When Birth Becomes Trauma: Understanding Perinatal PTSD Through Brain, Body & Healing

Written By: Sarah Donovan, LCPC, PMH-C | Perinatal Trauma Specialist | Certified EMDR Therapist & Consultant and Founder of Tilted Root

October 29, 2025

Photography By: E. Brady Robinson

We often imagine birth as a joyful new beginning — but for many, it can also feel terrifying, disorienting, and deeply isolating. In my work, I often hear:

“Everyone says I should just be happy.”

“I can’t stop replaying what happened.”

“Something about that day still doesn’t sit right.”

These feelings are valid — and yet many new parents feel silenced by unspoken expectations about childbirth and parenthood. Moments of fear, powerlessness, or loss that go unacknowledged don’t simply dissipate; they can quietly shape how we view ourselves, our babies, and our relationships.

This is what I mean when I use the term perinatal PTSD (P-PTSD): a trauma response rooted in survival, not weakness.

Why It’s Not Just “One Big Scare”

Perinatal PTSD doesn’t always arise from what people think of as “classic trauma.” It often emerges from feeling unheard, unsafe, or dismissed during pregnancy, birth, or postpartum care.

Birth trauma is layered and complex — the birthing event itself, when overlapped with prior experiences of threat or wounding, can reactivate deeply stored patterns of danger.

Recent evidence shows that among women in the perinatal period, about 1 in 10 report symptoms of P-PTSD, and about 1 in 20 meet diagnostic criteria.

So while not every birth leads to PTSD, the risk is neither rare nor trivial — especially when subjective experience, prior trauma history, or systemic harm are involved.

The Science: Brain + Body in the Perinatal Window

The perinatal period is one of the most dynamic windows of neurobiological change in a person’s life. Research shows that after birth, the brain undergoes structural and functional reorganization to support parental attunement, stress regulation, and caregiving (Hoekzema et al., 2023).

When trauma occurs in this window — whether due to a medical emergency, emotional invalidation, or unexpected birth path or loss — it can disrupt how the brain encodes memory. Instead of integrating into a coherent story, the trauma may fragment, lodging in the body as sensations, images, or emotions that resurface later as flashbacks, panic, or numbing.

Embodied Healing: Integrating Birth Trauma and Earlier Wounds

It’s vital to recognize that the perinatal window often reactivates not just the birth event itself, but earlier layers of trauma — childhood adversity, sexual abuse, neglect, or attachment injuries. Even when the birth was medically “normal,” it may still trigger flashbacks, intrusive thoughts, or hyperarousal — meeting criteria for perinatal PTSD.

Why? Because giving birth can awaken primal questions about safety, identity, and belonging — stirring memories and bodily responses that were once dormant.

Normalization matters. These responses are far more common than we discuss in OB-GYN, nursing, or therapy settings. Infertility journeys, long paths to parenthood, and loss (miscarriage, stillbirth, neonatal death) are often overlooked in the perinatal trauma conversation — though they profoundly shape how birth is experienced.

Recognizing how far someone has traveled to build a family honors their embodied journey, emotional terrain, and resilience.

“When the Body Remembers”

One client described driving to a pediatric appointment when panic engulfed her without warning. The curve of the road, the hospital entrance, even the scent in the waiting area transported her back to her emergency cesarean.

She didn’t think of the memory — she felt it. The sensations flooded her body as though the event were happening again. Together, we paused and untangled the memory. We tracked her breath, sensations, and nervous system — using grounding techniques and EMDR resourcing to bring her back to safety. Over time, we slowly re-mapped the memory toward integration, so it no longer felt like a trap in her body but a story she had lived — one that no longer held her back.

Triggers can be so ordinary: a calendar date, the sound of a monitor, the smell of antiseptic. Over time, chronic activation can appear as hypervigilance, emotional detachment, sleep disturbance, or difficulty connecting with oneself or one’s baby.

Matrescence: When Identity Shifts Drastically

The term matrescence—first introduced by medical anthropologist Dana Raphael in the 1970s—describes the complex, developmental transformation that occurs when someone becomes a mother. This transition, often called matrescence, mirrors adolescence in its intensity and complexity. When trauma intersects with this process, the line between transformation and fragmentation can blur.

Common reflections I hear:

“Why don’t I feel like myself?”

“Who am I now?”

One client said, “I’m a mother now, but I don’t recognize the woman I am or what I like to do for fun.” Through somatic work and EMDR, we helped her connect the part of her that survived the birth with the part still becoming a parent & discovering new wants and pleasures.

Eventually, she could say:

“I’m allowed to be both weary and joyful.”

Healing means integrating both the part that survived and the part learning to thrive.

The parental identity adds another layer: constant decision-making and exhaustion from caregiving often push personal recovery aside. In specialized perinatal trauma therapy, we help reorganize these fragmented parts of identity — inviting compassion where self-blame or societal pressure once lived leads to healing.

Repair and Reconnection

Healing from birth trauma doesn’t mean erasing what happened — it means helping the brain and body safely process how the experience has lived within you. Through EMDR and somatic therapies, we engage the body’s innate capacity to heal. When integration occurs, powerful shifts unfold:

• Calmer emotional responses

• Stronger parent-infant bonding

• More self-compassion, less shame

• Renewed sense of agency and joy

In my practice, I’ve witnessed ripple effects: firmer boundaries, renewed intimacy, and a deepened sense of self-trust. Many parents learn that gratitude for their baby can coexist with feeling anxious, unseen, or unheard during their birth.

