Bringing a new life into the world can be a profound and joyful experience, but for some mothers, it can be marred by birth trauma. Birth trauma refers to deeply distressing experiences during childbirth that may leave individuals feeling overwhelmed, frightened, and often betrayed by their bodies and/or healthcare providers. It can result from a variety of factors, including complicated deliveries, emergency interventions, significant pain, loss of control, perceived lack of support, or the presence of non-consensual procedures. It is important to acknowledge that birth trauma is subjective and can vary from person to person. What one individual might experience as traumatic might not be for someone else and that’s okay. 

Prevalence: While exact statistics on birth trauma can vary, it's estimated that around 30% (some studies show up to 45%) of women describe their childbirth experiences as traumatic (Beck, Watson, & Gable, 2018).  

Factors Contributing to Birth Trauma: Several factors can contribute to birth trauma, including unexpected complications during childbirth, feeling unheard or unsupported during labor, feelings of helplessness, despair, loss of control/dignity/autonomy, and negative interactions with medical professionals. I often hear clients talk about how everything happened so fast and they had to make emergency decisions in the moment they didn’t feel prepared were a possibility, or they felt a decision they didn’t want was made for them and this requires grieving. The trauma can be a result of emotional distress, physical distress and pain or injury or both.

Impact on Mental Health: Birth trauma can have a profound impact on a mother's mental health. It may lead to symptoms of post-traumatic stress disorder (PTSD), depression, anxiety, and difficulties with bonding with the baby. Studies indicate birth-related PTSD impacts around 17% of postpartum parents (Delicate, Ayers, & McMullen, 2020). Not everyone who experiences birth trauma, will develop PTSD or a mood disorder. Black women are disproportionately impacted, experiencing high rates of birth trauma and obstetric injury and a higher risk of developing postpartum depression, bipolar disorder and anxiety disorders than other women. This is compounded by systemic barriers to access to maternal mental health care. (Bartal, Jagodnik, Chan, Babu, & Dekel, 2023). The racial disparities in maternal health care in the United States and the fact that the United States has some of the poorest maternal and infant health outcomes of all developed countries is a topic for another article.

Some signs that someone might be struggling to cope with a traumatic birth experience include re-experiencing the event (intrusive thoughts, memories, flashbacks, nightmares), avoidance of birth related topics/places/people, hyperarousal (increased anxiety/feeling on edge and nervous system activation), and more negative thoughts/mood than usual. Birth trauma increases the overall risk of a woman developing a PMAD (Perinatal Mood and Anxiety Disorder) not just PTSD and should be taken seriously. To learn more about PMADs (Perinatal Mood and Anxiety Disorders and their signs and symptoms, read here.

Tips for Recovering from Birth Trauma

Seek Professional Help

If you find yourself struggling to cope with the emotional and psychological impacts of birth trauma, don't hesitate to seek help from a mental health professional, such as a licensed therapist experienced in treating trauma and postpartum issues. Mental health professionals specializing in trauma and the perinatal population can provide guidance, tools, and therapeutic interventions tailored to your specific needs. Therapy can provide a safe space to process your emotions, help you develop coping strategies, and work through the challenges that arise from your traumatic birth experience. Some themes that come up in therapy working with those recovering from birth trauma and adjusting to postpartum life include grieving the birth you had hoped for/envisioned, re-establishing bodily autonomy and trust in your body, making room for anger, sadness, confusion and all the complex emotions experienced during and after the experience, some exposure work around the events, practicing self-compassion, providing psychoeducation around trauma and the body’s responses, and creating and fostering healing connections.

To learn more about how to find a therapist licensed in your state and that meets your needs, read this article. In addition to professional mental health support, depending on your birth experience and physical state, you might benefit from pelvic floor physical therapy or other health professionals depending on your unique needs/recovery.

Connect with Supportive Communities

Joining support groups for mothers who have experienced birth trauma or other places to access a supportive community can be beneficial. Sharing your experiences and hearing from others who have walked a similar path can provide comfort and validation. Similar to any other traumatic experience, humans can react to the same event in a variety of ways and there is no “right” way to react. Some might find it beneficial to hear others’ similar stories, and some might find connection outside of their birth trauma more helpful. As humans, we are wired for connection and healing occurs in connection with others. 

