The relationship between birth trauma and perinatal mental health: a cross-sectional study

Globally, 130 million live births occur annually, including 3.6 million in the U.S. in 2023. While many women anticipate a positive birth experience, approximately 45% report birth trauma—a subjective experience that can occur regardless of medical complications. Birth trauma may increase risk for perinatal mental health disorders (PMHDs) such as depression, anxiety, obsessive–compulsive disorder (OCD), bipolar disorder, and psychosis. Existing research primarily focuses on birth trauma and perinatal PTSD, with limited exploration of its relationship to other PMHDs. This study examined associations between birth trauma and five PMHDs. A cross-sectional survey was conducted in December 2024 using Amazon Mechanical Turk and REDCap. Participants (N = 249) were U.S.-based women, 4 weeks–7 months postpartum. Birth trauma was assessed using the City Birth Trauma Scale; PMHDs were measured with validated tools including EPDS, PASS, DOCS, and MDQ. Modified Poisson and linear regressions, adjusted for demographic and birth variables, examined associations. Birth trauma was reported by 21.3% of respondents. PMHD prevalence was high: depression (84.7%), anxiety (81.9%), OCD (93.6%), bipolar disorder (10%), and psychosis (3.2%). Birth trauma was significantly associated with increased risk for depression (RR = 1.15), anxiety (RR = 1.34), bipolar disorder (RR = 9.59), and psychosis; OCD risk increase was non-significant. Symptom severity scores were higher across all PMHDs among women reporting birth trauma. Birth trauma is positively associated with elevated risk and symptom severity of multiple PMHDs beyond PTSD. Findings highlight the need for integrated postpartum screening and trauma-informed interventions to improve maternal mental health outcomes.