Understanding Maternal Near-Miss: The Hidden Trauma in Birth

Tiffany Lowther
3 days ago
5 min read

What is a Maternal Near-Miss?

A maternal near-miss is a life-threatening complication during pregnancy, childbirth, or within 42 days postpartum, where a birthing person almost dies but survives. This includes severe pregnancy complication, hemorrhage, eclampsia, organ failure, sepsis, ICU admission, and emergency hysterectomy. Even though survival occurs, the experience can leave emotional, physical, and psychological scars if unresolved and untreated.

Maternal Near-Miss can cause Trauma and PTSD:

Whereas perinatal trauma may resolve on it's on, if left untreated and unprocessed it can evolve into post-traumatic stress disorder. Post-traumatic stress disorder symptoms may start within the first three months after a traumatic event. But sometimes symptoms may not appear until years after the event. These symptoms last more than one month and cause major problems in social, personal or work situations and how well you get along with others.

Generally, PTSD symptoms are grouped into four types: (1) intrusive memories, (2) avoidance, (3) negative changes in thinking and mood, and (4) changes in physical and emotional reactions. Symptoms can vary over time or vary from person to person. For Perinatal PTSD symptoms can appear in both the birthing person and/or partner.

Systemic Inequities: Race, Class, and Policy

Maternal near-miss does not affect all people equally.

Black and Indigenous women are 2–4x more likely to experience life-threatening pregnancy complications
Low-income and rural patients face limited access to care and hospital closures
Discrimination, bias, and a legacy of medical racism contribute to ignored symptoms and delayed interventions

Impact on the Mom/Birthing Person

Birthing people often:

Feel unseen, disbelieved, or dismissed by their medical team
Struggle with medical PTSD, anxiety, or depression
Can be overprotective with the baby, fearful something will happen to them
Experience grief for the birth experience they expected
Question whether they’re allowed to feel pain or trauma because they survived
Feel disconnected from their body, baby, or support system
Feel they missed the newborn stage emotionally or physically due to trauma, ICU admission, or disassociation
May grieve the loss of breastfeeding, or face challenges initiating it due to separation, medications, or physical recovery
Experience grief if they are told or decide they cannot have more children due to medical risks
Feel guilt or shame for not wanting another pregnancy due to fear — or for being unable to grow their family as they had hoped

How It Impacts the Partner

Partners are often the invisible victims of maternal near-miss trauma.

Partners may witness the trauma in silence
They are often excluded from care discussions or left out of debriefing afterward
Many experience a deep sense of powerlessness or helplessness, watching the person they love suffer or nearly die without being able to stop it
PTSD symptoms can include nightmares, hypervigilance, withdrawal, or anger
Some feel conflicted between supporting their partner and managing their own trauma

Symptoms may show up in fear of future pregnancies, avoidance of intimacy, or difficulty engaging in emotional conversations.

When Planning Another Pregnancy

Another pregnancy often re-opens unprocessed trauma. It’s common for:

One partner to feel ready while the other shuts down
Fear, avoidance, and anxiety to surface — even years later
Grief if future pregnancies are no longer safe, or if the family-building journey is suddenly cut short

"Many birthing people feel deep sadness knowing they may never have another pregnancy — not by choice, but by medical necessity. Or, they may feel guilt if they simply can't go through it again due to fear or trauma."

Acknowledging these feelings and seeking trauma-informed couples counseling can help bring validation, safety, and shared healing.

Suggestions:

1. Work with a Licensed Perinatal Therapist and/or Support Group

Connecting with a licensed perinatal therapist—either individually or as a couple—during pregnancy and postpartum is one of the most supportive steps you can take. A trained and certified perinatal therapist can help you prepare emotionally, identify clinical concerns like pregnancy or postpartum anxiety, and offer consistent care throughout the journey. Postpartum Support International offers a search tool for vetted perinatal providers and offers free support groups for perinatal trauma and many other wonderful support groups with various topics. Reach out to Tiffany Lowther, Licensed Mental Health Counselor, to schedule is you live in the state of Florida and/or live in or close to Orlando or Winter Park.

2. Use EMDR to Shift from Danger to Safety

Eye Movement Desensitization and Reprocessing (EMDR), especially the Recent Traumatic Episode Protocol (R-TEP), is a powerful trauma treatment. It helps both birthing parents and partners process difficult or overwhelming events and calm the nervous system. EMDR supports the body in moving out of survival mode and into a sense of safety and regulation. Go here to learn more about emdr and pregnancy/postpartum.

3. Reclaim the Birth Story

Each parent deserves the chance to tell their birth story—ideally 10 to 20 times. Whether with a licensed therapist, trusted friend, support group, journal, or partner, the goal is to tell the story from beginning to end while eventually anchoring in a sense of emotional safety. This process is a healing step in integrating the experience.

4. Build a Medical & Support Team That Prioritizes You

OB-GYN

Ask your OB-GYN how they screen and refer patients for perinatal mood and anxiety disorders. How do they medicate if you or your partner are in need? Make sure they are informed about current laws and protocols and are prepared to support you medically and emotionally. Try to choose someone who you and your partner feel and they’ve stated will advocate for your health and not operate out of fear of liability. They should have a clear plan for handling medical emergencies and mental health concerns.

Pediatrician

Pediatricians often see families more frequently than Ob-gyn's postpartum and are in a critical position to support the whole family. If the parents aren't healthy that's going to negatively impact the mental and medical health of the baby. Ask how they screen birthing and non-birthing parents for postpartum mental health concerns. If they don’t screen often, ask if you request it, will they and what referrals they would give you. While Today, the American College of Obstetricians and Gynecologists (ACOG) recommends screening both parents, it's not yet required. Knowing your pediatrician understands the emotional demands of early parenthood—and will make thoughtful referrals—can make a huge difference.

Doula

A doula is a trained professional who provides emotional, physical, and informational support before, during, and after childbirth. Doulas are not medical providers, but they are advocates and companions who can help you feel empowered and cared for throughout the birth process. A postpartum doula can also assist with infant care, feeding support, rest, and recovery. Hiring a doula can reduce birth trauma and improve outcomes by making sure your voice and needs are heard. If you are in the Orlando, Central FL area- In Joy Birth is a great resource.

5. Offer Yourself Compassion and Self-Care

Your body and mind did what they needed to do to survive. If you feel like you're in survival mode or struggling, know that you are not broken—and you are not alone. Healing is possible.

6. NEXT STEPS

Looking for support through pregnancy, postpartum, or parenting? Tiffany Lowther, LMHC, PMH-C provides compassionate, trauma-informed counseling in Orlando, Winter Park and throughout Central Florida. With specialties in EMDR therapy, perinatal (pregnancy and postpartum) mental health, trauma, ptsd and anxiety treatment, Tiffany offers both in-person and HIPAA-compliant virtual sessions.

👉 Ready to take the next step? Schedule a session or free 15-minute consultation today.

Reach out to Tiffany at Tiffany@LowtherCS.com to request a PDF copy of this resource.

Lowther Counseling Services, www.LowtherCS.com, 2025