3 Ways Birth Trauma Is a Unique Type of Traumatic Event

The American Psychological Association defines trauma as a disturbing experience that results in significant fear, helplessness, or other disruptive feelings intense enough to have long-lasting negative effects on functioning. Traumatic events challenge one’s view of the world as a just, safe, and predictable place.

Birth, under certain highly distressing circumstances, can be traumatic. As it relates to childbirth, trauma encompasses the experiences that may occur during any phase of childbearing, including the pre- and postpartum periods as individuals interact with obstetric and reproductive services.

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While birth trauma fits the definition of a traumatic event, it is unique and complex in the following ways:

1. Society perceives birth as a positive event.

Even though about one in three women experience childbirth as traumatic, the only message women receive is that the day they give birth will be the best day of their life. Women are rarely informed of risks and vulnerabilities related to potential trauma.

Risk factors associated with birth trauma include pre-existing factors in an individual’s history (e.g., psychiatric and trauma history), obstetric factors (e.g., obstetric complications and interventions, pain, and infant complications), and subjective experiences related to childbirth (e.g., perceived lack of care, support, and control; fear; and poor communication).

Because there is a lack of education about birth trauma and an expectation that birth can only be a positive life event, people often have the misconception that birth cannot be traumatic. This is different than other types of traumatic events in which society does not have such positive associations with the event. As such, it can feel surreal for new parents to have a mismatch between their expectations and reality. Distress after birth is often associated with the loss of the expected or desired experience.

2. Birth generally involves several individuals: the person giving birth, their partner, the baby, and medical providers.

The number of people involved in childbirth adds a level of complexity to the event. Because medical providers have very different roles in the childbirth experience than those of the parents, they can also have a different perspective on the birth. That is, for medical providers, the birth of a live and healthy newborn is often considered the clear indicator of a successful birth. Birth trauma is reserved only for observable physical injuries obtained by the mother and infant. Therefore, many mothers believe the psychological birth trauma they experienced is “glossed over” by medical professionals who view their childbirth as routine. The lack of acknowledgment of the trauma by the very professionals who were present at the event can add to the confusion of making sense of the experience.

It is also important to recognize that contemporary definitions of trauma denote that exposure to an event can also be traumatic. As such, fathers and partners can experience the trauma of childbirth without giving birth themselves. As such, both partners can go home from the hospital traumatized. Research has demonstrated strains to the couple's relationship above and beyond what is typically seen during the transition to parenthood following birth trauma. There can also be disruptions to the parent–infant relationship with difficulties in breastfeeding and bonding. Long-term, it can also impact a couple’s decision-making around future family planning.

3. There is unavoidable continued contact with reminders of the inciting event.

A hallmark response to experiencing a traumatic event is attempting to avoid reminders that arouse distressing memories, thoughts, or feelings associated with the traumatic event. Following a traumatic birth, a parent has daily contact with their baby who serves as a constant reminder of the recent trauma. This is unlike other traumas where avoidance of triggers might be more possible. This has the potential to exacerbate symptoms and leads to poor parent–infant bonding if not understood or addressed.

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If you’re a new parent and any part of your reproductive story has left you with feelings of distress, know that you are not alone. Up to one in five moms and one in 10 dads experience mental health concerns during pregnancy and postpartum. These conditions are treatable, and, with help, you can feel well.

Ways to support new parents’ mental health:

• Locate a therapist specifically trained in supporting new parents’ mental health and trauma. There are therapies such as Eye Movement Desensitization and Reprocessing (EMDR) or exposure therapy shown to be effective in treating trauma symptoms.
• Because avoiding reminders of the traumatic event is common, parents often avoid returning to the hospital or seeing their medical provider. This may lead to missed postpartum wellness visits. However, it is important for new parents’ overall wellness to receive care, especially if the traumatic childbirth included physical complications. To feel more comfortable, bring a support person to the visit or ask to see a different provider altogether.
• While birth debriefs are not commonplace, one can be requested to have a more complete understanding of the labor and birth. This can be especially helpful if the person who gave birth was put under general anesthesia or their partner was not able to be present for some parts of or all of the childbirth.
• Challenge dichotomous thinking that doesn’t allow for the full processing of the birth experience. The message routinely given to parents is that a live and healthy newborn is the clear (and only) indicator of successful childbirth. A parent’s perception of traumatic childbirth and their psychological needs are pushed into the background. Allow space for all parts of the birth experience. There can be appreciation that a baby is healthy and grief for the loss of the expected or desired childbirth. Both experiences can exist, be true, and are valid.