Closing the door on trauma: my healing second birth story

After a traumatic birth with her first daughter Grace, which resulted in being diagnosed with PTSD, Caroline was determined to do everything she could to have a positive birth experience with her second child. With Grace, she ended up having an emergency C-section after three days of failed induction, so she knew her chances of an uncomplicated, vaginal birth were reduced – with the added potential of being in the same situation again, triggering and even worsening her PTSD. She hopes her story gives others the courage to plan the birth they want and need.

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I agonised over the decision to attempt a vaginal birth for months, in fact it had been going around and around in my head since Grace’s birth. I wrote every physical and mental risk versus benefit and discussed these with my husband, therapist, mental health midwife, doula and several obstetricians – I even ‘RAG (Red-Amber-Green) rated’ them (!) to come to the final decision – meaning I used colours to rank a good outcome (green), the worst outcome (red) and ‘neutral’ (amber) aspects. I found it really helpful to have a visual layout of my options to come to the right decision for me. I knew there was a high chance that I would always grieve the vaginal birth I never had, but the risk of both my husband and I feeling the way we did during and after Grace’s birth was too dangerous for me, and would not be fair on the new baby. With that in mind, I looked into my options for an elective “gentle” caesarean.

Army of support
Because of my previous birth trauma, I was under consultant care from the very beginning of my pregnancy, and was also assigned a mental health midwife who was fantastic in navigating my maternity journey during a pandemic: she ensured I was never alone and always received the support I needed. As an example, at my 12 week scan, even though my notes stated that my husband was allowed to be there, the sonographer refused and I ended up having a full anxiety attack during the scan. Just being in the hospital was triggering my symptoms and the sonographer’s lack of care and compassion, and the way in which she spoke to us was the final straw for me as it mirrored the way we were treated during Grace’s birth. After telling my mental health midwife, she immediately contacted the Head of Sonography and from then on all my scans were done by the Head and my husband attended with me. We also invested in a doula to support us through the pregnancy and she was also able to be at the birth. This continuity of care throughout my pregnancy was exactly what I needed to feel safe. After the treatment we received last time, I really felt like I had built an army of support to face whatever battle might be thrown our way. Thankfully in the end, there was no fight.

“As the date approached I practised mindfulness, breathing and grounding techniques to overcome any triggers”

Finally at peace
My consultant obstetrician met with me at 4 months and again as my pregnancy progressed. She talked me through my previous birth notes and discussed things with me that no one had told me before. She told me her clinical opinion and explained my risk of uterine rupture was higher, not only because of having had a previous C-section, but also because my scar was lower due to being fully dilated at the time of surgery, and weaker because the scar had been opened beyond the incision when they had to push Grace back up. She also explained that because I had reached 10cm but Grace couldn’t come any lower, even though I was told at the time her position was fine, it was likely that the size or shape of my pelvis could have been the issue, which may be a problem again in an attempted vaginal delivery. She discussed with me my options in an elective C-section and talked about a “gentle” caesarean whereby the baby comes out slower, the lights are dimmed, my music would be playing, I could watch the birth with the drape lowered, and skin-to-skin afterwards for the rest of the surgery. She made it all sound quite exciting, and her enthusiasm and kindness gave me hope that I really could have a positive experience this time. My decision was made, I finally felt at peace with it, and from that meeting, my doubts and fears turned into excitement and hope.

Mentally preparing
She gave us the date she would deliver the baby, 7 May – my dad’s birthday! – I would be 39+1. Grace was 42 weeks and I was so glad I would never have to go that far again. I spent the next month mentally preparing for the surgery and the initial postpartum period. With Grace, I was in a state of shock for months afterwards, and didn’t feel present or connected for a long time, I really hoped that this wouldn’t be the case this time. As the date approached I practised mindfulness, breathing and grounding techniques to overcome any triggers, and met with my mental health midwife and therapist to talk through any last minute doubts and nerves. My husband and doula were also prepared with ways to calm me and support me throughout the birth.

