What is birth trauma?

When someone experiences a distressing event, they can become psychologically and emotionally overwhelmed. Trauma is a lasting emotional response to a shocking, frightening, or dangerous experience. Often due to the difference between parents’ hopes for labour and birth and the reality of the event, many people can feel upset and at fault following a traumatic birth, leaving them in a vulnerable emotional state

Birth trauma is a term used to describe a significant emotional response to experiencing a labour and childbirth that felt shocking, frightening, or dangerous. Experiencing a traumatic labour or birth can harm a person’s sense of safety, confidence, and ability to regulate emotions and navigate relationships as a result of unfamiliar, intense, confusing, or frightening feelings.

When giving birth you may have felt: 

  • Out of control or helpless
  • Frightened, distressed
  • Confused or worried about what was happening to you and your baby
  • Concerned about your or your baby’s safety
  • That things were not happening as you had hoped or planned
  • That you couldn’t speak out or weren’t heard
  • You were watching yourself rather than being fully present 

You may also have been affected by yourself or your baby needing emergency medical intervention.

If you feel traumatised by your labour and birth experience, it is important to know that you are not alone. Around 30% of women report their birth as traumatic and PTSD (post-traumatic stress disorder) affects 1 in 25 women and birthing people following birth. There is no right or wrong way to feel following giving birth. No one can tell you if you had a traumatic birth or not. If you feel that your birth was traumatic, then it was for you.

If you feel you need more information please read this leaflet, which offers some guidance on how to understand, process, and get help for feelings that might arise following birth trauma.

How does birth trauma have an impact?

Some birth trauma symptoms you might experience are:

‘Re-experiencing’ moments from your labour or birth. This can occur unexpectedly or when you are reminded about the birth, and includes:

  • Experiencing unwanted pictures or images (flashbacks) or intrusive thoughts related to the birth, or the period around the birth. These might be visual, sounds, smells or sensations.
  • Reliving the worst parts of the birth over and over again.
  • Having upsetting dreams or nightmares about the birth
  • Feeling very distressed in situations that remind you of the birth.

Triggers involving your baby can feel particularly hard and can make it feel difficult to get to know or bond with your baby in the way you hoped.

  • Emotionally numb or detached from other people.
  •  Intense fear, anxiety or helplessness in reaction to reminders of the experience. You may be left feeling unsafe and fearful for your baby’s safety.
  • Overly-alert to possible dangers, e.g. carrying out lots of safety checks, being ‘wary’ of others, or feeling on edge.
  • Guilty, a failure or to blame; worrying that you are responsible for what happened or that you should have done things differently.
  • Confused and scared; finding it hard to make sense of what has happened and how you are feeling.
  •  Feeling irritable, agitated or having outbursts of anger. Anger can be at yourself, those supporting you or the health professionals involved in your care.
  • Depressed and pessimistic about the future.
  • Sad about your birth experience not being as you had hoped and the ongoing impact this is having on you.
  • Cut off from others, which may include your baby. It can be hard to stay connected to or enjoy the present moment when you are experiencing trauma symptoms.

Avoidance of things to do with the birth, for example:

  • Trying to avoid talking about, thinking about or remembering the birth.
  • Avoiding places, things, or people connected with the birth. For example, not wanting to return to the hospital for appointments.
  • Not being able to recall aspects of the birth (although this may be due to side effects of pain relief medication).
  • Trying to push away any feelings and emotions about the experience.
  • Avoiding people or activities that used to be important to you.
  • You may have lost confidence and feel overwhelmed by everything that is happening to you.

You may experience:

  • Feeling highly-alert to possible dangers, or feel on edge, jumpy, or easily startled. This is your body’s natural response to trauma.
  • Feeling on high alert for your own safety and the safety of your baby. You may feel the need to constantly check your surroundings or the safety of your baby.
  • Distressing physical reactions, such as your heart beating faster, feeling dizzy, increased sweating, and feeling shaky. This may be especially likely when you are faced with memories of the birth or situations that remind you of it.

Remember all of these are normal reactions to very difficult experiences. They are simply a sign that you have not yet been able to process what happened to you.

Birth trauma can impact on many areas of people’s lives, such as:

  • Loss of interest in activities that you used to enjoy.
  • Feeling as if you are struggling to care for or bond with your baby.
  • Difficulty sleeping due to memories or reminders of the birth.
  • Feeling extremely protective of your baby.
  • Fear getting pregnant again and worrying about having another traumatic birth. Some people then avoid intimacy with their partner.
  • Struggling with relationships. Your partner or family may not understand why you think or talk about the birth. They may also be experiencing trauma from the birth experience.
  • You may develop coping strategies which feel helpful, but can cause more long-term difficulties or place yourself at risk, such as misusing alcohol or drugs.

