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Looking after your mental health after a traumatic birth

https://kingstonhospital.nhs.uk/information/looking-after-your-mental-health-after-a-traumatic-birth

A traumatic birth can feel like an emotional shock. Birth was not ‘meant’ to be this way. So, understandably, it can feel hard to make sense of what has happened or how you are feeling. This can be doubly difficult when you add in the pressure of caring for your new baby, recovering physically, and navigating other people’s opinions and feelings. All of this takes immense energy, especially after trauma.

You are not alone. At least 25 out of every 100 women report their birth as traumatic. This is usually because some aspect of their experience meant they felt extremely afraid, helpless or out of control. A proportion of birth partners also report birth as traumatic.

Every person reacts to trauma in their own way

What feels traumatic to one person may not feel that way to another. It is certainly not for other people to judge what was or wasn’t traumatic for you. What matters most is your individual experiences and what they meant to you personally.

After a stressful event, the feelings can take some time to die down. But most people will recover naturally. Here, we describe some common reactions to birth trauma. We also explain how to look after your emotional wellbeing in the early weeks after birth.

The tips described here are designed to help that. Some people may need additional psychological support if they continue to have difficulties.

If you have been struggling with any of the issues explained here for a month or more after birth, see the section ‘What help is available’ at the end.

People sometimes find that thinking or reading about trauma can remind them of their own traumatic experiences. So, it may be helpful to read this at a pace that feels manageable to you or with the support of someone else.

Understanding how you might be feeling

In the first days and weeks after any trauma, it is normal to experience a range of unpleasant feelings, thoughts and sensations. This is your body and brain’s way of beginning to come to terms with what has happened and putting the memory in the past.

After a traumatic birth experience, the following is common.

  • Memories, images or thoughts about what happened can come into your mind, even when you don’t want them to. They can feel very ‘now’, as if they are happening again.
  • You may feel agitated and jumpy, or as if you are on ‘high alert’.
  • You may feel cut-off or numb, as if you are just ‘going through the motions’.
  • Strong emotions or bodily sensations can pop up. These might be linked with fear, loss, shame, guilt and/or anger. These emotions can be set off by an obvious trigger, for example, a particular thought, memory or situation (such as being with your baby). Or it may simply feel like they happen for no reason.
  • Concentration and sleep can be affected.
  • Your sense of yourself, your world and/or your future may feel changed in some way.
  • You may dwell on what happened and go over aspects of it in your mind. You may repeatedly think, “If only?….Why?…What if?…”.
  • You may feel cut off and distant from other people, including your baby.

Although none of these experiences are pleasant, they are normal. They are a natural, human reaction to extreme stress. They do not mean you are bad, losing control or any less of a mother or parent.

Remember: there is no right way to feel after birth trauma. Try to treat your experiences with compassion not criticism.

After a distressing experience, many of us are hard on ourselves for feeling things (or perhaps not feeling things). But this makes it more difficult to come to terms with what has happened. Try to think about what you would say to a friend or loved one who is going through something similar. Or, imagine someone who you think of as empathic, warm and supportive. What might they say to you right now?

Coping with intrusive memories and flashbacks

Why are flashbacks common?

When you experience something traumatic, it is hard for your brain to take in what is happening. Instead, the brain is focused on trying to respond to the threat. It doesn’t get to organise the different parts of your experience into a complete memory so it can be filed away properly.

Usually this means that, to begin with at least, memories after trauma feel and behave quite differently to memories of other non-traumatic experiences. They can seem very vivid and have a ‘nowness’ quality to them. They are also easily triggered. This means they pop up when you don’t want them to.

For these memories to feel and behave more like other memories, your brain needs to pull together all the different parts of your experience. For example, what you saw, heard, smelt and felt at the time must be put together with what you know now. This is a bit like parts being put together in a factory.

As this is happening, parts of your experience can pop into your awareness, often without warning. This is, of course, not pleasant but it is normal. It is a sign your brain is working hard to properly shape the memory. This way it can be properly stored away with other memories from the past.

How some ways of coping don’t help

It makes sense to want to control or avoid upsetting memories. Common strategies include trying to shut them down or avoid situations that trigger them. This might feel helpful in the short term. But, unfortunately, these strategies can actually mean more thoughts and memories pop up.

