Hard or frightening births

Common causes

• Feeling a loss of control over how labor and delivery went
• Feeling unsupported by your care team or loved ones
• The birth being very different from what you hoped for
• Your baby needing medical care, like time in the NICU, so you were apart or unsure if they were okay

A review of 50 studies found the strongest link to trauma after birth was how the birth felt to the mother: feeling frightened, powerless or unsupported. Feeling well supported during birth was linked to lower risk.

Things linked to higher risk

• A history of sexual assault or abuse
• Birth trauma in a previous pregnancy
• Depression, anxiety or PTSD before
• Fear of childbirth
• A previous stillbirth or miscarriage

It can look like

• Avoiding anything that reminds you of it, sometimes even your baby
• Blaming yourself, or feeling you “failed”
• Coping through alcohol, smoking or overspending
• Feeling constantly on edge about your baby’s safety
• Nightmares or memories of the birth that pop up out of nowhere, sometimes with panic

Birth trauma can also make bonding harder, and bring guilt, shame or depression. If it is affecting your day-to-day life, tell your clinical provider.

You might feel

• Feeling your body “failed”
• Grief for the birth you had hoped for
• Guilt, even though nothing was your fault
• Relief and fear tangled together
• Shock that it all happened so fast

Recovering from a C-section while looking after a baby is a lot. Pain and limits on lifting can make you feel helpless, which can stir up feelings from the birth.

What helps

• Accept help with lifting and chores, so your energy goes to resting and bonding
• Ask your care team what to expect as you heal
• Be patient with yourself; recovery is rarely a straight line
• Talk about how you feel, not just how the wound is healing

People often mean well, but comments like “at least the baby is fine” can leave you feeling your feelings don’t count. You can be grateful your baby is safe and still be shaken by what happened. Both are true.

The American Academy of Pediatrics says that if a baby needs medical care straight after birth, parents need not worry that their relationship has been harmed. Bonding has no time limit.

A Cochrane review found that early skin-to-skin contact should be normal practice for healthy newborns, including those born by C-section.

Ways to connect

• Ask your care team about skin-to-skin as soon as it is safe
• Cuddle, talk and sing to your baby as you recover
• Let your partner do skin-to-skin if you can’t yet

When a baby needs medical care, like time in the NICU, parents may be kept apart or left unsure whether their baby is okay. This is one of the common causes of birth trauma.

What can help

• Ask staff to explain what is happening, as often as you need
• Do what care you can: touch, talk, read or sing to your baby
• Keep a small journal or photos of your baby’s progress
• Take breaks to eat and rest; you matter too

Feeling powerless or unsupported during birth was strongly linked to trauma afterward, and feeling well supported was linked to lower risk. How you were treated matters.

Many hospitals have a patient relations or patient advocate office. Some people find it healing to share what happened, so care can improve for the next family. Others prefer not to. Either choice is okay.

If you decide to

• Ask for a copy of your medical records
• Bring someone with you to any meeting
• Write down what happened, with dates and names if you have them
• Say what you would like to happen: an explanation, an apology, a change

The CDC encourages patients to ask questions and share concerns, and encourages providers to build a culture of respectful maternity care.

Phrases that can help

• “Can you explain what’s happening and why?”
• “I need a moment to understand before we go on.”
• “I’m worried about something. Please listen.”
• “I’d like my support person to stay with me.”

For example

• Could anything have been done differently?
• Was my baby ever in danger?
• What would this mean for a future birth?
• Why did the plan change?

Sharing your birth story, by talking, writing or recording it, is one way people cope after a hard birth.

Go gently

• Choose a calm time and a safe place
• Stop if it feels like too much, and come back later
• Write the moments you felt cared for or proud, too
• Share it with someone who will listen without judging

You can raise how you feel about the birth at your postpartum visit. Your provider can refer you to a mental health professional who specializes in birth trauma or PTSD.

Counseling and cognitive behavioral therapy (CBT) can help after birth trauma.

For PTSD, the NHS recommends trauma-focused therapies such as trauma-focused CBT and EMDR (eye movement desensitisation and reprocessing), which helps the brain process traumatic memories.

Ideas

• Gentle yoga or stretching, when your body is ready
• Meditation or slow breathing for a few minutes
• Rest whenever you can
• Short walks outside

A local or online support group with other parents who had similar births can help you feel less alone.

Postpartum Support International runs more than 50 free online support groups, including groups for specific experiences.

Acknowledge your feelings, be patient with your recovery, and let go of shame. What you went through was hard.

What helps partners

• Getting support of your own if memories keep coming back
• Not hiding your feelings to be “the strong one”
• Talking about what you saw with someone you trust

Fathers and partners can also become depressed or anxious after a baby arrives. Postpartum Support International offers support for dads and partners.

Partners often remember different moments. Sharing your stories can fill gaps for each other, but go gently. Each of you may need time before you are ready to talk.

Ideas

• Agree on a calm time to talk, not at 3am
• Ask, “What was the hardest moment for you?”
• Listen without correcting each other’s memories
• Consider couples counseling if you feel stuck or distant

Ideas

• A conversation about your last birth, early in pregnancy
• A trusted support person with you on the day
• A written plan for what helps you feel safe
• Counseling for fear of birth

It is common to feel excited and frightened at the same time. Some people decide not to have another baby after a hard birth, and that is a valid choice too. Talking it through with a counselor can help you decide what feels right.

Words that can help

• “I’m here whenever you want to talk about it.”
• “That sounds really frightening.”
• “You didn’t fail. You got through something really hard.”
• “Would it help if I came with you to talk to the doctor?”

Try to avoid

• “All that matters is a healthy baby.”
• “At least it’s over now.”
• “It could have been worse.”
• “You should just move on.”

Ideas

• Bring meals and do the lifting after a C-section
• Drive her to appointments, including therapy
• Help her find a support group or therapist
• Take the baby so she can rest