Understanding Birth Trauma: Symptoms, Causes, and How to Get Help

Becoming a parent is one of the most challenging developmental stages you’ll ever go through, and brings rapid shifts in identity, changes in relationships, adjusting to the demands of taking care of yourself and others who depend on you.

Traumatic experiences during the time of trying to conceive, during pregnancy an postpartum makes this stage of life so much harder to cope with and create very unique challenges to your emotional and psychological well-being.

AND NO MATTER HOW WELL YOU’RE TAKING CARE OF YOURSELF OR HOW MUCH SUPPORT YOUR HAVE IN YOUR LIFE, GETTING OUTSIDE HELP IS OFTEN NECESSARY TO HEAL PERINATAL TRAUMA.

What is birth (or perinatal) trauma?

Perinatal trauma (also called birth trauma or reproductive trauma) can come from any experience that you felt was frightening, felt life threatening or that overwhelmed your ability to cope. A trauma is an event that you personally experienced, witnessed, or heard about. It can stem from something that happened:

- during your fertility process (IVF/ART)

- as you’re trying to conceive

- during pregnancy

- in labor and childbirth

-postpartum and early parenthood

-pregnancy or infant loss

-postpartum experiences; trauma may come from the way you were treated or a lack of communication. Anything that left you feeling out of control or helpless, unsafe, or afraid can be a source of trauma.

When old trauma makes a reappearance on your journey to parenthood...

The perinatal period (the time from conception, through pregnancy and postpartum) is also a time when past trauma often resurfaces, and memories of childhood wounds, ruptures in your relationships with caregivers, or other disturbing experiences come rushing back. If you have a history of trauma, you may be more vulnerable to problems with depression, anxiety and traumatic stress.

Large T Traumas are the most easily recognized kinds of traumatic events, defined as out of the ordinary events that are life threatening, result in injury or have the potential to threaten your physical well-being, or that of someone you love (your partner, your baby). Some examples of Large T trauma are life threatening medical crises or injuries, experience combat/living in a war zone, child abuse, sexual abuse, car accidents and natural disasters.

Small t traumas are not life threatening but highly distressing personal events and are usually harder to understand as “counting as trauma”. Small t traumas do, however, overwhelm your ability to cope and are deeply disturbing. Research is showing that the cumulative effect of small t traumas can cause more harm than experiencing one Large T trauma because of the layers of emotional suffering that build up over time, and the complexities of psychological, developmental, emotional and physical distress that result. This is where the term “Complex trauma” is used. Some examples of small t traumas are childhood physical/emotional neglect, social isolation, conflict with people you love, bullying, bigotry/discrimination (BIPOC/LGBTQIA) and divorce.

Common causes of perinatal trauma include:

▪️Fertility treatment/difficulty becoming and staying pregnant, diagnosis of infertility

▪️Fearing for the safety of your baby or yourself

▪️Difficulty breastfeeding

▪️NICU experience

▪️Miscarriage/pregnancy loss

▪️Neonatal loss/death of your baby

▪️Medical complications and emergency interventions during pregnancy, childbirth, or postpartum

▪️TFMR-termination of a wanted pregnancy

▪️Poor communication, having your needs dismissed, feeling disrespected or humiliated

▪️Previous trauma (Large T and Smal T traumas are easily stirred up by perinatal stressors).

12 Signs of Birth Trauma

Trauma symptoms can be difficult to recognize and many birthing people dismiss or push down their thoughts and feelings about what happened. Trauma shows up in behaviors, thoughts, emotions and in the body. So what should you be looking for?

Common indicators of trauma include:

#1 Replaying the memory over and over or having intrusive thoughts about the disturbing event

#2 Physical symptoms including chronic tension, discomfort, difficulty with physical affection/intimacy, fatigue and sleep disturbance that goes beyond the expected exhaustion of new parenthood

#3 Flashbacks and nightmares of the event, it feels like it’s still happening or happening again.

#4 Avoidance of conversations, people or places that bring up traumatic memories and distress when you encounter reminders.

#5 Hypervigilance, feeling like you’re in a constant state of high alert; expecting something bad to happen, feelings of dread and doom.

#6 Concerns about how you're bonding with your baby, emotional numbness or disconnection from your baby

#7 Indecisiveness or fear about the decision to have another baby/TTC, fear of being pregnant.

#8 Loss of trust in yourself and your body-which may show up as self-blame, shame and guilt; changes in body image; loss of confidence in your ability to create safety for yourself.

#9 Your relationships feel strained, you’re having difficulty feeling connected, supported and understood. (Often, both the birthing AND non-birthing partners are affected by perinatal trauma.)

#10 You feel numb, detached, things don’t feel real, you feel “out of body”.

#11 Loss of trust in your healthcare providers, which can lead to difficulty reaching out for support when you most need it.

#12 Feelings of depression, ANGER, guilt, shame that don’t go away.

A few more important things to know about trauma:

Trauma is subjective and personal to you. Your perception and experience is what matters the most.

Trauma is a stress response that can show up weeks, months, or years after the event is over.

Trauma is real and valid, even if you and your baby are “fine” now.

A trauma response is NOT a sign of weakness or failure, and it doesn’t mean you’re broken. It means you need the right kind of support.

Perinatal trauma is treatable, a full recovery is possible, and you don’t have to feel like this forever.

Next Steps: Getting Help for Perinatal Trauma

LOOKING AFTER YOUR PHYSICAL AND EMOTIONAL NEEDS IS ESPECIALLY IMPORTANT RIGHT NOW.

Perinatal trauma impacts you physically and emotionally. You may need to adjust how you tend to your needs and think differently about what self-care looks like for you—-for now. In her book “Infertility and PTSD: The Uncharted Storm”, Joanna Flemons outlines some important questions to ask yourself to help you build an understanding and awareness of your self-care needs including:

• Am I getting enough sleep, body movement, and nutrition?

• What people or activities in my life are helping me? What is hindering me?

• Do I have enough support?

• Who are my people?

• Am I being gentle with myself or pushing myself too hard?

• Am I setting good limits with others where I need to?

(Infertility and PTSD, Chapter 14, Self Care. Joanna Flemons, 2018)

HELP IS AVAILABLE, YOU DON’T HAVE TO GO THROUGH THIS ALONE.

Support and connection are so important as you create your own family and navigate the ups and downs along the way. Here are some resources to help you find the kind of help you need:

Therapist Network | Touchstone Institute

Postpartum Support International - PSI

Homepage | RESOLVE: The National Infertility Association

Return to Zero: H.O.P.E. (rtzhope.org)

Getting Started with Birth Trauma Therapy

Birth trauma impacts roughly one third of birthing people and can leave long-lasting emotional and psychological wounds. The good news is that trauma is treatable, you don’t need to suffer. If you’re interested in learning more about how to heal from reproductive trauma or postpartum PTSD, I encourage you to get the support you deserve through trauma focused therapy. I offer specialized trauma therapy to help you to make sense of your experiences and heal your trauma so that you can tend to what’s most important to you in the here and now. If you’re here in California, I’d love to talk to you about how I can help.