Pregnancy, birth, and the postnatal period are life-changing experiences. But for people with a history of trauma, whether from intergenerational, childhood, sexual violence, medical procedures, or even a previous birth, these moments can feel overwhelming, triggering, or unsafe. Trauma-informed care (TIC) is an approach that recognises this reality and seeks to create a maternity environment where every person feels respected, supported, and empowered.
So what does trauma-informed care actually mean in a maternity setting? And why is it vital for positive birth experiences?
Understanding Trauma in Pregnancy and Birth
Trauma leaves an imprint. It can shape how a person responds to stress, perceives authority, or experiences touch and vulnerability. For those pregnant and giving birth, past trauma may resurface unexpectedly triggered by medical procedures, loss of privacy, or feeling powerless in decision-making.
Studies suggest that as many as 1 in 3 women and birthing people in the UK have experienced trauma before pregnancy, with even higher rates in marginalised communities. Without awareness and support from maternity professionals, routine practices—vaginal examinations, monitoring, or even language used can unintentionally retraumatise individuals This is where trauma-informed care comes in.
The Principles of Trauma-Informed Care
At its core, trauma-informed care is about seeing the whole person, not just their pregnancy or medical needs. It requires healthcare teams to:
- Realise how common trauma is and how it affects health and behaviour.
- Recognise the signs of trauma (which may include anxiety, withdrawal, hypervigilance, or reluctance to engage in care).
- Respond in ways that prioritise emotional safety, choice, and trust.
- Resist re-traumatisation by avoiding actions or words that could replicate past harms.
In practical terms, this could mean asking permission before touching, explaining each step of care in plain language, and providing options whenever possible.
Trauma isnt always identifiable by the healthcare professional or even the birthing person which is why it is also important for the default to be a trauma informed approach, meeting everyone with compassion and respect.
Why Trauma-Informed Maternity Care Matters
The birth experience stays with people for a lifetime. Positive, empowering care builds confidence and emotional wellbeing, while negative experiences can lead to postnatal depression, anxiety, or even post-traumatic stress disorder (PTSD).
Trauma-informed approaches can help prevent this by:
- Reducing fear and stress during labour. Feeling safe and supported helps labour progress naturally and lowers intervention rates.
- Building trust in healthcare relationships. This increases attendance at antenatal appointments and helps people feel comfortable asking questions or voicing concerns.
- Improving outcomes for parent and baby. Less stress means better bonding and lower risks of complications linked to high maternal stress hormones.
What Birth Professionals Can Do
Trauma-informed care doesn’t require special equipment or extra time—it’s about mindset and communication. Here’s how maternity teams can support those with past trauma:
- Create a safe environment. Privacy, gentle tone of voice but avoid softening language as this can lead to unintended coercion. And consistent staffing all help.
- Offer choice and control. Ask “Would you prefer me to explain first or just proceed?” Give options for positions during examinations or birthing and respect their autonomy and choices. Consent can be withdrawn at anytime.
- Listen without judgement. Allow space for people to share fears or past experiences if they wish—but never pressure disclosure.
- Use compassionate language. Avoid phrases like “just relax” or “don’t worry” which can feel dismissive. Instead, say “Take your time” or “What would make this feel easier for you?”
- Be aware of cultural and social contexts. People from minoritised and marginalised communities may carry collective or intergenerational trauma due to systemic racism or discrimination in healthcare.
The Bigger Picture: A System-Wide Approach
While individual actions matter, trauma-informed maternity care also needs systemic support. This means training all staff, from receptionists to consultants to understand trauma. It also means redesigning policies and practices to value emotional safety as much as clinical outcomes.
Organisations like AIMS (Association for Improvements in the Maternity Services) and Birthrights advocate for human rights-centred care that aligns closely with trauma-informed principles. Their work highlights that respectful care benefits all service users—not just those with known trauma histories. While White Ribbon Alliance UK provide education for healthcare professionals.
For Parents: You Deserve Respectful Care
If you’re pregnant and have a history of trauma, it’s okay to tell your care team if you feel uncomfortable but you don’t have to. You can ask for a trauma-informed approach by saying what helps you feel safe, such as having a companion present, more time to make decisions, or being informed before physical contact.
Remember: You have the right to dignity, choice, and respect at every stage of your perinatal journey.
