What Is Birth Trauma? Tips for Prevention and Healing

And while preparation on your part may help you avoid a traumatic birth experience, know that birth trauma is never your fault.

Here’s more information on what might lead to birth trauma, how to know if you’ve been affected by birth trauma, and what to do next if you do experience it.

What Is Birth Trauma?

According to research published in Birth Issues in Prenatal Care, “A traumatic childbirth experience refers to a woman's experience of interactions and/or events directly related to childbirth that caused overwhelming distressing emotions and reactions; leading to short and/or long-term negative impacts on a woman's health and wellbeing.”

Birth trauma can happen to the birthing parent, or their partner or support person.

Trauma is typically associated with an event in which someone felt unsafe, violated, or afraid. This can have a physical or psychological impact that lingers long afterward.

Birth can be an unpredictable experience, and many people assume “birth trauma” means that something extreme happened during labor or birth. Sometimes that’s true, but birth trauma can also be caused by more subtle interactions and experiences. People experience the same situations differently, and what’s traumatic to one person may not be to the next.

“Trauma is how the birthing parent perceived, felt, experienced, and responded to their own emotions surrounding birth,” says Natalie Siepka, a perinatal mental health certified therapist at Fourth Trimester Postnatal Retreat in Washington, D.C. It’s not necessarily what happened, in itself, but how it affected you, she notes. If something felt deeply distressing and disturbing to you, then it was, regardless of how any other people may have responded to the same experience.

Importantly, birth trauma is not a diagnosis itself. But having a traumatic birth experience can put your health and mental health at risk. Concerns like anxiety, depression, and post-traumatic stress disorder are higher among people who’ve gone through birth trauma.

Birth Trauma Examples and Risk Factors

Some examples of experiences that could lead to birth trauma might include:

• A birth that didn’t go as planned
• Feelings of powerlessness, lack of control, or extreme fear
• Physical injuries, like vaginal tears or injuries to your baby
• Any type of emergency in pregnancy, labor, or birth
• Baby needing specialty care
• Inadequate pain relief
• Medical interventions that felt invasive

“What some [care providers] consider routine may be perceived as trauma by the birthing person,” says Perri Shaw Borish, founder and psychotherapist at Whole Heart Maternal Mental Health. That’s why it’s important to advocate for yourself and your birth plan, or have someone like a partner or doula advocate on your behalf.

Even unsupportive or controlling interactions can be a trigger for birth trauma, says Becca Reed, a perinatal mental health and trauma therapist. “This subtly signals danger to the birthing parent’s nervous system, which can activate a traumatic response,” she explains.

Certain people may be at higher risk of birth trauma, such as those who:

• Have a history of mental health disorders
• Have experienced sexual abuse
• Have had previous poor experiences with medical providers
• Are birthing parents of color
• Have a low income or low socioeconomic status
• Lack a support system

However, Siepka is quick to point out that birth trauma can occur in any birth, no matter the race, income, education, and health of the birthing parent.

Tips to Help Avoid Birth Trauma

Being aware of the potential for birth trauma may help empower you. Here’s how to help prepare for the best experience.

Write Down Your Birth Goals

It may be a good idea to enter the childbirth process thinking about your birth goals. “Goals are what one can hope to achieve, acknowledging that some things in medicine are beyond control,” Siepka explains. “Having a good understanding of goals and who to turn to if things don’t happen as expected is the best thing one can do.”

Our birth plan template can help you think about your goals and communicate them to your support person and healthcare team.

Ensure You Have Support

Having support can empower you to manage any experience you might encounter, even if you face a situation that could put you at risk for trauma. As Reed says, “Feeling heard and supported significantly mitigates the risk of having a traumatic birthing experience.”

If you don’t have a partner who will support you and your needs during labor and birth, consider hiring a birth doula that you trust, Reed highly encourages. “Doulas can’t make medical decisions, but they can support you in using your voice and advocating for you when needed,” she says.

Going over birth goals and communicating your preferences ahead of time can also help your support person or people know how to best support you during labor, too.

Communicate Clearly to Your Healthcare Team

Whenever possible, Borish says it can be helpful to communicate exactly what you need to your birthing care team. This is especially important if you’ve experienced trauma in the past.

“Ask for what you need from your providers to feel most safe and heard,” she urges. That’s not always easy to do when you’re going through labor, which is where your support team and birth plan can come into play. It’s also a good idea to communicate in advance, during the prenatal visits leading up to birth.

Signs and Symptoms of a Traumatic Birth

It’s a good idea to check in with yourself about how you’re feeling mentally and emotionally after birth so you can get help if you need it.

It’s also helpful to acknowledge that birth trauma can happen in birthing partners, too. “Partners are often forgotten about in the birth journey when it comes to addressing health and mental health,” Siepka says. “Partners need just as much support in validating, supporting, and healing their birth trauma.”

Both Siepka and Reed provide a list of questions you and/or a partner can ask yourselves to assess if you might have experienced birth trauma or have symptoms of birth trauma:

• Was my life or my baby’s life at risk during childbirth?
• Do I remember the details of my birth? Have I blocked parts of it out?
• Am I detached from my birth story, or do I feel separated from what happened?
• Did I lose my ability to make choices? Did I feel unsupported, unheard, disrespected, and/or violated?
• Did I feel helpless, alone, or out of control?
• Did my care team communicate with me? Were decisions explained to me?
• Did I have to make critical and time-sensitive decisions in an emergency?
• Am I having ongoing nightmares or intrusive thoughts about the birth?
• Do I feel persistent sadness or anger when I think about the birth?
• Am I avoiding thoughts or discussions about the birth?
• Am I experiencing fear about another pregnancy?

If your answer to any of these questions makes you uncomfortable or distressed, it may be a good idea to find support. The Maternal Mental Health Hotline can help; it’s free and confidential.

What to Do If You’ve Experienced Birth Trauma

Know that any birth trauma you experienced wasn’t because of something you did or didn’t do. “If birth trauma happens, it's not your fault and it’s not a personal failure on your part,” Borish says.

If you or your partner are struggling with birth trauma, Siepka says that it’s never too late to address it, whether the birth was recent or many years ago. She encourages anyone wondering if they experienced birth trauma to reach out to a mental health professional who specializes in perinatal mood disorders and trauma.

Boorish says that she uses a Perinatal Post-Traumatic Stress Disorder (PTSD) Questionnaire to help identify birth trauma and create a treatment plan for the people she works with.

“With help and support to process your birth trauma, you can get better and that's important for yourself and your baby,” Borish says.

If you are struggling with birth trauma, Postpartum Support International offers resources and support groups that can help.