Swept along and spat out: do I have birth trauma?

Cathy Williams
6 hours ago
5 min read

An Asian woman is sitting back on a sofa. She is holding her sleeping baby on her chest. She looks pensive.

Do I have birth trauma?

What is birth trauma?

When does a difficult birth become traumatic?

Are all traumatic births difficult births?

Can you really get PTSD after giving birth?

Meeting your baby is something you look forward to your entire pregnancy. It should be one of the best days of your life, right?

For many women and birthing people it is the opposite. If that is you, you are not alone.

Birth trauma is on the rise. One in three experience a traumatic labour, with one in 25 developing PTSD, and it affects partners too.

Speaking about the 2020 UK Birth Trauma Inquiry Report, Liberal Democrat MP Helen Morgan, who was among the MPs responsible for the inquiry, said it was "nothing short of a national tragedy" that so many women had experienced traumatic births.

https://www.bbc.co.uk/news/articles/c4n1jv7xxpwo

A difficult or traumatic birth is not defined by how much intervention you had.

A birth doesn’t need to be difficult to be traumatic, and a difficult birth doesn’t necessarily cause trauma.

Someone can have all the intervention under the sun and view it as a positive birth, because they felt in control, involved, and treated well. Similarly, someone can have a seemingly easy, straightforward birth, and find it traumatic. There is no hierarchy. Same goes for your birth partners.

Birth trauma can come from many aspects of birth: pain, fear for yourself or for your baby, how you were treated, whether you knew what was going on or not, how much you felt in control or involved in the decisions, and physical injury to you or your baby.

In labour, the hormones change your brain activity. The cerebral cortex becomes a little dormant, as the amygdala takes over: ‘labourland’ sensation. It is harder to understand time, manage language (understanding what is said to you, or difficulty finding words to say); and your sense of time is diminished. This means that it can be harder to understand what is happening, and harder to voice your wishes or ask questions.

You enter a state that psychologists call ‘suggestible’, meaning you have an increased sensitivity to what is said to you, especially negative comments. Old women can remember vivid details of when they gave birth.

Giving birth can feel like you are swept along in a fast flowing river, with no branch to cling to. You are vulnerable, in pain, trying to navigate, advocate for yourself. You may find your voice ignored, or being asked to override your instincts.

For some, their experience is akin to a nightmare, torture, or rape.

Even if that wasn’t your experience, If you found your birth traumatic then you have birth trauma.

How can I tell if I have birth trauma or PTSD?

If you are unsure, talk to your midwife or GP. Or look up on the NHS app or mental health charities.

Some people don’t realise they have birth trauma until some time after, even a year or more. For some, it is as their baby’s first birth approaches they realise they have trauma associated with their baby’s birth, or when they become pregnant again.

Some signs:

You don’t like talking about parts of your baby’s birth.
You can’t hear other people’s stories, or feel a sense of dread, panic, or grief.
You have a physical or emotional reaction to seeing the hospital, or something that reminds you of the birth. This can include smells, sounds, touch sensations, tastes.
You feel a barrier between you and your baby, or you have feelings of resentment to your baby or your partner. You may struggle with showing or receiving affection.
You have guilt for not being joyful, for how the birth went, for the impact on your baby, and on your relationship with them.
You have increased anxiety about your baby’s wellbeing, to the point of hypervigilance.
You feel a lack of trust of others, that nowhere is safe, and/or no one understands.
You experience intrusive thoughts or images.
You feel jumpy, easily upset or angry, and/or have difficulty concentrating.
You don’t like to touch or look at your caesarean scar, or perineal scar.
You don’t like your partner to touch parts of your body during sex. You don’t want sex.
There are parts of your birth experience that are blank.
You experience flashbacks of memories of the birth.
You have night sweats. (Though this can be the hormonal change postnatally.)

If you any combination of these resonate, then you might like to talk to someone, or consider the actions further down.

Impact on your mental health

It is very understandable if you have trauma after giving birth, for all the reasons I've mentioned. It is not something you can just 'get over'.

You go through the birth, and then you are looking after a newborn, with no support or resources to help you process, let alone heal, from your experience.

As well as birth trauma, you have all the other postnatal struggles. Caring for a new baby is like starting a new job, doing an evening course, and a night shift all at the same time. Sleep deprivation is used as a form of torture. Plus the huge hormonal shift post-pregnancy.

On top of that, your mental health can be further impacted by your birth experience, on top of the trauma, for example you may not have experienced the natural high levels of oxytocin and endorphins, both 'happy hormones', during and after giving birth, if you had an epidural, were induced, or were full of stress hormones.

You may also have trauma and grief around your postnatal experience too, including feeding grief and trauma.

You are not alone. It is not your fault. You didn't deserve it.

How to start healing?

Below are suggestions for healing for your mental health. You can dowload my guide for birth healing which includes suggestions for physical healing, and more details of mental health healing.

Professional help

Talking therapies: CBT, you can self-refer or ask your GP. Locally the Ocean team of midwives offer a variety of services. You can self-refer. CBT may not be as beneficial for neurodivergent people, and for birth trauma.

Medication: Birth trauma and difficulties increase your chance of having depression and anxiety.

Birth debrief/birth afterthoughts: helps you to understand the birth. If you have birth trauma you may find it is re-triggering, especially if it is done at the same hospital, by staff from that hospital, as they may be defensive. There are independent midwives and some experienced doulas who offer birth debriefs and/or listening services (like me). National guidelines say that birth debriefs/afterthoughts sessions are not recommended for people who have PTSD.

Note: Getting hold of your notes before a debrief can be helpful. The website of the hospital will have details of the records department, and how to get a copy of them.

If you are considering a complaint, I recommend getting your notes first.

EMDR: Eye movement desensitisation and reprocessing is recommended if you have PTSD, under national guidelines. You can ask for a referral from your GP.

Self-help

Rest All healing starts with rest
Journaling: writing, drawing, scribbling. Name the thoughts. What do you feel? Where? How does it show up? What are the unwritten rules you feel apply to your experience?
Regulate your nervous system: breathing, spent time in nature, singing, dancing, hugs, sunlight, laugher, music, positive touch inc massage.
Connect to your body: swimming, yoga, massage, self-massage (e.g. your hands).
Connect to others: go to a postnatal group, a baby and toddler group, local children’s centre.
Ask for support: family, friends, Home Start, children’s centre, postnatal doula.
Mental health organisations: they may offer information, self-help guides, and support groups.