We are now more educated on how abuse on children, adolescents and adults affects adulthood. Sexual abuse victims can have difficulties during birth. According to Bottoms and Epstein in an article entitled Child Sexual Abuse (see the article here) "The effects of sexual abuse extend far beyond childhood. Sexual abuse robs children of their childhood and creates a loss of trust, feelings of guilt and self-abusive behavior. It can lead to antisocial behavior, depression, identity confusion, loss of self-esteem and other serious emotional problems. It can also lead to difficulty with intimate relationships [such as with partners and children] later in life."
One in four women is estimated to have been sexually assaulted at least once in her life. This statistic is derived from two large-scale national studies that show the incidence of childhood sexual abuse to be 27 percent, with a further 17.6 percent of women reporting adult rape (attempted or completed), half of whom were also survivors of childhood sexual abuse. See this study here.
This is quite sobering especially if you are hearing this while sitting in a room with a group of women. The effects of sexual or child abuse on women during labor and delivery has often been overlooked. However we’re starting to learn how important these effects are. Unfortunately, because abuse isn’t often discussed during prenatal visits or during childbirth education (or the woman does not feel safe to discuss it or has repressed it so deep) the doctor, midwife, nurses, and labor companions assume any emotions or problems that come up during delivery are because “she couldn’t handle childbirth” and many mothers’ specific needs and concerns are not addressed.
If you have given birth to a child you can attest to the fact that it is one of the most vulnerable times you will ever experience in your life. The double-sided coin is that to possess complete control during the process a woman must give up complete control. She must trust and work with her body, baby and the process. The end result is the same for all women as it has been since the beginning of time--a baby will be born. However, the difference in how that mother receives that baby can range depending on the circumstances. If not handled correctly instead of feeling empowered and confident as a woman, new mothers who are also sexual abuse victims are often left having to relive traumatic experiences and feel victimized all over again.
With the above stats it is more likely than not that doulas will come across more and more clients who have experienced some sort of sexual abuse trauma. As a doula, I am fully aware of my scope of practice; I am not a therapist or counselor, but it doesn’t release me from the responsibility of being aware of how a mother is reacting to pregnancy, labor, delivery, postpartum and motherhood. During prenatal visits I have to try to build a relationship with all my clients by educating them as well as spending time learning about their experiences and expectations. Sometimes the subject may come up during our visits; other times intuition and previous experiences are my guide. During labor and delivery I am to adapt my response to these mothers so that I may not cause further harm. I need to be mindful of words used that can encourage your average mom but can make a survivor mom completely withdraw or become defensive. A touch that can sooth and comfort most women may send a survivor mom into a cocoon or worse have her completely shut down potentially prolonging her labor.
All of the literature, education, training for professionals and counseling for survivors continues to bring healing to women and mothers. Over time I will learn more so that I may better assist and be a better comfort and support to survivors of abuse.
For more information about supporting an abuse victim please see Penny Simkin’s Book When Survivors Give Birth: Understanding and Healing the Effects of Early Sexual Abuse on Childbbearing Women. Scroll down to purchase this book.
Natalia Hals is a mother, wife, daughter and best friend who is passionate about women having a safe and memorable birth experience that they desire. As long as she can remember she's been at awe of what we are able to do as woman and hope to help other women tap into their inner strength. Click here to learn more about Natalia and her doula/childbirth education services!