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
- 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
- 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.