MOTHERS "not being listened to" by medical staff during childbirth is a common theme running through cases of birth trauma, according to the charity which supports women suffering from postnatal PTSD.
The Birth Trauma Association was set up in 2004 and now has around 8000 members on it private Facebook page.
Kim Thomas, its CEO, said they receives around 10-20 emails a week from women in distress.
Thomas said: "The majority of women - probably around three quarters - tell us that they felt the way they were treated during labour was a big contributor to them developing PTSD.
"Things like not being told what was going on when there was an emergency, being treated very coldly or shouted at even.
"Sometimes they've had procedures performed without consent.
"And not being listened to as well. So sometimes women will say 'I told them there was something wrong and they were very dismissive'.
"Then the woman has been proved right and there is something wrong.
"A lot of the time it seems that bad decisions are made in childbirth and women are left to suffer in pain, or they're denied procedures they need, or given procedures they don't need. It can sometimes feel quite haphazard."
Read more: Mother's postnatal PTSD ordeal after midwife warned she would 'harm her baby'
In Scotland 32 per cent of singleton births are caesarean deliveries - and half of them are emergencies.
Forceps deliveries account for around one in 10 births and 11% of mothers have their labours induced.
As well as the 52,529 live births recorded in 2017/18, there were also 222 stillbirths - down from around 300 in 2010.
It is unclear exactly how many women develop postnatal PTSD because no official data is collected. Many cases will be missed completely or misdiagnosed as postnatal depression.
The best estimate is 4% based on a 2017 systemic review that included 28 studies of postnatal PTSD.
That is up from previous estimates of 1.5-3%.
High-profile maternity scandals such as Morecambe Bay in England, where one mother and 11 babies died unnecessarily in what was later condemned as a "seriously dysfunctional" department where midwives would pursue normal childbirth "at any cost", are extreme - but not unique - cases.
They are a reminder of the worst that can happen when egos overtake patients.
Safe staffing is also fundamental. In Scotland, nearly one in 20 midwife posts are empty and 41% of midwives are over 50, prompting warnings of a looming "retirement timebomb".
"A priority for us is proper staffing, so that midwives and obstetricians aren't rushed and have the time to look after women properly," said Thomas. "I think that's one of the big issues, understaffing."
Read more: Only two in 300 mothers in Scotland are having a home birth
Elizabeth Duff, a senior policy adviser for the National Childbirth Trust, said:
"The 2018 Scottish Maternity Survey found around one in five women reported that they were worried at being left alone during labour or birth and one in ten described their concerns as not taken seriously by staff.
"The Care Quality Commission in England carries out a similar annual survey and its latest findings reflect many of the same concerns.
"These sort of experiences, often the result of an overstretched midwifery workforce, can lead to women feeling powerless and not involved in decisions about their treatment.
"For some women, this perception will exacerbate the risks of a traumatic birth and consequent mental health problems such as PTSD."
Dr Mary Ross Davie, the Royal College of Midwives director for Scotland, said: “It’s vital that we understand as much as we can about the things that increase the risk of women experiencing their birth as traumatic and the work that organisations like the Birth Trauma Association do is vital in raising awareness and offering support.
"We are always saddened to hear of the times when women do not feel they have experienced great care from their midwife.
"We would always encourage women and families who feel that they have not received high quality care to raise their concerns with the Head of Midwifery in the maternity unit where they gave birth.
"This will ensure that the service is able to make improvements and changes when needed."
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