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Birth trauma definition


What is Birth Trauma? - Birth Trauma Association

Birth trauma is a shorthand phrase for post-traumatic stress disorder (PTSD) after childbirth. We also use it for women who have some symptoms of PTSD, but not enough for a full diagnosis.

PTSD was first identified amongst soldiers returning from the Vietnam War, and most people still think of it as a condition experienced by soldiers. In fact, PTSD can follow any traumatic event – such as being in a car accident, being sexually abused or having a very difficult birth. It can also happen to people who have witnessed a traumatic event, so people who have seen someone else violently killed, for example, often experience PTSD. This is why some partners, and even midwives, experience PTSD after seeing a traumatic birth.

In most cases, what makes birth traumatic is the fear that you or your baby are going to die. We very often see birth trauma in women who have lost a lot of blood, for example, or who had to have an emergency caesarean because their baby’s heartrate suddenly dipped.

You can download our leaflet on coping with a difficult birth here.

Symptoms of birth trauma (postnatal PTSD)

There are four main symptoms:
  • Re-experiencing the traumatic event through flashbacks, nightmares or intrusive memories. These make you feel distressed and panicky.
  • Avoiding anything that reminds you of the trauma. This can mean refusing to walk past the hospital where you gave birth, or avoiding meeting other women with new babies.
  • Feeling hypervigilant: this means that you are constantly alert, irritable and jumpy. You worry that something terrible is going to happen to your baby.
  • Feeling low and unhappy (“negative cognition” in the medical jargon). You may feel guilty and blame yourself for your traumatic birth. You may have difficulty remembering parts of your birth experience.

Not everyone who has had a traumatic experience suffers from PTSD, but many do. It’s a completely normal response, and not a sign of weakness. It’s also involuntary: brain scans show a difference between the brains of people with PTSD and those without. PTSD is not something that can be cured by “pulling yourself together” or “focusing on the positive,” despite what other people tell you.

Who gets birth trauma?

Some women experience events during childbirth (as well as in pregnancy or immediately after birth) that would traumatise any normal person.

For other women, it is not always the sensational or dramatic events that trigger childbirth trauma but other factors such as loss of control, loss of dignity, the hostile attitudes of the people around them, feelings of not being heard or the absence of informed consent to medical procedures.

There is still a lot of research to be done, but some of the factors that make birth trauma more likely are:
  • Lengthy labour or short and very painful labour
  • Induction
  • Poor pain relief
  • Feelings of loss of control
  • High levels of medical intervention
  • Forceps births
  • Emergency caesarean section
  • Impersonal treatment or problems with staff attitudes
  • Not being listened to
  • Lack of information or explanation
  • Lack of privacy and dignity
  • Fear for baby's safety
  • Stillbirth
  • Birth of a baby with a disability resulting from a traumatic birth
  • Baby’s stay in the special care baby unit or neonatal intensive care unit
  • Poor postnatal care
  • Previous trauma (for example, in childhood, with a previous birth or domestic violence)

Finally, people who witness their partner’s traumatic childbirth experience may also feel traumatised as a result. See our partners page for more information.

What is different about birth trauma?

Women affected by birth trauma often find that there is nowhere to turn for support because even other mothers who have not had traumatising births can find it hard to understand the impact of a traumatic birth. This can make sufferers lonely and depressed as they often feel they are somehow weaker than other women because they are unable to forget their birth experience. They may feel incredibly guilty as a result.

This is a terrible burden to shoulder. The nature of PTSD means it’s impossible to stop constantly thinking about the birth experience, but very few people are aware of this. Even health care professionals don't always understand.

Unfortunately, this lack of support can mean that relationships with friends and family may deteriorate. Many women end up feeling torn between their desire for more children and their determination to avoid another pregnancy. They may also lose interest in sex and these problems can place a great strain on relationships.

Some women also avoid any medical intervention that reminds them of their birth experience, such as smear tests.

For many women, their greatest concern is the day-to-day difficulties they encounter bonding with their baby who they see as a constant reminder of the trauma they have experienced.

The BTA aims to tackle this isolation by offering women much needed support and showing them that they are far from alone. By working together and providing women with a voice, we hope that we can help change those practices that contribute to birth trauma

What’s the difference between birth trauma and postnatal depression?

Birth trauma can overlap with postnatal depression (PND) as some of the symptoms are the same, but the two illnesses are distinct and need to be treated individually.

Unfortunately, many women are wrongly diagnosed with PND and are prescribed medication that may do little, or nothing, to help their situation. Women tell us that they are frequently told by their health care professionals that they should try and move on with their lives or that they should just be grateful that they have a healthy baby. This can exacerbate the feelings of guilt and isolation that women already feel. Women may then end up with prescriptions for anti-depressants, simply because doctors do not understand the disorder.

Sometimes PND can go hand in hand with birth trauma, however, and in those cases anti-depressants may be appropriate. If you are concerned that you have been misdiagnosed, do speak to your GP or health visitor. Please show them a copy of our leaflet if they appear to be unaware of birth trauma or the fact that it requires specialised treatment.
 

