When Birth Feels Traumatic: Understanding Birth Trauma and How a Doula Can Help
For many families, the birth of their baby is a beautiful and positive experience, filled with joy and celebration. However, 1 in 3 women in Australia experience birth trauma, which can have a lasting impact on their health and wellbeing.
What is Birth Trauma?
Birth related trauma can be due to physical trauma, psychological trauma, or a combination of both.
Physical trauma
Some women’s experience of trauma comes from physical injuries and/or medical complications, such as:
- Perineal tears
- Bladder damage
- Pelvic floor damage
- Pelvic organ prolapse
- Infection
- Postpartum haemorrhage
- Emergency interventions (e.g. caesarean, instrumental birth)
Psychological trauma
Emotional or psychological trauma comes from any experience in childbirth that has left someone feeling unsafe, frightened, or emotionally distressed.
Psychological birth trauma often occurs when someone perceives a threat to their own safety, their baby’s safety, bodily autonomy, or emotional wellbeing. Some experiences that may contribute to birth trauma include:
- Feeling out of control or afraid
- Lack of informed consent or coercion from medical professionals
- Obstetric violence
- Not being listened to or respected
- Being alone or unsupported
- Separation from your baby
- A long, difficult, or very fast labour
- Any unexpected or distressing event during or directly after birth
It’s often less about what happened, and more about how it felt. Everyone’s experience of trauma is different – what feels traumatic for one person may not feel traumatic for another.
If your birth felt traumatic to you, then it was.
Signs of Birth Trauma
- Feelings of disappointment, shame, anger, or grief around your birth experience
- Intrusive thoughts, nightmares, or flashbacks of the traumatic event
- Avoiding triggers (like people, places, conversations) that remind you of the birth
- Anxiety, panic attacks, or hypervigilance
- Mood swings – teary, withdrawn, anger, dissociating, agitated, disorientated etc
- Brain fog or struggling to remember what happened during the birth
- Difficulty sleeping
- Struggling to bond with baby
- Relationship issues
How Can a Doula Help Reduce the Risk of Birth Trauma?
Continuity of Care
Maternity care is often fragmented, which means care is provided by multiple healthcare professionals, and women may not have the opportunity to receive care from the same midwife throughout pregnancy and birth.
A doula, however, stays with you continuously throughout labour and birth, and often into the early postpartum period. During this time, a doula can:
- Create a calm, supportive environment
- Offer reassurance, encouragement, and validation
- Provide physical comfort during labour, such as position changes, breathing support, massage etc
- Work collaboratively with your medical team to support clear communication and help ensure your wishes are heard and respected
Research shows that continuous support throughout labour is associated with more positive birth experiences and fewer negative feelings about childbirth, compared to women who do not receive continuous support.
This matters because when a woman feels supported and understood, her nervous system is more likely to feel safe and regulated, and less likely to shift into a fight or flight response.
Improved Birth Outcomes
Doula support doesn’t guarantee any specific outcome. However, there are a number of studies that have found that women who have had continuous labour support were:
- More likely to have spontaneous vaginal births
- Less likely to use pain medications, including epidurals
- Less likely to have instrumental births and caesareans
- Labours were shorter by approximately 40 minutes
- Babies were less likely to have low Apgar scores at birth
- Some evidence also suggests that doula support in labour lowers rate of postpartum depression
Education and Informed Decision-Making
A doula doesn’t provide medical care – but they can absolutely help you understand all your options and support you to make decisions that feel right for you and your baby.
Before labour, doulas can:
- Provide education about birth and what to expect
- Help you explore evidence-based information
- Talk you through what procedures mean and why they might happen
- Support you to create a flexible birth plan
- Encourage you to ask questions and voice what matters to you most
This preparation can help reduce fear and give you a greater sense of autonomy and confidence when making decisions.
Advocacy and Communication
During labour, the thinking part of your brain naturally switches off, which can make it harder to understand information, ask questions, or voice your concerns. When it feels like you have no control over what is happening, this can be very distressing.
A doula can help by:
- Ensuring your care team is aware of your birth plan
- Translating medical language or asking for clarification when needed
- Suggesting questions you might want to ask
- Reminding you and your partner of your preferences
- Supporting your partner
- Asking for time and space to consider options if decisions need to be made
Advocacy isn’t about creating division, and it isn’t a doula’s role to make decisions for you. It’s about helping you feel in charge of your body and your birth, even when things don’t go exactly as planned. A doula works alongside your care team to support clear communication, ensure you feel heard and respected, and give you the space to make informed decisions that feel right for you and your baby.
Preparing for Birth after Birth Trauma
Suggestions from a doula with lived experience of birth trauma and an empowering second birth
- Process your traumatic birth in a way that feels safe and right for you
- Before preparing for another birth, take time to process the last one.
- Therapies like counselling, EMDR, somatic practices, or birth story debriefs can help reduce feelings of distress, fear, and anxiety.
- There’s no right way to do this. It’s not about how you process, it’s about the process itself.
- Find the right birth support team
- Choose a place of birth that feels safe, and a care provider who is trauma informed, and respects you and your boundaries. Someone who sees you as a person, not a number.
I know this is often easier said than done. If you’re birthing in the public system:
- Ask for continuity of care with a midwife
- Decline appointments with providers who are not supportive, or request to be seen by someone else
- Bring a support person to appointments
- Get a doula who will be your sounding board, offer emotional support, and advocate for you
Take back ownership of your birth
Remember that you always have the right to say no, ask questions, and take your time. Your provider is not the expert on you – you are. They may follow policy, but that doesn’t always equal evidence-based care.
You have the final say over your body, your baby, your birth.
Reclaiming autonomy after birth trauma is powerful. It rebuilds your sense of safety and trust in yourself.
Create a Birth Map
A birth map is a communication tool that explores different paths your birth might take and outlines your informed decisions at each fork in the road.
The process of a birth map can help you:
- Navigate your options
- Identify possible triggers
- Implement a safety plan to help you feel more supported
Support your nervous system
Your nervous system and sense of safety plays a huge role in labour and birth.
If you’ve experienced birth trauma, your nervous system may be on high alert, making it harder to feel safe or surrender to the process of birth.
Supporting it prior to labour will help you understand your stress responses, and identify what you need to feel safe.
Tools that can support your nervous system:
- Breathwork
- Meditation
- Visualisation
- Bodywork
- Movement (like yoga, stretching, or walking)
- Affirmations that actually resonate (not just fluffy ones about lotus flowers unless that’s your thing)
Birth trauma is more common than many of us realise, and feeling traumatised does not mean you failed. It means your nervous system was responding to stress, fear, or a lack of support during a very intense experience.
Whether you choose to work with a doula, strengthen your support team, or simply educate yourself and your partner ahead of time – feeling informed, supported, and respected can make all the difference to how you experience birth.
If you’ve already been through a difficult birth, remember: your experience and feelings are valid, and healing takes time. You don’t have to do this alone, there are so many support options available. I have included some links below.
Helpful Resources
Mums Matter (bulk-billed psychology)
My name is Ney Kelegouris, and I am a trauma-informed doula training with the Doula Training Academy. I service Southeast Melbourne, Mornington Peninsula, and parts of West Gippsland. I have a background in social work, lived experience of birth trauma, and am passionate about helping women feel heard, supported, and in control of their birth experience.
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