As well as the psychological impact, you may have experienced a physical trauma. Physical injuries may include damage to the pelvic floor or perineal area and require expert medical advice and assessment.

Don’t be afraid to ask questions and seek medical attention.

Why is this happening to me?

Trauma memories are processed and stored differently to memories of other day-to- day experiences. The brain goes into overdrive, working to ‘file’ these memories away. However, sometimes the brain gets ‘stuck’ trying to process and make sense of these memories.

These internal processes – which we aren’t usually aware of – can lead to the ongoing symptoms of trauma. For example, if we haven’t been able to fully piece together any fragmented memories of the event, our brain may keep ‘popping’ these into our minds; our brain wants us to piece things together so that we can make sense of what happened, and store the memory away.

However, experiencing the memories coming into our minds when we don’t want them to can be incredibly intrusive and distressing. This can lead us to try to avoid any situations which remind us of the event. But the more we avoid the memories, the more our brain may work to try to make sense of things, leading to more intrusive thoughts and images, increasing the distressing cycle you may be feeling stuck in.

However, the good news is that there are effective ways to overcome these symptoms. You are not alone, and help is available.

Remember it is your individual birth experience, and how you feel about it, that matters.

Getting help and support - what can you do about birth trauma?

  • Stay connected to people you care about and trust. Ask for their help looking after your baby so that you can have some time to yourself or take a short break. Can they help you practically, such as cooking a meal or helping with some tasks?
  • Find someone who will listen. Social support is crucial in overcoming trauma. Seeing others can be incredibly hard can help your recovery.

It can be helpful to talk to others who have had similar experiences. You could try:

The BTA also have a private Facebook group for peer support: www.facebook.com/groups/TheBTA

It is important to acknowledge that you have been traumatized. Trying to cope with the effects of trauma is extremely hard and you may need to try
different strategies to help you manage. Below are a few suggestions:

  • Focus on your wellbeing, through gentle exercise, eating well, seeing friends or family.
  • Rest when possible.
  • Think about small tasks you could do for yourself and with your baby.
  • Rebuilding or reclaiming your life:
    • What did you used to enjoy?
    • What made you feel good?
    • What had you hoped to do with your baby?
    • What have you stopped doing because of the trauma?
    • If some activities are difficult with a young baby or because of how you are feeling, are there any alternatives?
  • Try to start simple, with one or two small specific goals that feel realistic and manageable.

  • Writing down your birth story and your feelings in a journal or letters to key people in the process (midwives, partners, doctors) can help make better sense of your experience.
  • Contact your local Patient Advice and Liaison Service (PALS).

  • Use techniques that help you stay connected to the present moment.
  • Focus on your senses: what you can see, hear, touch, smell. Notice what is different where you are now to where you were when the trauma happened. This helps to place the trauma in the past. You are safe now.
  • Learn relaxation and breathing techniques to help soothe your body’s threat response.
  • Stand back and observe intrusive thoughts or memories rather than push them away: label them and picture them as external to you. Focus on something that reminds you the trauma is over and that you are safe.

Most people who experience trauma make excellent recoveries, even if they feel highly distressed at first. However, extra support may be needed to help recovery. Do not be ashamed in asking for help.

  • Two recommended evidence-based therapies for people with Post Traumatic Stress are very effective in helping overcome trauma symptoms: Cognitive Behaviour Therapy (CBT) and Eye Movement Desensitization and Reprocessing (EMDR).
  • Therapy can help you make sense of your experience and process what has happened to you. These therapies can be accessed by your GP. Some services may accept self-referral. If you are pregnant or have a young baby you should be prioritized for treatment.
  • You may wish to discuss your birth or review your notes with a health care professional; this may be available via a reflection service at your hospital.
  • Speak to your GP, Health Visitor or other health care professional to find out what is available, and see if they can signpost or refer you to services.
  • You can self-refer to an NHS Talking Therapies service by finding one local to your GP: www.nhs.uk/service-search/mental-health/find-apsychological-therapies-service/.
  • Surrey and Borders Partnership NHS Foundation Trust have services designed to support perinatal mental health difficulties:
    • Maternal Mental Health Service: AFLoaT: Addressing Fear, Loss and Trauma relating to your maternity experience.
    • Community perinatal mental health teams based at sites across the county.

Further support

It can be helpful to understand more about how birth trauma affects your brain and body, and why you have the symptoms you do.

Remember be kind to yourself; the experience you had was extremely difficult and now you are trying to adjust to a life-changing event. This is hard right now, but things can and will improve. It is ok to ask for and accept help to achieve this recovery.

Sometimes people who have experienced trauma may have thoughts and plans of ending their life or thoughts of harming their baby. If you are
experiencing these please either:

  • Attend your local A&E department
  • Dial 999
  • Call the Surrey Crisis Line: 0800 915 4644

Remember there is no right way to feel after birth trauma. Try to treat your experiences with compassion not criticism.