Trauma

Maternal Birth Trauma and PTSD

Understanding what it is and how it can cause PTSD.

Posted May 29, 2020

When most people think of trauma, they think about large-scale and uncontrollable events. Circumstances like war, natural disasters, rape, and car or plane accidents are some of the possible scenarios that come to mind. Unfortunately, due to the narrow scope with how the general public tends to conceptualize trauma, it is quite easy for a person to overlook their own experience as traumatic. This often means suffering in silence without seeking the necessary help to heal.

Previously, I have written about different trauma topics, yet one I have not discussed is maternal birth trauma. The label "birth trauma" has been defined as a shorthand name for post-traumatic stress disorder (PTSD) after going through childbirth. However, it is often used for women who do not meet the criteria for a full PTSD diagnosis but have symptoms of PTSD.

Trauma in and of itself relies on a person’s subjective experience of an event and to what extent they believe their life, bodily integrity, or psychological well-being was threatened. If you are even asking the question “Is my birth experience considered a trauma?” please read on.

Birth Trauma Experiences

Since trauma is a subjective experience, a traumatic birth occurs when you experience intense fear that you or your baby are going to die. This can include, but is not limited to:

  • Births where the mom experienced significant blood loss
  • Emergency caesarean, after the baby's heart rate suddenly drops
  • Forceps birth
  • Extreme or intense pain
  • Stillbirth
  • Escalated medical intervention to save the baby or mom
  • Baby born with a disability as a result of traumatic birth
  • Unexpected, or early, delivery of the baby
  • Baby admitted into the special care baby unit or neonatal intensive care unit

Core Symptoms of Birth Trauma

After experiencing a traumatic childbirth, you may experience symptoms of a post-trauma response. These can include:

  • Intrusive (i.e., unwanted and repeated) memories or dream/nightmares of the bothersome/stressful event(s), and likely attempts to distract yourself or avoid thinking about it 
  • Avoiding people, places, conversations, activities, objects, or situations that remind of the event(s) — this could include driving by the hospital where you gave birth, looking at photos from the hospital, etc.
  • Changes in mood (including depression, anxiety, anger)
  • Physiological response when reminded of the event(s) — (e.g., heart racing, sweating, difficulty breathing)
  • Difficulty remembering parts of the experience
  • Overly negative beliefs about yourself, others, and the world (and especially in the areas of safety, trust, intimacy, power/control, and esteem)
  • Blaming yourself or someone else for what happened
  • Feeling hypervigilant (e.g., constantly alert and jumpy). You may worry that something terrible could happen to your baby.

Do You Experience These Symptoms?

Interestingly, some women who have experienced a traumatic childbirth may not label their experience as trauma. This line of thinking may be due to cognitive dissonance that can occur when self-identifying as having experienced a (at times, significant) trauma. However, by not labeling that experience as such, the woman may not receive the help and support they really need. Additionally, we know that avoidance of traumatic experiences only intensifies a person's trauma, or PTSD, symptoms and is likely to lead to longer-term psychological difficulties.

Avoidance Is Not the Solution

There is much healing to be done after a traumatic childbirth occurs; simply brushing the situation and related thoughts and emotions under the proverbial rug does not rid oneself of what has happened. As trauma specialists, we know that avoidance is the number one factor in the development and maintenance of PTSD. 

Denying that your childbirth experience was traumatic will not erase the cognitive or body memory. In fact, it is likely the opposite will occur and down the road, the woman who has experienced birth trauma but forgone acknowledging and processing the experience is more likely to have an exacerbation of symptoms. 

Another factor unique to this type of trauma, but actually not all that different from military deployed in a combat zone (which, again, is the type of event we tend to think of when discussing trauma), is the need to refocus one's attention away from the childbirth experience and on the immediate situation around them (i.e., caring for their new child). This immediate avoidance is largely unintentional as the new mom rightfully becomes preoccupied with caring for their baby; however, it can set a woman down a continued path of avoidance if she is not intentional in avoiding avoidance.