“Not once did we feel patronised, threatened or belittled: the hallmark of our previous experience”

Respect and decency
The day finally arrived, and we got to the hospital for 7am, with our doula with us as we waited. There were two elective caesareans that morning, and we were first. We went down at about 9am – it was the weirdest feeling knowing we were just about to meet our baby, and to not be in excruciating labour pain! Everyone was so lovely, I can’t put into words how important this was to my experience, we were treated with the utmost respect and decency by everyone in theatre, they were so kind and talked to us on their level and with such compassion. Not once did we feel patronised, threatened or belittled, which was the hallmark of our previous experience.

Never worried
There’s no denying that I was terrified as I got onto the operating table. The spinal took a while to be inserted as the anaesthetist struggled to get it in place – this was quite painful and stressful. I did panic at this point, as this was a big trigger for me from the last C-section where I was knowingly cut open with feeling still on my left side. It eventually went in OK and the numbness was almost instant, such an amazing feeling and so much more effective than an epidural. My music began to play and all but the operating lights were turned off – these simple things honestly felt so relaxing. Whereas Grace was out within 5 minutes, it took a lot longer to get to the baby this time due to the amount of scar tissue I had from the previous surgery. My bladder and stomach had fused to my uterus and it took 20 minutes to cut these away carefully. I thought this would really scare me, but our obstetrician kept us informed the whole time, and was so calm and smiley, I never felt worried.

“My daughter was put on my chest, securely wrapped under my gown”

Overwhelming relief
Eventually they said it was time to meet our daughter, and the drape was lowered. It was so amazing to see her being born! She immediately cried, and the relief that she was here safe and well was overwhelming. Freya Elizabeth Rose was born at 9.55am. She was put on my legs while the delayed chord clamping took place, then she was quickly cleaned up, my husband cut her chord, and she was was put on my chest, securely wrapped under my gown, where she stayed for the duration of the surgery and into recovery. They had to check my bladder hadn’t been injured due to the scar tissue surgery, which included an amazing blue dye, which meant I had ‘smurf wee’ for the day! Luckily all was fine and once I was sewn back up, we were wheeled into recovery while we waited for the midwife to take us back down onto the postnatal ward.

Like a dream
After a whole day of beautiful skin-to-skin cuddles, I eventually got dressed and by late afternoon I was out of bed and tucking into the banana bread I had made the night before to bring with us – we even had a glass of Prosecco! We were both buzzing and on cloud nine, not just because we had another beautiful baby girl, but also because we both felt so different to last time. We were smiling and laughing, neither of us tired or traumatised in any way. It really was like we were in a dream. We spent three nights in hospital as I didn’t want to come home until we felt 100 percent ready to leave. Unfortunately feeding was painful again, and I knew Freya had tongue-tie like I’m sure Grace did – this time I was determined to get it diagnosed before leaving hospital, which it was. We got home and were eager to introduce Grace to her new baby sister which was just the best feeling – Grace excitedly took to her new role instantly.

“I will be forever grateful to those who enabled me to have such a healing, final birth”

Closing the door on trauma
I finally felt like I had closure. The positive experience we had this time, as well as knowing that Freya is our last, meant that I could finally begin to close the door on my traumatic birth and know that I will never go through it again. Obviously the nature of trauma will no doubt mean that certain things may always be triggers for me to some extent, but I have my complete family, our girls, and I will be forever grateful to those who enabled me to have such a healing, final birth. It also helped that my obstetrician later confirmed that an elective C-section was the less risky choice of delivery due to the extensive scar tissue: if there had been another emergency the time it took to get to the baby and the risk of injury would have been dangerous. Of course, I will always be sad about my first experience, but I won’t let it consume me anymore. I will use it in my work to challenge the system and fight for other women and families, and to draw on the strength I needed to overcome the trauma, but no longer will it impact me in such a way as it has done for 2.5 years. I hope my story gives other women the courage to plan the birth they want and need, and to not feel any shame or regret in doing so.

Caroline also wrote about her traumatic experience with her first child, Grace. You can read it here.