All of this can make it harder for your brain to properly rebuild the memory. This can mean you suffer for longer than necessary. Another consequence of trying to control the memories is that it takes up valuable time and energy. This can make life more limited for you and your new baby.

Better ways of managing the memories

A better way of treating the intruding memories is to stand back and observe them. This is instead of trying to control, analyse or push them away.

So, where possible, try a ‘hands off’ approach. You might want to label them as, “that’s just part of the memory again”. Or picture them as something external to you, that moves through your mind, such as leaves on a stream, clouds in the sky, or trains coming through a station.

You might also find it helpful to focus on things which remind you that the trauma is over and that you are safe now.

The importance of support and not giving up on what matters to you

After a traumatic birth, and with a new baby to care for, any kind of routine, or energy for even basic activities, can be missing.

It might feel tempting to shut yourself away, to avoid talking about what has happened, or to give up on the things you enjoy or have planned. However, all of this can just leave you feeling more isolated and upset, and that your life cannot move on.

Stay connected to people you care about and ask for help

Where possible, try to stay connected with the people you care about. If it feels safe to, talk about what you have experienced and how you are feeling with people you trust to support you.

Ask for help and support. Consider letting friends or family look after your baby whilst you have time to yourself. Let people cook meals or help with chores. Let them provide a space to listen or find ways to help so that you feel calm and cared for.

Consider peer support

You might find it helpful to get support from others who have had a similar experience to you. There are a list of organisations you may find helpful at the end of this information. Research shows that support from others is key to recovery after a traumatic experience, including birth trauma.

Others have found it helpful to express their feelings in a journal.

Keep doing the things that matter to you

Try to think about small tasks you could do for yourself and with your baby. Keep on top of the basics if you can, for example:

  • eat regularly
  • rest when possible
  • remember to shower and brush your teeth
  • try to fit in gentle exercise.

Rebuilding or ‘reclaiming’ your life is an important step towards recovery after trauma.

  • What did you used to enjoy?
  • What made you feel good?
  • What had you hoped to do with your baby?
  • What have you stopped doing because of the trauma?

If some activities are impossible with a young baby, or because of how you are feeling physically at the moment, are there any alternatives?

Start simple, with one or two small specific goals that feel realistic and manageable. Consider how other people can support with these things too.

What help is available 

Talk to your midwife, health visitor, GP or mental health team to discuss how you can be referred for any of the following help. 

Go to your local Emergency Department (A&E) or dial 999 if you need urgent help with how you are feeling.

Talking therapy 

Talking therapies help you address difficult thoughts and feelings.  

These therapies have been proved to help people with PTSD: 

  • trauma focused Cognitive Behaviour Therapy (tfCBT)
  • Eye Movement Desensitisation Therapy (EMDR).    

These can help you make sense of what happened, put the memories into the past and get on with enjoying life with your baby. These can be accessed via your GP. If you are pregnant or have a young baby you should be prioritised for treatment. 

Medicines 

Medication is not the first option for treating PTSD. But for some people it can be helpful alongside other support, especially if their mood is also very low.  

Speak to your GP if you would like to understand more about the medication options which might help. 

Reviewing your birth 

Most hospitals offer a service to talk through your birth experience. This is sometimes called a ‘Birth Reflections’ or ‘Birth Afterthoughts’ service.  

This can be helpful if you want to better understand what happened and why certain decisions were made. You will also be able to ask questions you may have about future deliveries.  

Contact your maternity unit or ask your health visitor or midwife about what is available locally. 

Peer support 

Connecting with other people who have had a similar experience has also been shown to be very helpful. Here are some organisations dedicated to supporting people after a traumatic birth. 


Birth Trauma Association
www.birthtraumaassociation.org.uk 

Make Birth Better
www.makebirthbetter.org 


Many thanks to Dr Cathy Green and Dr Ellen Craig for allowing us to use the content from their patient leaflet: 

Green C, Craig E. Looking after your mental health in the early weeks after a traumatic birth. Information Leaflet, 2022.

Looking after your mental health after a traumatic birth - Kingston Hospit Download PDF


Contacts

Bridge Team (pregnancy mental health midwife team) 020 8934 2939/3988
Birth reflection appointment with senior midwife (PMA) 020 8934 6434
Contact your GP for other advice and referral

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