CITY UNIVERSITY LONDON 
Birth Trauma Scale 

This questionnaire asks about your experience during the birth of your most recent 
baby. It asks about potential traumatic events during (or immediately after) the 
labour and birth, and whether you are experiencing symptoms that are reported by 
some women after birth. Please tick the responses closest to your experience. 

What date was your baby born?_______________________________________ 

During the labour, birth and immediately afterwards: 
Did you believe you or your baby would be seriously injured? Yes No 
Did you believe you or your baby would die? Yes No 

The next questions ask about symptoms you might have experienced. Please 
indicate how often you have experienced the following symptoms in the last week: 

Symptoms about the birth* NOT AT 
ALL 
ONCE 2 -4 
TIMES 
5 OR MORE 
TIMES 
Recurrent unwanted memories of the birth (or parts of 
the birth) that you can’t control 
Bad dreams or nightmares about the birth (or related to 
the birth) 
Flashbacks to the birth and/or reliving the experience 
Getting upset when reminded of the birth 
Feeling tense or anxious when reminded of the birth 
Trying to avoid thinking about the birth 
Trying to avoid things that remind me of the birth (e.g. 
people, places, TV programs) 
Not able to remember details of the birth 
Blaming myself or others for what happened during the 
birth 
Feeling strong negative emotions about the birth (e.g. 
fear, anger, shame) 

* Although these questions refer to the birth, many women have symptoms about events that 
happened just before or after birth. If this is the case for you, and the events were related to 
pregnancy, birth or the baby then please answer for these events. 
© City Birth Trauma Scale Version 2.0 2018 Page 1 


Symptoms that began or got worse since the 
birth 
ymptoms that began or got worse since the 
birth 
NOT AT 
ALL 
ONCE 2 -4 
TIMES 
5 OR MORE 
TIMES 
Feeling negative about myself or thinking something 
awful will happen 
Lost interest in activities that were important to me 
Feeling detached from other people 
Not able to feel positive emotions (e.g. happy, excited) 
Feeling irritable or aggressive 
Feeling self-destructive or acting recklessly 
Feeling tense and on edge 
Feeling jumpy or easily startled 
Problems concentrating 
Not sleeping well because of things that are not due to 
the baby’s sleep pattern 
Feeling detached or as if you are in a dream 
Feeling things are distorted or not real 

If you have any of these symptoms: 


When did these symptoms start? 
Before the birth 
In the first 6 months after birth 
More than 6 months after birth 
Not applicable (I have no symptoms) 

How long have these symptoms lasted? 
Less than 1 month 
1 to 3 months 
3 months or more 
Not applicable (I have no symptoms) 

Do these symptoms cause you a lot of distress? Yes No Sometimes 
Do they prevent you doing things you usually do (e.g. socialising, 
daily activities)? 
Yes No Sometimes 
Could any of these symptoms be due to medication, alcohol, drugs, 
or physical illness? 
Yes No Maybe 

Thank you for completing this questionnaire 


© City Birth Trauma Scale Version 2.0 2018 Page 2