Galina Zhigalova/Getty ImagesFor some women, the birth of their baby is one of the happiest days of their lives. Others remember it as a frightening, overwhelming or deeply distressing experience. Around one in three women report their birth experience as traumatic.Women can be traumatised during birth when there is a medical emergency such as a caesarean section, heavy bleeding, or a newborn baby needing intensive care. But it’s not always the emergency itself that leaves a lasting impact. Women also experience trauma when they feel they are not being listened to, don’t have enough information, or when procedures are carried out without their full consent.Of the women who experience a traumatic birth, around one in five develop post-traumatic stress disorder (PTSD). PTSD may involve symptoms of unwanted memories, nightmares or flashbacks, avoiding reminders of the birth, or feeling constantly on edge.So can debriefing about a difficult birth stop it turning into trauma?Not all women find debriefing helpfulMany hospitals offer postnatal debriefing of women’s birth experiences, but there is no single agreed way to do it. It might be a general conversation as part of routine care with a maternity health professional caring for the woman. Or it might be a planned, one-off structured session with hospital staff specifically to discuss a birth, emergency or difficult event, or if requested by the woman. Some women say debriefing can be beneficial to make sense of what happened and to feel heard, helping them to gain a sense of closure.But there is no clear benefit of debriefing for all women, particularly in preventing the development of PTSD.Timing also matters. If a debriefing session is offered too early, women may not have had the chance to process their experiences, which can mean reliving the event before they are ready and may be harmful.Both the World Health Organization and the United Kingdom’s National Institute for Health and Care Excellence recommend against routine single-session psychological debriefing. Opt-in debriefs can help process difficult birthsStudies have identified that providing debriefing to women who have specifically requested it or are referred can lead to a reduction in PTSD symptoms. Continuity of care where the same midwife supports a family through pregnancy, birth and post-natally may also help build a trusting relationship where women feel listened to and supported after a traumatic birth.So rather than a one-size-fits-all approach to postnatal debriefing, the evidence suggests that what matters most is that women who want a debrief can access one at a time that feels right, focused on the questions they actually want answered. However, any debriefing should sit alongside a referral through the maternity team or GP to a health professional trained in perinatal psychological trauma, such as a psychologist or counsellor with experience in birth trauma.Debriefs won’t always prevent PTSDBut even with the right support in place, some women will go on to develop PTSD symptoms.These can be easy to miss at a time when new parents are adjusting to major changes and often experiencing sleep deprivation. Weeks or months later, memories and flashbacks of the birth may still feel as vivid as the day of the birth. Other symptoms include withdrawing from family or finding it difficult to bond with their baby. These symptoms can have a real impact on the family unit. Yet many women with these symptoms remain un-diagnosed, as routine screening by maternity services after birth tends to focus on depression rather than birth trauma. Researchers have developed a tool known as the City Birth Trauma Scale to help health professionals identify PTSD symptoms specifically related to childbirth to enable them to get the right support. What if you want a debrief?Raising the option of a debrief during pregnancy or at a postnatal check can help women know it’s available if they need it. If you are considering debriefing with a health professional after a distressing birth experience, Birth Trauma Australia has developed a helpful guide. It suggests thinking about what you hope to gain from the conversation, such as understanding what happened medically or having your experiences acknowledged. Before a planned debrief session, it can help to request a copy of the hospital, medical or birthing notes, so there is something concrete to refer to. Useful questions to bring include what decisions were made and when, and information on any medical terms or procedures and if they were explained at the time. Women can also ask for a support person to be present and can request the debrief with a specific health professional, such as their own midwife or obstetrician.Only you can decide if and when you would like to talk about the childbirth experience. If you’re asked you about your birth experience and you’re not ready to discuss this, it is reasonable to say so.Given the psychological impact on women and their birth partners, who can also develop PTSD after witnessing a traumatic birth, timely discussions, individualised care and access to appropriate ongoing perinatal mental health support may be key considerations in supporting families.If you or someone you know is showing signs of perinatal mental illness or PTSD related to pregnancy or birth, support is available through ForWhen Helpline (1300 24 23 22), Birth Trauma Australia, PANDA (1300 726 306) and COPE or Lifeline (131114).Kelly Haynes does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.