the silent struggle of birth trauma: what happens when you’re not ‘fine’
MOTHERHOOD
WRITTEN BY DR SARAH EMMERSON
APRIL 8, 2025
Sophia* sits in my consulting room, her eyes are fixed on a spot on the floor. I can tell she doesn't want to talk about why she is here. The details emerge slowly and every step of the way, Sophia is very careful to reassure me that she is really, actually fine.
In this article:
01 A Pregnancy Touched by the Past
02 The Unspoken Trauma of Birth
03 Understanding the Trauma Response
04 Loss, Grief, and the Shame We Carry
05 Matrescence: The Often-Ignored Transition
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Sophia is pregnant again. She gave birth to her son during COVID via an emergency C-section, an experience that she doesn't like to talk about and feels she has been able to put behind her. She and her partner tried for 2 years to become pregnant again after that. It was a long and difficult journey and when she finds out she is expecting, she isn't sure if she can or wants to believe it. Sophia and her partner had already lost 3 pregnancies and for her the excitement of another pregnancy is tinged with fear, dread and apprehension. She wants so badly to be happy about this, she feels terrible for having doubts and fears, but the cloud of dread follows her around everywhere.
She tells me that she continued on and made it to her first scan, which she can barely remember. She explained that just being in that environment again made her feel completely numb. Three times she had had to make it through scans in which she had been told her baby had died.
Now she is just on autopilot.
When the sonographer tells her the baby looked healthy, Sophia remembers just staring at her. Her second scan at 20 weeks is also normal. Everything is going well but Sophia can hardly bare to think about this baby. She feels anxious, on edge and has this unshakable sense that something bad is going to happen. When, during her next midwife appointment she is asked about her birth preferences, Sophia breaks down. She starts to sob and can't stop herself. She has a panic attack in the clinic and her partner takes her home.
She doesn't understand what is happening to her. Why can't she just be happy? What is wrong with her that she isn't able to enjoy this pregnancy? What kind of person would feel like this when they're finally expecting a new baby? Sophia asks me these questions in our first session. I can hear her inner voice berating her so harshly and all I can try to do is reassure her that absolutely nothing is wrong with her at all.
So many women like Sophia feel like pregnancy and motherhood should feel a certain way. Any deviation from the excitement, joy and wholeness they are supposed to feel, feels like an indictment of their failings as a woman and a mother. When nothing could be further from the truth.
Sophia put a lot of pressure on herself to be happy about her pregnancy without acknowledging for herself that she had been through something traumatic. When I talked to her more, it emerged that her first experience of birth was much more traumatising than she or anyone around her had realised.
Sophia had planned for a natural vaginal birth with minimal pain relief. But her labour lasted for two days and after 48 hours of excruciating pain, the decision was made to do an emergency C-section. Sophia was exhausted, her baby was in distress and any options she may have had in the beginning were suddenly taken away, without much explanation or time to think.
Sophia remembers feeling like she wasn’t really in her body anymore, that everything that happened was just being done to her. She felt violated and out of control. No one really explained to her what was going on, and she remembers her partner’s shocked look when a dozen medical professionals descended on her room and rolled her out. Sophie remembers going numb then as she did in her ultrasounds and that she was numb on and off for weeks later.
“23-45% of women experience their birth as traumatic. ”
What Sophia experienced is common, more common than we would probably like to think. The reported ranges vary widely but somewhere between 23-45% of women experience their birth as traumatic.
Sophia’s response to trauma was dissociation, her mind and body going numb. Her brain went into a freeze state in an effort to protect her from the intense emotions that she felt in that moment. Sophia had no control over any of it. Very often, this freeze response can carry over into the first weeks and months of early motherhood.
Also very commonly, when confronted with another pregnancy, Sophia’s fight, flight or freeze system kicked in again. Sophia felt panic, dread and constant anxiety, because her mind was trying to protect her from something traumatising happening again and then her mind and body froze. Other women might experience a range of emotions and symptoms in response to birth trauma, e.g. intense anger or mood swings, avoiding reminders of the trauma, difficulty bonding with their baby, as well as flashbacks to what happened. All of these are normal and understandable reactions to a traumatic experience.
The recent All Party Parliamentary Group on Birth trauma inquiry found that some of the major risk factors for women experiencing birth as traumatic is not feeling listened to, poor communication between maternity staff and patients and a lack of informed consent in situations in which patients should know what is going to happen to their bodies.
