Purpose <p>Women with a history of sexual trauma (ST) have heightened risk for postpartum psychopathology. Although ST increases risk for traumatic delivery and maternal psychopathology, knowledge of the functional connections among various psychiatric symptoms and complicated delivery remains limited.</p> Methods <p>We used regularized partial correlation networks to examine connections between symptoms of childbirth-related PTSD (CB-PTSD), depression, anxiety, somatization, obsessive-compulsive disorder, and complicated delivery (e.g., presence of obstetric complications, preterm birth, advanced maternal age) in 1,916 postpartum women. We compared networks of women with and without a history of sexual trauma (<i>n</i>_<i>ST</i> <i>=</i> 958 and <i>n</i>_<i>NST</i> <i>=</i> 958, respectively).</p> Results <p>Complicated delivery in both groups connected with three CB-PTSD clusters: reexperiencing, avoidance, and negative alterations in cognition and mood. Network comparison tests revealed a significant difference in global strength invariance, but not network invariance. ST network CB-PTSD nodes were significantly more strongly interconnected as compared to those with no ST (NST). Conversely, stronger connections in the NST network were Mood with Anxiety and Avoidance with Somatic symptoms.</p> Conclusion <p>The ST group’s stronger PTSD symptom coactivation may reflect differences in risk for the emergence of CB-PTSD for women with a history of ST.</p>