The next pregnancy: what to say, and what to ask for differently
A previous traumatic birth is a recognised risk factor. Say it out loud to whoever cares for you next time, early.
A previous traumatic birth is not history to be got past. It is a recognised risk factor for fear in the next pregnancy, and fear in pregnancy is itself one of the things that raises the risk of trauma next time. It travels forward unless someone interrupts it.
So the first thing to ask for is that it is written down and known. Not remembered by you. Recorded, at booking, by them.
The second is support during labour, and this one has the best randomised evidence in the whole field. The Cochrane review of it covers 27 trials in all, and for how women looked back on the birth the pooling is of 11 of those trials and 11,133 women. Women who had continuous one-to-one support through labour were less likely to rate the birth negatively afterward. In absolute terms, that is 55 fewer women per 1,000 with a negative view of their birth, with the range running from 37 to 73 fewer. The reviewers also found no evidence of any harm from it. Support means someone whose only job is to be with you, continuously, which is not the same as a busy nurse or midwife coming in and out.
The third is agreeing in advance how decisions will be made, rather than what will happen. You cannot pre-agree the events. You can pre-agree that nobody touches you without telling you first, that changes are explained as they happen, and that one named person is responsible for talking to you.
"I want continuous one-to-one support in labour. How do we arrange that here?"
"If something has to change quickly, I want someone to tell me what is happening while it happens, even in an emergency."
"These things happened last time. I want them not to happen again, and I want to know now if that is not possible."