Birth trauma is incredibly prevalent: mention the phrase “traumatic birth” in any group of parents and prepare to be immersed in stories of fear, pain, and loss of autonomy.
Regardless of whether the birth involved an unarguably scary sequence of events, a bad injury, or a personal perception that others may not share, trauma can be indelibly wrapped up in the birth experience and stored in the body’s memory.
This is true for the whole family: it is not simply the birthing parent who can experience and store trauma, but everyone who is close to the birth. Everyone touched by birth trauma should be supported to move through trauma into self-empowerment.
The ideal time to start trauma healing is during the natural postpartum healing process. This can help prevent a true trauma response with internalization and triggers, turning it into a memory instead of imbuing it with power as it lies in wait to strike. However, many of us walk through our lives with deeply internalized trauma, and processing it is important work that happens when the time is right—a major life transition, moments of clarity and self-reflection, and very often in a subsequent birth. Supporting the harder, longer process of healing from old trauma is often part of the birth process and postpartum healing.
Herbs are extremely useful for processing birth trauma, along with adjunct therapies and therapeutic communication techniques. While we cannot take away an experience, we can help others integrate the experience into their life story in a way that is empowering instead of traumatic.
The ultimate goal is to help people step into their deepest power, which is only revealed through transformative hardship: the odyssey shapes the hero.
Types of Birth Trauma
Birth is an unpredictable mystery that can be incredibly jarring for people, upsetting their sense of autonomy and bodily control, even with a good outcome. It is important to respect that a person may experience trauma in a situation that other people wouldn’t; they are the authority on their experience, and it is not on us (or anyone else) to try to explain how their birth was fine/normal/expected/etc.
There are many possibilities for physical trauma to the birthing parent, including a bad tear, episiotomy, prolapse, hemorrhage, infection, vacuum assisted delivery, and surgical birth (caesarian section). For the new baby, physical trauma can include a wide variety of events both in utero and during the birth process, including problems with the fetal heart rate, difficult fetal positioning, maternal or fetal bleeding, infection, problems with the placenta, umbilical cord issues, vacuum assisted delivery, and difficulty fitting. Families that experience these types of events may feel fine about them, or they may experience emotional trauma as well as tissue injury.
Often, emotional trauma surrounding birth includes feelings of the loss or theft of autonomy or control; lack of trust in self, support people, or providers; loss of self-efficacy or self-esteem; and fear of irreparable harm or death of self, infant, or beloved. These types of feelings may be expressed after a normal birth as well as a physically difficult one.
Somatic Trauma Processing
Somatic trauma, physical or emotional trauma stored in the body itself, is particularly common in the realm of birth trauma, as our bodies go through a tremendous upheaval. The healing and integration process following a physiologically and emotionally healthy birth is not a return to the prepregnancy normal, but instead develops a new normal in a body that is transformed by parenthood. When that postpartum healing process is accompanied by the need to heal from trauma, it is extremely common for the physical symptoms, feelings, memories, and subsequent triggers to become healed into the body during the healing process—think of the formation of scar tissue, both physically and metaphorically, holding an old injury in place and supporting healing around it, allowing the body and mind to function around an old area of weakness through the development of strong but inflexible tissue.
It is very common to see birthing people process old somatic trauma during birth as the physical transformation takes place, whether that be from a previous difficult birth experience, miscarriage, car accident (especially affecting pelvis or lower back), body dysphoria, sexual assault, long-standing eating disorders or other conditions involving self-deprivation and body image, emotional abuse, and chronically internalizing negative feelings about oneself. This sudden processing of internalized somatic trauma can be frightening if the birthing person is not prepared for it, so a discussion ahead of time can be helpful in cases of a known history. Birth workers can assist in supporting this process as it happens with drop doses of heart openers and stimulating dispersants as described below, to help them look at the experience without fear and let go of it.
Reactivation of Past Trauma
It is extraordinarily common to see a reactivation of past trauma, as everything comes out in the birth process, from body fluids to old scars to eventually a brand new person. Managed well, this breaking up of trauma scar tissue can be an acute healing crisis as the person processes deeply internalized trauma during the birth transformation, as discussed above. However, sometimes the past trauma can be reactivated and compounded by a traumatic birth, in which case speedy intervention in the postpartum period is absolutely essential.
