Birth Is Sensory: How Trauma and Neurodivergence Shape the Labor Experience

May 25

Modern maternity care often treats labor and birth as a series of procedures and protocols. But for many birthing people—especially those who are neurodivergent or have a trauma history—birth is not just physical. It’s sensory. It’s psychological. It’s deeply relational. And when providers fail to recognize this, they may unintentionally cause harm.

This article is for two groups:

Birthing people who identify as neurodivergent or trauma survivors, and
Birth professionals who want to support them with greater sensitivity, knowledge, and care.

Together, we can create a safer and more empowering birth culture—one that honors nervous system differences, sensory needs, and the resilience it takes to navigate a system not designed for all bodies and minds.

What Do We Mean by “Neurodivergent”?

“Neurodivergent” is a broad umbrella that includes (but is not limited to):

Autism
ADHD
Sensory Processing Disorder (SPD)
PTSD/C-PTSD
OCD
Learning disabilities
Highly sensitive nervous systems (even without a formal diagnosis)

People who are neurodivergent may experience:

Sensory sensitivities (to light, sound, smell, touch, temperature, etc.)
Different pain perception or expression
Difficulty processing verbal instructions under stress
Emotional regulation challenges
Hyperarousal or dissociation in high-stimulation environments
High-masking behaviors—appearing “fine” while struggling internally

These traits often overlap with trauma responses, which can compound the difficulty of navigating pregnancy, labor, and birth.

Trauma and the Nervous System in Birth

Trauma rewires the nervous system for survival. During birth, this can manifest in several ways:

Hypervigilance or difficulty feeling safe in the birth environment
Fight, flight, freeze, or fawn responses—especially in response to perceived threats like loss of control, unexpected touch, or power imbalances
Disassociation or numbness during labor or interventions
Panic or shutdown when providers override consent or rush decision-making

Unfortunately, many medical environments unintentionally mimic the powerlessness of previous trauma. For someone with a trauma history, being told “Just relax, you’re fine” while bright lights flood the room or multiple strangers enter without warning can recreate the conditions of earlier harm—even if no one means to.

Overlooked and Misunderstood: The Cost of High Masking

Some of the most marginalized birthing people are those who appear to be coping “normally” while experiencing immense internal distress.

Clients who are high masking (consciously or unconsciously hiding their neurodivergent traits or trauma symptoms) are often:

Dismissed when they advocate for their needs
Misunderstood when they withdraw or go quiet
Overridden when they set sensory or bodily boundaries

These clients may seem “compliant” but are often in freeze or fawn states—neurological responses to overwhelm. Providers who mistake this for consent or cooperation can unintentionally violate boundaries, retraumatizing the birthing person.

Common Hospital Triggers for Neurodivergent and Trauma-Affected Clients

Unconsented touch (especially cervical checks or fundal pressure)
Bright overhead lights or sudden lighting changes
Strong smells (disinfectants, perfumes, latex)
Multiple unfamiliar staff entering the room without warning
Urgent or directive language (“You need to push now,” “You can’t do that”)
Monitoring equipment or alarms with loud, high-pitched noises
Cold, clinical tone when explaining interventions or outcomes
Lack of time to process decisions, especially under pressure
Disbelief or dismissal of pain, fear, or physical sensitivity

How to Create a Trauma-Informed, Neurodivergent-Affirming Birth Space

For Providers and Birth Professionals:

Ask about sensory and communication preferences early.

Offer intake questions like: “Are there any sounds, lights, or types of touch you find overwhelming?” or “How do you best process information under stress?”
Always ask before touching—every time.

Even familiar touch (e.g. guiding someone’s hand) can feel startling to a nervous system on high alert.
Use plain, slow, and compassionate language.

Avoid fast explanations or medical jargon. Pause after you speak. Ask, “Would you like me to repeat that or explain it differently?”
Dim lights and reduce background noise when possible.

Sensory calming can regulate the nervous system and reduce pain perception.
Limit the number of people in the room.

Explain who each person is and why they’re present. Allow the birthing person to decline extra observers or students.
Honor autonomy and informed consent—especially for internal exams, medications, or interventions.

Trauma survivors may feel violated even by clinically necessary procedures if they aren’t clearly explained and consensual.
Trust the doula or advocate.

If someone speaks up about the client’s specific needs, take them seriously. Assume there is more going on beneath the surface.

For Birthing People Navigating This Journey

You are not “too much.” You are not overreacting. You are sensitive in all the right ways, and your needs deserve to be honored.

