Birth trauma: When expectations don’t meet reality

How you experience birth impacts how you experience postpartum and parenthood. If it left you shaken, frightened or feeling like a part of you is still in that room, you deserve support.

The focus on the baby

One of the hardest things about a difficult birth experience is that the people around you may not see it. The focus is usually on the baby. If your baby arrives safely without complications, conversations tend to move quickly to feedings, sleep and milestones. If there were complications, you may be holding grief and trauma at the same time, and that experience deserves separate, specific and meaningful support. In both circumstances, what you went through can get lost.

Research suggests that up to 45% of birthing people describe their birth as traumatic. What makes a birth traumatic is not a checklist of events. It’s how the birthing person and their partners or other support people present for the birth experienced those events, including whether you felt unsafe, out of control, unheard or in danger. Two people can have the same medical outcome and have completely different experiences of getting there.

The social pressure to focus on the “healthy baby” is real and well-documented. It does not mean your distress is any less real. Both things can be true at once.

What birth trauma can look like

Birth trauma is not always about a medical emergency. It can follow a long and frightening labour, an unplanned intervention, feeling dismissed by staff, or simply a birth that unfolded in a way that left you feeling powerless.

In the weeks after a difficult birth, some people notice they keep replaying what happened in their head. This can look like scenes that surface without warning, at night or during quiet moments, or often while feeding the baby. Some find it hard to talk about the birth, or avoid anything that brings back memories of it. Some feel detached from the experience of new parenthood, as though they’re watching themselves from a distance. Some feel jumpy or on edge in ways that feel new.

These responses are the mind and body's way of processing something significant. They’re not signs that you are broken or that something is wrong with you as a parent.

The important thing to watch is time. In the weeks right after birth, these kinds of responses are common and usually begin to ease on their own. If they continue or get more intense, you may want to seek out support.

If you're the non-birthing parent

While birth trauma is more common for the birthing parent, non-birthing parents can also experience birth as traumatic. Non-birthing parents are often the main support person in the room with the birthing person and can be very involved in the process. You may not have been able to be as involved as you had hoped, or may have been witness to events that left you scared. Sometimes both parents experience the birth as traumatic, and other times one may experience trauma while the other did not. Even though you’re not the person who gave birth, your experience and emotional wellbeing matters. The information here applies to you as well, including the recommendation to seek support, when needed.

Whether you’re struggling or not, you might be worried about your partner — how they experienced the birth and how they’re coping now. Perhaps they don’t seem like themselves — they may seem emotionally flat, or flinch when someone mentions the birth, or be reluctant to talk about what happened. Or they may have shared with you that they’re struggling with everything.

If you’re concerned about your partner, you can let them know that you’re willing to listen, and that however they feel about the birth is understandable. Be present and understanding. Don’t try to change their mind about how they should feel about the birth. Simply listen and be present with them, and give them space to share how they’re feeling. If it feels right, encourage them to seek out other forms of support.

Why it can be hard to talk about Intrusive memories are thoughts or images of the birth that surface without warning. They’re one of the most common and least-talked about parts of difficult birth experiences. Many people keep them to themselves, like a heavy secret, and worry that having them means something bad about who they are as a parent.

It doesn't. These thoughts are unwanted precisely because they’re upsetting to you. They surface because something significant happened, not because of who you are.

Research suggests that shame about what happened during birth, and fear about being judged, is one of the main things that often stops people from reaching out. If you’ve been minimizing what you went through, perhaps telling yourself others have it worse or that you should be over it by now, that is worth noticing.

What can help

Birth trauma responds to support, and research suggests that the earlier support is accessed the better outcomes tend to be. A couple of things that can make a difference:

• Talking to someone who understands perinatal trauma specifically
• Connecting with others who have had similar experiences, which can reduce the isolation that often follows a difficult birth

Good care after a difficult birth should take your whole experience into account. It is not just about what happened medically. If your care provider doesn’t acknowledge this, you deserve better, and it’s not too late to find better support.

You don't need to know exactly what to call what you're feeling. You can just say: "I'm struggling after my birth." That’s enough to start. Or use our Services Finder to connect with someone who works specifically with birth trauma.

This article was developed using sourced educational content from Canadian Perinatal Mental Health Trainings (CPMHT), and informed by the collective knowledge and expertise of CPMHT professionals and Karen Clarke, BA, MSW, RSW, Doula (Open Book Doula, Counselling and Consulting Services), as well as the following cited research and clinical practice guidelines: