Why a traumatic birth can make returning to work harder

Going back to work after having a baby is never easy. You’re sleep deprived and after months of adjusting to life as a parent, you’re suddenly required to navigate childcare as well as work. But it can be even more difficult if you’ve had a traumatic birth experience.

It’s difficult to pinpoint exactly how many women experience birth trauma, because not everyone is able to – or has the opportunity to – talk about their experience. Some studies suggest as many as 45% of those who give birth are left traumatised, but the number may be higher. And the effects of a frightening birth can continue to impact on the birthers and their partners long after they return to work.

When a woman has had a traumatic birth, it is common to experience trauma symptoms such as flashbacks or intense anxiety, says Kim Thomas, CEO of the Birth Trauma Association.

“All sorts of things can trigger these symptoms. Women who work in a clinical setting often find it impossible to return to work because the reminder of the trauma is so intense that they simply can’t cope,” she says.

“But even an ordinary workplace can be full of triggers. Office strip lighting, for example, can take someone right back to the operating theatre where she had an emergency caesarean. The sight of a colleague who is pregnant or who has brought their baby into work can evoke feelings of fear or anxiety.”

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Childbirth can also leave women with physical injuries that can make work difficult. Up to nine in every 10 first time mothers who have a vaginal birth will experience some sort of tear or graze, which can take time to heal. “If a woman has incontinence as a result of severe tearing, she may need to be able to get to the toilet very quickly, which can be a source of anxiety if she has to walk to another floor,” says Thomas.

For some, the trauma is so intense it can even prevent a return to work. “Other women are so anxious that they find it impossible to leave their baby for fear that something bad will happen,” says Thomas. “We also come across women who are so traumatised they can’t even leave the house.”

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A traumatic birth experience – or a difficult pregnancy – can also have a lasting impact on a woman’s confidence. “It can affect a woman's self-esteem and confidence in her ability to perform at work,” says therapist Jenny Warwick, a member of the Counselling Directory. “They may also face mental health issues because of the birth, such as post-traumatic stress, anxiety or depression, all of which can adversely impact their ability to manage work-related stressors,” adds Warwick.

How employers can support new mothers

It’s essential for employers to support all parents returning to work, but not everyone’s needs are the same. Thomas highlights that it’s important for employers to avoid making assumptions about what women will want when they go back to work. “It’s best if they have a confidential discussion before the woman returns so that the employer is aware of any needs she may have, so that they can be in place from day one,” says Thomas.

Longer maternity leave

Only one in four mothers are able to take their full maternity leave entitlement due to financial hardship, according to research by the charity Pregnant Then Screwed. Rates of maternity pay in the UK are some of the lowest among comparable countries, and the cost of living crisis has exacerbated the problem. The situation is even more dire for those needing more physical or mental recovery time.

Offering enhanced maternity pay for longer will give women more time to recover after birth. “It is good for the woman, good for their baby, and ultimately good for the employer, because hopefully the person who returns will be more able to meet the requirements of her job,” says Thomas.

A phased return or flexible hours

A gradual return to work, such as shorter or fewer days, can allow a new mother to physically and mentally re-adjust to working life. Flexible working is also helpful for those experiencing physical or mental health problems. “Opportunities to change working patterns might benefit some women. These could include compressed hours, work from home, reducing hours and reducing travel,” says Thomas.

Open communication

It’s important for women to be able to speak up about concerns to their employers in regular meetings. “Training managers to recognise signs of distress and having inclusive policies in place that acknowledge the unique needs of employees dealing with birth trauma can help to create a supportive environment,” says Warwick.

Occupational health

“Birth trauma is a valid reason for referral to occupational health, where counselling and physiotherapy might be available,” says Thomas.

Additionally, employers could make adjustments where needed – for example, adjustable height desks and regular breaks. Some women might benefit from a separate, private space they can go to if they suddenly experience a flashback or anxiety attack.

Back to work buddies

Some big employers offer a ‘back to work buddy’ – a peer from another department who has also returned from maternity leave. “This can be particularly helpful for women with birth trauma,” says Thomas.

Support outside of work

Women who feel psychologically traumatised by birth can ask for a referral to their local perinatal mental health team, who should be able to offer counselling support. In England, this is available for up to two years after the birth. It’s also possible to access therapy via the NHS Talking Therapies service, although waiting lists can be long. The Birth Trauma Association offers support through a peer support team.

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