Conditions that threaten women’s lives in childbirth & pregnancy

Fertility and future pregnancies

For many women, their life threatening condition in childbirth had a long lasting impact on their fertility or their approach to future pregnancies. In this summary we discuss what women told us about how their obstetric emergency impacted on their ability to have more children or their approach to any future pregnancies they may have considered.
Some of the women we spoke to had a hysterectomy as a live-saving procedure during the emergency. For some, not being able to have any more children was not a big issue as they felt as though their family was complete. Karen felt regret at having the choice taken away from her, but she was in her early 40s and felt her family was finished.
Other women were devastated by having to have a hysterectomy before having all the children they had wanted. Alison had a hysterectomy after her first son was born, when she was 30 years old. She said, “I would love to have more children, but there’s no denying that… I would have liked [son] to have a sibling close in age to him, but that’s not going to happen biologically.” Mandy who also had a hysterectomy after her first son was born, was pragmatic about the choice that doctors had to make, it was her life or her womb.
(For more experiences see ‘Hysterectomy’).
Losing a baby or the ability to have a baby
Losing a baby, or ability to have another, made some women feel very focused on having another, by whatever means. Deborah lost her baby during childbirth, and said, “When you lose a baby it is the only thing you want.” Some women we spoke to had hysterectomies but completed their families by other means. Alison had found it helpful to talk to a fertility counsellor when thinking about having another child through surrogacy or adoption. Cara, who had a hysterectomy after her first daughter was born, went on to have biological twins with a surrogate. Rachel who lost her son in childbirth and had a hysterectomy, went on to adopt twins from another country. “They are wonderful and the best thing I’ve ever done.”
In addition to grieving for the children they would not be able to have, some women also felt resentful or insecure in the knowledge that their husbands or partners could still have children with another partner. Alison said, “I feel that it is different for him, because he could have more children if he really wanted to have more children. But I think from what he has said to me, he’s just happy he’s got what he’s got. I think he’s just thankful that I’m alive.” Lisa felt that although she had been permanently altered by her hysterectomy, her partner had the option of finding someone else. “You can meet somebody else and forget about us, if you want to. You can, in a year’s time, do this all over again with somebody else. Men do it all the time.”
Concern about future pregnancies
But what about the women who did not have hysterectomies, and could potentially still get pregnant and have more children? How did their obstetric emergency affect their attitudes to future pregnancies? For some women, their life threatening experience in one pregnancy did not affect their approach to more children, because they already felt that their families were complete. Sophie, who had a pulmonary embolism (a blood clot in the main artery of the lung) and haemorrhage (heavy uncontrolled bleeding) with her second daughter, said, “Definitely it’s put me off having any more… I don’t think we planned to go beyond two children anyway, so it’s not like I’m worried about that.”
However, even if women are confident that their families are complete, they are still concerned that they might get pregnant, be at high risk and faced with a difficult choice. Kerry who haemorrhaged due to placenta praevia (the placenta may be partly or completely covering the cervix/birth canal) said, “That frightens me, because I don’t agree with abortions myself. But I’m just so frightened where it would be something where I would bleed again. I wouldn’t even want to take the risk.” Alex, who had placenta praevia, was considering sterilisation. Craig’s wife had complications during an emergency caesarean. He was so frightened of having more children he went to see his GP about a vasectomy shortly after the birth of his twins.
Some women would have liked more children. However they felt that the risks were too high.
Other women we spoke to were told, that while their subsequent pregnancies would be higher risk, it was still reasonable to think about more children. For some, this was reassuring and they did not feel particularly anxious about getting pregnant again. Henrietta had a post-partum haemorrhage (heavy uncontrolled bleeding after birth) and was pregnant at the time of the interview. She said she did not feel particularly worried. Natalie, who had a post-partum haemorrhage with her first child, had been told by doctors that in another pregnancy she would be classed as high-risk and would need to be under consultant care, but she did not feel too concerned. “At the moment it doesn’t concern me, I just think I dealt with it before, I’d deal with it again.”
Some women found it difficult weighing up the risks of another pregnancy. Helen had HELLP syndrome (a combined liver and blood clotting disorder) with her first son, and felt uncomfortable about the increased risks of having it again. Julie had pre-eclampsia (high blood pressure) during her first pregnancy, and felt, “I still want to ask questions, and sort out if I have another child, what are the risks?” Two years on, she did feel she was ready to try again. Samantha had pre-eclampsia and was reassured by a meeting with her consultant who encouraged her to come back and talk if she was thinking of getting pregnant again.

Last reviewed April 2016.


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