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This is the first in a series of articles on operative birth and psychological issues. This paper looks at negative childbirth experiences and how they can result in the development of trauma symptoms and post-traumatic stress disorder (PTSD). Psychological trauma symptoms following childbirth are debilitating, and may affect a woman's ability to care for her baby. This study aimed to examine the relationship between type of birth and symptoms of psychological trauma at 4–6 weeks postpartum. 400 Australian women in the last trimester of pregnancy were recruited from three public antenatal clinics. Participants were interviewed about the birth within 72 hours postpartum and telephone interviews conducted at 4–6 weeks postpartum to assess symptoms of psychological trauma. Results showed that women who had an emergency caesarean delivery or operative vaginal delivery were more likely to meet the diagnostic criteria for PTSD than women who had an elective caesarean section or spontaneous vaginal birth.