Unveiling birth trauma: understanding PTSD after childbirth

In summary

The birth of a child is usually a cause for celebration, but for some women, the experience of labour can be traumatic and have long-term consequences for their mental health.

At City St George’s, University of London, Dr Susan Ayers, Professor of Maternal and Child Health, has spent over 25 years researching women's perinatal mental health, including birth trauma, anxiety, and post-traumatic stress disorder.

In particular, Professor Ayers and colleagues are also examining the prevalence, causes, screening and treatment of anxiety in pregnant and postnatal women, as well as the impact of mental health on the mother-baby and family relationships.

In this new video for the Research Spotlight series, Professor Ayers discusses the research, recommendations and what can be done to help affected women.

What did we explore and how?

In a recent study conducted by Professor Ayers in collaboration with a European network of experts in birth trauma, it was found that for around one in three women, the experience of labour is traumatic. One in 25 women develop post-traumatic stress disorder (PTSD) as a result, affecting mother, child and wider family members.

Traumatic births usually occur because of complications during childbirth, poor care or mistreatment, leading to long-term consequences for the mental health of mothers, including flashbacks, nightmares and negative thoughts, emotional detachment and a tendency to avoid reminders of the birth.

Traumatic births also carry economic consequences, generating substantial healthcare costs. In the UK, a large portion of NHS clinical negligence claims are maternity related (63% of the total – £6.6 billion – in 2022-23). The recent UK birth trauma inquiry report, led by Theo Clarke MP and involving Professor Ayers, showed how often it can involve complications that lead to injury or death.

I was drawn to research on traumatic birth and postpartum PTSD because it brings together both my personal and academic interests. On a personal level, I’ve seen how profoundly birth experiences can shape someone’s mental health and their transition into parenthood, yet these stories are often hidden or dismissed.

That silence can leave people feeling isolated at a time when they need support the most.

From a research perspective, I’m motivated by the opportunity to better understand these experiences and help make them visible in ways that can drive change in healthcare practice.

My hope is that this work not only validates the experiences of those who have lived through birth trauma but also contributes to creating more compassionate systems of care, so that every parent feels heard, supported, and safe in the aftermath of birth.

Benefits and influence of this research

At the moment, little is also known about the potential long-term effects of traumatic birth and PTSD on babies. Research into other types of trauma suggests the possibility of transmission between generations.

These gaps need to be filled quickly if we are to address the current failures in maternity care, and stop today’s trauma from affecting future generations, and current research is taking place at City St George’s to bridge that gap.

Putting our recommendations into practice as part of a broad approach supporting maternity staff, women and their partners could reduce traumatic births and improve birth experiences.