It is essential to remember that the partner, other children, parents, and other loved ones can experience trauma too, especially if the birthing person is the central pillar or force around whom the rest of the family organizes their sense of selves. It can be earth-shattering to think that your beloved might die right now, or your mama, or your child, and yet the family is often forgotten in the shuffle of supporting the most visibly affected person. Witnesses and close family usually benefit from a therapeutic herbal regimen as well.
Useful Herbs for Birth Trauma
Vulneraries are an essential class of herbs for supporting physical healing. Combine them with astringents and antimicrobials for tears, episiotomies, hemorrhoids, and other tissue injuries. I like to blend yarrow, calendula, plantain, witch hazel, and sea salt, provided warm in the squirt bottle with every pad change, or as a sitz blend in the bath tub, or soaked onto pads before freezing to make herbal ice packs.
For people who have hemorrhaged, it is essential to support the regeneration of their blood cells. These people should drink as much water and tea as possible and sleep as much as their body will allow, and their support people need to be cognizant of that plan. Mineral-rich tea can speed up the process, as well as helping prevent milk supply issues following hemorrhage (which are unfortunately common in those who do not rest, hydrate, and eat appropriately following a major blood loss, as their body simply does not have the extra it needs for lactogenesis). Nettles, oatstraw, raspberry, alfalfa, and yarrow flowers make a nice base. Tinctures of yarrow flower and lady’s mantle are wonderful allies to help tighten lax uterine tissues and speed the healing process following hemorrhage; this is also helpful for uterine prolapse.
For those who have an infection now, had one in labor, or are at a risk of developing one postpartum, antimicrobials and immune stimulants are warranted. Echinacea is safe internally for breastfeeding parents, as are spilanthes and elder. Tinctures can be added to squirt bottles for direct perineal application, or taken internally as usual. It is important to realize that the immune system may not be functioning at its utmost capacity following birth due to exhaustion, depletion of nutrients, and blood loss, so provide support early and often.
Muscle pain is extremely common and can be supported with any of your usual anti-inflammatory and analgesic liniments, massage oils, and salves, as well as baths and resting on a heating pad or hot water bottle. Muscle pain that persists past the first 2 or 3 days may be indicative of an actual injury, such as a muscle or ligament torn in the birth process. In these cases, rest, massage, and more aggressive musculoskeletal support may be warranted (arnica massage oil, Solomon’s seal, etc.). Abdominal binders are very helpful for postpartum back or pelvic pain that appears musculoskeletal in origin, as supporting the musculature helps tissues heal in the right places without straining or over-stretching, in the absence of abdominal muscles.
To support emotional healing in the wake of a traumatic birth, we prioritize uplifting mood, supporting the development of circadian rhythm and an appropriate sleep routine, managing healthy lactation, and preventing postpartum depression.
Non-drowsy uplifting nervines are essential for this type of healing. Milky oats tincture is one of my absolute favorites, as it works quickly when you need it and has an increasing effect with regular use, and gives an overall feeling of rejuvenation that is so essential for the chrysalis-shedding of the healing process. It helps prevent postpartum depression, a major risk following traumatic birth (especially if someone has a history of depression), combined with mimosa flowers for great effect. Lemon balm is another nervine perfect for this type of healing as it can help with feelings of exhaustion and depletion as well, especially in warm weather; it can be added to a daily tea or taken as a tincture or oxymel. Small doses of skullcap tincture are appropriate for anxiety or bouts of fury, especially with drop doses of heart openers as discussed below.
Adaptogens also have an important place in supporting healing from emotional trauma, but they should be chosen based on the specific presentation instead of one-size-fits-all (…like always). If the person seems especially run down, in particular after hemorrhage, infection requiring antibiotics, multi-day induction, or other long drawn-out saga, ashwaganda is an excellent anabolic ally to rebuild deep strength. I turn to shatavari if there is a major circadian rhythm disruption that their hormones would normally have regulated (like they aren’t able to rouse to nurse, or aren’t able to nap), and if there is a true milk supply issue, which is actually much less common than people think—often what is called “milk supply” is actually a latch issue, engorgement, or dehydration, so it is essential to be sure there is actually a milk supply issue before telling their body to make more milk; galactagogues are often not the answer. For circadian rhythm disruptions together with depression, anxiety, or fury, schisandra is a perfect ally, especially as a honey.
