Secondary Trauma in Birth Work: When to Seek Therapy
You became a doula, midwife, nurse, or doctor because you wanted to support families during one of life's most transformative experiences. The privilege of witnessing birth, the profound connections with clients, the knowledge that your presence makes a difference—these are the rewards that sustain you through long hours and challenging situations.
But what happens when the very empathy and dedication that make you excellent at your job also leave you vulnerable to emotional harm? What happens when supporting others through trauma begins to traumatize you?
The Reality of Secondary Trauma in Birth Work
Secondary traumatic stress—also called compassion fatigue—is the emotional distress that results from hearing about, witnessing, or being involved in another person's traumatic experience. For birth professionals, this isn't an abstract concept. Research shows that secondary trauma affects 25-35% of maternity care providers worldwide (Kendall-Tackett & Beck, 2022), making it a remarkably common yet under-addressed issue in our field.
Whether you're a labor and delivery nurse watching a client experience a difficult birth, a midwife supporting someone through postpartum depression, a doula witnessing obstetric violence, or an obstetrician navigating an emergency situation, you're at risk for developing secondary trauma. Studies have found that 45-96.9% of maternity health professionals have witnessed traumatic birth events, with secondary traumatic stress prevalence ranging from 12.6% to 38.7% (Rice et al., 2022).
Trauma Is in the Eye of the Beholder
Here's something crucial to understand: trauma is subjective. A birth that appears routine and medically straightforward to you might be deeply traumatic for your client. Conversely, you might experience secondary trauma from witnessing an event that the family processes positively. Even when a baby is healthy and a birth has a good outcome, both providers and parents can still experience the effects of trauma.
This subjectivity means your emotional response is valid regardless of how others perceived the same event. You don't need to justify your feelings or compare your experience to anyone else's. Your trauma is real because you experienced it as traumatic. Research confirms that up to 45% of birthing people experience birth trauma (National Institutes of Health), highlighting how common traumatic experiences are in the birth space.
Recognizing the Signs: A Self-Assessment Guide
Important Note: This guide is for educational purposes only and is not a substitute for professional assessment.
Secondary trauma can manifest in cognitive, behavioral, emotional, and physical symptoms that mirror those of PTSD. Consider whether you've experienced any of the following:
Intrusive Symptoms
Flashbacks or vivid memories of difficult births or client situations
Nightmares related to work experiences
Intrusive thoughts about clients or traumatic events
Feeling suddenly "back" in a traumatic situation
Avoidance and Emotional Numbing
Avoiding certain types of clients or birth situations
Emotional detachment from clients or work
Loss of enjoyment in birth work or personal activities
Difficulty connecting with family and friends
Mood and Thinking Changes
Persistent negative beliefs about birth, medicine, or your ability to help
Excessive worry about clients or their outcomes
Increased cynicism about birth work
Difficulty concentrating or making decisions
Feeling hopeless about your impact or the healthcare system
Physical and Behavioral Symptoms
Sleep disturbances
Easily startled or feeling on edge
Changes in appetite
Increased use of alcohol, substances, or other coping mechanisms
Avoiding places or situations that remind you of traumatic work experiences
Professional Impact
Decreased motivation or job satisfaction
Impaired work performance
Difficulty maintaining professional boundaries
Considering leaving birth work to preserve your mental health
Beyond Trauma: The Value of Professional Support
Even if you're not experiencing what you would identify as trauma, having a space to process your work can be incredibly beneficial. Birth work is inherently high-intensity. You hold space for people during their most vulnerable moments, navigate complex family dynamics, witness medical emergencies, and often work irregular hours while being on-call.
You deserve a place to unload this emotional labor. Processing your experiences with a trained professional can help you:
Maintain healthy boundaries
Develop effective coping strategies
Prevent burnout and secondary trauma
Stay connected to your passion for birth work
Navigate challenging client relationships
Process moral injury when you can't provide the care you believe is best
Specialized Support for Birth Professionals
Secondary trauma in birth work has unique characteristics that benefit from specialized understanding. The cyclic nature of birth work, the unpredictability of labor, the intensity of witnessing both joy and trauma, and the deep relationships formed with clients all create specific therapeutic needs.
Mental health professionals trained in trauma work—including approaches like Lifespan Integration, Internal Family Systems (IFS), and EMDR—can provide targeted support that addresses both the symptoms of secondary trauma and the underlying factors that contribute to it in birth work settings.
Your Mental Health Matters
The same compassion you show your clients needs to be extended to yourself. Seeking therapy isn't a sign of weakness or professional inadequacy—it's a sign of wisdom and self-care. Just as you encourage your clients to seek support when they need it, you deserve that same level of care and attention.
Remember that taking care of your mental health ultimately benefits everyone you serve. When you're emotionally healthy and resilient, you can show up more fully for your clients, maintain the empathy that drew you to this work, and sustain a longer, more fulfilling career in birth work.
Professional support can help you maintain both your passion for birth work and your emotional wellbeing.
Sources:
Kendall-Tackett, K. A., & Beck, C. T. (2022). Secondary traumatic stress and moral injury in maternity care providers: A narrative and exploratory review. Frontiers in Global Women's Health.
National Institutes of Health. (2023). Birth trauma statistics.
Rice, H., Bennett, P., Billings, J., Sainsbury, K., & Isitt, J. (2022). The perceived impact of birth trauma witnessed by maternity health professionals: A systematic review. Women and Birth, 35(5), 464-475.
