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What Is Trauma, and How Common Is It?

What birth trauma is, how to know if you've experienced it, and the impacts.

Key points

  • Birth trauma happens when the mother finds the events or care she received during birth deeply distressing.
  • Whether or not your birth is “traumatic” is determined only by your own individual experience.
  • Symptoms may include psychological distress related to birthing experience, and repetitive thoughts about it.
  • Birth trauma has a “ripple effect”; it has long-term, wide-reaching impacts on many areas of a mother’s life.

Research finds that up to 45 percent of mothers report experiencing “birth trauma.” Yet, despite almost half of mothers experiencing birth trauma, it is rarely included as a part of labor and delivery preparation, screened for in the postpartum period, or even discussed. It seems to be something that birthing individuals are just expected to “get over,” particularly when everyone is physically healthy after the birth.

Birth trauma is poorly defined in the research and the terms “birth trauma” and “traumatic birth” are often used interchangeably. A concept analysis based on previous research proposed the following definition of birth trauma (read the concept analysis here):

"The emergence of a baby from the body of its mother, in a way which may or may not have caused physical injury. The mother finds either the events, injury, or the care she received deeply distressing or disturbing. The distress is of an enduring nature."

Birth trauma can also occur in birthing partners or any observers of the birth.

How Do You Know if You Experienced Birth Trauma?

Whether or not your birth is “traumatic” is determined only by your own individual experience. A doctor or nurse present at your birth may perceive the birth as entirely uncomplicated and typical—but based on your own experience of feeling unsupported or afraid, it may be a traumatic birth.

The DSM-5 defines trauma as the experience of “actual or threatened death, serious injury, or sexual violence.” It can involve experiencing the event yourself, witnessing others experience it, or even learning that it happened to a family member or close friend (or this in case, an infant).

It is important to note that birthing individuals are in such a vulnerable position that you may perceive the threat of an injury or death even when a medical professional may not. However, many clinicians and researchers think the definition of trauma should be broader—an individual can perceive an event as traumatic even if it does not involve threatened injury or death. Trauma may instead be defined as an event that disrupts foundational beliefs about yourself, others, or the world, and/or changes the direction of your life (for example, you think in terms of before and after the trauma).

On the other hand, a difficult birth or birth involving injury to you or the baby doesn’t necessarily lead to birth trauma. Regardless of what happens during the birthing experience, it is entirely up to the birthing individual to determine whether it was a traumatic experience or not.

Symptoms of Birth Trauma

Symptoms of birth trauma can include:

  • Psychological distress related to your birthing experience.
  • Repetitive and intrusive thoughts, flashbacks, or nightmares about your birthing experience or anything related to it.
  • Avoiding people, places, and memories related to the birth.
  • Being overly aware of potential threats to you or your baby.
  • Feeling guilty or blaming yourself.
  • Having difficulty remembering important parts of the birth.
  • The birthing experience significantly and negatively changing your thoughts about yourself, others, or the world, or causing a significant and negative change in mood.

Examples of Birth Trauma

Birth trauma can include late miscarriages or stillbirths, medical complications for the birthing individual or baby, emergency C-sections, resuscitation of the infant, hemorrhaging during or after delivery, any type of birth injury, the infant being taken to the NICU, the baby being born with disability or illness, or feeling in extreme pain or out of control during labor. Birth trauma may also include obstetric violence, which is any medical procedures performed without consent, a lack of respect or information from medical professionals, or anything that dehumanizes or takes away the rights of the birthing individual.

What Are the Impacts of Birth Trauma?

Birth trauma has a “ripple effect,” meaning it has long-term and wide-reaching impacts on many areas of a mother’s life. Birth trauma may negatively impact breastfeeding experiences, increase anxiety related to later pregnancies or birth experiences, and negatively impact your relationship with a partner for up to two years.

Birth trauma may also disrupt bonding with your infant. When you experience a traumatic event, you often experience distress related to anything that reminds you of the trauma. In the case of birth trauma, your own infant can remind of the traumatic event. In one qualitative study, women reported an initial feeling of rejection toward their infant which faded over time.

Those who experience a traumatic birth may also experience an immense sense of loss about their birth experience, transition to motherhood, or sense of self. They may experience a fear of childbirth in the future, and/or make a decision to not have additional children or have an elective C-section in order to eliminate uncertainty about future births.

However, many people who experience traumatic birth are made to feel shameful or ungrateful if they discuss it as such. Many people are told that as long as they have a healthy baby that the birth doesn’t matter or are told that their birth complications could have been worse.

Birth Trauma and Mental Health

Birth trauma dramatically increases the risk for postpartum depression with some studies showing up a 4 to 5 times increase in the risk for postpartum depression in mothers reporting a high level of birth trauma. Birth trauma is also associated with an increased risk for postpartum depression in partners.

Birth trauma also increases the risk of postpartum anxiety and elevated stress during the postpartum period. Birth trauma may even increase the risk for postpartum psychosis.

Stay tuned for future articles about coping with birth trauma.

More from Cara Goodwin, Ph.D.
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