The processes occurring during traumatic childbirth experiences, factors mediating development of PTSD symptoms and the impact on post-partum adaptation were explored in a cohort of 20 women 10 months post childbirth. Pain, past experiences and beliefs that their baby would be harmed led to feeling out of control which was maintained by failed attempts to elicit practical and emotional support from staff and partners. Following childbirth, coping strategies relating to successfully accessing more than one source of social support, positive reinterpretation of traumatic events and making time for own interests were associated with reduced distress. Avoidance of thinking about events and a belief that one should not admit to not coping maintained distress. Consequences of continued distress related to an impact on self, relationships with others and fear of future childbirth. The Revised Impact of Event Scale (Horowitz et al., 1979) was used as a measure of PTSD symptoms. Six women reported scores above the cut-off point indicating clinically significant scores and two women had borderline scores. The present findings therefore support the evidence from the PTSD and childbirth literature that some women do report clinically significant levels of PTSD symptoms following childbirth.