Birth Trauma and Mama Drama: When you didn't have the birth you expected and wonder if you'll ever have another child

Birth Trauma and Mama Drama: When you didn't have the birth you expected and wonder if you'll ever have another child. By Rachelle Keng, MD

Are you worried about getting pregnant again because the last delivery experience was so horrible?

Do you still feel a secret shame of how your delivery went, replaying the moments where you wish you had spoken up? 

Did you have a postpartum experience that was so bad, you never want to get pregnant again?

Have you blacked out your last delivery experience because it has been too painful to talk about?

Are you still grieving the time you lost when your baby was in the NICU?

If you have ever asked any of these questions, you most likely have experienced what I call Mama Trauma. Birth Trauma. Newborn Trauma. Postpartum Trauma. We don’t like to say those words, because of course, our babies are worth the assault to our bodies and our minds. The whole experience is so beautiful, how dare we say how hard it actually was? 

The romance of childbirth and postpartum is beautiful. But when it isn’t, that hallmark card gets ripped to shreds pretty quickly.

Although we are aware of the physical recovery after a vaginal delivery or a c-section, the trauma that is experienced emotionally and mentally is different. It is quieter, not as recognized, and doesn’t get the same attention. At your postpartum visit, your receive a check-up of any tears or your incision, but that doesn’t necessarily mean your delivery experience has been erased from your mind.

Maternal mental health trauma can be so dramatic that it can cause trouble with bonding with their child or give mamas excessive guilt. Some women wonder if they have damaged their children by missing out on important moments with their child. Deep down, mommy guilt tells them that these missed moments are the reason their child is struggling today.

I often see these women in my office fearful of getting pregnant again after having such a tough delivery and recovery experience.

The top reasons that women are afraid to get pregnant again are:

1.  Repeating the birth story that she did not expect:  She is fearful of having the same thing happen again. She did not feel heard during their delivery. Or her delivery emergency was so quick that there was no time for them to process what was actually happening.  And because of this unexpected story, she has missed bonding experiences with her child. 

2. A Miserable Recovery: The list can be endless: postpartum depression, postpartum hemorrhages, not having good pain management, a fourth degree tear that wouldn’t heal, a pelvic organ prolapse that has required hours of therapy to fix, postpartum preeclampsia, postpartum admission for infection. These experiences only amplify the hormonal swings that are already happening postpartum.

3. A Traumatic Newborn Experience: When babies are separated from their mommies, their babies may forget but mamas never do. Perhaps there was a baby in the NICU with more snuggle time under the warmer than in her arms. Perhaps there was trouble feeding her baby, or she was helplessly trying to soothe a baby with colic. Or perhaps she has felt like a failure when breastfeeding doesn’t work out. 

4. Postpartum Depression: The lows can be so incredibly low, that it is terrifying to imagine going back there again.

If this is you, it’s OK to be afraid of getting pregnant again. The natural human response is to run away from it, or control every factor possible to prevent it from happening again. 

But maybe we don't need to run away. Maybe we need to just call it out. When we don't need to hide, then we can begin to heal.

When you have gone through Mama Trauma, you have experienced grief. 

You have experienced missed moments of bonding and missed moments of a sweet newborn experience.

You have grieved your body not doing what you thought it was supposed to do.

It’s OK to grieve that your delivery and newborn experience was different than what you may have imagined. Admitting that you have grief even in what should be one of the “most beautiful days of your life” is going to help you heal.

And ultimately, you will need to believe that:

1. You did the best you could with what you had been given.

2. Your medical team made the best decision they could in the moment.

We have romanticized childbirth so much that we almost expect a vaginal delivery and a healthy baby as the norm. Although we know complications can happen, we just don’t expect them to happen to us. Because we’re living in such information-saturated culture, it’s easy to believe that by having knowledge and education that we are able to overcome any obstacle. But motherhood does not have a formula. Often it is a changing foreign language that does not have set rules. This is both terrifying and freeing when you figure this out.

So if you have gone through Mama Trauma:

Here are some practical ways to help you process what happened during to help you advocate for yourself during your next delivery. 

1. Find a medical team that you trust. This may seem obvious. But if you do not trust your medical team, you will have more chances of miscommunication and dissatisfaction with your birth experience. Finding providers that you trust and respect will be important to having an experience that you can do-over. 

  2. Find the pain point in your story. No pun intended. Ask yourself: When did I feel least in control of this process? What did I lose because this turned out differently? What will help me feel like I have done the best that I can do even when circumstances are not ideal? If you can answer these questions for yourself, you may know how to better advocate for yourself with your provider.  

  3. Define your priorities. There is a self-satisfaction in achieving the birth plan that you wanted. However, as you probably already know, motherhood is about laying your life down for somebody else. Which means you may even need to lay down your birth plan if needed especially if your

baby doesn't want to go along with your plan.

  4.  Fill out my Birth questionnaire/Birth Plan Template to bring it to your next obstetric appointment. This is a resource to help you communicate with your provider. When you can verbalize what are your greatest fears about your delivery experience as well as what your most looking forward to, you will know better how to advocate for yourself. This will help you have a conversation where you feel heard by your medical team.

Ultimately, your birth experience is beautiful, even when it is hard. Even when life does not go the way we expect, there is purpose in the struggle. The Bible talks about purposeful suffering. Hebrews 12:2 (NIV) says that "For the joy that was set before Him (Jesus), He endured the cross, despising and ignoring the shame, and is now seated at the right hand of the Father." Just like His suffering was purposeful, ours can be too. There is a reason why we hurt. There is a reason why we grieve. There are mercies at every step of the way even in our worst case scenarios. Learning to focus on these mercies of God, rather than what we have lost is what will help you recover, and even have a redemptive birth experience with the next delivery.

What is a redemptive birth experience? A do-over birth. But not only a different physical birth - but a do-over birth with a transformed mindset. A birth where your focus is on the Joy set before you. No matter the unexpected outcomes that can occur, you know God is big enough and loving enough to carry you. He is able to work through even the hardest moments of your life and He wants to do that for you. If you believe this to be true, then no experience will be too hard, too daunting, nor too much.

It’s still OK to be afraid and to worry and wonder if you were made for this. 

It’s OK to wonder if you should get pregnant again. 

Having these conversations with your provider before getting pregnant can also help you feel better. In my experience, most women have a birth experience that goes better the next time. But even if things are worse than the first time, you are still gonna make it. 

You’re gonna make it because if you’ve been called to be this child’s mother. 

God will give you the strength to do whatever this motherhood journey for this particular child needs. 

Stop looking back. Stop looking around. Instead, look up, and you will be found. 

I’m praying for your redemptive birth experience, my friend.

If you want to read more on having a redemptive birth experience and how to find peace in your next pregnancy, check out Rachelle's book, "Woven in the Womb: Peace for the Pregnant and Postpartum Soul."