How Can Sexual Abuse Affect Pregnancy and Birth?

This guest blog post is written by the sexual assault crisis centre, SARSAS.

In the media, pregnancy is presented as a time when women and parents-to-be are at their best. Often pregnant people in advertising are glowing and serene – dreamily content with the process of creating new life. Portrayals of pregnancy have become somewhat more realistic in recent years but there is still a long way to go to ensure that everyone’s experiences are represented.

If you’ve ever been pregnant or are close to somebody who has been, you’ll know that it’s not quite the idealised vision we’re often presented with. Pregnancy and birth can be beautiful and transformative but  can also involve many challenges.

Pregnancy can be hard for a whole host of reasons. Your hormones are in flux, your body is changing, you might be experiencing pain, fatigue, or sickness, you could be worried about what lies ahead, and you’re in a position where you might be receiving reactions from friends, family and even strangers who take an interest in you and your bump. Childbirth  can also be a traumatic experience for many.

If you’ve experienced trauma, including sexual abuse, the experiences you may have while pregnant or during birth also have the potential to be triggering* in other ways. Read on to find out more.

Impacts of sexual abuse on pregnancy

Changes in the body

During pregnancy the shape, feel, and sensations of your body change. Something happening to your body that feels out of your control may mean that trauma responses such as anxiety, nightmares, or flashbacks  can intensify or increase.

It might help to explore ways to feel more connected to the changes that are happening in your body; for example, going to pregnancy yoga or using a pregnancy app to keep informed about the changes.

Unsolicited attention 

It can sometimes feel like pregnant women are viewed as public property; strangers asking when you are due and touching your bump; friends and family members asking intimate questions and hoping to feel the baby kick. These might cross your boundaries, and it’s okay to set (or reset) these boundaries as needed.

To help avoid and handle situations like this, it might be useful to have conversations with friends and family to set clear boundaries about what you’re verbally and physically willing to share with them during your pregnancy. You may also want to think about phrases that feel comfortable to use with strangers for when you don’t want this unsolicited attention. Examples could be:

  • Thanks so much for asking, but we aren’t sharing that information beyond close family at this stage.
  • Please could you give me some personal space?
  • I feel uncomfortable, please could we create some space between us?
  • Thank you for showing your interest, but I’m not comfortable with that.

Prenatal appointments

Prenatal appointments can be intimate and might even feel intrusive at times. They may involve lying down and being touched, which may bring on strong memories or flashbacks of the things you have been through, or evoke physical and psychological responses, like a panic attack, dissociation, or freezing.

If you’re worried about this happening and how you might cope, or what your midwife might think, it can help to let your nurse know before the test. For example, you can tell them “I might cry” or “I might not be able to answer your questions”. You do not have to explain why you might react this way. It’s also important to remember you can ask  to take a break at any point or request a chaperone.

You may want to bring someone you trust with you for support and, if you feel comfortable to do so, it can help to explain to your midwife that you have experienced sexual trauma in the past.

There are things they can do to make apportionments easier for you such as:

  • Checking in with you regularly
  • Talking to you about what they are doing
  • Booking a longer appointment

Impacts of sexual abuse on birth

Loss of control

There are lots of unknown variables during birth. You might be questioning whether the baby will be early or late, or breech, or where you will have the baby. You will have some choices in the lead up to the birth, but it’s quite common that there are things which we can’t control or  that might change at the last minute.

This loss of control of your body might feel challenging. Working with a specialist or, if you have a birthing partner, making sure you have talked to them about things that are a priority for you may help you to feel more in control of things. It can also help to talk through your birth priorities with your midwife ahead of the birth and to look at the options of where you can give birth.

Labour

Sexual abuse and childbirth often involve the same areas of the body and both can involve pain and involuntary bodily reactions; you may experience flashbacks or other symptoms of post-traumatic stress during the birth.

There may be certain words or phrases or body positions that you find triggering or upsetting during the birth.

It can help to make medical practitioners aware of phrases or body positions that you would like to avoid ahead of time.  If you don’t feel able to talk to the doctors directly you can make notes in your ‘yellow book’ that has your pregnancy information in it.

Preparation

Every pregnancy and birth is different – it’s hard to know how you’ll respond. You may experience the issues described above. But you may also find the process of pregnancy and birth healing. There are things you can do to prepare for the experience:

  • Speak to a specialist (midwife, doctor, doula, counsellor) to talk about things you might find triggering
  • Work on your calming tools e.g. breathing techniques, visualisation
  • Find positive birth stories

Having worries about pregnancy and birth is really normal, but with preparation it can be a positive experience.

Support details

If you’re pregnant and would like support, here are some options that may be available to you:

References

  • When a Survivor Gives Birth, Penny Simkin & Phyllis Klaus
  • The Body Keeps the Score, Bessel van der Kolk

* A trigger is anything that generates a memory of a flashback to a traumatic event. Different things can trigger different people. A trigger can be a sound or smell, a word, an object, a place, or anything that takes you back to a traumatic experience.

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