Birth Trauma Resolution (BTR) therapy is a gentle, evidence-informed approach designed to help women process and recover from the emotional and psychological impacts of traumatic birth experiences. By calming the nervous system and helping the brain safely reprocess trauma, BTR supports women to move forward with greater calm, confidence, and emotional freedom.
For women who are suffering from symptoms such as:
If the woman is currently experiencing:
If the woman becomes highly dissociated when discussing the birth, for example, feeling detached from herself or her surroundings, losing periods of time, or becoming unable to remain oriented to the present.
Dissociation is recognised as an important feature that can occur with PTSD, and trauma treatment should include strategies for managing distress and arousal.
If they answer yes to questions 23 and 24 on the city birth PTSD form.
If talking about the birth causes overwhelming distress, panic, flooding or loss of emotional control, it may be more appropriate to work initially on stabilisation, grounding, emotional regulation and safety rather than processing the traumatic memory.
For example, someone experiencing an untreated psychotic illness or severe bipolar episode would generally require appropriate psychiatric care before undertaking trauma-focused work.
For example, ongoing domestic violence, coercive control or another significant threat to safety should be addressed before asking someone to undertake trauma processing. It can be difficult to process trauma effectively when the person is still experiencing an active threat.
A difficult birth does not automatically mean PTSD. Early support, listening and reassurance may be more appropriate initially. NICE recommends offering women who have experienced a traumatic birth the opportunity to talk about what happened and receive support. BTR therapy is usually not suggested until 4 weeks after the birth.
Birth trauma is a significant issue within Australian maternity care. The Australian Birth Experience Study (BESt), a national survey of women who had given birth in Australia, found that 29% of women described their most recent birth as traumatic, increasing to 33% among women who provided a detailed response regarding their birth experience. (BMJ Open)
Although experiencing a traumatic birth does not necessarily result in post-traumatic stress disorder (PTSD), birth trauma can have an ongoing psychological impact, including anxiety and fear relating to subsequent pregnancy and birth. An Australian study found that 31.5% of women having their first baby experienced high levels of childbirth fear, while 18% of women who had previously given birth also experienced high fear. Previous operative birth was associated with increased fear of childbirth in a subsequent pregnancy. (PubMed Central (PMC))
More recent Australian research highlights the importance of proactively identifying women who have experienced birth trauma. In a 2026 study of women attending a tertiary antenatal clinic, 55% reported either a previous negative birth or maternity care experience and/or current fear of birth. Notably, 46% of women who reported a previous negative experience indicated that they may not have disclosed this experience unless specifically asked. (PubMed) These findings demonstrate the importance of sensitive, woman-centred assessment, acknowledgement and validation of previous birth experiences. Early identification may provide an opportunity to develop individualised care plans and support women to regain a sense of safety, autonomy, confidence and control during a subsequent pregnancy.
The BESt study is particularly strong: it involved 8,804 Australian women, and reported that 29% of the total cohort described their birth as traumatic; among those who answered the detailed open-text question, the figure was 33%.
The Toohill et al. study is useful for linking a previous birth experience with fear in a subsequent pregnancy: overall childbirth fear was 24%, with high fear reported by 31.5% of first-time mothers and 18% of women who had previously given birth. Previous operative birth was also associated with greater fear.
The new 2026 Pidd et al. study is especially relevant to your case because it focuses on screening for previous traumatic birth and current fear of birth in a subsequent pregnancy.
The 2026 MacMillan systematic review was produced by researchers from Murdoch University and King Edward Memorial Hospital in Perth, making it particularly relevant to an Australian/WA context.
Ayers, S., Handelzalts, J. E., Webb, R., Constantinou, G., Grollman, C., Lucas, G., Awad-Sirhan, N., Baird, K., Baldisserotto, M. L., Batool, R., Batool, S., Brekalo, M., Caparros-Gonzalez, R. A., Chorwe-Sungani, G., Christoforou, A., Coo, S., Costa, R., Dikmen-Yildiz, P., Ďuríčeková, B., … Zedan, H. S. (2026). International prevalence of childbirth-related post-traumatic stress disorder: INTERSECT study. The British Journal of Psychiatry. https://doi.org/10.1192/bjp.2026.10708
Keedle, H., Lockwood, R., Keedle, W., Susic, D., & Dahlen, H. G. (2023). What women want if they were to have another baby: The Australian Birth Experience Study (BESt) cross-sectional national survey. BMJ Open, 13(9), e071582. https://doi.org/10.1136/bmjopen-2023-071582
Pidd, D., East, C., Adams, C., & Newton, M. (2026). Making the invisible visible: Exploring women’s and maternity care providers’ views on an antenatal screening tool to identify women with previous traumatic birth experience and or a current fear of birth in a subsequent pregnancy. Midwifery, 154, 104710. https://doi.org/10.1016/j.midw.2026.104710
Toohill, J., Fenwick, J., Gamble, J., & Creedy, D. K. (2014). Prevalence of childbirth fear in an Australian sample of pregnant women. BMC Pregnancy and Childbirth, 14, 275. https://doi.org/10.1186/1471-2393-14-275
MacMillan, K. K., Greenhalgh, C. F., Cleary, D. B., Cahill, J., Dedman, K., Bright, C., & Watson, S. J. (2026). Childbirth related post-traumatic stress disorder and childbirth trauma: A systematic review of available primary antenatal intervention. Birth, 53(2), 245–257. https://doi.org/10.1111/birt.70053
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