Being trauma-informed means recognizing that trauma is common, often unseen, and deeply influential in people’s lives. Trauma-informed care begins with one core understanding:
every person has a story, and behaviours, reactions, and emotions are often shaped by past experiences rather than personal choice.
As the quote often paraphrased reminds us:
“There’s a story behind every person. There’s a reason why they are the way they are.”
Trauma-informed care shifts the question from “What’s wrong with you?” to
“What happened to you?”
Trauma is far more widespread than many people realize. Research consistently shows high rates of exposure to traumatic events across the population:
Approximately 70% of people experience at least one traumatic event in their lifetime
Around 8% develop post-traumatic stress disorder (PTSD) following trauma exposure (Bellenbaum et al., 2018)
Rates of trauma are significantly higher among women, particularly related to interpersonal and gender-based violence
Beyond overt events, trauma can also stem from discrimination, neglect, emotional abuse, systemic inequity, and chronic stress. In other words, trauma is not rare—and it often goes unrecognized.
Pregnancy and childbirth are major life transitions and can be stressful even under ideal circumstances. Certain individuals, however, are more vulnerable to distress, particularly those with a history of trauma such as sexual abuse or prior medical trauma.
The perinatal period—including pregnancy, childbirth, breastfeeding, and early parenting—can reactivate past trauma, even if a person appeared to be coping well earlier in life.
Trauma does not look the same in everyone. There is no single way to identify trauma based on appearance or behavior.
Some individuals may appear to be functioning well outwardly
Others may carry emotional or physical responses that surface only in specific situations
Pregnancy, childbirth, and parenting transitions may trigger memories, emotions, or bodily responses connected to earlier experiences
The absence of visible distress does not mean trauma is absent.
Research suggests that approximately one-third of women experience childbirth as traumatic (Reed, 2017). These experiences are often associated with:
Perinatal mood and anxiety disorders
Postpartum depression
Generalized anxiety
Post-traumatic stress symptoms
Increased reliance on maladaptive coping strategies
Individuals with trauma histories are at higher risk for complications, including increased emotional distress during pregnancy and higher rates of preterm birth (Kendall-Tackett, 2017).
Traumatic birth experiences can impact:
Sense of identity and self-trust
Parent-infant bonding
Family relationships
Long-term emotional and mental health outcomes for both parent and child
Trauma can affect individuals on multiple levels:
Anxiety, fear, or hypervigilance
Difficulty trusting others
Depression or emotional numbness
Heightened stress responses
Sleep disturbances
Increased sensitivity to pain or medical procedures
Challenges with attachment and bonding
Strained interpersonal relationships
Increased risk of mood and anxiety disorders
Effects on parenting confidence and wellbeing
Influence on children’s emotional and developmental outcomes
Trauma-informed care acknowledges the widespread impact of trauma and seeks to create safe, respectful, and empowering environments. In perinatal and healthcare settings, this includes:
Prioritizing physical and emotional safety
Offering choice and control whenever possible
Supporting collaboration and shared decision-making
Avoiding re-traumatization
Practicing empathy without requiring disclosure of trauma
Trauma-informed care benefits everyone, not only those with known trauma histories.
Trauma does not affect only the birthing individual; it can also influence parent–infant bonding, child development, and long-term family well-being. Experiences during pregnancy and birth can shape how parents relate to their babies and how confident they feel in their caregiving role.
Recognizing this broader impact is one of the most compelling reasons why trauma-informed care is essential in perinatal services.
In 2014, the World Health Organization (WHO) issued a formal statement calling for “respectful care for birthing women.” Evidence shows that how individuals are treated during pregnancy and childbirth has profound implications for outcomes—not only emotionally, but physically as well.
WHO emphasized that prenatal experiences directly influence breastfeeding success, stating that:
“If we want to increase breastfeeding rates, gentle care can make all the difference.”
(Kendall-Tackett et al., 2017)
Respect, dignity, and emotional safety are not optional extras—they are foundational elements of effective perinatal care.
For individuals with a history of sexual abuse, pregnancy and childbirth may be particularly vulnerable periods. Routine aspects of maternity care—such as physical examinations, exposure, and loss of bodily autonomy—can unintentionally trigger traumatic memories or emotional distress (Harris, 2018; Reed et al., 2017).
Some individuals may experience:
Heightened anxiety or emotional distress
Sleep or concentration difficulties
Avoidance of reminders related to childbirth
Persistent feelings of being “on edge”
Research suggests that approximately 3% of prenatal and 4% of postpartum individuals meet criteria for PTSD during the transition into parenthood (Bellenbaum et al., 2018). These experiences can significantly affect well-being if left unrecognized and unsupported.
The Trauma-Informed Approach (TIA) is designed to acknowledge the widespread impact of trauma and to help care providers work collaboratively with individuals toward healing—while minimizing the risk of re-traumatization.
At its core, trauma-informed care invites a shift in perspective:
instead of asking “What’s wrong with you?”
we ask “What happened to you?”
This approach removes blame, reduces stigma, and respects the lived experiences people bring with them into pregnancy, birth, and parenting.
According to the Substance Abuse and Mental Health Services Administration (SAMHSA), trauma-informed care is guided by four key principles—the 4 Rs:
Trauma is widespread. A universal approach assumes that anyone may carry a trauma history, even if it is undisclosed. Care should always be delivered with sensitivity and respect.
Trauma and its effects may show up in emotional responses, behaviors, or physical reactions. Pregnancy is often a window of opportunity for healing, as individuals may be more open to growth and new beginnings. Support organizations, such as Postpartum Support International (Canada and the U.S.), play a critical role here.
Organizations and providers must integrate trauma-informed principles into policies, procedures, and staff training, making trauma-informed care a standard—not an exception.
Every effort should be made to avoid practices that may unintentionally recreate feelings of powerlessness, fear, or loss of control.
Trauma-informed care is grounded in five core principles:
Ensure physical and emotional safety at all times.
Provide education and options so individuals can make informed decisions during pregnancy and childbirth.
Work in partnership with families and healthcare providers toward shared goals.
Build trust through transparency and consistency—do what you say you will do.
Focus on strengths, build coping skills, and support individuals in reclaiming control and confidence.
“We need to understand and try to change the way we think. Remember, sometimes we only know their name—not their story.”
Childbirth educators, labour doulas, postpartum doulas, lactation educators, nurses, and new parent educators all play a powerful role in shaping birth experiences.
Let trauma-informed care be our standard of practice—not an added option.
When we lead with compassion, respect, and awareness, we support not only parents—but future generations.
Trauma-informed care is not a technique—it is a lens through which care is delivered. Recognizing that trauma is common allows healthcare providers, educators, and support professionals to offer compassionate, respectful, and effective care.
When families feel seen, heard, and supported, outcomes improve—not only during pregnancy and birth, but across the lifespan.
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