A systematic review of birth trauma in the Middle East

Psychological trauma associated with childbirth is underappreciated in the Middle East as an issue that can significantly alter a woman's perception and satisfaction with her birth experience, increasing risk of postpartum mental health issues such as anxiety, depression or post-traumatic stress disorders (PTSD), impacting her ability to fully engage in motherhood and bond with and care for her newborn. This study reviews published literature on birth trauma and PTSD in the region to identify links to current maternity care practices, maternal mental health, and other health and social outcomes and offer insight into areas for further research and action. A systematic review of peer-reviewed articles published in English 2000-2025, using CRD reporting guidelines. Pre-determined inclusion/exclusion criteria were applied, selected articles were evaluated using CASP checklists. Eighteen articles report women in the Middle East find giving birth stressful, with notable rates of childbirth anxiety, trauma and PTSD symptoms. This is influenced by maternity care practice issues, routine medical interventions, limited pain management, lack of support, and communication challenges with care providers, linked to women’s perceptions of having negative birthing experiences. Social norms, women’s cultural beliefs, perceptions and satisfaction with labour and birth are intertwined with fear of childbirth, pain tolerance, ratings of traumatic experiences,symptoms of PTSD, and other maternal and infant health and outcomes. Strategies for prevention, management of birth trauma and enhancement of the birth experience are outlined. This study highlights the importance of consideration of women’s birth experiences, needs for enhanced empowerment, support and resources in maternity care and options for pain management and relief during childbirth in Middle Eastern birth settings. Links to postpartum maternal mental health, ability to breastfeed and bond with the newborn, potential for recovery, subsequent pregnancies and wider impact on infant development, relationships and families should not be underestimated. It is crucial to comprehend the fundamental impact birth experiences have on women’s mental health and wellbeing, and their perceptions and capacity for pregnancy, childbirth, breastfeeding and motherhood. Further research on maternal mental health, birth trauma, PTSD and development of corresponding policy, strategies and interventions in maternity care in the Middle East is necessary.