Childbirth Trauma: It’s not about what happened, it’s about how you felt

*Inhale*

Let’s talk about childbirth trauma. 

*Exhale*

As a trauma therapist specializing in perinatal mental health, childbirth trauma is a topic that comes up with almost all of my clients. Whether it’s in conversations in pregnancy about worries or fears about what the birthing experience might be like or what might take place, or it’s in conversations in postpartum processing what did happen or come up for someone during this life-changing event- I can always feel the question of trauma looming over these conversations in the words that are not said.

In between the lines of what is said, I all-too-often hear a common thread of fear:

“What if my birth is “traumatic?”

And a common thread of doubt:

“I’m not sure if my birth counts as “traumatic.” 

This fear and doubt is only natural. In our culture and society we are seriously underserved and misinformed when it comes to childbirth and trauma. We don’t talk about either of these topics nearly as much as we should and we often dismiss our experiences.

So let’s talk about it!

What is trauma?

I have three favorite definitions for trauma:

  1. Anything that happens “too much, too fast, too soon” or “too little, too slow, for too long.” 

  2. Any time we feel out of control or threatened by our bodies or our environments. 
    And perhaps my favorite definition of trauma by Gabor Mate points to the idea that trauma might not be at all about threat but is:

  3. “The absence of connection.”

Childbirth inherently involves a mix of these elements. Sometimes things happen too fast. Other times things go on for too long. Sometimes things happen that we cannot control. 

We know that childbirth can sometimes involve interventions, medications, procedures, transfers, changes in plans, changes in providers, changes in settings, and the list goes on. However, not one of these things inherently makes a birth “traumatic.” A birth can have every single one of these experiences and not be traumatic. In fact, for many people, these experiences can end up being experiences of empowerment, connection, strength, resiliency, and so on. Alternatively, a birth can have none of these things happen and still be traumatic for the individual. 

This is because it’s not about what happened, it’s about how you felt during it.

Postpartum PTSD occurs when people develop PTSD symptoms following their childbirth experience. Research tells us that 9% of birthing people experience postpartum PTSD following childbirth (Beck, C. et al., 2011). A 2004 study found that most people who developed PTSD following their birthing experience had births that were considered routine by their medical providers (Beck, C., 2004). This is important because it validates why so many people doubt whether or not their birthing experience even “counts” as traumatic, and it also tells us that childbirth trauma is not caused by a specific intervention, procedure, or experience. In fact, this 2004 study found that the actual causes of postpartum PTSD were:

  1. A felt sense of a lack of care

  2. A felt sense of a lack of communication

Because trauma is much more about how you felt than what happened, we actually can do a lot to prevent postpartum PTSD, no matter what your birth ends up looking like. Working with a therapist during pregnancy can help you:

  • learn tools to resource your nervous system to stay regulated in the event something happens faster or slower than you had hoped for

  • Identify and develop internal and external resources that help you tap into a felt sense of connection, safety, and support

  • Learn and practice communication and advocacy skills for feeling more confident about asking about your choices

  • Process your worries and fears about childbirth so you can feel more empowered going into the experience

Likewise, if you have recently given birth and are wondering if your birth “counts as traumatic”, chances are you may be struggling with some Postpartum PTSD symptoms.

Common symptoms include:

  • intrusive thoughts, memories, dreams, or feelings about the birthing experience

  • feelings of distress at reminders of the birthing experience

  • avoidance of reminders of the birthing experience

  • persistent increased arousal (irritability, difficulty sleeping, hyper-vigilance)

  • feeling detached from others (including or not including baby).

PTSD does not always include all of these symptoms and can look different for everyone.

If you are experiencing any of these symptoms, it is 100% possible to feel well again. Connecting with a therapist to process your birth can help.


This article was written by Maggie Saltiel, LCSW

Maggie Saltiel