Really hard! It silences survivors… very easily! It can affect generations.  Many women (and men) live alone in their trauma. It can cause damage to the absolute core of a person… especially if done by someone who is suppose to love them, like a family member or a friend. Sexual abuse can cause physical damage, emotional damage and mental damage. And it can take a lifetime to heal from. Many never heal completely.

For women who are about to give birth it can be a subject that becomes intense. Sexual abuse can leave a woman doubting her body’s ability to function correctly… and her mind’s ability to make a good decision. Growing a baby, giving birth, should be a miraculous and sacred experience. Woman creating the world and giving life is AWESOME! Many, who have experienced birth, know the awe that surrounds it, and for many survivors giving birth is a tremendously healing experience. But a woman with sexual abuse during her childhood or young adult years can have an altered outlook on birth. It can change birth into pain and trauma, especially if the birthing woman doesn’t have appropriate support or a compassionate care provider. The support or provider may not even be aware, but they need to be, so women should be supported in finding their voice.

Sexual abuse can leave women feeling anxious or out of control. Survivors may feel like they don’t own their own body. They may feel like they are not the decision maker for their own body. They can be left feeling used, or broken. Birth and interactions with a care provider have the possibility of triggering a survivor. Pain and vaginal discomfort can be triggering. So, though it is important for all women to be treated respectfully and gently, finding someone who understands survivors may need more privacy, a more conscientious, gentle touch and respectful words is even more important for survivors of abuse. It may be necessary to find a care provider who limits vaginal exams, and ALWAYS asks for permission before touching.

Sometimes giving birth in a certain position can trigger a memory… or trigger emotions that remind women of their trauma. Having a care provider who is open to pushing in a position that feels MOST comfortable and empowering to YOU is important.

Certain phrases can trigger memories and emotions too. “Just relax” OR “spread your legs” are a couple of examples. It can help to have discussions beforehand and agreed upon words and phrases.

This can all seem very overwhelming and add to the stress and anxiety a woman experiences. Thankfully there are some things that can be done to relieve that stress, and also to help ensure a more supportive and desirable birthing environment.

Breaking the silence – reaching out for support is crucial to healing from sexual abuse. Therapy, group therapy, art therapy, music therapy, dance therapy, or even just a good friend or doula… there are so many options. Find what feels right to you. There are people out there who are waiting to help, who understand and want to be there.

Find a care provider who listens and takes the time to hear all the fears and hopes. A care provider who understands the effects sexual abuse can have on a person and on a birth. If you do not feel supported then you should say so. The provider may not realize your preferences or needs. Also if you aren’t comfortable providers can be switched right up to the very last minute.

Decide carefully on where to give birth. Give birth where it feels most safe to you. Interview a homebirth midwife. Tour the hospital AND the birthing centers near you. Women deserve to know ALL the options before making decisions. Some women need the familiarity and comfort of their own home – and that’s ok! Others need a hospital or birthing center – and again, that is ok!

Watching videos and reading birth stories that bring joy and inspiration is helpful. Try to allow the feelings to come – ignoring them can cause more harm.

PPD is more common in moms who have trauma in their past – So, getting extra help during the first few months, or even just the first few weeks, after birth can make a difference. Doulas are a great resource and many are deeply trained in the subject of sexual abuse and how it relates to birth. However, they are not therapists and often victims of sexual abuse need a professional. Doula’s can refer you to one in your area. Take the time to heal, rest and be with your baby. Mothers deserve this time of letting someone mother them.

Doulas: When you are working with a client with sexual abuse in their past, here are a few things to remember:

-Because it can be hard to talk about, it’s important to include a question or two on your intake form, so she has the opportunity to communicate.

-Educate yourself on triggers, flashbacks and the concept of dissociation. Your client may not be aware of the effects birth can have on sexual abuse victims.

-If you need to leave her – make sure she is with someone she trusts.

-Understand her need for privacy. Help her stay covered up.

-Know that touching can trigger her. Ask her permission before touching and if needed, remind the medical personnel to do the same.

-Never say “just relax” or “spread your legs”

-Hopefully the mother will be comfortable talking with her care provider about her past. But we all know, if she’s birthing at a hospital, she probably won’t see her care provider much at all during her labor and possibly very little of the pushing phase too. She may not want to tell every medical person who walks into her room about her trauma. As the doula, you need to respect her privacy and at the same time, advocate for what she needs.

-She may prefer that no one other than her care provider perform any vaginal exams. But in the case of an emergency or unexpected circumstances, you and her partner need to be prepared to support with minimizing people in the room, keeping eye contact, using words of encouragement and gentle touch, if wanted.

-Remind her of her strength and power. If you see her starting to drift away, get glassy eyes …make eye contact with her and ask her where she is. Some women go to a safe place and it helps them get through their labor, others go to a scary place and need help coming back. Turning on music and talking to her, reminding her that she is a birthing goddess who is about to meet her baby …bringing her back to the present.

-Don’t be surprised if she gets angry, stay close to her and don’t take it personally.

-Create a space she feels safe, empowered and in control to open and birth her baby. Suggest to mom the idea of packing a small altar full of her power objects, to have with her in her birthing space.

-The sense of smell can be very powerful during birth and can help a mother stay present. Lavender, peppermint, sage… there are many options. Have her decide on the scent before she’s in labor.

-Some mothers feel Hypno-birthing is helpful. At your first prenatal, suggest this so she has time to prepare.

Websites –

Adult Survivors of Child Abuse: www.asasupport.org

Child Help Website: www.childhelpusa.org

Trauma and Birth Stress: www.tabs.org.nz (help with the postpartum period and breastfeeding)

Hotlines – 

National Child Abuse Hotline: 1-800-422-4453

National Domestic Violence Hotline: 1-800-799-SAFE

National Hopeline Network: 1-800-SUICIDE

Parents Anonymous: 1-800-843-5437 www.parentsanonymous.org

(Resource for help to stop abusing)

Books – (I have not read all of these…only some…but they all come highly recommended)

The Hidden Feelings of Motherhood, by Kathleen Kendall-Tackett

Allies in Healing, by Laura Davis (a book for partners of survivors)

The “Am I Ready to Reconcile” workbook, by Laura Davis

The Courage to Heal: A Guide for Women Survivors of Child Sexual Abuse, E. Bass and L. Davis

The Body Remembers:  The Psychophysiology of Trauma and Trauma Treatment, by B. Rothschild

The Secret Trauma:  Incest in the Lives of Girls and Women, by D.E.H. Russell

Survivor Moms Women’s Stories of Birthing, Mothering and Healing after Sexual Abuse, By Mickey Sperlich, MA, CPM and by Julia S. S