Birth Trauma in Germany, Switzerland, and Austria—and How Doulas Make a Real Difference
- Stephanie Johne
- Aug 31
- 3 min read
Updated: Sep 3
Birth trauma is a significant concern in Germany, Switzerland, and Austria impacting around one in three birthing individuals. Yet in this challenging context, doulas offer a deep abundance of emotional safety, continuous presence, and respectful advocacy. Supported by a great body of research, doula care consistently reduces medical interventions, supports positive psychological outcomes, and can transform potentially traumatic births into a calm, safe experience.
By prioritizing doulas as part of respectful, trauma-informed maternity care, we take meaningful steps toward birthing cultures rooted in dignity, healing, and human connection.
1. Understanding the Current Landscape: Birth Trauma in the DACH Region
Birth trauma can be a distressing experience during childbirth that has emotional or psychological repercussions and has become a central topic of discussion in German-speaking countries. Particularly, statistics show that around one-third of birthing individuals in Germany, Switzerland, and Austria report a traumatic birth. This includes those who experienced unplanned cesarean sections, emergency interventions, or a profound sense of loss of control during labor .
As awareness of birth trauma increases, doulas psychosocial birth companions are steadily gaining visibility and demand across the region. They bring qualities like strength, intuition, warmth, and a grounding presence that cultivate feelings of safety and emotional support during birth
2. What Is Birth Trauma and Why It Matters
Birth trauma can arise from:
Unplanned or emergency interventions
Feeling unsupported, dismissed, or unsafe during labor
Lack of emotional or physical continuity in care
The emotional burden can be long-lasting impacting postpartum mental health, mother–infant bonding, breastfeeding success, and even future reproductive experiences. That’s why creating a nurturing, empowering birth environment matters so much.
3. How Doulas Protect Against Birth Trauma: Evidence and Mechanisms
a. Continuous Emotional and Physical Support
A Cochrane Review across 26 studies and over 15,000 birth experiences shows that continuous support from a doula:
Increases likelihood of vaginal birth (without interventions like cesarean, forceps, or vacuum extraction)
Reduces use of pain medication
Shortens labor duration
Elevates satisfaction with birth and postpartum experience
Enhances newborn Apgar scores
Encourages smoother breastfeeding initiation
Fosters culturally responsive and empowering care environments
All of these improvements help reduce the risk factors commonly associated with birth trauma, such as feeling out of control or unnecessarily intervened upon.
b. Lower Medical Intervention Rates
Evidence consistently shows that doula support significantly reduces interventions:
Cesarean delivery likelihood: Reduced by about 32–39%
Instrument-assisted vaginal births: Lower odds (odds ratio ~0.54)
Other reductions: Some studies report cuts in analgesia (pain meds), oxytocin use, and forceps/vacuum deliveries, alongside shorter labor and increased breastfeeding success
This reduction in invasive interventions often associated with heightened distress and creates a calmer, more respectful birthing experience.
c. Trauma-Informed Care
A trauma-informed doula approach emphasizes:
Safety and trust
Transparency
Peer support (including survivors)
Collaboration and mutuality
Empowerment, voice, and choice
Cultural and historical sensitivity
Such care helps prevent re-traumatization and honors the birthing person’s autonomy and dignity, a critical aspect often overlooked in clinical environments.
4. Why Doulas Make Birth Experiences Safer and More Empowering
Domain | Impact of Doula Support |
Intervention Rates | Lower cesarean and instrumental deliveries |
Birth Satisfaction | Higher emotional satisfaction and more positive memories |
Trauma Prevention | Mitigates risk by promoting empowerment and advocacy |
Postpartum Outcomes | Better breastfeeding, mental health, and bonding |
Cultural Sensitivity | Tailored support that recognizes social and historical contexts |
5. Practical Recommendations for the DACH Context
Increase doula training, especially in postpartum trauma-sensitive approaches. Also trainings that include rascism, queer education. Histroy of birth is so important to understand.
Educate clinicians on the value of continuous support—not only for birth outcomes but for psychological well-being.
Raise public awareness around doulas as a viable, non-medical, empowering source of support.
Foster collaboration between doulas, midwives, and obstetric teams to support informed, respectful care.
Birth is not neutral. It’s political—especially if you have a womb, especially if your body has been historically overlooked, controlled, or dismissed. As doulas, we are not separate from this reality. We are part of the system, and we are also part of the change.
To truly support all birthing people, we must commit to ongoing learning, unlearning, and deep self-reflection. We need to understand the systems we’re working within, the power dynamics at play, and the lived experiences of those we serve.
Tackling birth trauma starts with listening, really listening—to women and birthing people. And from that listening, we must act. Not just with compassion, but with courage. Not just with intention, but with impact.
Because every birth deserves safety. Every birthing person deserves dignity. And none of us are free until we all are.
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