Perinatal and birth trauma: Why many experiences go unseen and unspoken
Birth trauma is often misunderstood, minimised or difficult to recognise, especially when a baby is physically healthy. This article explores why some birth and perinatal experiences live within us long afterwards, and how trauma is heldin the nervous system rather than simply in the events themselves.
We might think that recognising birth trauma should be simple. If someone had a frightening or difficult experience, they'd be offered them care and support, right?
Sadly not. Birth trauma is complex, varied, often hidden and it’s very different from trauma from other life-threatening experiences. Partly because the responses people receive around birth can have a kind of gaslighting effect, sometimes intentional, often not. These messages can come from society, from professionals, from loved ones, and sometimes even from ourselves. Comments such as, “But your baby is healthy,” “At least you’re both okay,” “Birth doesn’t always go to plan,” or “You should feel grateful,” can reinforce the idea that birth trauma somehow doesn’t count. They may unintentionally invalidate the nervous system’s response, deepen shame and self-blame, and shut down disclosure and conversation, delaying healing and support.
I often think of this analogy shared by psychologist Emma Svanberg in Why Birth Trauma Matters: Imagine two people are involved in a serious car accident and genuinely fear for their lives. Normally, caring helpers would ask how they were feeling and offer support. Their partner would be checked on, and any trauma symptoms would be recognised as understandable responses to a frightening experience.
Now imagine same incident, but a different response: everyone focuses only on the car, without asking how you are, and if you express distress, people just say: “But the car's fine”. You are expected to feel grateful. Meanwhile you have to get back into the car every day, clean it, look at photographs of it and talk about it endlessly. A year later, everyone celebrates the anniversary while you quietly try not to cry and you can’t face driving again so you just learn to take the bus instead.
This is what birth and perinatal trauma can feel like, especially if a baby is physically healthy, the focus naturally shifts to them. Your own fear, shock, grief or helplessness can feel difficult to justify, particularly if the birth looked “fine” from the outside. At the same time, caring for a baby may both remind you of the experience and distract you from processing it, thereby creating the perfect conditions for avoidance.
The trauma often gets pushed aside until it later shows up as anxiety, flashbacks, nightmares, panic, hypervigilance, difficulty considering another pregnancy or a persistent feeling that something still doesn’t sit right.
If any part of this resonates, you're absolutely not weak, broken or ungrateful; you're having a deeply human response to an overwhelming experience.
Understanding Birth Trauma
A birth experience doesn't need to be medically dramatic to feel traumatic, because, as Peter Levine says, “trauma is in the nervous system, not the event.”
A difficult birth or perinatal experience is more likely to lead to symptoms of trauma if you felt overwhelmed, unsafe, unsupported, powerless or voiceless, and unable to influence what was happening. Experiences that are too much, too soon or too fast can overwhelm our natural capacity to cope and process them.
Whether the baby was medically “fine”, whether interventions were necessary or what anyone else thinks you should feel does not, and should not, define trauma.
Research suggests that around 1 in 25 women and birthing people experience PTSD after childbirth, while up to one third of parents feel some aspect of their birth was traumatic, even if it doesn't meet full PTSD criteria. Emerging evidence suggests that trans and non-binary people may face increased risk of traumatic birth experiences and perinatal distress, often linked to discrimination, misgendering, lack of safety within healthcare settings, and previous experiences of trauma.
Birth trauma can affect anyone after any kind of birth, and it may relate not only to birth itself, but also to fertility treatment, pregnancy complications, feeding difficulties, NICU experiences or postnatal care. Again and again, research shows that feelings of unsafety, helplessness, isolation and lack of support are often the key ingredients in traumatic birth experiences.
Our bodies don't simply record facts, or stories, they record sensations, of whether we felt safe, heard, respected or alone and unsupported.
Hence two people can experience seemingly similar births, yet leave with completely different nervous system responses.
If you're struggling to make sense of a difficult birth experience, a birth reflection session with an experienced midwife and trauma informed practitioner, can offer a gentle, safe space to explore the impact of what happened, with care and understanding.