Birth Trauma—Distress During Childbirth and Its Lasting Effects

When thinking of an example of an event that might have a lasting emotional and psychological effect, it's usually war, assault, or an accident that comes to mind.

But childbirth can have that effect, too. It's known as birth trauma, and it can occur when the birthing parent has a physical, emotional, or psychological experience—feeling unsafe shortly before, during, or after labor and delivery. The birthing parent's partner may also experience birth trauma.

After experiencing or witnessing a traumatic event, some people might have a hard time recovering and getting back into the swing of life.

"It could be that the baby was at risk at birth, the labor went quickly from managed to a state of crisis for the birthing parent or baby, or the partner witnessed parts of the birth in which they were the only one not in crisis," New York City-based therapist Rachael Benjamin, LCSW, the director of Tribeca Maternity, a branch of Tribeca Therapy that specifically focuses on maternity-related issues, told Health.

Types of Birth Trauma

There are several types of experiences that can constitute birth trauma, according to Benjamin. A physical medical emergency to the birthing parent during or shortly before or after the birth is one way someone might experience birth trauma. Those emergencies can include:

• Induction—methods to bring on labor
• Needing an emergency C-section
• Hemorrhaging after the birth
• Eclampsia—a complication of preeclampsia
• Placental abruption—separation of the placenta from the uterus before the birth
• Immediate need for a large medical team in a way that was unknown prior to labor or delivery

Birth trauma can also take the form of a lack of pain management during a C-section, the feeling that the birthing environment is not emotionally safe, or the feeling of being continually unseen or unheard during the birthing process.

The second category of birth trauma is when the baby is at medical risk, when there is a stillbirth, or when the baby passes shortly after birth. Birth trauma relating to the baby's health may also arise with:

• Preterm labor
• Discovery post-birth that requires intense medical intervention
• Diagnosis of an unanticipated medical condition
• An extended stay in the neonatal intensive care unit
• An injury to the baby during labor and delivery

"Having a baby whisked away for unforeseen medical intervention can be traumatizing for both parents," said Benjamin.

Partners often get left out of the conversation around birth trauma, but they too can have trauma from witnessing the safety of a birthing parent or baby in jeopardy. When a baby and birthing parent are separated after birth for medical reasons, the fact that a partner has to choose between whom to be with during that time can be a traumatic experience, said Benjamin.

Another type of birth trauma is when the experience of labor and delivery triggers the birthing parent to remember past traumatic events, such as sexual abuse, domestic violence, or emotional or physical distress. "These can be occasions in which the birthing parent both feels the trauma of what happened in labor/delivery as well as the traumatic experience brought up from the past," explained Benjamin.

Lingering Impact

Trauma truly is in the eye of the beholder, pointed out Paige Bellenbaum, LMSW, founding director of New York's The Motherhood Center, which provides mental health support services for new and expecting moms. "What might feel traumatic to one person may not to another—it's the person's experience that matters," Bellenbaum told Health.

Prevelance of Trauma During Birth

Between three and six percent of women experience birth-related post-traumatic stress disorder (PTSD)—but that's just the recorded rate and likely doesn't show the full story.

"For those of us in the maternal mental health field, we know this rate is much higher," said Bellenbaum. She said she believes that the majority of PMAD (perinatal mood and anxiety disorder) cases go untreated and undiagnosed due to the fear, shame, and stigma that surround PMADs.

Birth trauma can be all-consuming and greatly affect the transition to parenthood, including making it harder to feel connected to your own self, the baby, a partner, or the present moment. "A person who has experienced birth trauma may be continually experiencing hypervigilance, panic, anxiety, or flooding of thoughts [about] re-experiencing the event in waking moments or dreams," said Benjamin.

Revisiting Past Trauma

In cases where the baby is healthy and the labor and delivery were smooth enough but the treatment or event echoed past experiences such as sexual or physical abuse, memories of these past events can come up frequently in the time following the birth, in ways such as flashbacks. A person can also feel blocked by the birth experience, unable to emotionally move on from the birth.

When you experience birth trauma or are reminded of past traumas because of your present-day birthing experience, it can be hard for daily life to be front and center. Denying or minimizing a traumatic birth experience also delays facing what happened; it hurts more for longer, said Benjamin.

And if the birth trauma isn't addressed, or not adequately addressed, it can make it difficult for the individual to connect to the baby or to their family and friends the way they used to.

In some cases, they may be very connected to their baby, while also experiencing great anxiety, stress, or an inability to rest out of fear that something else will happen to them or the baby, added Benjamin.

How to Deal With Birth Trauma

Anxiety, hypervigilance, a feeling of being disconnected, overwhelming thoughts, or panic in the days, weeks, or months following the birth are just some of the symptoms you may experience after birth trauma, according to Benjamin.

And if you're wrestling with any lingering emotional and psychological effects that stem from birth trauma, you're not alone—and there are many things you can do to feel better.

Therapy

When it comes to minimizing symptoms, Bellenbaum said that therapy can be "very effective." That therapy can include exposure therapies, when patients are encouraged to confront their fears; cognitive behavioral therapy, a talking therapy that can help you manage your issues by changing the way you think and behave; and eye movement desensitization and reprocessing, which combines exposure therapy and a guided sense of eye movements.

Birth trauma symptoms will last until the trauma is cared for. To move past the trauma, it needs to be felt, processed, and grieved, said Benjamin.

Strong Support Team

It's important that you have a strong support team, Benjamin noted—this could be a therapist, postpartum doula, trusted friends or family members, your partner, or a parenting group for birthing parents who had a traumatic birth experience.

"Don't be scared to ask for all the help you need, especially with the practical aspects of caring for your baby," added Benjamin. "This makes it easier to take care of yourself and find the space to address your trauma. When we face, feel, and grieve trauma, we can also make more space for what we want in life now that we have fully honored the traumatic event."

Encouraging Conversation

If it seems like you're hearing more about birth trauma than you used to, that's largely due to the increase in online platforms and social media influencers speaking out in an effort to normalize these traumatic experiences. "They need to be felt, acknowledged, and grieved in [the] community," said Benjamin.

Bellenbaum had another theory as to why you're hearing about it more. "The US has the highest maternal mortality rate among developed countries," explained Bellenbaum. "Due to this alarming statistic, more states and localities are starting to pay closer attention to the birthing experience, which in turn is highlighting birth trauma."

Bellenbaum also believed that society is beginning to create a slightly safer space for people to talk about the hard parts of pregnancy, birth, and the postpartum period—not just the "romanticized" and "glamorized" versions.

"The more permission that is given to women to talk about messy parts of motherhood—the tears, the anxieties, the breastfeeding challenges, the exhaustion, and the overwhelm—the more women feel comfortable coming forward and speaking their truth," said Bellenbaum.