Some births are frightening. An emergency C-section, heavy bleeding, a baby taken straight to the NICU, pain that wasn't taken seriously, or feeling powerless and unheard can all leave a mark, even when everyone is physically fine now. Whether a birth was traumatic often has more to do with how it felt to you than with what's in your chart.

In studies, up to a third of women describe their birth as traumatic, and a smaller number, around 4 in 100 women overall and more after a very difficult birth, go on to have post-traumatic stress disorder (PTSD). Dads and partners who were there can be affected too.

What it can look like

Some of this is common in the first days and weeks, and it often fades. If it lasts more than a month, keeps getting worse, shows up weeks or months later, or gets in the way of sleeping, eating or caring for yourself or your baby, it may be PTSD after birth. That is treatable, and it is not a sign of weakness. You don't need to wait a month, or be sure it's PTSD, to ask for help. If it's hard now, tell your provider now.

• Replaying the birth again and again, or nightmares about it.
• Feeling on edge, jumpy or unable to relax, even when things are calm.
• Avoiding reminders: the hospital, the doctor's office, births on TV, even talking about it.
• Feeling numb or detached, as if it happened to someone else.
• Anger, guilt or shame about what happened, or about what you think you should have done.
• Trouble feeling close to the baby, or constant fear that something terrible will happen.

What can help

• Tell your story when you are ready, to someone who will simply listen. Some people find it helps to write it down.
• Ask your OB or midwife to go through what happened with you. Some hospitals and practices offer a visit to talk through the birth and your records. Understanding what happened, and why, can help.
• Say it plainly at your postpartum checkup: "The birth was frightening, and I keep thinking about it." Your provider can check how you are doing and refer you.
• Trauma-focused therapies help many people with PTSD. When you contact a therapist, ask whether they work with birth trauma.
• If you plan another pregnancy, tell your provider about this birth early. A plan made in advance can make the next one feel safer.

For dads and partners who were there

Dads and partners often hold it together in the room and fall apart later, or never where anyone can see. You may have flashbacks, feel guilty that you couldn't do more, or avoid the subject entirely. That counts too, and the same kinds of help are there for you. Talk to someone, and see a therapist of your own if it doesn't ease.

For family and friends

• Skip "at least you're both healthy." Both things can be true: they are grateful, and it was terrible.
• Let them tell it as many times as they need, without correcting it or comparing it with another birth story.
• Offer practical help getting to follow-up appointments, and to therapy if they start.

When not to wait

If you have thoughts of harming yourself or the baby, call or text 988 now. If they feel like something you might act on, or anyone is in immediate danger, call 911. If you feel hopeless or can't get through the day, don't wait for the one-month mark: call your provider today, or the National Maternal Mental Health Hotline at 1-833-TLC-MAMA (1-833-852-6262).