Spiritual Healing: Heart Openers and Stimulating Dispersants
If the person is dissociating, distancing from their family, reports postpartum depression, the emotional trauma is deeply rooted in a forest of pre-existing traumas, or the birth was not recent, supporting spiritual healing is appropriate as well. The goals here are to help them reintegrate their experiences and sense of self, and to help the family find tangible means of love and support, to help hold the person through an important grief and healing process.
The term “Heart Openers” has become so overused as to become almost generic, with some practitioners using it to mean almost any herb that makes them feel calm, happy, or physically present. I’m using the term in a specific sense, to mean herbs that help us access experiences and feelings that we otherwise wall off inside ourselves as a coping mechanism. Accessing those experiences, taking them out and looking at them, allows us to process them appropriately following a difficult event, which can help prevent us from internalizing the trauma and thus creating a deep-seated, long term trauma point that can affect us for years to come.
In these situations, we combine stimulating dispersants with heart openers specific for grief and trauma that are uplifting and improving to motivation. Doses range from drop doses up to 1/8 teaspoon. This helps the person take out the memory, look at it without fear, and let go. Guided visualization or meditation can be helpful with this, as they breath it out or blow it away or watch it flow out of their fingertips or whatever works for them. These formulas should always be combined with an appropriate nervine to support emotional well-being simultaneously: do not cover them with the raw meat of their memories and leave them to the wolves.
One of my favorite formulas is a honey made from hawthorn, rose, and prickly ash, with the hawthorn and rose working as uplifting trauma-specific heart openers that improve motivation, the prickly ash as a stimulating dispersant, and the sweetness of the honey sending the medicine deep in the body to help loosen stored memories.
I also love borage, for its mood-uplifting nature and how it helps us stand firm in the face of adversity, which can be really helpful for staring down bad memories, especially for assault survivors. I use drop doses of borage generally, but they can take larger doses if they are not nursing and after miscarriage, especially as an oxymel with lemon balm and ginger.
If grounding is needed, burdock or elecampane can be useful allies depending on the person’s constitution.
Other stimulating dispersants useful in this application include ginger, elecampane, pine, artemesia sagebrushes, juniper, wormwood, and mugwort, depending on the person’s constitution and how the trauma is manifesting itself (i.e. during dreams, mugwort).
Nutrition provides the foundation for healing. Rest, hydration, and a healing diet high in quality protein, fat, minerals, and vitamins is essential for tissue repair, regeneration of blood cells, healthy nervous system and immune function, and milk supply development. Diets must provide ample iron, calcium, fat, and protein, with vitamin C and vitamin D to improve absorption. We give our cells every advantage when we build them from a strong foundation: grounding, nourishing, warming foods support physical and emotional healing. Foods like bone broth, stews, seaweed, live cultures, high quality meat, leafy greens, eggs, fish, avocados, and sweet fruit are ideal. Balance healthy food with comfort food: the warming stick-to-your-ribs nourishment of our families is often an essential expression of love, and should not be thrown out with the bathwater. Instead, encourage the family to integrate healthy foods into their diet in creative ways, or have the lasagna/tamales/fried chicken/macaroni and cheese for dinner and bone broth miso soup for lunch.
The words you use when speaking about someone’s birth experience matter. Ask for their impressions instead of making assumptions. As each person is the authority on their own health and body, it is inappropriate to engage in downplaying or ranking traumas, as in the common practice of informing birthing people that an experience perceived as terrifying is actually normal or common, or that they didn’t have it that bad, etc.
Asking for their birth story and using limbic resonance to really be there with them is extremely therapeutic, whether it was traumatic or not: “Tell me about your birth, how was it?” is a great opener. In the days after birth a family is integrating the experience and talking about it in detail can help prevent it from becoming traumatizing if it was scary, and regardless help it become a source of power for both parents. Use their words back to them; if the partner says “She was like a fertility goddess, I still can’t believe it,” referring to her goddessness a few minutes later reinforces the importance of the partner’s perceptions and communicates to the partner that their role is central to the narrative.
