What is birth trauma?

'Birth trauma' is a wound or damage experienced during or after childbirth. While trauma can be physical, it may also be emotional or psychological. The emotional impact of birth trauma is often due to a difference between your expectation of labour and birth and what actually happened. It can also affect your non-birthing partner.

At the time of birth, you may have felt unsupported, helpless or unheard. After the birth, it's possible to feel shocked or numb and this can lead to anxiety, depression and post-traumatic stress disorder. Your trauma is valid, and although everyone experiences trauma differently, it is not uncommon. It has been estimated that up to 1 in 3 people who give birth may experience birth trauma.

You may find the experience of childbirth emotionally traumatic even when there was no physical trauma.

What are the risk factors for birth trauma?

There are many factors that can contribute to birth trauma.

Risk factors during the labour and birth include:

• experiencing pain or physical stress
• not receiving enough pain relief
• experiencing emotional distress or worries that you were going to die
• needing medical intervention
• being unprepared for the difficult sensations, emotions and interventions you experienced
• feeling a loss of control or not being respected

Risk factors existing prior to the labour and birth include:

• previous sexual or other abuse
• mental health concerns
• pre-existing physical birth injuries
• previous stillbirth or difficult pregnancy
• not receiving enough pain relief in a previous labour

Can birth trauma be prevented?

Birth trauma can't always be prevented, but there are things you can do to reduce your risk. If you are experiencing any signs of trauma, support and treatment are available.

You may have risk factors and experiences that are out of your control, but there are ways to help you psychologically prepare for birth:

• Learn about childbirth: Antenatal classes or podcasts, for example, help you know what to expect and your options.
• Try to have realistic expectations: There is no 'right' way to give birth. Things don't always go to plan and some things are beyond your control.
• Try to keep an open mind: No one can predict what will or won't happen during pregnancy and birth.
• Establish a support network: Surround yourself with people who can support you. Ask your doctor or midwife to recommend a supportive parents group.
• Be guided by your midwife or doctor: Their focus is a safe birth for you and your baby.
• Seek mental health support:If you are concerned about your emotional wellbeing during pregnancy, speak to your doctor who can recommend mental wellbeing support options.

Given that trauma is often related to a disconnect between expectations and real life, decisions about your birth should be a shared decision making process between you and your doctor or midwife. Your health team will give you an explanation of any intervention, as well as the risks and benefits to you and your baby before you can give your informed consent.

What is the emotional impact of birth trauma?

Some psychological symptoms, including the 'baby blues', are very common around the time of birth. If you still feel distressed 2 or more weeks after the birth, you could have postnatal depression or anxiety or post-traumatic stress disorder. It is important to seek help from your GP or maternal child health nurse.

How do I recover from birth trauma?

Recovering from birth trauma will mean different things for different people. Here are some suggestions of steps you can take to help your recovery:

• Acknowledge that you have experienced a distressing birth, and are likely to benefit from support.
• Ask for practical and emotional support from friends and family — these can give you space to recover.
• Speak about your experience with a trusted family member or friend. This can reduce the likelihood of you reliving the experience or holding on to distressing emotions.
• Talk to your doctor, midwife or maternal child health nurse about your experience, once you feel you are ready for a debrief or want to discuss how you feel.
• Use self-help measures, such as exercise and mindfulness.

Sometimes, counselling, psychological therapy or medicines can also be used as treatment. Your doctor is the best person to advise you on this.

Resources and support

As well as asking your doctor or midwife for advice, you can get help and information from:

• Pregnancy, Birth and Baby — call 1800 882 436 to speak to a maternal child health nurse or video call. (7 days a week, 7am to midnight AEST).
• The Australian Birth Trauma Association offers advice, resources and a peer-to-peer support service.
• The Centre of Perinatal Excellence (COPE) provides information and a list of support services.
• Perinatal Anxiety & Depression Australia (PANDA) — call 1300 726 306 to speak with a counsellor (Mon to Fri, 9am to 7.30pm AEST).