Preparing to give birth again after a previously difficult birth experience can be a huge mental and emotional challenge. Many mums tell me that they really want to have another child, but feel really anxious about the whole idea of going through another birth.
If you are pregnant again, or thinking about trying to conceive, wanting to have a better birth experience will probably be at the front of your mind! One place to start? Understanding how important continuity of care might be for your next pregnancy – and how it could help.
Why is continuity of care important for women who have experienced birth trauma?
I would actually argue that continuity of care is important for all women, and all births, based on the evidence that it has better outcomes for both mother and baby on a range of factors, particularly if that care is with a midwife (1). It is also the model of care that most women are asking for when preparing to give birth (2).
You’re probably already aware that one in three women describe their birth as traumatic – and I always remember that even more mothers may not use that word, but have had upsetting or negative experiences during pregnancy, birth or postpartum. For some families, it is not until the time comes to have another baby the level of trauma is properly recognised.
Preparing to give birth again after birth trauma can feel scary – and I believe you deserves specific support.
As a perinatal psychologist, I see how anxiety tends to increase with each trimester, as the birth approaches and the idea of giving birth again gets more real. This can feel even harder to cope with if you are having to navigate through your pregnancy seeing a different person at each appointment, with no consistency or ongoing emotional support.
Here are four key ways continuity of care could make a real difference:
1. Your story can be heard and recognised – without you having to tell it over and over.
Continuity of care enables you to let your care-provider know what you experienced last time, which can help them to help you. This is the cornerstone of trauma-informed care: that your trauma is recognised by those caring for you.
Importantly, you don’t have retell your birth story over and over again, which might be retraumatising and unhelpful for you. Continuity of care in your next pregnancy could be a way to ensure you are supported by professionals who understand that what you experienced last time will naturally impact how you are travelling through this pregnancy, as well as your specific needs during birth
2) You can rebuild trust in those caring for you.
A difficult birth experience usually erodes the trust you previously had in the maternity system, and perhaps the doctors and midwifes responsible for your care. Rebuilding that trust during pregnancy is important, and much harder if you are seeing a range of different people in the system.
I always say that it is up to your care-provider to help restore that trust, by showing you that they deserve it!
Continuity with your care-provider means you can get to know them and suss out their approach to birth. You can get a sense of their willingness to collaborate with you and respect your wishes during your pregnancy – which can help you to feel safer to trust in them when it is time to have your baby.
3) It makes it easier to express your needs and wishes.
Let’s be honest, it isn’t easy to speak up about your needs with someone you’ve only just met! You’ll be making important decisions during your pregnancy, and continuity of care can help you to feel more comfortable to ask all the questions you need.
As the birth approaches and you get into the nitty gritty of birth planning and decision-making, you may want to decline certain suggestions or make specific requests. If your care-provider already knows you and your birth choices, you may find these conversations much easier to navigate – so you can confidently be the decision-maker for your birth.
4) It helps your nervous system and supports your body’s physiology.
Our bodies need to feel safe enough to birth. There are environmental cues that can help your body know it’s okay to birth your baby, such as dim lighting or soft music. But as humans, we get almost all our safety cues from the other humans in our birth space. Our nervous systems are designed to be constantly assessing the signs from those around us, essentially asking ‘am I safe, am I okay here with you?’
During birth, we are likely to feel more vulnerable (and reliant on others) than ever before, and vulnerable to feeling threatened based on how we are talked to, treated and touched during birth. This is why tone, body language, and the words used in birth can be a major factor in birth trauma – if we don’t feel safe due to the people in the birth space, this can activate a huge sense of threat internally.
When birthing again after birth trauma, it can make a really big difference to be birthing with someone who is familiar to you, as well as warm and emotionally supportive. This kind of care can actually support your nervous system to dial down, instead of activating your threat-response. When we experience safety and trust in a relationship, it activates the parasympathetic branch of our autonomic nervous system, which promotes relaxation and a sense of well-being.
You deserve to feel safe and supported in your next birth – so choosing your caregiver and model of care might be the most important decision you make.
If you’d like to learn more about how to prepare for a much better birth experience next time, download a free copy of my guide ‘Five Ways to Prepare for a Better Birth‘, specifically created for mums who have experienced birth trauma.
References:
- J. Sandall, H. Soltani, S. Gates, A. Shennan, D. Devane, Midwife-led continuity models versus other models of care for childbearing women, Cochrane Database Syst. Rev. 4 (4)(2016). Cd004667.
- Faktor L, Small K, Bradfield Z, Baird K, Fenwick J, Gray JE, Robinson M, Warton C, Cusack S, Homer CS. What do women in Australia want from their maternity care: A scoping review. Women Birth. 2024 Mar;37(2):278-287.
