with a consultant a few months after the birth when I was a bit more distanced from the event to help me rationalise the flashbacks that I was getting.  I do think that the debrief after a period of time helped as I think immediately post birth it was all just too much for my brain to cope with so I actually was quite blasé when I was told how serious it had been.

At my booking in appointment my midwife referred me to the consultant straight away due to me being anxious about the birth even though standard practice I believe is to wait until the 20 week scan and I saw him at 15 weeks.  I’m really grateful to the midwife for doing this as although it was only about 8 weeks early it was naturally something that was preying on my mind.  Having the discussion early gave me less time to hypothesise about what we would do differently this time.

The consultant advised me that a vaginal delivery with a managed third stage was by far the safest option and asked if I was happy to be referred back to midwife care which I agreed to.  My husband had been expecting us to be offered a c-section (and had rather bought into the idea of knowing the exact date of delivery)…whilst I was happy with the advice from a medical perspective it did mean that I would have to go into another labour which I knew would be difficult mentally.  I know that if I really pushed and said that I didn’t think I could go through with it I may have been allowed a c-section but decided that I wanted to take the lowest risk option.  I did also ask the consultant if there was anything I could do antenatally to minimise the risk…so I got given the challenge to keep my iron levels high.  It might have been a small thing but giving me something that I could manage (i.e. my diet) gave me a feeling that I had a bit more control over the birth and something to focus on.

I’m an engineer by trade so am used to working with risks and probabilities.  I knew that the likelihood of the event occurring again was low, but however rationally I was able to be there was always a niggling voice in my head saying ‘but last time statistically it shouldn’t have happened’.  It’s hard to be rational all the time when you WERE the 1 in goodness knows how many thousands.

I still had some questions over the birth and expressed this at my midwife appointment and they put me in touch with the Head of Midwifery.  I’d got really fed up of well-meaning people thinking they were being reassuring by saying ‘it won’t happen again.’  and so it was a breath of fresh air to hear someone say ‘yes it’s unlikely that it happens again but just in case it does…here’s what we’re going to do’.  We covered every aspect of labour…who would be informed when I was in labour, how I would be assigned a senior MW, how I could still use the birthing pool, how the placenta delivery would be managed, what drugs would be used to help contract my uterus etc.  Additionally we also covered some non medical aspects such as what would happen if things progressed quickly and our childcare (my mother-in-law) didn’t arrive in time to take my daughter.  I was worried about her seeing things if events kicked off as before.  Knowing that she would be looked after by the staff so that she wouldn’t see anything whilst allowing my husband to be with me was so important.

As my due date neared the nightmares came flooding back.  I know it was linked to my subconscious fear of history repeating itself as during the day, when my rational brain was in charge, I was always able to suppress any worries by grounding myself with the statistics and the plan we had in place.  I shared this with my midwives at my antenatal appointments and the fact that each and every one was happy to talk to me about my fears (the overwhelming fear of leaving my husband, daughter and as yet unborn child) and sympathise was much appreciated.  Being told by a midwife that they were proud with how well I’d coped with everything was an extra nice gesture….it allowed me to give myself a break and stop beating myself up over my anxiety…fuelled of course by the well meaning comments of ‘you’ll be fine, it won’t happen again.’  On reflection I now see how damaging that kind of language was as I felt it was devaluing the anxieties that I had, as if somehow I didn’t have a right to be worried.

When I went into labour I rang the hospital explained who I was and got ready to go in.  I’ve found out since that in that time the midwife coordinator who had been sent the plan in advance briefed the team on duty so that everyone was prepared.  The midwife I was assigned was lovely and I think picked up how anxious I was.  I wasn’t in established labour when I arrived and when examined was only 2-3cm, 20 minutes later was holding a rational conversation with the midwife about how I was feeling a bit sick so was going to lie down for a bit and then 15 minutes later was holding my daughter in my arms.  I don’t remember much of being in labour other than it being extremely intense and how the flashbacks came back thick and fast.  After delivery the plan was quickly put into action and I don’t think I fully appreciated how much fear I had suppressed until that moment.  I focussed on feeding my daughter whilst listening in on what was happening.  Hearing that the placenta looked intact and that my uterus was contracting down nicely was the point at which I finally breathed a sigh of relief and knew that everything was going to be ok.

If I had to summarise what I think were the key things that helped with the pregnancy it would be active listening and having a clear plan in place, even if the risk of re-occurrence is low.  Whilst well meaning it’s no use telling someone that something ‘isn’t going to happen’, however much the statistics are in their favour, more focussing on the mitigations that are being put in place and how they will lower the risk of either the event occurring or the severity of the outcome.

And yes…I’m glad that it’s all over now.

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What was your maternity experience? Please tell the campaign on Twitter or on Facebook.