Therapy to Process Birth Trauma: Healing After a Frightening or Overwhelming Birth
Table of Contents
- What birth trauma can look and feel like
- Birth trauma vs. a “difficult birth”
- Why birth trauma is more common than people realize
- How traumatic stress can show up after a traumatic birth
- How therapy can support recovery from birth trauma and postpartum PTSD
- Preparing for future pregnancies or medical procedures after a traumatic birth
- Telehealth birth trauma therapy
- Frequently asked questions
- Further reading
1. What birth trauma can look and feel like
Birth trauma can occur when an experience during labor, delivery, or immediate postpartum feels life threatening, out of control, violating, or dehumanizing. The type of birth someone had does not automatically qualify or disqualify it as a traumatic experience. Instead, it is important to consider how the person experienced birth and the impact it has on them at present.
Birthing parents, their partners, and support system can all experience a loved one’s birth as traumatic. Each person’s responses to a labor and delivery experience are valid, even if others tell them that nothing bad happened or that they should be grateful.
2. Birth trauma vs. a “difficult birth”
A difficult birth may involve experiencing frustration, anger, anxiety, or disappointment during or afterward. Birth trauma often involves experiencing fear, helplessness, loss of dignity, or the sense that the birthing person and/or the baby were in imminent danger. Not having time to feel and process emotions fully during the labor and birth can also be a risk factor for developing PTSD after birth. Some people will develop PTSD, depression, anxiety, and/or OCD after a traumatic birth.
Both difficult and traumatic birth experiences deserve compassion, and each person should determine if they think it might be helpful to process their labor and delivery experience in therapy. I offer personalized treatment approaches to clients based on how each client describes the impact of their birth experience on their well-being.
3. Why birth trauma is more common than people realize
Many people do not realize how frequently birth trauma occurs because it is often spoken about quietly, or not at all. There are cultural messages that childbirth should be empowering or joyful, which can make it difficult to acknowledge when the experience was frightening or overwhelming. Our culture often focuses on welcoming a healthy baby, rather than prioritizing the emotional well-being of the birthing person and their support system during the process.
Birth trauma may stem from many types of experiences during labor, delivery, or the immediate postpartum. Examples include:
- Emergency OB/GYN procedures such as cesarean delivery or procedures to respond to a shoulder dystocia
- Medical complications such as hemorrhage, HELLP syndrome, or preeclampsia
- Failed epidural or pain that is not well managed during vaginal or cesarean deliveries
- Cervical or pelvic exams that occur without consent or a sense of control
- Feeling pressured into procedures
- Long inductions or labors
- Preterm birth or unexpected complications with the baby
- Stillbirth
- Feeling unheard, ignored, dismissed, devalued, or unsafe
- Feeling like their sense of dignity was compromised
- NICU or PICU stays
The impact of these experiences can be mental and emotional as much as it is physical.
4. How traumatic stress can show up after a traumatic birth
Some people will experience stress after a traumatic birth that may last for a few days or weeks, and others will experience the impacts of trauma for months or years afterward. If a person notices that the traumatic event still feels alive for them in their day to day life, they likely have posttraumatic stress symptoms. Traumatic stress symptoms after birth can include:
- Intrusive memories, flashbacks, or nightmares about part of the birth or previous traumatic experiences
- Avoiding reminders such as hospitals, medical appointments, birth stories, looking at their body, or other parents with babies
- Feeling constantly on guard or easily startled
- Anxiety about the baby’s safety
- Emotional numbness or disconnection
- Heart racing or sweating when hearing medical sounds or certain phrases that remind them of the birth
- Difficulty making decisions
- Guilt, shame, or self-blame
- Physical tension or sleep disruption
These reactions to a traumatic birth are not personal failings. They are natural human responses to overwhelming events. As a psychologist, I assess how clients have been impacted by trauma in order to understand what type of treatment may be most beneficial.
5. How therapy can support recovery from birth trauma and postpartum PTSD
Therapy with an experienced provider can promote recovery from trauma more effectively and efficiently than general, supportive talk therapy. Evidence-based therapy for PTSD can be a safe space to understand why the mind and body have responded with traumatic stress symptoms, and learn ways to integrate the traumatic experience into one’s life story rather than have it feel as though it is still happening in the present.
There are two trauma treatments with a strong evidence base for effectively treating PTSD:
Prolonged Exposure (PE)
Prolonged Exposure is helpful when a person feels as though they are constantly reliving or being reminded of a traumatic event, and those reminders significantly change how they move through their life. In PE, I create a safe and structured space to guide clients through revisiting and retelling the traumatic experience. This process allows the mind and body to more fully process what happened.
PE also involves examining how trauma may have caused a person’s world to shrink due to fear and practicing reengagement in meaningful parts of life that have been impacted.
Cognitive Processing Therapy (CPT)
Cognitive Processing Therapy is helpful when a person experiences significant changes in how they view themselves, other people, or the world following a traumatic event. CPT focuses on understanding what happened and how the event impacted the person’s beliefs. I work with clients to examine these beliefs, often referred to as “stuck points,” and explore whether they are accurate, helpful, or contributing to ongoing distress.
We also address common areas of life affected by trauma, including trust, intimacy, safety, control, and self-esteem.
Therapy is paced collaboratively, and I do not ask clients to revisit traumatic events before they feel ready. Sometimes, we first focus on building grounding and emotion regulation skills so clients feel more stable before beginning trauma processing. As part of PTSD recovery, we may also explore grief, anger, guilt, and other painful emotions related to trauma.
I support clients in rebuilding trust in their decision-making, reconnecting with their bodies, and developing strategies for coping with trauma reminders in daily life and medical settings.
6. Preparing for future pregnancies or medical procedures after a traumatic birth
Some people seek therapy not only to heal from birth trauma, but also to prepare for experiences in the future that may bring up reminders of a traumatic event. Experiences that clients may want to prepare for can include:
- Beginning to engage in sexual activity after birth
- Future pregnancies
- Decision making about birth setting and birth preferences
- Planned cesarean delivery
- Vaginal birth and VBACs
- Fertility treatment
- Pelvic floor physical therapy
- Pelvic exams
- Oncology or gynecologic procedures
I work with clients to create coping plans, identify supports that can help, communicate boundaries, and approach future care with more agency and steadiness.
7. Telehealth birth trauma therapy
I provide specialized trauma therapy by telehealth for clients located in North Carolina, California, and many PSYPACT states. Online sessions allow people to access support from home at a pace that respects their capacity and honors their needs.
8. Frequently Asked Questions
Is birth trauma the same as postpartum PTSD?
Birth trauma can lead to postpartum PTSD, but not always. Often people feel intense reactions after birth trauma, like feeling numb or out of body, on high alert, or replaying what happened over and over in their mind. For many people, these symptoms fade within a few days or weeks. PTSD involves lasting symptoms like intrusive memories, strong physical or emotional reactions to reminders of the trauma, being on guard constantly, avoiding thinking about the trauma or any reminders of it, and changes in mood or thinking.
What if my provider said the birth was “routine”?
Birth trauma is defined by a person’s experience, not by how the medical team documented or described it.
Can birth trauma affect bonding?
Yes, it can. Many people feel disconnected from themselves and others after trauma. Therapy can help you reconnect with yourself and your baby.
Does birth trauma get better with time alone?
For some people it softens and is integrated into part of their life experience. However, many continue to feel that the trauma weighs heavily on them much of the time, and they feel distressed about it in a way that is difficult to carry alone. Therapy specifically designed for traumatic stress can help people heal more fully.
