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Is Birth Trauma a Real Thing?

Yep, sure is. Internationally, as many as 5.9% of birthing people later experience Posttraumatic Stress Disorder (PTSD) as a result of birth trauma1. But a diagnosis of PTSD is a very high bar to clear; it describes a specific set of symptoms with specific duration and impact. This must mean that there are many more birthing people who experience traumatic or highly distressing births, whose experience isn’t best described by the PTSD label.


And yet, when we talk about birth, we’re supposed to find it magical, spiritual, and perfect. A birthing person is supposed to tap into a preternatural instinct, to bring forth their new kiddo with a motherly roar, full of confidence in their body and their strength, and immediately bond with that wiggly, screaming pile of goop. It’s supposed to be beautiful.


There’s a problem with this. What about people who feel weak, fearful, or even helpless during their birth? What about people who feel disempowered or dismissed? What if you didn’t like your birthing experience, or you feel like you weren’t even there? Have you failed to reach some enlightened ideal of how you are supposed to begin your parental journey? Did you somehow do something less impressive or less valuable than your counterparts who loved their birth experience? And if you’re alive and your baby is alive, shouldn’t you just be grateful for how your birth went?

I would argue no. Birth trauma is not a personal failure. Birth is, among other things, unpredictable. It’s often a long process, and touches on many complicated factors, including interactions with medical providers, perceived support from loved ones, and any trauma a birthing person might have had in their past. Even one birthing experience may not be a monolith - not all good nor all bad, but a complicated blend of experiences, difficult to untangle. So let’s not talk about birth like there is one expected outcome. Let’s get a more humanistic, compassionate view of it.


What is birth trauma?

Do I have it? Why did it happen? Will it go away? All good questions. Let’s get into it.

Bessel Van der Kolk (a globally recognized expert in trauma) defines trauma as an experience which “overwhelms the brain’s capacity to cope.”3 For many people, birth presents significant challenges, but those challenges are not so massive that they overwhelm our resources. This isn’t the case for people who experience birth trauma. For such people, their birthing experience was so frightening, so overwhelming, or so disempowering that the brain’s capacity to cope (its ability to process what is happening, to stay engaged in the present while making plans and enacting them) is outmatched. This can lead to lasting effects we know as trauma.


Trauma is a large umbrella term, which can present many different ways. There are specific criteria for obtaining the PTSD label, but to speak broadly, trauma can be thought of as over-arousal or under-arousal of the body in response to triggers. Over-arousal is marked by things like your heart racing, a feeling of panic, the desire to flee, experiencing flashbacks, and becoming highly emotional. Under-arousal is when the mind responds by shutting down or dissociating; zoning out, forgetting, or feeling numb are common manifestations of this hypo-arousal.


Birthing is one of the most vulnerable times in a person’s life. You’re in pain, you’re experiencing the biggest hormone surge of your life, and you know that on the other side is something fully life-changing. It means a lot. Add to that the fact that your mobility is severely limited and you may be placing your care in the hands of strangers, and we have a high-risk situation for trauma. Van der Kolk suggests that an essential condition for the development of trauma is the inability to escape3. Once labor really gets going, there’s no escaping birth, and there are aspects of today’s medical system which can make a person feel trapped and powerless.


A lot of people come out of this experience feeling empowered, thrilled, and delighted with their new little baby. That’s common, and it’s normal. But it’s also common and normal to come out of this experience feeling dizzy, asking yourself what in the world just happened. Some people don’t remember their births, or feel like their birth was less the experience of a precious new relationship beginning, and more like enduring a terrifying nightmare. And it doesn’t end when you leave the hospital.


In the months or years that follow birth, a person who experiences birth trauma is likely to experience the kinds of posttraumatic symptoms described above. Maybe they’ll be consumed with frightening memories of the birth. Maybe they’ll feel painfully alone in this experience. Maybe they’ll have moments of panic, depression, social withdrawal, anxiety, or difficulty bonding with their new baby2. They may be terrified to have another birth, even though they would love to have another child. Birth trauma is not the same as postpartum depression or anxiety, but a traumatic birthing experience does put the birthing person at increased risk of developing postpartum depression, postpartum anxiety, and postpartum psychosis4.


How do I know if I have birth trauma?

How do you feel when you think about your birthing experience? Do happy tears come to your eyes? Do you remember joy and pain and great accomplishments? Or does your body squirm with a desire to escape the memory? If thinking about your birth evokes a feeling of panic, a terrible sadness, numbness, or a feeling of helplessness, this is worth exploring further.

And if you’re asking yourself how this could have happened to you, check out the next blog in this series, “What Causes Birth Trauma?”


It might be a good idea to talk with a therapist to resolve such experiences. The Enrich Relationship Center is here to help. And if you’re living in Colorado and you’d like to talk with me further about birth trauma, you just need to reach out. You can contact me at DrKress@enrichcenter.org

You can also find resources at Postpartum Support International, an organization which provides education and crisis services, and helps connect all sorts of folks with the help they need. Check them out at www.pospartum.net


Sources:

1)Beck, C. T. (2009). Birth trauma and its sequelae. Journal of Trauma & Dissociation, 10(2), 189-203. 2)Tsakmakis, P. L., Akter, S., & Bohren, M. A. (2022). A qualitative exploration of women’s and their partners’ experiences of birth trauma in Australia, utilising critical feminist theory. Women and Birth. 3)Van der Kolk, B. (2018). The Nature of Trauma [PowerPoint slides]. 4)Waller, R., Kornfield, S. L., White, L. K., Chaiyachati, B. H., Barzilay, R., Njoroge, W., ... & Elovitz, M. A. (2022). Clinician-reported childbirth outcomes, patient-reported childbirth trauma, and risk for postpartum depression. Archives of Women's Mental Health, 25(5), 985-993.


A post-script about inclusive language: If you’re wondering why in this article, I talked about “birthing people” instead of mothers, good question! A person with a uterus may or may not identify as a woman and/or a mother. See the next article in this series for some more information about how gender impacts birth experiences.

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