Birth trauma refers to the physical injuries or emotional distress that can occur before, during, or after childbirth. While some people recover quickly, others develop lasting symptoms such as anxiety, intrusive memories, or post-traumatic stress disorder (PTSD). This article explains the different types of birth trauma, common causes, symptoms, and how behavioral health organizations can support recovery through trauma-informed care.

Birth trauma is a serious condition that affects large numbers of women each year. Yet, it is still widely misunderstood. Due to this, those experiencing birth trauma may not seek help right away or at all. When those experiencing birth trauma do come to your organization, it is crucial for your staff to understand this type of trauma and how to help those living with its effects.

What is birth trauma?

Birth trauma is adverse physical or psychological responses to childbirth that can occur before, during, or after a woman gives birth. These two different types of birth trauma are brought on by different circumstances and can have different effects.

Psychological birth trauma

Birth trauma is an adverse psychological reaction following pregnancy or childbirth similar to post-traumatic stress disorder (PTSD). Also labeled as postpartum PTSD or postnatal PTSD, birth trauma can occur for several reasons.

The most common cause of birth trauma is a difficult labor or delivery or an unplanned birth scenario. These situations can include injuries to the mother or child during birth, emergency caesarean sections (C-sections), not receiving the proper care or attention during birth, and more.

Unfortunately, research has shown that birth trauma affects as many as one-in-three women. The signs and symptoms of birth trauma can vary based on the person and their experience. Common signs of birth trauma include:

• Feelings of depression, anxiety, and/or guilt
• Flashbacks, intrusive thoughts, or nightmares regarding the event that caused trauma.
• Avoiding reminders of the traumatic event — behaviors like not driving by the hospital where the birth took place, not talking to the doctor, not spending time with family or friends with babies, and more
• Hypervigilant behavior — symptoms for new parents like constantly worrying that a traumatic event will happen to their baby, leading to irritability, jumpiness, and constant feelings of alertness

There’s much more to birth trauma, but now that we have a baseline understanding, let’s look at what your organization can do to help individuals living with this condition.

Physical birth trauma

Childbirth is a physically demanding process at the best of times. Unfortunately, it can also prove traumatic.

Physical birth trauma refers to injuries sustained by the birthing parent during labor or delivery. These injuries differ from birth injuries affecting the infant, although both may occur during difficult deliveries.

Common causes of physical birth trauma include:

• Birth injuries: A birth injury is a serious physical injury suffered during childbirth. While uncommon, it can happen and cause serious harm to the birthing parent. Examples of birth injuries include a ruptured uterus, difficulty getting the baby through the birth canal, or another even that would require medical attention.
• Birth complications: Birth complications are event that require emergency delivery techniques. Examples include emergency C-sections and the use of vacuums or forceps to deliver.
• Life-threatening emergencies: These events occur with the birthing parent’s life is threatened by the act of giving of birth. This can prove traumatic for the individual giving birth, their loved ones, and the care team.

A trauma-informed approach to birth trauma

To help your clients cope with and overcome the effects of birth trauma, it’s important that your organization adopt a trauma-informed approach to care.

The goal of trauma-informed care (TIC) is to prevent traumatization, or re-traumatization. To accomplish this goal, TIC emphasizes that symptoms and diagnoses related to trauma are skillful adaptations to stressful events or situations. The focus of care is then placed on the individual experience and perception of need, with an emphasis on psychoeducation, collaboration, and empowerment.

Studies have also found that organizations using TIC see improvements in client outcomes and well-being. In this section, we’ll explore how to implement TIC in cases of birth trauma so your organization can achieve better outcomes for these clients.

How to become trauma-informed

TIC provides a foundation of sorts for your work as a behavioral healthcare specialist, rather than a set of step-by-step procedures. To adopt trauma-informed practices, work on integrating the following six principles into your organization’s policies on working with clients and staff.

• Safety: The most important principle of TIC is establishing and maintaining safety. Those with a history of trauma have sustained a fundamental injury to their sense of safety.
• Trustworthiness and transparency: Clinical and non-clinical staff must be consistent and communicate with clarity, while maintaining professionalism transparency. This is very important in establishing mutual boundaries and expectations for care.
• Peer support: Peer support involves having individuals with lived experience of a certain condition giving support to those with the same condition — in this case, birth trauma. Creating support groups at your organization for individuals recovering from birth trauma can provide a healing and supportive climate for these clients.
• Collaboration and mutuality: This involves sharing power rather than unilateral decision-making. It can include treatment planning and goal setting, as well as allowing clients to take part in shaping policy and programs at your organization.
• Empowerment, voice, and choice: Survivors of trauma often feel helpless or powerless. Give options to clients regarding ways to receive services and supports, and honor client’s choices and preferences as much as possible.
• Cultural, historical, and gender issues: Clients may have cultural or religious influences which affect the way they respond, or do not respond, to birth trauma. To provide the most culturally responsive services, understand how an individual’s sociocultural support network views birth trauma, and be aware of their religious/spiritual beliefs. Also be aware of how the individual’s gender identity or expression may impact their unique experience around their birth trauma.

