Historical sexual trauma: some effects on pregnancy and labour
Pregnancy and birth can be a particularly tricky time for sexual assault and abuse survivors. At a time when women are usually expected to be full of joy and anticipation, survivors can find that painful and difficult feelings related to the assaults and abuse are triggered.
This can be really hard to talk about; sexual trauma in itself is not something that we as a society are very comfortable discussing. This can be compounded when it is combined with the cultural taboo around disclosing negative feelings about motherhood. This can make it incredibly hard to acknowledge your feelings - even to yourself.
In this article, I discuss several common reactions that survivors have (although it is by no means comprehensive), and then I list a few things that might help you.
You may feel nauseous even though morning sickness has passed, numb, invaded, angry, or any other number of uncomfortable feelings.
Invasive medical examinations and procedures before, during and after the birth may cause your body to remember the trauma again. This may happen in the form of emotional and physical sensation flashbacks, or memory flashbacks. Receiving care from health professionals who may expect you to be compliant can re-evoke the dynamics of the abuse where you might have felt powerless, submissive or unequal.
Some of the changes happening in your body can leave you feeling quite out of control, both during the pregnancy, birth and after your baby is born. Being out of control may have been a feature of your abuse.
You may struggle to trust your body, to allow it to grow and birth your baby. Experiences of abuse may have left you feeling as though your body is damaged, untrustworthy, or dangerous. You may have learned to cut off to survive.
Contractions, the baby's needs coming before your own, the vulnerability of labour and birth, all of these are also common triggers. Women can also feel colonised and invaded by their growing baby.
Pregnancy and birth can bring you face to face with the physicality of your body, the sheer body-ness of you. While this can be intensely triggering if you have a conflicted relationship with your body, it does not have to be the end of it.
Knowing how you feel, you can then make plans to deal with any fears or vulnerabilities you have. This will increase your sense of autonomy and control which can only help you deal with the challenges ahead.
Some things that may help
1. You are completely normal; all of the above (and many, many more that I have not mentioned) are normal and understandable responses to sexual assault. It is truly awful that these feelings are being triggered by something as life-affirming as having a baby, but it is not your fault and you are not a bad Mum (or potential Mum) for feeling them.
2. If you can, find someone accepting and non-judgmental to talk to about your feelings. Sometimes just letting them see the light is enough to diminish their power and help separate your feelings about the assault/s from your pregnancy and upcoming birth.
When trauma is triggered, particularly sexual trauma, it is very common to feel guilt and shame about your feelings. These are usually old, left-over emotions from the original assault (not that you have anything to feel guilty and ashamed about at all), but they can be powerfully persuasive in preventing you from talking.
3. Writing a birth plan can be enormously empowering. Some women write two, one with their survivor status and how they would like to be treated if triggered, and one without. You can then share only what you feel safe sharing with each midwife.
4. If you feel safe with them, try and talk to your care provider. You can ask them not to include your survivor status in your medical notes if you would prefer to choose how much to disclose to the midwifes at your labour.
5. Consider booking a doula; a doula is a trained supporter, experienced in matters relating to birth and pregnancy (although they do not have medical training). This means that you can choose a professional helper that you like and trust. Share as much or as little with her about your abuse history as you feel comfortable doing.
(If you can't afford a qualified doula, there are also trainees who charge significantly less but will be equally passionate about birth.)
6. If you have a supportive partner or birth partner, discuss with them in advance what you are frightened of, and plan together for how they can best support you in the moment.
7. It may also be worth speaking to a professional counsellor or trauma therapist if you feel you would like more support, or would like some space to unpick your experiences in more depth.
It will not hurt your baby to talk about these things; you are already feeling them. Far better to process them and allow yourself to move through them.
One last word
I wish you all the luck on your journey, and I hope you have the support that you need.
I have no doubt that the strength to deal with whatever comes your way is right there, deep down in the bones of you.