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My first birth was traumatic: should I have a second baby?

My first and only child is three and a half, and I’ve been thinking about having another. This is something I really want, but part of me is scared. When I had my first child, it went badly: physically and emotionally. The birth itself was very traumatic, and three days after she was born I had a panic attack, which spiralled into postnatal depression and PTSD from the birth. The first year of her life I found extremely difficult and for a long time I thought I’d never want another child. But I have now changed my mind.

However, I’m worried about my mental and physical health. I am also worried about the inevitable, albeit temporary, distance that a newborn would put between me and my husband, and that the age gap between my children will be too great. I confess I compare myself with other mothers I see on social media. Am I kidding myself into thinking I could cope with two when I found it so hard to cope with one?

I’m sorry to hear about your experience, and not at all surprised that you experienced the fallout you did. Birth trauma is real but often minimised, by others and sometimes by ourselves. We rationalise it by telling ourselves the main thing is that our babies are OK – which is important, but doesn’t take away the impact of what happened.

The first thing I want to say is that the ideal gap between children is what’s ideal for you, no one else. (I have an intentional five-and-a-half-year age gap between my children, and I think it works really well.)

I spoke to two people in relation to your letter: Jo Stubley, a consultant psychiatrist in psychotherapy and trauma expert at the Tavistock and Portman NHS Trust, and Kim Thomas from the Birth Trauma Association (BTA).

Struggling to cope with the traumatic birth of a firstborn does not mean you would be unable to cope with the second. But you are wise to be thoughtful, given what happened, because I want you to think (birth aside) about what is the same this time round, and what is different. Specifically, what support do you have now that perhaps you didn’t before? Thomas said that “going into a second birth feeling informed and in control is very important for women who have suffered traumatic births”.

This is especially important because, as Stubley explains: “If we perceive the social support network that we have to be inadequate, it puts us more at risk of trauma and PTSD.”

Finding out more about what happened three years ago may help you process the details around the birth and help you make a more informed decision. You can request a copy of your notes from the hospital, and a midwife to go through them with you; there’s more about how to do this on the BTA website. This can work really well for some women: it can validate the way they feel and fill in details they had forgotten; it can also help some to realise certain situations were beyond their control.

Thomas also wanted to point out that you don’t have to give birth in the same hospital if you don’t want to. You have options as to how and where you give birth, which you can explore with BTA or at Birthrights.

“Trauma and PTSD,” Stubley said, “are linked to disempowerment and disconnection from others [both of which you may have felt during and after the birth], so the two things you can do now are empower yourself and get connected with others. Allow yourself to think about what happened, what you would like to change this time, and try to connect with the right groups to support you. It doesn’t have to be the same again.”

Also, talk through your worries with your husband (fathers can also get PTSD after a traumatic birth). This may also help you feel – and stay – connected.

If you are going to compare yourself with other mothers on social media, I hope you are doing so as the woman you are: someone who is thoughtful, self-aware and resilient. Those are tremendous qualities to bring to (second) motherhood.

Every week Annalisa Barbieri addresses a family-related problem sent in by a reader. If you would like advice from Annalisa on a family matter, please send your problem to ask.annalisa@theguardian.com. Annalisa regrets she cannot enter into personal correspondence. Submissions are subject to our terms and conditions: see gu.com/letters-terms.

Conversations with Annalisa Barbieri, a new podcast series, is available here.

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