The perinatal period can be challenging, and for those who have experienced trauma, it can be triggering. Survivors of trauma who are pregnant, trying to get pregnant, struggling with infertility, or have delivered children often encounter situations that remind them of previous trauma. These experiences may be traumatizing in and of themselves. Loved ones of these survivors may desire to provide support but feel unsure about how to do so. In this article, I provide background on trauma and the perinatal period and offer some suggestions for supporting loved ones who are at this intersection.
Defining “perinatal period” and “trauma”
First, it’s important that we have some shared definitions of “perinatal period” and “trauma.”
Perinatal period: I use this phrase to describe the period of time between deciding to conceive through the first year after delivery. This is an expansion of the standard definition of perinatal, which is often defined as starting at conception.
Trauma: Trauma can occur when a person’s capacity to cope is seriously overwhelmed by an event or series of events, which has an adverse impact on one’s ability to function (at work, school, with friends, self-care, etc.).
According to the Substance Abuse and Mental Health Services Administration (SAMHSA; 2012):
Trauma is defined as an event, series of events, or set of circumstances that is experienced by an individual as physically or emotionally harmful or threatening, and that has lasting adverse effects on the individual’s functioning and physical, social, emotional, or spiritual well-being. (p. 2)
The Diagnostic and Statistical Manual (DSM) 5-TR, a tool used to diagnose mental health disorders, lists a few specific events that can potentially cause trauma. However, trauma practitioners know that anything can be traumatic. Trauma is subjective, meaning that something one person experienced as traumatic may not be experienced as such by another. It can also be the result of several smaller events that compound into a larger experience of trauma.
Trauma reminders, aka “triggers”
As van der Kolk (2014) so aptly put it, “the body keeps the score” of our trauma. Bodies store trauma memories, resulting in symptoms that could include memory loss, hypervigilance, or physical ailments such as irritable bowel syndrome or chronic pain. With one’s body holding onto their trauma, survivors may experience certain forms of touch, textures, scents, lighting, sounds––and so much more––as triggers. For some, this can be a deeply upsetting experience, can lead to flashbacks or behavior changes like hyperarousal or avoidance, and can even retraumatize survivors (Sperlich et al., 2017).
There are common experiences that may act as trauma reminders for survivors during the perinatal period, listed below. It is important to note that this list is not exhaustive–just like trauma, anything can be a trauma reminder.
Common trauma reminders during the perinatal period:
- Lack of consent prior to exams
- Insertion of fingers or medical instruments (with or without consent)
- Routine injections
- Lack of information regarding what is happening in the patient’s body and/or and what is happening in exams and procedures
- An imbalance of power between the patient and medical professionals
- Being ignored by medical professionals
- Receiving inadequate medical care
- Experiencing a medical emergency, including but not limited to a miscarriage, emergency C-section, or eclampsia
- Infant death
- Separation from one’s infant in the NICU
How does trauma impact survivors during the perinatal period?
Studies have found that folks with trauma histories are at a higher risk of experiencing perinatal anxiety and depression, as well as are more likely to experience their delivery as traumatic. For those who reported experiencing childbirth as traumatic, there has been found to be an increased rate of post-traumatic stress disorder (PTSD), postpartum anxiety or depression, as well as difficulty bonding and building secure attachment with the infant (Beck, 2017; Glover, 2017). In other words, trauma can impact not only the birthing parent, but also the infant’s attachment style.
There are multiple factors that lead to the aforementioned connection between trauma, perinatal mental health diagnoses, and issues with bonding/attachment. One factor is the perinatal period itself. The perinatal period is a period of many changes and new experiences. The experiences of conceiving, carrying, delivering, and/or breast-feeding are embodied experiences–the body is the center of it all. As a result, the perinatal period often includes multiple doctors appointments, physical and/or emotional vulnerability with unfamiliar folks in unfamiliar or uncomfortable places, and experiencing physical and/or emotional discomfort or pain. This combination of factors has a great deal of potential for creating scenarios in which survivors of trauma may experience trauma reminders.
What support can I offer to survivors of trauma during the perinatal period?
Given the opportunities for trauma reminders during the perinatal period and their potential impacts, trauma-informed support could be beneficial to the birthing parent and the whole family.
When trying to figure out how to support your loved one, remember that you can always ask! Your loved one may have tons of ideas in mind. Asking them what would be helpful can ensure that your efforts will be welcome and useful to them. Keep in mind that, for some folks in need of support, being asked how you can support them may feel exhausting–like they’re being given another task. Loved ones looking to provide support may find it helpful to provide examples of specific ways they could be supportive. Those examples might include:
- Attending doctor’s appointments or being available to chat after a doctor’s appointment
- Advocating on their behalf, particularly with medical professionals
- Creating an atmosphere that feels safe (ensuring items that make your loved one feel safe are present, limiting harsh lighting and loud noises, etc.)
- Collaborating with them on a care plan
- Researching and/or connecting them with resources (therapists, doulas, support groups, prenatal yoga, etc.)
- Providing an empathic, validating, nonjudgmental ear
- Grocery shopping or preparing meals on their behalf
- Completing household chores (cleaning, laundry, etc.)
It is important to note that support is not universal. What one person may appreciate, another may not appreciate–and one person may feel both ways at different times. Within the context of trauma, support that is provided without first obtaining consent may be triggering. This is because trauma often involves a lack of consent and evokes feelings of powerlessness or a lack of agency. Asking for your loved one’s consent prior to providing support will help ensure that they do not experience the support as retraumatizing and provides an opportunity for empowerment.
A prerequisite to providing support to someone else is taking care of yourself. You cannot give support if there is no “you”! It is important to make sure that you are also receiving the support and care you need in order to offer your loved ones the best trauma-informed support possible. This might mean leaning on your family and friends a bit more, penciling in some additional self-care, or seeking out a support group.
If you are interested in learning more about trauma and/or the perinatal period, check out the following resources:
- The Body Keeps the Score by Bessel van der Kolk
- Waking the Tiger by Peter Levine
- Postpartum Support International
- Maternal Mental Health Leadership Alliance (MMHLA)
- American Society for Reproductive Medicine (ASRM)
At Wildflower, we understand the deep and lasting impact that trauma can have, especially during the transformative period of pregnancy and postpartum. Our team of therapists specializes in both trauma and the perinatal transition, offering compassionate, evidence-based support tailored to the unique challenges survivors face. Whether you are navigating past trauma, experiencing new triggers, or seeking guidance in this complex journey, we are here to help. You don’t have to go through this alone—reach out to us to find the support and healing you deserve.
References
Beck, C. (2017, Oct. 13). Birth Trauma: The Ever-Widening Ripple Effect. [Webinar]. PSI PAC, virtual.
Glover, V. (2017, Oct. 24). Prenatal depression, anxiety, and stress and effects on the fetus and child. [Webinar]. PSI PAC, virtual.
Sperlich, M., Seng, J., Li, Y., Taylor, J., & Bradbury-Jones, C. (2017). Integrating Trauma-Informed Care Into Maternity Care Practice: Conceptual and Practical Issues. Journal of Midwifery and Women’s health, 00(0), 1-12. doi:10.1111/jmwh.12674
Substance Abuse and Mental Health Services Administration. SAMHSA’s working definition of trauma and principles and guidance for a trauma-informed approach. Rockville, MD: Substance Abuse and Mental Health Services Administration; 2012.
van der Kolk, B. A. (2014). The body keeps the score: Brain, mind, and body in the healing oftrauma. Viking.
