For the many women who have experienced sexual abuse in their past (whether as an adult or as a child), onset of pregnancy can bring up emotional trauma. Common pregnancy sensations and discomforts, like tension or an aching back may trigger physical and emotional reminders of past abuse. Invasive tests or exams, repeatedly undressing, even if done with a medical intent, may especially trigger past memories. A woman may find herself unexpectedly experiencing flashbacks, tension, feelings of helplessness and being out of control. Pregnancy on its own can cause a feeling of helplessness or being overpowered, as if the baby growing within has taken control of the mother’s body. Often, a woman may experience unconscious body memories and subsequent emotions of anger, fear, tension, and stress.
It would seem a simple solution would be to try to “relax”. Most prepared childbirth classes, in fact, teach relaxation exercises in an effort to ease the pain. For women affected by sexual abuse, however, these techniques can backfire. Hearing the words, “relax and it won’t hurt” or “give in, surrender” to the sensation could have the opposite effect meant by the words. Perhaps the woman has built up a wall in an effort to regain control of her body and to guard against further abuse. Perhaps a woman feels her body is scarred, abused, broken, and therefore cannot be trusted with the task of giving birth. At some point during childbirth, pain that is reminiscent of sexual abuse (perineal pain, vaginal pain, heaviness, etc.) might make relaxation nearly impossible.
What can be done ?
01. Realize that it’s okay to feel the tension and stress. Allow yourself to realize your feelings are normal and to be expected. Rather than heaping more stress or guilt on top of trauma, take the time to acknowledge your past history and the emotions that come with it.
02. Once you have identified the source of your fear, stress, tension, anxiety — focus on those emotions. Recognize how they are affecting your pregnancy or labor. Realize that your pregnancy and labor are different than the abuse. Remind yourself that you and your body are the ones in control of this situation. Find a counselor or therapist specially trained in healing from past abuse and who is well-versed in childbirth. Read books designed for survivors of abuse and learn techniques to cope with flashbacks and physical tension.
03. Take a prepared childbirth class… know what is going on with your body during pregnancy, labor, and birth. Understand the processes you will go through in order to birth your baby. Knowledge truly is power and in this case power will make you feel more in control and less helpless.
04. Talk to your provider…or not. If you are comfortable bringing up the sexual abuse history with your midwife or ob/gyn, by all means do so. They may have professional advice or resources to share with you. If you do not feel like sharing this information with your provider, however, ask yourself why you don’t. Could you find a provider who may be more sympathetic, or do you prefer keeping your history separate from your prenatal care? Analyze what may be holding you back from disclosing this information. Does your provider never have time to discuss emotional issues? Would you feel embarrassed or ashamed having the discussion with your provider? Figure out how you truly feel and whether you want to talk to your provider for help.
05. Hire a doula, if at all possible. Doulas have received specific training in emotionally supporting women during pregnancy, labor, birth, and the postpartum period. Share your concerns and fears, if not your entire sexual abuse history. Rely on your doula for critical physical and emotional support.
06. Share your feelings with the support people in your life.. your partner, your doula, your mom or sister, or a very close friend. Saying how you feel out loud can make tension and apprehension melt away. Are there certain procedures or examinations that make you feel particularly uncomfortable? Be sure you have your support person with you for these procedures. Come up with ways to cope with things that make you feel uncomfortable.. whether it be distraction, or simply having an understanding and knowing hand to hold.
07. Communicate clearly with a birth plan. If you don’t want any vaginal exams during labor, put that in writing! If you want to have as much privacy as possible to labor in, be sure you let people know this. If certain procedures cause flashbacks or other negative emotions, ask what options are available to change or avoid the procedure. If being stuck in bed with electronic fetal monitoring bothers you, for example, ask if you can avoid continuous electronic fetal monitoring or have a nurse come in to listen to baby’s heart rate with a fetoscope.
Awareness is one of the biggest tools to combat negative effects from sexual abuse. Be aware that you have options during your pregnancy, labor, and birth… options to educate yourself, receive support, and choose the best path for you and your baby.