Women who have previously given birth can have trauma related to the past pregnancy, birth and/or postpartum experience.

Women can be concerned that these past circumstances may repeat or that current circumstances may bring up unresolved feelings related to the events of the past. Concerns such as these have guided women into A Safe Passage birth counselling.

We have provided a brief overview of some of the most common circumstances that contribute to unresolved feelings of pregnancy-related grief and/or loss:

• difficult previous birth experience
• past miscarriage
• past elective abortion

Trauma from a past birth experience... grieving the birth that wasn't

For your previous pregnancy(ies), from the moment you knew you were pregnant you may have started envisioning what giving birth would be like:

• You may have started to connect with other women who have had children, trying to gather information related to the childbearing year.
• You may have gathered books and watched every television program related to pregnancy and birth to start preparing for all the changes that bringing a baby into the world would bring into your life.
• You may have joined a prenatal fitness / yoga class to prepare your body for the process of labour and birth.

Or, on the contrary, you may have felt confident that the pregnancy would unfold without a problem without any special preparations. Sometimes women avoid pregnancy- and birth- related material altogether and feel that the birth will more or less "take care of itself" so why worry?

Regardless of how you did or did not prepare to labour and give birth, your experience(s) of giving birth may have ended up differing from what your understanding, expectations or preferences were. If so, you may have experienced — may still be experiencing — birth-related grief and loss. You may notice yourself frequently thinking negative thoughts about your previous birth experience(s), and being visited by unresolved feelings about what happened during the birth, how you were treated, or question the outcome of the birth itself. Perhaps you are already aware of how and why you are being affected or perhaps it is not clear to you why you can't seem to move past your previous childbirth experience.

You are not alone in experiencing difficulties related to a previous birth. Many women have told us about their difficult birth experiences. Like them, you too may have experienced one or more of the following:

• the pregnancy may not have been consensual
• the pregnancy may have been ill-timed
• you may not have felt well prepared for the birth
• you may not have been well informed about your choices
• your support people may not have provided you with the type of care you expected or needed
• interventions may have occurred at the birth that you did not want
• pain management for you may have been inadequate, ineffective or unavailable
• your baby may have needed assistance after the birth that was unexpected and/or prolonged
• there may have been other life stressors impacting on your labour, birth and postpartum, such as the loss of a loved one or a recent separation
• you may not have had the opportunity to talk about your birth experience while having someone "just listen" to your story
• you may be a survivor of abuse and trauma was triggered through the process of giving birth

It is not uncommon for women who have had challenging/traumatizing births to feel a mixture of feelings, such as: anger, grief, fear, numbness, panic, rage and to wonder whether or not they are going "crazy." These feelings may not have surfaced right away or you may not have been able to acknowledge these feelings out of concern that they were not "normal." Well-meaning family, friends and professionals sometimes dismiss these feelings by saying things such as: "you should feel grateful to have such a healthy baby," "don't be hard on yourself, you did the best you could," or "the prize is the same in the end."

However, deep down you may be struggling with residual, unresolved feelings. These feelings are real and you may find that they have had a profound impact on whether or not you want to get pregnant again or how you have reacted to a subsequent pregnancy, including the current one. In some cases there was nothing that could have been done differently to change the outcome of the birth and in other cases perhaps there were things that could have been done differently. It can be difficult to know the difference and hard to get answers.

Steps you can take to assist you in processing your birth:

• Talk to your caregiver about your birth and ask for clarification on any aspect that you are not clear about
• obtain copies of your birth records from the hospital in which you gave birth or from the midwife who attended your birth
• Find a friend or family member willing to listen
• Find a counselor in your community who works in grief and loss issues
• Write your birth story out and create a ritual to represent "letting it go"
• join a postpartum support group where you can connect with other moms and professionals used to assisting women in postpartum

In your current or a future pregnancy, you may wish to do the following:

• explore with your caregiver what you would like to see happen differently this time around
• have a different caregiver (midwife, family doctor, obstetrician)
• explore a different place of birth (home vs. hospital)
• explore your full range of birthing-related options (positions, interventions, etc.)
• think about who you may want as a support person(s) (doula)
• attend prenatal education classes that reflect the type of birth you would like
• obtain the support of a skilled counselor or therapist who works in the area of unresolved birth experiences

Most importantly give yourself permission to grieve the loss of a birth experience that wasn't what you intended. You have the right to question what happened to you, your body and your baby. If you find yourself unable to process your birth experience on your own, we encourage you to avail yourself of counselling services or other supports that may help you free your current experiences from the memories of the past.

 

The loss of a pregnancy is the loss of a child. If you are a woman who has miscarried and are now pregnant, you likely have a whole host of feelings associated with a subsequent pregnancy:

• You may feel excited, anxious, fearful, disconnected or numb and are not sure how you will cope with these emotions or feelings for an entire pregnancy.
• You may be anxious that you will miscarry again and therefore are afraid to start planning or even thinking about the possibility that all will go well
• You may feel that the pain of losing a baby is so great that you'd rather just "ignore" that you are pregnant until you are past the stage in your current pregnancy at which the previous pregnancy(ies) miscarried.

Your family and friends may not have known what to say to you and in their own grief were unable to provide you with the support you required to work through the emotional and physical aftereffects of a miscarriage. They may not have known what to do... You may have feelings of resentment towards your partner or a family member because they didn't appear to understand the significance of your loss nor grieve the way you did, for as long as you did. They may have been afraid to show you how much the loss meant to them, or they may have been worried that their grief would add to the pain you were already experiencing.

Now that you are pregnant again you may wish to speak with a professional. You may want to connect with other parents who have lost a baby through miscarriage to have your feelings validated by others who, like you and your family, have experienced the death of a baby.

 

The grief a woman experiences after an abortion can be referred to as "forbidden grief." As a society we are quick to assume that because a woman had an abortion, she must have been okay with the decision. And yes, that is often true to an extent. However we also know that there is much more involved in the decision. For lots of women it is a much more complex choice that has come at the end of a process of weighing out options. You may have been pressured into the decision by people in your life or by the realities of your life circumstances. A pregnancy may have compromised an existing health condition or you may have become overwhelmed by the possibility of becoming a mother. Whatever the reason, you had the right to make your choice.

And while you may have felt certain that the decision was best for you at the time, this doesn't exclude the fact that you still may have a mixture of thoughts and feelings related to your choice. A subsequent pregnancy that you choose to carry to term may bring up previously suppressed feelings. If you now find yourself struggling with post-abortion feelings, you may wish to seek support through a counsellor or support group.

You are entitled to receive support in a non-judgmental way regarding your choice to terminate a previous pregnancy and carry a subsequent pregnancy to term. If you are unable to find support in a non-biased manner, you may not have the appropriate caregiver for you. Please search out another option for your care if you are able. Sometimes this is not possible because of the limited availability of service providers. If you are limited in your options, we suggest connecting with on-line support groups or visiting your public library for resources related to post-abortion support.