What is Birth Trauma?

Birth trauma is an expression that used to describe a physical injury to the baby as a consequence of a challenging birth. However, today it usually refers to the experience of the birthing woman and it means the emotional, physical, psychological, spiritual, relational, and health-related consequences of a traumatic birth experience. It includes many of the symptoms of trauma as defined in the DSM-V (American Psychological Association’s Diagnostic and Statistical Manual #5, 2013) and can include post-traumatic stress disorder. Postpartum depression and anxiety often accompany trauma, but treatments for depression often don't work for the symptoms of trauma. 

When talking about trauma, one definition comes from neurologist Robert Scaer M.D.

"Trauma is an experience that is perceived to be a threat to life in the face of helplessness. And helplessness may, in fact, be the defining element that generates the neurophysiology of trauma itself.” 

Throughout the developed world, about one third of women report that their birth experience was traumatic. For most, it included a deep sense of helplessness. Sadly, about 5-17% of these individuals will meet the clinical diagnosis of post-traumatic stress disorder (PTSD), with many more having some of the symptoms of PTSD. Parents with postpartum PTSD are also 5 times more likely to be dealing with depression and 3 times more likely to have anxiety. They're also at increased risk for attempting suicide. 

What makes a birth traumatic?

Trauma is “in the eye of the beholder”, meaning that it is the one who experienced it that decides if it was traumatic. In this case, it is woman that determines if the experience was traumatic or not. In fact, events that may seem ordinary to everyone else, including the doctor, nurse, or midwife, might register as traumatic to the woman or her partner. However, research has been a tremendous benefit in that we now know what events are more likely to make the birth a traumatic one.

Sometimes birth becomes an emergency and requires necessary medical interventions. One might think that an emergency would be one of the greatest risks for a traumatic experience. However, it’s not. An emergency can be traumatic, but the greatest risk factor is not the emergency itself but rather how the woman was treated.

A birth becomes traumatic when women feel:

  • Powerless
    • they aren’t given information
    • they are excluded from making decisions about their own care
    • they are not asked for, nor do they give, their consent to what happens to themselves or their babies
  • Fearful
    • they fear for their baby’s life
    • they fear for their own life
    • they fear the repercussions (punishment) of the staff if they are a “difficult patient”
  • Pain
    • they lack good pain management or emotional or physical support to manage their pain
    • they are cut or stitched without medication
  • Abused
    • they are told lies about their baby’s condition to get them to agree to something they don’t want
    • they are physically abused, held down, or restrained
    • they are sexually violated through groping or penetrations
    • they are insulted, mocked, or belittled
    • they feel their dignity is stripped away
  • Unsupported
    • they feel they don’t matter
    • they feel the staff are doing things that suit them or their hospital that puts them or their baby at risk
    • they feel neglected and unimportant
    • they feel betrayed

The strongest predictor of developing birth-related trauma is a problematic relationship and difficult interactions with care providers, in particular, a lack of support

With good research on our side, we are equipped to make changes in how care providers and patients interact with one another to ensure a positive experience!

And the good news is that there is healing for trauma. Great research also helps us to know how parents and practitioners can engage in healing strategies that really work.

You can review the references for the above information here.

Doctor writing on medical chart beside patient

Doctor writing on medical chart beside patient