Birth Trauma

Birth trauma describes symptoms of trauma related to the birth itself and/or circumstances around the birth.

Trauma is a big word. Birth trauma does not necessarily mean a diagnosis of Post-Traumatic Stress Disorder (PTSD).

What we really mean with birth trauma is that you felt intensely afraid, fearful, out of control or helpless when you were giving birth, when you were pregnant (or trying to get pregnant) or after you had your baby. And that this has left a lasting imprint on you mentally and/or physically.

The issue with the term ‘birth trauma’ is that it sounds like we’re just talking about a distressing birthing experience. When in fact, we’re talking about all the symptoms which might present at any stage in someone’s ‘perinatal journey’. ‘Perinatal’ refers to the period from trying to conceive, to being pregnant, to giving birth, to after you’ve just had your baby. So the term ‘perinatal trauma’ is more accurate than ‘birth trauma’.

Birth trauma might also include:

Infertility diagnosis, recurrent pregnancy loss and the impact of fertility treatment (often called “reproductive trauma”).

• Post-traumatic stress symptoms are also common in pregnant people who have experienced Hyperemesis Gravidarum (HG) – uncontrollable nausea and vomiting during pregnancy – which is strongly correlated with PTSD and anxiety.
• Increasingly, it is being recognised that for some, breastfeeding can be a traumatic experience.

Research shows at least 1 in 3 women find some aspect of their birth traumatic. This translates to 200,000 new mums in the UK each year. There is very limited research on the prevalence of birth trauma in trans and non-binary folk but we know that their experiences of perinatal care are consistently worse for members of the LGBTQIA+ community (see more here).

There are four symptoms to look out for when it comes to birth trauma and postnatal PTSD. Someone suffering from birth trauma might experience one or more of these trauma symptoms.

1. Re-experiencing your trauma. Might present as: flashbacks, smells or sensations which transport you back, distress after reminders, nightmares, physiological reactions and pain.
2. Using avoidance behaviours. Might present as: avoiding someone/somewhere, isolating yourself from others, avoiding anything that reminds you of your distress.
3. Feeling a heightened sense of threat. Might present as: very jumpy, irritable, destructive behaviour, hypervigilance, difficulty concentrating or sleeping.
4. Negative thoughts or feelings. Might present as: feeling flat, overly self-critical, exaggerated blame of self / others, intrusive thoughts, guilt, shame.

A clinician will look at your symptoms and use a specific tool (a diagnostic manual called either DSM-5 or ICD-11) for diagnosis. To be diagnosed with PTSD you would be experiencing symptoms from all four categories and symptoms would have lasted more than one month. But it’s important to understand that even mild to moderate symptoms can leave you feeling unsafe in the world.

The key thing to understand here is that other people cannot judge what you will or will not find traumatic or incredibly hard. You or your baby don’t have to be at risk of death or be facing a serious injury for the birth, or period around it, to be experienced as traumatic or very difficult. Your feelings are valid and your experience matters.

Having said that, we do see common themes in stories of trauma. For example poor communication, feeling pressured / coercion, feeling scared / scaremongering, feelings of failure / disappointment, a cascade of interventions, no sense of control, a lack of bodily autonomy and/or a lack of informed consent. These themes show that healthcare professionals play an important role in the prevention of birth trauma, which is why it is vital to upskill maternity services on trauma-informed care.

Research also shows that some people are more susceptible to birth trauma. Susceptibility factors are divided up in different categories: prenatal, intrapartum and postnatal. This means that they impacted somebody during (or before) pregnancy, during birth or after birth.

This framework below shows a detailed, but not exhaustive, picture:

Birth trauma can impact both parents and professionals. Essentially anyone who went through or witnessed the traumatic event.

Partners often don’t realise they are impacted too, or they find it hard to speak up as ‘it didn’t happen to them’. Read more here about the impact of birth trauma on partners.

For professionals it is key to understand how witnessing traumatic events can impact them too. As it might make it more difficult to look after yourself and others because of it.

If you think you might suffer from birth trauma, the first step is to speak up to a loved one or healthcare professional. Birth trauma can be treated and healing is absolutely possible. You can read more about how to find support here.

Baptie, G., Andrade, J., Bacon, A. & Norman, A. (2020). Birth trauma: the mediating effects of perceived support. British Journal of Midwifery. 8 (10). https://www.britishjournalofmidwifery.com/content/other/birth-trauma-the-mediating-effects-of-perceived-support

Make Birth Better supports both parents and professionals impacted by birth trauma, they offer a wide range of training and raise their voices through campaigning.

Visit www.makebirthbetter.org or email info@makebirthbetter.org