Partners are often ignored, especially in emergencies; this can be hard even in normal birth, but especially when things get scary. This is also true of other children. Eliciting their impressions, feelings, and stories with gravity can help them integrate the experience and be able to step into a caregiving role more fully.
One of the most common pieces of sadness that people carry in their hearts for decades is the idea that they didn’t “really” give birth if they gave birth surgically via caesarian section, which is ableist garbage. Unfortunately, this idea is reinforced by our natural health community’s narrative that the “right” way to birth is unmedicated, at home, ideally in a tub; while this is a very nice birth it’s certainly not the only way, and the narrative is racist, classist, ableist, and completely tone deaf to the complex multifactorial influences on health outcomes that dictate how our bodies are able to birth safely, especially those related to socioeconomic status and race. It is a backlash against the overmedicalization of birth and the destruction of a home birth tradition as old as time, powered by the glorious resurgence that we’ve seen in the last 2 decades. It’s an understandable narrative trying to normalize natural birth; however, it is very untherapeutic for our many friends and loved ones who need to birth differently. Instead of surgery or c-section, referring to “surgical birth” is an important distinction, and peppering the conversation with phrases like “when you gave birth,” “your birth,” “giving birth,” etc. is an essential act, as it can help them reframe the experience and ameliorate feelings of insufficiency, making space for self-empowerment.
Never assume that a train wreck was traumatic; likewise, don’t assume that a good outcome was not. I’ve worked with innumerable families who experienced trauma when births veered off their planned path but were still routine, like a long induction or a baby with jaundice therapy, as well as families who had a very challenging experience and emerged without feeling traumatized (i.e. emergency surgery, baby needing resuscitation or medications, someone being flown to a bigger hospital in a helicopter). It is possible to go through these things and feel okay about it, like “that was really scary, I’m glad it’s over, thank goodness we’re all okay, now what’s for lunch?” integrating the experience as a hard day in the past.
Integrating the Experience
As parents, we often don’t allow ourselves the luxury of time and space to grieve, as there are so many demands on every moment of our lives. It is appropriate for many people to grieve after a traumatic experience: maybe they grieve for the birth they hoped to have, maybe for the person they were before, maybe for what they learned about themselves in the process…allowing time to grieve improves the chances of a solid integration. This is most effective right away, during the postpartum healing process.
Validate their feelings and encourage them to claim their power. Using therapeutic language combined with limbic resonance and reflecting feelings is helpful, while trying to help them reframe the experience with themselves as the protagonist, as opposed to someone powerless that has things done to them. Help them identify sources of power and claim them over and over until it sticks. Phrases like, “you never knew exactly how strong you were before, and no one can ever take that knowledge from you” can be helpful. Look to your heart openers and nervines, as discussed throughout.
Numerous other modalities can be extremely helpful as adjuncts. Limbic resonance is always a helpful tool when speaking to people about personal topics, and in particular when dealing with trauma. Some people may benefit from talk therapy, EMDR, or other trauma-specific therapy modalities, especially those experiencing reactivation or compounding of past trauma. Mindfulness meditation can be helpful for people who have experienced numerous traumatic events in their life.
Massage, acupuncture, and yoga can help release somatic trauma, especially combined with heart openers and visualization. Massage can make use of herbal infused oils to increase efficacy. Gentle massage can also be very helpful for newborns after a difficult birth. In yoga, hip opening poses are especially helpful. Moxibustion can be a powerful acupuncture tool to send the medicine deep. I have had great results in my practice with using these tools concurrently with herbs to release stored trauma; however, it is possible for the person to experience a healing crisis when memories are initially triggered, so it is essential that it happen on their timeframe, when they feel strong, and that they are provided with a rescue formula for anxiety, fury, or panic if relevant.
Craniosacral therapy can be wonderful for somatic trauma stored in the pelvis or lower back, as well as postpartum back pain. However, my absolute favorite use of craniosacral therapy is for newborns who had a rough delivery. Often, these kids may not be nursing well because they don’t feel good, which is a set up for further problems like jaundice, latch problems, or mastitis. They might not be sleeping comfortably because one side of their head or shoulder hurts. Craniosacral can work wonders in this situation.