Here are some ways to prepare:

Create a sensory birth plan: include preferences for lighting, sound, touch, language, communication, clothing, and temperature.
Bring comfort tools: weighted blanket, noise-canceling headphones, essential oils (if helpful), eye mask, fidget object, grounding stone, etc.
Choose your team carefully: if possible, find trauma-informed providers or midwives open to collaboration. Having a doula who understands your nervous system is essential.
Practice self-advocacy with scripting: e.g., “Please speak slowly. I need time to process.” or “I’m sensitive to light. Can we turn that off?”
Use written communication: if speaking is hard during labor, bring a notepad or have someone advocate on your behalf.
Plan for flexibility: if your birth plan needs to shift, have a coping strategy in place that doesn’t depend on control, but on safety and agency.

Final Thoughts

Birth is an inherently vulnerable experience. But for people who are neurodivergent, trauma survivors, or highly sensitive, that vulnerability can be magnified in ways that others cannot see—and medical systems often do not accommodate.

You are not alone in your experience. There is nothing wrong with your body or brain. You are worthy of gentleness, agency, and safety at every stage of this journey.

And to providers: birth is not just a physiological event—it is a deeply neurological and relational one. We cannot offer whole-person care until we account for the whole nervous system. Birth is not a one-size-fits-all process. The more we tailor our support to each person’s unique wiring and history, the more healing—and less harm—we can create.

Resources for Further Learning

Gaskin, I.M. Birth Matters
Ogden, P. Trauma and the Body
Rothschild, B. The Body Remembers
Dana, D. The Polyvagal Theory in Therapy
“Autistic and Pregnant” — Blog by neurodivergent birth educator Meg Proctor
Trauma-Informed Birth Worker Trainings (e.g. Birthing Advocacy Doula Trainings, Cornerstone Trainings)

References

Leight, K. L., et al. (2010). Antenatal depression and maternal anxiety: Effects on pregnancy and neonatal outcome. Best Practice & Research Clinical Obstetrics & Gynaecology, 24(3), 349–362.
→ Discusses how trauma and anxiety affect pregnancy outcomes via the nervous system.
Seng, J. S., Low, L. K., Sperlich, M., Ronis, D. L., & Liberzon, I. (2009). Post-traumatic stress disorder, child abuse history, birthweight and gestational age: A prospective cohort study. BJOG: An International Journal of Obstetrics & Gynaecology, 118(11), 1329–1339.
→ Connects PTSD history with altered birth outcomes, including preterm birth and low birthweight.
Simkin, P., & Bolding, A. (2004). Update on nonpharmacologic approaches to relieve labor pain and prevent suffering. Journal of Midwifery & Women’s Health, 49(6), 489–504.
→ Emphasizes the importance of agency, environment, and trauma-informed touch in labor.
Kitzinger, S. (2006). Birth trauma: Talking with women about the past. Birth, 33(4), 274–279.
→ Details how unacknowledged trauma can resurface during labor and the importance of compassionate care.
Schulz, A., & Gold, S. N. (2006). The long-term impact of child abuse on adult mental health. Journal of Interpersonal Violence, 21(3), 315–337.
→ Provides foundational data on how early trauma shapes adult stress responses.
Brown, C., & Dunn, W. (2002). Adolescent/adult sensory profile: User’s manual. Pearson Assessments.
→ A key resource on sensory processing differences in adolescents and adults, including during high-stress events.
Raymaker, D. M., et al. (2017). “I can’t do this, it’s too much”: Sensory and emotional overload in autistic adults. Autism in Adulthood, 1(1), 10–20.
→ Offers insights into how autistic adults process overstimulating environments, relevant to hospital birth settings.
Treweeke, H., et al. (2022). Birthing with autism: A systematic review of autistic people’s experiences of pregnancy, birth, and postnatal care. Midwifery, 109, 103306.
→ Highlights gaps in care and recommendations for neurodivergent-affirming maternity support.
Dana, D. (2018). The Polyvagal Theory in Therapy: Engaging the Rhythm of Regulation. Norton & Company.
→ Discusses the physiological responses to safety, trauma, and care through the lens of the autonomic nervous system.
Uvnäs-Moberg, K., Handlin, L., & Petersson, M. (2015). Self-soothing behaviors with particular reference to oxytocin release induced by non-noxious sensory stimulation. Frontiers in Psychology, 5, 1529.
→ Explains how sensory input can trigger nervous system regulation or dysregulation, depending on context and past trauma.

Eloise Howell