 

Birth trauma (emotional) | Pregnancy Birth and Baby

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What is birth trauma?

'Birth trauma' is distress experienced by a mother during or after childbirth. While trauma can be physical, it is often emotional and psychological.

Birth trauma is not just about what happened during labour and the birth. It can also refer to how you, as the mother, are left feeling afterwards. Sometimes the effects of birth trauma can emerge and continue for some time after you've given birth.

At the time of birth, you may have felt fearful, helpless or unheard. After the birth, it's possible to feel shocked, guilty or numb and even experience panic attacks or anxiety.

If you notice any of these symptoms, you may be experiencing birth trauma. If so, you are certainly not alone. It's been estimated that up to 1 in 3 women who give birth may experience birth trauma.

Many women find the experience of childbirth emotionally traumatic. Birth trauma can't always be prevented, but there are things you can do to reduce your risk. If you are experiencing any signs of trauma, support and treatment are available.

What are the risk factors for birth trauma?

There are many factors that can contribute to birth trauma. These include:

  • your childbirth experience not going to plan, or not matching your expectations
  • having a difficult labour or experiencing labour complications
  • needing intervention during labour, such as an assisted delivery (using forceps or ventouse) or an emergency caesarean
  • you or your baby suffering birth injury
  • your baby needing medical attention after the birth
  • stillbirth or neonatal death
  • not receiving the care or support you needed at the time of birth, or afterwards
  • previous birth trauma
  • a tendency to experience anxiety

A woman may be especially at risk of trauma during pregnancy, birth and after the birth if she experienced trauma earlier in her life. This can include domestic violence, childhood sexual abuse, rape and migration-related trauma.

Can birth trauma be prevented?

Childbirth doesn't always go to plan. Many women who experience birth trauma are unable to avoid it because the risk factors (for example, a history of trauma) are beyond their control.

However, there are ways to help reduce the risk of birth trauma:

  • Prepare for childbirth: Antenatal classes, for example, help you know what to expect and your options.
  • Try to have realistic expectations: There is no 'right' way to give birth. Things don't always go to plan and some things are beyond your control.
  • Try to keep an open mind: No one can predict what will or won't happen during pregnancy and birth.
  • Establish a support network: Surround yourself with people who can support you.
  • Seek mental health support: If you are prone to anxiety or depression, or if you had a difficult pregnancy or labour, counselling can help you come to terms with what happened.

How is birth trauma treated?

If you think you could be experiencing emotional trauma, it's very important to seek help as early as possible — which benefits both you and your family.

Some psychological symptoms, including the 'baby blues', are very common around the time of birth. But if you still feel distressed 2 or more weeks after the birth, you could have postnatal depression or anxiety.

In some cases, not getting treatment for birth trauma can lead to post-traumatic stress disorder (PTSD). One Australian study found that more than 1 in 20 mothers may show signs of PTSD at 12 weeks after giving birth.

It may help you to:

  • talk to a midwife immediately after the birth about your experience
  • talk to your doctor, midwife or maternal child health nurse at any stage about how you feel
  • ask for practical and emotional support from friends and family
  • use self-help measures, such as exercise and mindfulness

If needed, therapy or medicines can also be used as treatment. Your doctor is the best person to advise you on this.

Where can I go for more support and advice?

As well as asking your doctor or nurse for advice, you can get help and information from:

  • Pregnancy, Birth and Baby — call 1800 882 436 to speak to a maternal child health nurse (7 days a week, 7am to midnight AEST).
  • The Australian Birth Trauma Association offers advice, resources and a peer-to-peer support service.
  • The Centre of Perinatal Excellence (COPE) provides information and a list of support services.
  • Perinatal Anxiety & Depression Australia (PANDA) — call 1300 726 306 to speak with a counsellor (Mon to Fri, 9am to 7.30pm AEST).

Sources:
Australasian Birth Trauma Association (What is birth trauma), Australasian Birth Trauma Association (What is psychological birth trauma), Centre of Perinatal Excellence (When things don’t go to plan), Perinatal Anxiety & Depression Australia (Childbirth trauma), SA Health (South Australian Perinatal Practice Guideline - Managing women in distress after a traumatic birth experience), Centre of Perinatal Excellence (Preparing for birth), Centre of Perinatal Excellence (Recovering from a traumatic birth), Psychological Medicine (A prospective longitudinal study of the prevalence of post-traumatic stress disorder resulting from childbirth events), Perinatal Anxiety & Depression Australia (Complicated births), Perinatal Anxiety & Depression Australia (During pregnancy)

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Last reviewed: May 2021


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Related pages

  • Mum's first few days after giving birth
  • Your physical and emotional wellbeing
  • Baby blues
  • Birth injury (to the mother)
  • Birth injury (to the baby)

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Psychological Trauma - Birth Trauma