What is trauma-informed care?

WARNING — This article contains information on some of the causes of trauma, including birth trauma.

What is trauma?

In the past, trauma has been considered a physical issue. These days, the psychological and emotional impacts of trauma are also seen as a health issue.

Trauma causes a state of high alert. It can happen from a single incident where you are threatened or feel threatened. Or it can add up over time. It can also be intergenerational, where trauma passes from one generation to another.

The experience of trauma can overwhelm your ability to cope.

Having a baby is usually a positive event for many people. But for some it can be a mixed event. It can cause physical or psychological injury, or a mix of both. This can have a lasting negative impact on the lives of:

• you
• the father or non-birthing parent
• your child

Different terms can be used to describe trauma and abuse.

What is trauma-informed care?

Trauma-informed care is a way of giving care that recognises, understands and responds to trauma.

Trauma-informed care considers your symptoms, responses and behaviours based on your personal experiences. It emphasises physical, emotional and psychological safety for both you and the healthcare professionals looking after you.

It aims to give care in a collaborative way that:

• avoids making your trauma worse
• helps healing by thinking about how care is given
• creates a collaborative care environment

Trauma-informed care uses neutral and supportive language. You should never feel judged or labelled.

How do I discuss past trauma with my doctor or midwife?

It’s common to feel a bit worried about sharing your concerns with a health professional.

People often forget what they want to tell their healthcare provider during an appointment. It can be helpful to prepare a list of your concerns and questions.

You may want to take a trusted person with you to your appointment.

ASK YOUR DOCTOR — Preparing for an appointment? Use the Question Builder for general tips on what to ask your GP or specialist.

Why is trauma-informed care important during pregnancy and birth?

Having trauma-informed care during all stages of pregnancy, birth and after childbirth is important for a positive birth experience.

By creating a safe, supportive, and inclusive environment, midwives, doctors and other health professionals can help ease stress and anxiety about childbirth.

Trauma-informed maternity care makes sure that you feel physically and emotionally safe. The care promotes trust. It’s collaborative and ensures you are supported to make informed choices about your care. This is sometimes called shared decision-making, which can help enhance informed consent.

Informed consent is when you agree to healthcare, while understanding the potential benefits and risks involved. Informed consent can also help to prevent birth trauma.

Antenatal education also plays a role in preparing parents for pregnancy, childbirth and parenthood. It supports expectant parents and can help improve birth outcomes.

How can I get mental health care?

It can be hard to find trauma-informed doctors and midwives. Trauma-informed care covers social, psychological, and medical care to help support you.

The Centre of Perinatal Excellence (COPE) aims to reduce the impact of mental health problems before and after birth. COPE hosts a directory of professionals with experience in mental health care during and after pregnancy.

How can trauma impact my pregnancy?

For some people, pregnancy and birth may cause worry or anxiety. Both pregnancy and birth can cause a relapse of mental health problems. This may be due to feeling a loss of control as your body changes with pregnancy.

If you have a history of trauma, you may have more anxiety and flashbacks as your pregnancy progresses. For example, early childhood trauma is linked to increased post-traumatic stress disorder (PTSD) symptoms during pregnancy.

People with a history of trauma may delay maternity care, and are at greater risk of:

• miscarriage
• having a premature baby
• having a longer labour

How can trauma impact labour?

For some people, childbirth can trigger flashbacks to past trauma — particularly sexual abuse or domestic abuse.

A history of previous birth trauma, sexual violence or abuse has been linked to requests for a caesarean section. This can be caused by tokophobia (severe fear of childbirth).

People who have experiences of trauma may have dissociation (out-of-body experiences and loss of memory or awareness of time) during labour.

How can trauma impact me after having a baby?

Some people have severe emotional distress after a traumatic birth, even if there was no physical trauma. This can cause mental health challenges, such as anxiety and depression.

It’s important to know that birth trauma can have lasting effects on you, your baby and your partner. It’s often caused by a lack of support and control over the birth process.

Many people do not get support for birth trauma for months or even years after the birth.

What do I do if I'm not happy with the care I'm getting?

It’s best to start by speaking to your doctor or midwife. Sometimes, talking to the healthcare professionals caring for you can help you understand what’s happening. This can help to ease your concerns.

Sometimes, you might not be happy with your healthcare team. In such cases, you might decide to make a healthcare complaint.

Resources and support

The Centre of Perinatal Excellence (COPE) is a not-for-profit organisation. It aims to reduce the impact of emotional and mental health problems in the time before and after having a baby.

Blue Knot helps support survivors of complex trauma. You can find information about trauma-informed care in languages other than English on the Blue Knot website.

Blue Knot have also partnered with Head to Health to offer information for supporters or survivors of complex trauma.

Call Head to Health on 1800 595 212 for advice and to get connected to local mental health services.

The Australasian Birth Trauma Association offer information and peer support groups for people who have experiences birth trauma.