How to apply a trauma-informed approach to birth trauma

TIC is not a specific treatment model for healing trauma, but rather a comprehensive lens to assess environments and create safe spaces and processes. It can be used to support services that appropriately address the needs of people who may have experienced trauma.

Ideally, your organization should screen all new clients for trauma. Having a universal approach to trauma screening is one important aspect of being a trauma-informed organization, and this can help you identify individuals who may be experiencing birth trauma even if this is not the reason they came to seek your services.

For individuals who did come to your organization to address birth trauma, provide an initial trauma screening and assessment to identify any other traumatic events that may have occurred in their life prior to pregnancy and birth.

After the initial screening, the exact treatment should be determined by the clinician and client. No matter the course of treatment, however, it must support resilience in the client.

Resilience is the ability to adapt during times of trauma, stress, loss, or other challenging circumstances. High levels of resilience protect against adverse psychological outcomes. Resilience factors include:

• Seeking out support from friends, family, or support groups
• Learning to feel acceptance with one’s actions in response to a traumatic event
• Having a coping strategy for getting through and learning from a traumatic event
• Being prepared and able to respond to upsetting events as they occur, despite feeling fear

Trauma-informed practices have proven effective at promoting resilience among women with birth trauma, helping them better treat their psychological and physical distress.

Train your staff on the TIC framework

To provide the best care possible to those experiencing birth trauma, your entire organization should operate on the TIC model. To do this, you’ll need to provide some level of TIC training to all staff, not just your clinicians.

When implementing a TIC approach to care, use assessments to gauge the knowledge level of your current staff, as well as any new hires. From these baselines, you can assign the appropriate training to staff members based on their roles within your organization. Some topics to consider including in these trainings are:

• The basics of trauma-informed care
• Crisis prevention, de-escalation, and intervention
• Motivational interviewing
• Evidence-based practices for trauma treatment

By training your staff on trauma-informed care, you’ll be able to provide better care to clients experiencing birth trauma or other trauma-related conditions from their first interaction with your organization.

Frequently asked questions about birth trauma

What is birth trauma?

Birth trauma refers to the physical injuries or psychological distress that can occur before, during, or after childbirth. While some individuals recover quickly, others experience lasting emotional effects such as anxiety, intrusive memories, or post-traumatic stress disorder (PTSD). Birth trauma can result from unexpected complications, difficult labor, emergency interventions, or feeling unsupported or unsafe during the birth experience.

Can birth trauma cause PTSD?

Yes. Some individuals develop childbirth-related PTSD after experiencing or witnessing a traumatic birth. Symptoms may include flashbacks, nightmares, avoidance of reminders of the birth, hypervigilance, and persistent feelings of fear or distress. While not everyone who experiences birth trauma develops PTSD, early screening and evidence-based treatment can improve outcomes.

What are the signs and symptoms of birth trauma?

Symptoms of psychological birth trauma vary from person to person but commonly include anxiety, depression, guilt, intrusive thoughts, nightmares, emotional numbness, irritability, difficulty bonding with a baby, avoidance of reminders of childbirth, and heightened alertness or hypervigilance. Physical birth trauma may involve injuries sustained during labor and delivery that require medical treatment or rehabilitation.

How is birth trauma treated?

Treatment depends on each individual’s needs and may include trauma-informed care, trauma-focused cognitive behavioral therapy (CBT), eye movement desensitization and reprocessing (EMDR), peer support groups, medication when appropriate, and referrals to perinatal mental health specialists. Behavioral health professionals can help clients develop coping strategies, build resilience, and process their experiences in a safe, supportive environment.

How can behavioral health organizations support clients experiencing birth trauma?

Behavioral health organizations can support clients by adopting a trauma-informed approach to care that emphasizes safety, trust, collaboration, empowerment, and cultural responsiveness. Universal trauma screening, evidence-based treatment, staff training, and referrals to specialized perinatal mental health services can help improve recovery and long-term outcomes for individuals affected by birth trauma.