Gone are the days when dads were relegated to the hospital hallways – almost all fathers are present at their children’s births. It’s an exciting but undeniably challenging experience that can influence a man’s identity as a father, sense of self, his relationship with his child and his partner.
“Many pregnant women and their partners know birthing their baby will be hard work but very few expect, or are prepared, for their labour and childbirth to be complicated or dangerous,” says Julie Borninkhof, CEO of Perinatal Anxiety & Depression Australia (PANDA).
One in three women describes their birth experience as traumatic, a topic that barely gets enough airtime for women let alone their male partners who are often treated as bystanders to the process of birth.
“The biggest thing that we hear from the families that we support is, ‘Why didn't anybody tell me?’” says Amy Dawes, the CEO and co-founder of the Australasian Birth Trauma Association. “Often, people go into birth expecting it to be the best day of their life, and for many, it is far from that, and for a large number of women and their partners, it's incredibly traumatising.”
Research is only just beginning to look at the impacts of birth-related trauma on dads, who say it affects their mental health and relationships, long after leaving the hospital.
What is birth trauma?
Birth trauma can be both physical (such as a wound, serious injury or damage), psychological (emotional distress) or a combination of both.
This trauma can result from what happens during labour and childbirth – which could involve, but isn’t limited to, sudden changes to the birth plan, emergency caesarean, postpartum complications and inadequate care received from staff – but also how a parent feels about their birthing experience. If you found yourself feeling powerless, out of control or that your needs were not met you, might experience birth-related trauma.
At the time of birth, parents may feel fearful, helpless, confused, abandoned, disrespected or unheard. After the birth, it's possible to feel shock, guilt, disappointment, shame, anger, anxiety, grief or numbness.
“We recognise that actually, trauma is not just something that occurs during the birth itself, but it can often be events that occur in pregnancy, during the labour and birth process, or during the postpartum period,” Amy says. “We are seeing a lot more conversations around the broader aspects of how birth trauma can impact individuals.”
Individuality is a point of particular importance when it comes to birth trauma. Trauma is a personal, subjective experience, and it’s not always connected to physical pain, medical intervention or injury.
“What could look like a perfectly trouble-free birth to one person could be extremely traumatic to another,” Amy says.
“Birth trauma research suggests the impacts on mental health and wellbeing aren’t just associated with medical intervention,” Julie says. “Factors that may contribute to a traumatic birth experience include everyone’s personal history and response to their experience. For example, a history of sexual abuse, injury or not being able to birth on Country may increase the risk of post-traumatic stress symptoms and feelings of distress.”
A traumatic birth can cause psychological distress and it increases the risk of anxiety, depression and post-traumatic stress disorder (PTSD) in women if it’s not properly identified and treated. Despite the potential impact of PTSD on fathers, it remains an under-researched area. A traumatic birth experience can also have unique negative impacts on different groups, including other non-birthing partners, Aboriginal and Torres Strait Islander people, LGBTIQ+ people, and people from cultural minority communities.
Signs of PTSD
Reliving the traumatic event (this could be through unwanted and recurring memories, flashbacks, nightmares, and physical sensations such as sweating, nausea or trembling)
Being overly alert (also known as hypervigilance), wound up or irritable (this could include panicking when reminded of the trauma, finding it hard to sleep, being easily upset or angry)
Avoiding reminders of the event (this could be by keeping busy, avoiding certain situations, being unable to remember the details of what happened, feeling emotionally numb, being unable to express affection, using alcohol or drugs to avoid memories)
How dads are impacted by birth trauma
Kids were always on the cards for Clayton Schmidt, 48, who’s now a father of three.
“I was one of those guys that pictured themselves married and having kids at 18,” he says, “I wanted to be a very hands-on father, helping as much as I could.”
When it came to childbirth, he imagined he’d be his wife’s advocate throughout the process, “That I would be her rock, and to be there to support her a hundred per cent.” But fear, a sense of failure and complete lack of support were the common themes of the three uniquely traumatic births experienced by him and his wife.
“Not once did anyone talk to us, they didn't check on us afterwards,” Clayton says. “Just [no support] at all, did not get a phone call, didn’t have a follow-up, I didn't have one person ask me, ‘Are you okay?’ It's like I was invisible.”