Communicate Your Feelings and Practice Self-Care

Talk openly about your birth experience with a trusted friend, partner, or family member. Expressing your emotions and recounting the details of your experience can help you make sense of what happened and provide emotional relief. Prioritize self-care to nurture your physical and emotional well-being . Engage in activities that bring you joy, relaxation, and a sense of normalcy. This may include gentle exercise, meditation, journaling, creative outlets/hobbies, and maintaining social connections. This can be especially challenging given that if you experienced birth trauma, you are probably also caring for a needy newborn, but don’t underestimate the cumulative effect of one hour out of the home or time for yourself. One hour here and there of relaxation is not going to change your birth experience, but it can increase your capacity to cope.

Gradual Exposure

This should be done under the guidance of a therapist to ensure your emotional safety. Talk with your therapist about ways to gradually expose yourself to triggers related to your birth trauma. This could be the hospital, the OBGYN, the physical position of giving birth (c-section or vaginally), items from that day, or imaginal exposure (the memories from that day). Gradual and methodical exposure with a trained professional can help desensitize the emotional response associated with traumatic memories.

Educate and Advocate for Yourself - Know Your Options and Resources Available to You

Understanding the events that led to your birth trauma can be empowering. Educate yourself about childbirth, the options, the policies and procedures at your hospital, the possible needed medical procedures, and your rights as a patient. Knowledge can help you regain a sense of control and make informed choices in the future.  Should you decide to have more children, remember that you have the right to advocate for the birth experience you want. Communicate your preferences with your healthcare provider and seek a supportive birthing team who will prioritize your emotional as well as physical well-being. A doula can be a good option to help advocate for you throughout the process. It's also okay to seek out a new provider or hospital (even if they didn’t do anything wrong and you just want a new experience). For subsequent births, creating as many knowns as possible, even small things like the music you play, the items you have with you, the coping tools accessible, and people present can be helpful in re-establishing autonomy in the birth process.

Post-traumatic growth is also possible. Factors that make post-traumatic growth more likely include relational support, sense of self-efficacy/empathy in recovery, positive coping strategies, and resources/access to mental health professionals. Like other traumatic events, we can’t always prevent it, but the amount of post-traumatic growth factors present have the ability to greatly mitigate the long term distress caused by birth trauma. 

Birth trauma is a complex and often overlooked issue that affects a significant number of mothers. It is sadly something that our society has accepted as a “normal” part of becoming a mother for so many creating a lack of conversation and education around it. It's crucial to recognize its prevalence and the profound impact it can have on a woman's mental health and well-being. By seeking professional help from a therapist and connecting with supportive communities, mothers can navigate the path to healing and ultimately find peace and closure in their birth experiences. Remember, you are not alone, and there is hope for recovery.

If you're experiencing any signs of perinatal/postpartum anxiety, depression, or experienced birth trauma, know that you're not alone, and there is help available. Therapy for birth trauma and postpartum depression can provide you with the education, tools, and support to feel like yourself again. As a Perinatal Mental Health Certified Therapist, I specialize in supporting women struggling with pregnancy and postpartum anxiety and depression. Reach out to schedule your free consultation call today!

References 

Bartal A, Jagodnik KM, Chan SJ, Babu MS, Dekel S. Identifying women with postdelivery posttraumatic stress disorder using natural language processing of personal childbirth narratives. American Journal of Obstetrics & Gynecology MFM. 2023;5(3):100834. doi:10.1016/j.ajogmf.2022.100834

Beck CT, Watson S, Gable RK. Traumatic Childbirth and Its Aftermath: Is There Anything Positive? J Perinat Educ. 2018 Jun;27(3):175-184. doi: 10.1891/1058-1243.27.3.175. PMID: 30364308; PMCID: PMC6193358.

Delicate A, Ayers S, McMullen S. Health-care practitioners’ assessment and observations of birth trauma in mothers and partners. Journal of Reproductive and Infant Psychology. 2020;40(1):34-46. doi:10.1080/02646838.2020.1788210