• Pregnancy and birth are immense physical and psychological events – for some women, the experience results in PTSD

  • Mia Scotland, perinatal clinical psychologist and doula, offers four tips to promote recovery after a traumatic birth 

  • We have therapists who specialise in pregnancy, women's health and trauma – find yours here

We associate post-traumatic stress disorder (PTSD) with the battlefield, with horror and violence. In contrast, we associate birth with babies and joy and excitement. So how can it be that up to 6% of women come away from their births with PTSD? And how can it be that fathers are also leaving the birthing room traumatised?

PTSD is a clinical diagnosis for a specific anxiety disorder, caused by a specific event. It involves three symptom clusters. 

  1. reliving of the awful event such as flashbacks, intrusions, being triggered
  2. anxiety symptoms such as inability to sleep, jumpiness, irritability, panic attacks
  3. avoidance – a need to stay away from reminders or memories of the awful event

However, you can be suffering from the effects of a bad birth without having full-blown PTSD. If you feel awful every time you think back to the birth, or find that you can’t seem to move on from it, or find reminders come into your life when you least want them to, or find that you can’t talk about it without crying, then you might be experiencing trauma from your birth. It is sadly, far too common. And because we associate birth with happy things, we tend to feel that it isn’t okay to focus on the fact that we feel dreadful. Other people can inadvertently make it worse by saying things like “at least you have a healthy baby, why don’t you just focus on that?”. To say that is to fundamentally misunderstand the nature of trauma and anxiety. You can’t just move on from it! That’s one of the reasons it’s so distressing.

To add to the mix, you have just had a new baby, and so your time and energy is massively taken up with adapting to and learning about this new 24-hour relentless and difficult job you’ve been afforded – both consciously (how DO you change a nappy or get a baby to sleep) and unconsciously (establishing milk supply, physical healing, hormonal shifts).

So, if you have a healthy baby, but you are finding it impossible to move on from the birth, you are crying about it a lot, or feeling guilty or ashamed, or full of anxiety and angst about it, then take this seriously as a sign that you need to do some healing. If your birth was many years ago, but you know that you never really dealt with it, then this is for you too. Here are some tips about how to recover.

1. Get professional help

There are plenty of great therapists out there to help you – but I would advise that you find one who specialises in birth trauma. This is because they need to understand why birth can be traumatising – research suggests that the traumatising element isn’t always about blood and danger. Often, it is more about the way that you were treated by the staff. To be disrespected or ignored in labour is a danger signal to a labouring mother because she is relying on others to protect her while she is unable to protect herself (you can’t run away or win a fist fight while in labour). Sometimes, women experience their birth as abusive, or like an assault, and your therapist would benefit from an understanding of how this can happen in maternity services.

2. Prioritise recovery time

After a traumatic event, the brain needs to process the event, so that it can lay it to rest, and move on. In order to process something traumatic, we need the conditions for healing – we need to eat well, rest well and eliminate stress as much as possible from our lives. Obviously, this is challenging with a new baby, but it is crucial for recovery. We often treat “down-time” as something that we only do if we get the chance. But if you have had a difficult birth, my advice is for you to schedule down-time in your diary and make sure you stick to it. Having a bath, listening to a relaxation recording, reading a favourite book, having a pyjama day, staying in bed, sitting on the sofa all day with your baby watching TV, putting jobs on hold, and whatever else you can think of. 

Recruit the help of others for this – you can’t do it on your own. Get your partner to encourage you to go to bed in the day, or have a lie in. Get your friends to hold baby while you take a bath, accept all offers of help, and if people don’t offer to help, ask for it. Most people love to feel useful but they need some guidance as to HOW to be useful.

3. Let go of self-blame

It is common for women to come away from their births blaming themselves for what went wrong. “I should have been more assertive, I shouldn’t have been so assertive, I should have written a birth plan, I shouldn’t have written a birth plan, why couldn’t my body do it when others can, I failed my baby, my body failed me” and so on. You have been through a very difficult time, you deserve some love and respect. If it was a difficult birth, then you are even more amazing than you realise because you are being a mum in the midst of all these difficult feelings. Watch out for this tendency to blame ourselves, and if you are doing it, make a conscious effort to let it go. Would you blame some-one else if the same thing happened to them? If not, then you shouldn’t blame yourself either. Be as kind to yourself as you would be to them. 

4. Process your birth

If you’ve had a difficult birth, and you can’t stop thinking about it, then it might be time to give it the attention that it is craving. You can do this by telling your birth story in full detail to a willing listener. Or maybe write your birth story down. Take care of yourself while you do this – it could elicit a lot of tears. As long as it feels cathartic (rather than panicky), then it’s doing you good. 

Some people process their birth in the form of drawings (doesn’t have to be a work of art – just an expression of how you feel about it all). Some people find the midwifery birth reflections or listening service really useful. There might be one local to you.

The airline message that you should put your oxygen mask on before you put your child’s on is also true of your mental health. Your baby matters, but you matter too. Take your mental health seriously, and your baby will thank you for it.

Mia Scotland is the author of Birth Shock: How to Recover from Birth Trauma, published by Pinter & Martin

Further reading

7 self-care tips to manage the intensity of being a new mother

How EMDR can support you through trauma

Maternal isolation: it takes a village to support a mother

Living with the loss of a baby: the impact on subsequent pregnancy and birth

Understanding trauma and flashbacks

The supermum myth: why good enough is the goal in parenting