Julie says that the PANDA helpline hears from plenty of dads who feel traumatised following the birth of their baby, and often feel overlooked or disregarded by medical and support teams.
“Dads can feel powerless, unheard, invalidated, and disregarded, any of these feelings may be influenced or complicated by that dad’s personal mental health history and life experiences,” Julie says. “Until more recently, many pregnancy and postnatal support systems have been mainly focussed on mums, with dads very much left in the background.”
Clayton deals with depression, anxiety and post-traumatic stress disorder due to birth-related trauma, but he didn’t recognise that straight away.
“I was angry all the time, I was a snappy, shitty dad and I wasn't the person I wanted to be,” he says. “My wife and I had the discussion. She's like, ‘You need to go and see someone. You need to go and talk to someone. There's something going on.’”
“Many dads feel that they need to be the rock of their family, and this can be a barrier to reaching out for support,” Julie says.
Stigma, fear and not really understanding what you’re feeling can also set you back.
“They have the guilt that they may not feel okay about what has occurred in the birth experience, but it didn't happen to them, so they've got to be strong,” Amy says.
Men can experience a range of mental health problems following the birth of a child, with one in 10 dads experiencing postnatal anxiety and/or depression. Ignoring the signs that something is wrong can have an impact not only on the individual but on the wellbeing of children and their relationship with their partner.
What you can do if you’re impacted by birth trauma
“Our advice is to reach out for help, even if you are not sure what you are feeling,” Julie says. “Every day at PANDA, we help dads to understand what they might be feeling and help them to explore potential support options for themselves and their families.”
Getting help early can reduce the severity of the impact of birth trauma on your mood, relationships, and bond with your baby.
“If you have gone through something difficult, there's no shame in seeking support, it is so important that you are able to care for yourself so that you can care for your loved ones,” Amy says.
It’s also important to understand that the impacts of birth trauma might not surface immediately.
“Many women don't recognise that they have birth trauma until they're pregnant with their second child,” Amy says. “How it manifests for dads is they may just be unwilling to grow their family. They may have had conversations where they'd always envisioned that they would have a bigger family, and then they are just not willing to go through that process again.”
Whether it’s a friend, a local dad’s group, or a health professional, it’s important to find someone to talk to, especially if you feel like you don’t want to burden your partner.
“It might even be as simple as talking to your best mate… or you might need a professional to help you get through it,” Clayton says, who found both helpful in his experience. “We don't ask for help enough,” he says. “We need to go, 'There's something not right,' and work out what it actually is.”
Talking about it also helps reduce stigma and might encourage others to speak up.
“The only way that we can raise awareness and reduce the stigma is if we talk about it and we share our stories,” Amy says. “Connecting with other dads that have been through it and they've come out the other side, they're your people, and they can often be the first step in getting the help that you need.”
What else needs to change?
“Dads do like to go along to those antenatal appointments, but then suddenly the baby's here and those touchpoints drop off, so how can we check in with dad?” Amy says. “What can we do to make sure that they're also accessing care in a timely manner so that it isn't years down the line where they're suddenly angry or anxious or helicopter parenting because they have got unresolved trauma?”
But when it comes to reducing birth-related trauma and addressing its ongoing impacts, there needs to be a greater change than encouraging individuals to speak up after the experience.
Healthy Male’s Plus Paternal: Case for Change recognises that non-birthing parents, most commonly men, are not systematically engaged or supported when couples seek to, or have a child. And this can lead to worse outcomes for the whole family.
Addressing male-specific needs requires tailored support and genuine engagement of men as equal partners throughout pregnancy, birth and beyond. You can read more about Plus Paternal and our work here.
If you need to talk to someone, contact:
 Daniels, E., Arden-Close, E. & Mayers, A. 2020. Be quiet and man up: a qualitative questionnaire study into fathers who witnessed their Partner’s birth trauma. BMC Pregnancy Childbirth https://doi.org/10.1186/s12884-020-02902-2
 Yildiz, P., Ayers, S., & Phillips, L. (2017). The prevalence of posttraumatic stress disorder in pregnancy and after birth: A systematic review and meta-analysis. Journal Of Affective Disorders doi: 10.1016/j.jad.2016.10.009