Editor’s Note:
The following article contains discussion of birth trauma, neonatal death, grief, PTSD, sensory overwhelm, and trauma-related neurological changes. Reader discretion and self-care are encouraged.
Written by Nicole Longmire, MPH, MAEd, IBCLC, PMH-C
Owner, Mother Nurture Consulting LLC
Complicated grief and trauma as acquired neurodivergence: a conversation about birth trauma and neonatal death.
In November 2021 I gave birth completely alone in a foreign country. And 5 weeks later, I took my newborn off life support after 36 days of intensive care. I knew that what I had survived was traumatic. I knew that I had a long road ahead of me if I were ever going to heal. However, when a year later, I couldn’t go into a grocery store without having a panic attack, I thought it was a sign of pathology. When 3 years in, I couldn't fall asleep without a TV show I had watched hundreds of times in the background, I was confused why I was “not better yet.” Even today, when crowded rooms start feeling unbearable, or when I struggle to process the email in front of me, I catch myself brushing it off as just being tired from parenting my living children.
But slowly, I have begun to wonder: what if surviving profound trauma can actually reshape perception, sensory processing, emotional regulation, and social interaction? We often talk about the brain as though it exists separately from experience, but childbirth trauma, isolation, medical vulnerability, cultural displacement, and the death of a newborn are not abstract events. They are neurological events and they happened to me; to my body and to my brain. What if it was my trauma that was rearranging time, altering my nervous system, my relationships, my sense of safety, even the way I was processing sound, touch, conversation, and overwhelm?
The term “neurodiversity” was coined by Judy Singer in the late 1990s to describe natural neurological variation, specifically autism spectrum (Singer, 1998). At that time, the early neurodiversity discourse focused mainly on innate neurodevelopmental differences like autism, ADHD, dyslexia, and Tourette’s. But over time, some advocates and clinicians have expanded the idea to include trauma-related and acquired neurological changes (“acquired neurodivergence”) because we know trauma and injury can (sometimes permanently) alter functioning. This makes sense; afterall, when a human nervous system survives something it was never meant to survive alone, it adapts. These adaptations don’t happen because our brains are broken, but because adaptation is required for survival.
Although “acquired neurodivergence” is not formally recognized by the DSM, what the DSM does acknowledge is that trauma can profoundly alter cognition, sensory processing, emotional regulation, memory, attention, dissociation, social functioning, and nervous system activation (American Psychiatric Association, 2022). PTSD, especially complex or chronic trauma, can involve hypervigilance, sensory sensitivity, executive dysfunction, emotional overwhelm, shutdown/freeze responses, dissociation, social exhaustion, and altered threat perception (American Psychiatric Association, 2022). And while the concept of acquired neurodiversity sits somewhat outside the traditional medical framework, it is an emerging and potentially useful conceptual one.
So how could birth trauma and neonatal death lead to the development of acquired neurodiversity? A birth may be considered traumatic when someone experiences intense fear, helplessness, loss of control, violation, abandonment, or threat to their own life or their baby’s life (Fugate,et al 2025). This can occur even when the birth appears “routine” from a medical perspective. In addition, the hospital environment is often characterized by bright lights, constant noise, and unwanted physical touch which can trigger intense sensory overload. In situations like mine, where there is also cultural displacement and a language barrier, and at the height of the COVID era restrictions in birth centers and hospitals, women risk being belittled, ignored, or uninformed which can lead to feelings of abandonment and fear. This can push a previously regulated nervous system into a state of chronic hyper-arousal, leading to later acquired sensory processing issues, rigid thinking patterns, and executive dysfunction commonly seen in neurodivergent individuals. Combined with the drastic drop in estrogen following childbirth, which significantly impacts executive functioning even under “normal” circumstances, it seems logical that a traumatic birth experience could unmask neurodivergence, making postpartum mental recovery incredibly difficult. When then topped with medically complex infant death, severe depressive episodes, and prolonged stress can cause neurological symptoms like time blindness, sensory sensitivities, emotional dysregulation, and brain fog (Bhatt, et al 2020); thus acting as a “driver” for acquired neurodivergence.
