BACKGROUND: Psychological birth trauma (BT) is a prevalent yet underrecognized complication of childbirth that can lead to short- and long-term impacts on maternal and family wellbeing. This study aimed to quantify the population-level burden of BT in Colorado and identify specific supportive interventions necessary for maternal recovery.
METHODS: This mixed-methods public health study utilized two sources of data. Quantitative estimates of BT prevalence and care utilization rates were calculated using novel maternal health surveillance data from new mothers in Colorado (2023-2024). This was complemented by a qualitative study involving in-depth semi-structured interviews with women who experienced traumatic births to explore their experiences and the supports that facilitated their recovery during and beyond the postpartum period.
RESULTS: Preliminary surveillance estimates from 2023 indicate a BT prevalence rate of 9% among new mothers in Colorado (over 4800 mothers/year), with only 46% of those affected receiving helpful, timely care. Qualitative findings identified five critical areas where women and families lack adequate support: 1) Understanding the cognitive and behavioral impacts of BT; 2) Learning adaptive coping strategies for difficult emotions (anxiety, rage) and reactions (isolation, hypervigilance, overcontrol); 3) Addressing immediate and long-term physical health conditions resulting from pregnancy and childbirth; 4) Navigating mental health and medical care to determine the viability of subsequent, healthy pregnancies; 5) Accessing paid parental leave that reflects the actual time needed for postpartum recovery and caring for babies discharged from the NICU.
IMPLICATIONS: The high prevalence of BT coupled with low rates of care indicate a critical gap in the perinatal care continuum. Public health and clinical strategies must shift toward systemic, trauma-informed models. This includes educating providers, women, partners, and families; improving postpartum mental health screenings; integrating behavioral health within obstetric care; and enacting supportive labor policies like comprehensive paid parental leave to facilitate long-term maternal recovery.
