Understanding reproductive trauma: the disruption to parenthood

The decision of whether we want to bring a child into the world starts long before we even consider whether we wish to conceive. It starts in early childhood. We look to our family role models, our peers, and the religious, societal, and cultural messages about what it means to be a parent, as well as our own hopes and identity.

We construct an internal story as early as when we play with cars and dolls, seeing how we were parented and discovering what the next steps might be in our own lives. This internal script continues to form throughout our lives. It gets embedded as our core beliefs about what it may mean to be a parent, to build a family and to experience pregnancy.

This has been coined as our reproductive story by Psychotherapists Janet Jaffe and Martha Diamond. Having a reproductive story is universal. We all have one, regardless of gender, sexuality and whether we want or don’t want children. It can be conscious: "When I have children, I will name my child…" or unconscious: "It will happen someday…"

This reproductive story makes us who we are, so it can be absolutely devastating when we get put on a different path from the story that we had for ourselves. It can feel like our life plan has been shattered. In the field of Psychotherapy, Jaffe and Diamond call this reproductive trauma. Sometimes we don’t even realise we have a reproductive story until a loss or a reproductive trauma occurs. 

What is reproductive trauma?

Reproductive trauma is any event that disrupts the path to parenthood. This can include infertility, miscarriage, stillbirth, ectopic pregnancy, neonatal loss, traumatic birth, premature birth, postpartum issues, adoption failure, surrogacy and abortion.

An individual can also experience reproductive trauma when they have decided to become a parent but have not yet had a child. This is known as psychological parenthood. When one decides they would like to plan for a family, there is a shift in identity before a child is even born, and trauma can occur if they have difficulties in their reproductive story. This is because attachment to a potential child exists long before a child is born. 

Single parents by choice and LGBTQ+ couples or individuals can also experience reproductive trauma. Some may rely on third-party reproduction, such as sperm or egg donation, surrogacy or adoption. When these routes to parenthood don’t go as hoped, the grief can weigh heavily. For some transgender and non-binary individuals, reproductive procedures or fertility preservation may also bring up feelings of gender dysphoria alongside experiences of loss.

Jaffe and Diamond highlighted that the psychological impact of fertility and pregnancy losses is very similar to other forms of catastrophic trauma, causing worldview fragmentation, intense grief, anxiety, and a loss of personal control.

What does reproductive trauma feel like?

Trauma is not just about what happened; it is about how one’s mind and body process the event. Dr Bessel van der Kolk, who wrote extensively on trauma in his book The Body Keeps the Score, emphasised that trauma is not the historical event itself, but rather the biological and psychological imprint that the event leaves behind inside the human body.

Because reproductive losses are frequently suffered in silence, one may feel extremely isolated. Common signs of reproductive trauma might include:

Hypervigilance

Feeling constantly on edge and anxious, rumination, feeling consumed by medical details, or experiencing intense fear regarding future attempts or medical procedures and environments.

Intrusive thoughts or flashbacks

Reliving a painful diagnosis, a distressing medical procedure, or the experience of a traumatic birth.

Deep grief and disconnection

Feeling detached from your body, experiencing a sense of failure, or feeling alienated from friends and family who seem to move forward effortlessly.

Strained relationships

Experiencing tension with your partner, as individuals often process grief and trauma on completely different timelines and in different ways.

How to heal 

The most fundamental element of trying to heal from reproductive trauma is to acknowledge your pain and to validate your thoughts, feelings and experience of what you have gone through or are still going through. Your pain is absolutely valid, and it is important not to compare yourself with others.

The path towards healing can occur in so many ways, some of which include talking to a trained psychotherapist or a counsellor, joining a support group, having a supportive network in friends and family, creating meaningful personalised rituals or memorials, especially if there have been losses, utilising somatic healing techniques and incorporating movement to help ground and regulate your body.

Within Janet Jaffe’s frameworks of reproductive story and reproductive trauma, working with a trained professional can help you make sense of how your journey to parenthood has gone off script and how it has impacted you. It can be a space to understand your reproductive story and grieve what hasn’t been. It can also be a place to pave a new narrative, should you wish. The healing process is often not linear and doesn’t mean for you to be ‘fixed’ but rather for you to find a way forward. 

If you’re struggling with reproductive trauma, consider reaching out for professional support. Having a safe space to explore your experiences can help you navigate this difficult and challenging journey.