Birthing In The Wake Of Sexual Trauma

Birthing In The Wake Of Sexual Trauma

Given that one in three females have reportedly experienced sexual trauma and that trauma is present on a continuum, we can assume that this topic applies to vast numbers of birthing women.
Trauma can be experienced as ‘a thousand cuts’ or a series of cumulative minor boundary violations rather than a ‘tsunami’ or major ruptures of boundaries. This may include previous sexual encounters where boundaries were blurred and true consent was lacking, and can also extend to prior gynaecological procedures where there was a cocktail of fear plus a lack of attunement to one’s emotional state.

 

Also given that birth and sexuality involve the same anatomical parts, there is significant potential for implicit (somatic and emotional) memories to be triggered in birth when sexual trauma has not been addressed to any large extent. Triggers are entirely personal and often unpredictable as the person will have learnt to avoid situations that precipitate frightening flashbacks or moments of feeling as though they were re-living past events. They may arise through their senses of touch, hearing, sight, smell or taste, particular words or phrases spoken by others, any situations where fear abounds (and birth, in general, can often present these), power-over situations where they feel trapped and are not offered choice, and situations where their emotional needs are overlooked.

As a trauma therapist with a special focus on both birth and sexual traumas, I have found that supporting a woman to prepare for birth in the wake of prior sexual trauma takes special consideration from a variety of different angles. Ideally, seeking professional support for sexual trauma would not be left until pregnancy but attended to well before. Feelings of safety and receiving attuned care during pregnancy, birth and post-natally will be essential to avoiding further trauma.

 

Tips for anyone preparing for birth with a history of sexual trauma include:

  • As far as possible aim for continuity of care e.g. with a doula, midwife or obstetrician who has specific experience in attuning to these special needs and providing compassionate care. Your birth team may or may not include a partner, friend or family member, depending on who you feel might best support you.
  • Your sense of feeling safe is the best guide to making decisions about your baby’s birth. This may sometimes mean opting for an elective Caesarean even though undisturbed birth is known to be the gold standard for families.
  • If possible, engage in holistic and embodied methods of birth preparation which lead to a felt sense of confidence for birth. These may include trauma-sensitive bodywork, yoga and other embodiment practices. My signature approach, Primal Mama – embodiment for birth, also falls in this category.
  • Become very clear and specific about potential triggers in birth, and communicate these well ahead of birth to your birth team, for example being touched without explicit consent, vaginal examinations, and the use of particular language by care providers.
  • Communicate to your birth team the ways in which you might feel safe and soothed.
  • Consider at least a few sessions with a trauma therapist who specializes in this field so that you gain a better understanding of trauma, your own survival responses, your likely challenges in birth, your existing internal and external resources, boundaries & consent, and ways in which you can ask for your needs to be met in birth. I personally offer a trauma-sensitive birth rehearsal journey to help desensitize to the intensity and sensations of birth as a guided process which may include consensual touch. For anyone with a history of sexual or other trauma, this creates a space for potential triggers to declare themselves and be worked through well before birth.
  • Focus on approaches and self-care practices which specifically help with the regulation of your nervous system in pregnancy and leading up to birth e.g. Somatic Experiencing, Somatic Practice, Cranio Sacral Therapy, acupuncture, Shiatsu, holistic styles of osteopathy and chiropractic.
  • Build into your birth plan a birth debriefing session with a trauma-trained perinatal practitioner, or your doula/ midwife at the very least.

 

Tips for care providers:

  • List questions about trauma including sexual trauma on client/patient intake form.
  • Ask what helps the birthing person feel safe and soothed.
  • If they are okay with disclosure, include very specific details about how they wish to be supported in a patient care document in order to reduce the potential for re-traumatization.
  • Promote their agency wherever possible. Practice boundary-setting in small steps during pregnancy where their No responses are completely honoured.
  • When appropriate, ask about previous experiences with birth, vaginal examinations, nursing and medical procedures, and specifics of what helps. Clients may be encouraged to compile a detailed birth preferences outline (please refer to Penny Simkin’s website).  Assess whether specifically triggering obstetric procedures are essential.
  • Look out for protective survival responses during pregnancy and birth, especially Freeze or Appease which can be less apparent and more easily missed.
  • Support a return to greater regulation through your own nervous system stability and unhurried presence.
  •  Check continuously that the birthing person feels safe, seen (or attuned to) and soothed. Attempts at  soothing count.

 

While one cannot allow for all possibilities in birth, know that any bit of chipping away with measures you apply towards reducing fear and highlighting choice will open the door to a positive birthing experience for all concerned, including baby.

 

Resources:

  • When Survivors Give Birth: Understanding and Healing the Effects of Early Sexual Abuse on Childbearing Women – Penny Simkin & Phyllis Klaus

 

  • Secret Bad Girl: A Sexual Trauma Memoir & Resolution Guide – Rachael Maddox 

 

  • The Sexual Healing Journey – Wendy Maltz 

 

  • Healing Sex – Staci Haines 

 

  • Come As You Are – Emily Nagoski 

 

  • Science For Sexual Happiness – Caffe Jesse

 

  • Come As You Are Workbook – Emily Nagoski 

 

 

Nisha Gill works at the intersection of trauma, birth and female sexual embodiment, weaving her understanding and experience from Somatic Experiencing (trauma resolution), counselling, birth education, doula birth support, embodiment coaching and bodywork to facilitate safety and connection.

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