However, birth trauma really is entirely subjective, an important point for women who might feel like they do not have the right to feel traumatised. A birth, that from a medical standpoint may seem like a straightforward delivery, can still be deeply harmful for both the woman and family involved because it is the subjective experience that matters, not what might objectively seem traumatising. And what the Birth trauma inquiry made very clear is that the aftermath of these experiences can be hugely debilitating and have long-lasting effects on everyone involved.
For Sophia, the prospect of going through another birth is what made her spiral into complete panic, something that she realised after some weeks in therapy. We also talked about Sophia’s 3 losses. We thought about the babies that she didn’t get to hold, the futures that were taken away from her. Sophia never allowed herself to feel any of the grief, the anger, panic or despair that all of these experiences stirred up in her. Instead, she blamed herself and her body for not functioning the way she was supposed to. She felt ashamed. Why was something that was supposed to be so natural so difficult for her?
In our time together, Sophia and I worked on why she thought she was not allowed to feel these feelings. We created space for her birth experience and named the trauma that Sophia had not been able to acknowledge. Sophia had learned early in her life that expressing feelings was not something that she could allow herself to do. Even subconsciously, she had become very good at avoiding anything that might trigger her, until she couldn’t anymore.
For most women, Matrescence, the transition to motherhood is a major upheaval in almost every area of their lives. Starting with hormonal shifts and major brain changes, to the re-structuring of a woman’s entire social network and the very real sense that time is no longer your own. We are only now starting to acknowledge the tremendousness of this process on its own.
But we have a long way to go in supporting women whose experience of birth, the starting point of this all-encompassing journey, is traumatising. We need to acknowledge that no matter how medically straight-forward a birth may have been, it can still be deeply distressing for the family involved. Rarely are women as physically and emotionally vulnerable, as they are when giving birth and that vulnerability can be a major risk factor for trauma.
We need to raise awareness of the narratives of shame and deficiency that surround women in pregnancy and early motherhood. There are so many ways in which women can feel they have failed during this time. We need to be clearer as a society and within the medical system that we support and embrace mothers, regardless of their choices around pregnancy, birth or feeding and regardless of how they might feel about motherhood at any given time. It is okay to not be fine, to struggle, doubt and question even or especially during matresence. We also need to be more mindful of the impact of pregnancy loss. We need to talk about it as something that is yes common, but also deeply distressing, no matter when or how it happens.
For Sophia, putting her back in control of her body and her pregnancy did the most to help her in the end. She was able to create a birth plan with her maternity team that took into account any eventuality so that she would not be surprised or feel out of control again. She was able to use tools and strategies for herself to deal with her feelings when they arose rather than suppress them so that she could go into this new pregnancy and birth experience with a sense of agency. And she built a team around her of trusted family and professionals who she knew would advocate for her when she couldn’t.
Sophia’s story is the story of so many women. If you are dealing with birth trauma or any trauma, please know that support is out there. And remember, that no one has the right to tell you how to feel about your pregnancy, birth or about becoming a mother. Your experience is yours and yours alone and you deserve all the support and grace that you need.
For more information and sources of support, please see the resource list below:
For professional support, ask your GP or other healthcare professional for a referral to your local Perinatal team, Maternal mental health service or NHS Talking therapies
*Not real name, details have been changed
about the author
CONTRIBUTING WRITER
Sarah is a Chartered Counselling Psychologist with many years of experience working as a senior clinician in the NHS. She recently co-founded Talking Women, a private Psychological therapy practice for women.
She and her co-founder Clare are committed to providing compassionate and specialist evidence-based support for women navigating a wide range of issues. Sarah specialises in Perinatal Psychology and is most passionate about improving mental health care for mothers and families.
dr sarah
References:
UK Government. (2023, March 23). Health and social care secretary speech at birth trauma APPG. GOV.UK. https://www.gov.uk/government/speeches/health-and-social-care-secretary-speech-at-birth-trauma-appg
Challacombe, F. (2023). Break free from maternal anxiety. Cambridge University Press.
Bristow, J., & Huggins, C. (Eds.). (2014). Handbook of perinatal clinical psychology: From theory to practice. Routledge.
Conaboy, C. (2021). Mother brain: How neuroscience is reshaping our understanding of motherhood. Hachette UK.
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