Understanding the Prevalence of Complex Post Traumatic Stress Disorder (C-PTSD) in Midwifery


Complex Post Traumatic Stress Disorder (C-PTSD) is a psychological condition that develops as a result of prolonged or repeated exposure to traumatic events. Examples are childhood abuse and neglect, domestic violence, workplace violence or phycological abuse from a loved one or partner. Midwives are particularly at risk for C-PTSD because the nature of the job decreases our threshold and erodes our coping resources. Being up all night, sitting with people in pain, and worrying about our livelihood being impacted by other peoples decisions is enough, but then you have the life or death nature of our responsibilities and the often hostile realities when asking for help and you have a veritable recipe for C-PTSD. It is a more severe and complex form of Post Traumatic Stress Disorder (PTSD). In this blog post, we will delve deeper into the symptoms of C-PTSD, shedding light on the emotional, cognitive, and relational challenges individuals may face.

1. Emotional Dysregulation:

One of the hallmark symptoms of C-PTSD is emotional dysregulation. People with C-PTSD often find themselves experiencing intense and unpredictable emotions. They may struggle to manage and regulate their emotions effectively, leading to frequent mood swings, angry outbursts, or feelings of emptiness. The emotional roller coaster can be overwhelming and disruptive to daily life. If you or a colleague has ever lashed out at a student, posted something you later regretted, or been depressed for ‘no reason’, consider that you may have C-PTSD.

2. Dissociation:

Individuals with C-PTSD may experience dissociation, a state of detachment from their own thoughts, feelings, and surroundings. They might feel as if they are watching themselves from outside their own bodies (depersonalization) or perceive the world as unreal or distorted (derealization). Dissociative episodes can be distressing, making individuals feel disconnected and detached from their own reality. You know how often midwives get home from a birth on autopilot – this is concerning.


3. Negative Self-Perception:

C-PTSD often engenders negative self-perception and a distorted self-image. Survivors may harbor feelings of shame, guilt, or worthlessness, even when those feelings are irrational or unfounded. They may blame themselves for the traumatic events they experienced, leading to self-criticism and a diminished sense of self-worth. Midwives often blame themselves for birth outcomes that they have no control over – expecting god-like abilities when it comes to meeting their clients needs and then they inevitably shame themselves when unable to meeting it.

4. Disturbed Relationships:

Individuals with C-PTSD may face significant challenges in forming and maintaining healthy relationships. Trust issues, difficulties with intimacy, and problems setting boundaries are common. Survivors may find themselves repeating unhealthy relationship patterns or engaging in self-sabotaging behaviors. These relational struggles can further exacerbate feelings of isolation and loneliness. Divorce and business break-ups are the norm in this profession.

5. Hypervigilance and Altered Arousal:

C-PTSD often leaves individuals in a state of heightened vigilance and arousal. They may constantly feel on guard, as if anticipating danger. This hypervigilance can manifest as difficulty sleeping, irritability, an exaggerated startled response, or difficulties concentrating. The constant state of hyperarousal can be mentally and physically exhausting. This is what gives midwives part of their super powers, but eventually if you dont heal and bring balance into your life, there is no way to sustain the pace of modern midwifery, which is why theres so much burnout in the profession.

6. Chronic Feelings of Emptiness:

A pervasive sense of emptiness is a common experience for those with C-PTSD. Survivors may struggle with a lack of purpose or fulfillment in their lives. This sense of emptiness can be overwhelming, leading to a deep yearning for meaning and a feeling of being disconnected from oneself and the world. But you’re not alone, more than half of the midwives we surveyed are struggling with the same symptoms.



While Complex Post Traumatic Stress Disorder (C-PTSD) is not yet recognized as a separate diagnosis in the DSM-5, it captures the unique symptoms and challenges faced by individuals who have endured prolonged trauma. Recognizing and understanding the symptoms of C-PTSD is crucial for healthcare professionals and individuals alike. If you suspect you or or a midwife colleague may be experiencing C-PTSD, seeking professional help from a mental health practitioner is essential for a comprehensive evaluation and appropriate treatment.

Here are some resources we love:

And of course we offer confidential legal, clinical, and grief counseling for midwives and student midwives after challenging cases – book a consult here Remember, C-PTSD is a complex condition, and healing takes time. With proper support, therapy, and self-care, individuals can embark on a journey of recovery, reclaiming their lives and finding a sense of peace and resilience in the face of adversity.


If you are a community-based midwife in the United States, even if you are in counseling, you likely suffer from complex or singular PTSD or CPTSD. After months or years of stress and trauma and constant need to over decrease adrenaline and cortisol, the adrenal glands become fatigued. This has been called adrenal fatigue....




Midwife. Mentor. Muse. Over 20 year experience in midwifery, traveling the world, proud grandma. Here building a community of incredible humans to help make midwifery mainstream! Welcome home midwives.




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