Additionally, for individuals who were already neurodivergent, overwhelming trauma can severely deplete their coping mechanisms, making their baseline ADHD or Autism traits (like impulsivity or sensory overload) much more intense.
But does it matter what we call it? Yes. For one, it might shift our understanding of things like “prolonged grief disorder”, a controversial diagnosis that emerged within the last few years. Maybe what is actually happening is more akin to this acquired neurodivergence. It is well known and accepted that a neurodivergent brain processes loss and trauma uniquely. Many individuals may appear unaffected or stoic on the outside due to emotional processing delays or "shunting" (e.g., laughing or using morbid humor to regulate intense panic). Executive functions may temporarily collapse, and routine tasks can become completely overwhelming. Individuals may experience severe physical symptoms like tics, extreme fatigue, or intense physical reactions to sensory triggers that they associate with the loss. It may also explain what is happening long after the traditional grief symptoms wane but …something persists.
And secondly, this distinction also reveals an important gap between being trauma-aware and disability-aware. Trauma-aware care asks: What happened to this person, and how might their nervous system be protecting them? It focuses on understanding survival responses and avoiding re-traumatization. Disability-aware care asks a different question: What barriers are preventing this person from functioning or participating fully? (Reeves, 2015). Disability-aware care recognizes that some neurological changes may not be temporary, and that support may require accommodation, not simply recovery. This matters deeply in conversations about birth trauma and neonatal loss, because many grieving parents are treated as though they are merely “not healed yet,” rather than people whose nervous systems may have been fundamentally altered by profound trauma.
What I am describing here is not an argument for a new formal diagnosis, nor an attempt to further pathologize grief but rather an invitation to widen the conversation around what profound trauma does to the human nervous system, especially in mothers navigating birth trauma and neonatal loss. For myself, acquired neurodivergence has offered language for experiences that I was struggling to explain: why the world suddenly felt too loud, too fast, too demanding; why ordinary tasks became neurologically exhausting; why safety, focus, memory, and sensory processing no longer function the way they once did inside my body. If trauma can reshape the brain in enduring ways, then healing may not always mean “returning” to who we were before. And perhaps we should begin asking what it means to support nervous systems that adapted exactly as they were designed to in the face of unbearable trauma so that we can move beyond treating trauma as something temporary to “recover from,” and move toward an understanding that that some differences may be enduring and require ongoing accommodation rather than normalization.
American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders (5th ed., text rev.; DSM-5-TR). American Psychiatric Association Publishing. https://doi.org/10.1176/appi.books.9780890425787
Bhatt, S., Hillmer, A. T., Girgenti, M. J., Holmes, S. E., Yuan, Y., Pietrzak, R. H., … Krystal, J. H. (2020). PTSD is associated with neuroimmune suppression: Evidence from PET imaging and postmortem transcriptomic studies. Nature Communications, 11(1), 2360. https://doi.org/10.1038/s41467-020-15930-5
Fugate, S., Conklin, A., & Maines, J. (2025). Birth trauma. In StatPearls. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK539831/
Reeves, E. (2015). A synthesis of the literature on trauma-informed care. Issues in Mental Health Nursing, 36(9), 698–709. https://doi.org/10.3109/01612840.2015.1025319
Singer, J. (1998). Odd people in: The birth of community amongst people on the “autistic spectrum”: A personal exploration of a new social movement based on neurological diversity (Honours thesis, University of Technology Sydney). University of Technology Sydney.
Nicole Longmire is an IBCLC, postpartum doula, childbirth educator, certified life coach, public speaker, advocate and community organiser. Her work brings together public health, education, lactation, postpartum support and lived experience to support families through pregnancy, birth, loss, identity and healing.
Mother Nurture Consulting LLC supports families through pregnancy, birth, postpartum, lactation, loss, identity and healing through trauma-informed, emotionally attuned and community-centred care.
Website: mothernurtureconsulting.com
Location: Melbourne, Florida, USA