This information was written by Debby Gould from Birthtalk, for the Caesarean Awareness Network Australia. It is reproduced here with permission.

Q “I feel that the only way to avoid a traumatic birth is to have an elective caesarean so I can control everything…is this true?”

A This is quite an understandable and common response. Many of us feel nervous about our perceived lack of control in natural birth and believe that this might be eliminated in an elective caesarean delivery. But an elective caesarean is certainly no guarantee against experiencing a traumatic birth. Whilst it is true that we cannot control the exact path our birth may take (including during a caesarean) this does not in itself render us powerless and susceptible to a negative or traumatic birth experience.

The key factor in how a woman experiences her birth lies in how she feels during it. Issues such as powerlessness, fear, isolation, abandonment, and disrespect are common in traumatic birth. All of these feelings can be experienced in both natural and caesarean birth,

The good news is: there are things you can do to avoid these feelings, regardless of your birth path, and to have a better birth. (For more info see our page Planning a Positive Birth)

We can have a positive birth experience whether we birth vaginally or by caesarean. There are many gifts that birth is designed to give us. One gift is the confidence that will extend into motherhood from informed decision making as opposed to being directed by fear.

You may need some more information and support to explore any feelings or fears you have around birth and to be able to gain information to truly weigh up the pro’s and con’s for you and your family.(see our Brisbane Meetings & Courses, or Contact Us for support options.).
Q “My friend said the only way to get over my traumatic caesarean was to have a natural birth – a VBAC – next time. Will this fix things?”

A Healing from a traumatic birth (whether vaginal or caesarean) is not dependant on having a better experience next time. You can move through and process the previous birth completely independently of your decision to birth again. In fact, many women finds this takes the pressure off the next baby and birth to be ‘perfect’ & ‘fix things’. It means the subsequent birth can be enjoyed in its own right, rather than as a salve for the emotional wounds of the previous birth. It also means that if you have finished your family, you can still heal and move on from your traumatic birth.

An important point to remember is that having a vbac next time will not necessarily determine a positive birth experience. More relevant issues are such things as feeling supported, involved, respected and safe. These can be achieved regardless of what exact path your birth takes (although if these needs are met you are likely to have a vbac if that is what you want!). As always there are no guarantees and, as already discussed, this is not a main determining factor in your experience being positive. As such we would suggest that of more benefit and importance is to work towards an EBAC (Empowered birth after Caesarean). (see our Planning a Positive Caesarean page )

There are many ways of healing from a traumatic birth. Many women are not really sure of why they feel so bad and do not know what they can do about it. Often debriefing your birth with someone who understands the importance of birth can be extremely beneficial. Certain information regarding ‘the purpose’ of birth (beyond getting your baby out) and the gifts it is designed to give us for parenthood may help you identify more fully what it is you are sad about and that what you are feeling is likely to be very normal considering your experience. This identification then allows us to grieve our losses and with time move forward.

For women who are traumatised by their birth the fall-out is experienced on a daily basis. Often they experienced ‘terror’ in their birth and felt that they or their child was at risk of serious harm or even death. Unlike grief, trauma does not heal or lessen over time. Trauma will also not disappear with a subsequent positive birth. Trauma must be processed, faced, talked through and explored to truly heal.

Happily, you can make peace with your birth. The intensity you are feeling can lessen.

This healing process may give you many insights and strengths that you will have for your next birth. And if you have finished your family, you may, like other women, find healing allows you to enjoy the family you already have, even more.

If you are going to have another baby, you can do much to work towards a better birth.

But please know there are things you can do to heal from your first birth regardless of whether you have more children or not. Please find the information and support you and your family needs.

Q “Last time was so bad. Next time should I just have a general anaesthetic so I can wake up with a baby and bypass the whole thing?”

A Considering how bad your last experience was, I can fully understand your thought process. However, to truly make the best decision for you and your family, you need to be fully informed. This is important so that your expectations are realistic, and you have the opportunity to get your needs met, and you can feel confidence in your decision making.

Some things to consider:
It is likely that many of the things that made your first birth so bad can be rectified in subsequent births. Birth is not bad in itself. Rather, it is how we feel during birth that is a defining factor in whether we experience our birth as being bad or good.

Start by answering these questions:
Did you feel safe? Did you feel powerful?
Did you feel acknowledged and an important part of the event?
Did you feel respected?

If your answer to any of these is “No”, then you have a starting point to what you may need next time. It is these things that women report make for a better birth. Not by robbing themselves of the event completely. But by learning about what they can control in birth, and finding out how to bring these into their own experience.
(see our page on Planning a Positive Birth)

It is possible to heal and move forward from your first birth. By processing the experience, and exploring ‘what happened’, you can make peace with the birth. This may enable you to see a subsequent birth as an opportunity to create a better experience for you and your baby, understanding that if you can feel safe, supported, and strong as you birth, then you are more likely to feel good about the birth.

There are specific risks associated with caesarean sections, for this birth and for your future health, pregnancies and births. (see the Birth After Caesareans infosheet at the Maternity Coalition website).

Many women who have undergone caesareans under general anaesthetic report it as a negative experience postnatally. They often experience difficulty bonding and accepting that the child is their own, and feel emotionally removed from their baby. Accordingly, you and your baby may have some extra challenges in your recovery. You may need extra support in caring for your baby.

There are positive steps you can take to address some of these potential challenges and to hormonally support you and babies bonding and transition into motherhood.
(see The Caesarean Awareness Network Australia’s (CANA)  example of a caesarean birth plan).

There is information and support to help you work towards a better birth.
(see CANA Education & Support and Resources pages).

It is up to you to decide once you have all the possible information what is best for you and your baby’s situation.

We encourage you to answer all your questions and make decisions based on information, not fear – this is too important.

©Birthtalk.org 2016   Authors of How to Heal a Bad Birth : making sense, making peace and moving on