“This is where healing becomes possible — when the body’s unfinished story is finally met with safety, awareness, and compassion.”

A Personal Reflection: Making Space for What Was and What’s Becoming

My own path into this work has been shaped by both loss and renewal. I’ve walked through motherhood, grief, and burnout — the kind of breakdown that demands rest and re-rooting.

Losing my mother, navigating miscarriage, and rebuilding my career taught me that healing rarely moves in a straight line.

Founding Tilted Root grew from the insight that growth often begins underground — in darkness — before reaching toward the light. Today, I have the privilege of walking alongside women and parents doing the same: finding strength in their roots, even when the ground has shifted.

Healing doesn’t mean the pain disappears — it means there’s finally room for hope and joy beside it.

A Call for Trauma-Informed Perinatal Care & Education

Birth trauma is not rare — and untreated, it can echo across generations. Integrating trauma-informed mental health care into obstetric, midwifery, and pediatric settings is vital.

Maternal mental health is health.

That’s why my colleague, Nina Davey, LCPC, ATR-BC, PMH-C, and I are co-leading a continuing-education training next year:

Perinatal and Maternal Mental Health: Through the Trauma Lens

🗓 Wednesday, January 28, 2026

9:00 AM – 12:15 PM EST

3 CEUs

👉 Register Here

Further Reading, Resources & Research

Perinatal & Maternal Mental Health

• Beck, Cheryl Tatano. Traumatic Childbirth. Foundational qualitative work on birth trauma and P-PTSD.

• Jones, Lucy. Matrescence: On the Metamorphosis of Becoming a Mother. Explores identity shifts and the mother-self.

• Thomas, Kim. Birth Trauma: A Guide for You, Your Friends and Family. Accessible, client-friendly framing.

• Jones, Julia. What About the Mother? Names the mother’s experience often sidelined in postpartum discourse.

• Kleiman, Karen. What About Us? For partners navigating postpartum change.

  
  

Healing, Loss & Trauma

• Devine, Megan. It’s OK That You’re Not OK. A reframing of grief and non-linear healing.

• Davis, Deborah. Empty Cradle, Broken Heart. On miscarriage, stillbirth, and early loss.

• Park, J. S. As Long as You Need: Permission to Grieve. Invites slower recovery timelines.

• Crist, Jami & others. The Losses We Keep. Collective voices on loss.

• Schreiber, Melody. What We Didn’t Expect. On loss and becoming.

• Patel, Mahaley & Souder, Emily. NICU Story. Healing narrative on early medical trauma.

• Souder, Emily. Birth Story Brave. Honors birth stories with emotional complexity.

  
  

Modern Motherhood & Identity

• Conaboy, Chelsea. Mother Brain: How Neuroscience Redefines Motherhood. Bridges brain science with lived maternal experience.

• Reddy, Nancy. The Good Mother Myth. Critical, culturally relevant reflection.

• Davis, KC. How to Keep House While Drowning. Realistic look at postpartum life.

• Romolini, Jennifer. Ambition Monster. Explores motherhood and identity tension.

Perinatal Body & Recovery

• Johnson, Kimberly Ann. The Fourth Trimester. Emphasizes embodied postpartum transition.

• DuFlo, Dr. Sam. Pelvic Prep School. Practical, body-aware guide to recovery.

• Macy, Ruth E. & Naliboff, Courtney. Your Postpartum Body. Gentle, comprehensive support.

  
  

Organizations & Professional Resources

• Postpartum Support International (PSI) – Education, helplines, and training.

• Birth Trauma Association (UK) – Awareness and peer support.

• EMDR International Association (EMDRIA) – Research updates and therapist directory.

• NIDCAP Federation International – Focus on supportive neonatal care.

  
  

Peer-Reviewed Research & Scientific References (2022–2025)

• Madigan, S., Wade, M., Tarabulsy, G. M., & Jenkins, J. M. (2022). Links between maternal perinatal PTSS and infant outcomes: A longitudinal study. Frontiers in Psychiatry.

• Bergunde, L. et al. (2023). Childbirth-related posttraumatic stress symptoms. Links between trauma, biology, and P-PTSS risk.

• Hall et al. (2024). Perinatal PTSD Diagnoses Among Commercially Insured People. U.S. diagnostic trends.

• Peng, Z. et al. (2024). Psychological interventions for pregnancy-related PTSD: A scoping review.

• Vega-Sanz, M. et al. (2024). Perinatal PTSD as a predictor of mother–child bonding difficulties.

• Policy Center for Maternal Mental Health (2025). Childbirth-related PTSD: A Critical Maternal Health Issue.

• Rehberg, F. (2025). Perinatal PTSD and the Mother–Infant Bond: A Systematic Review.

Sarah Sloane Donovan, LCPC, PMH-C is a Certified EMDR Therapist and EMDRIA-Approved Consultant based in Maryland. She is the founder of Tilted Root, a trauma-informed mental health counseling practice supporting women, parents and couples through all seasons of life. Specialties: perinatal & maternal mental-health, EMDR, DBT, walk & talk therapy, trauma & burnout recovery — helping clients heal and thrive beyond survival.