Becoming a parent brings joys and difficulties. Women who have survived child sexual abuse may have added difficulties with pregnancy, childbirth and early parenting. While this article is mostly relevant to female survivors of child sexual abuse, male survivors may also have concerns, particularly around early parenting. Of course, every situation is different. You may find that some of the issues discussed relate to you, while others do not.
Coming to terms with being abused as a child or young person is different for every survivor. Learning to cope and recover can depend on many factors, such as how the abuse was dealt with at the time, the support of family and friends, your own personal inner resources, and other life events.
Connecting to the past
Pregnancy is a life-changing event that involves an intense focus on the body. It is common and not surprising that many survivors of child sexual abuse experience particular difficulties. You may find that during your pregnancy feelings from your past resurface. You may feel that you are not coping. These feelings are normal and it is reasonable that you may have anxieties at this time.
Many women who have experienced child sexual abuse have found pregnancy and parenting to be a turning point in their healing. Pregnancy may give you an opportunity to relate to your body in a new way.
Your body is creating a new life and is therefore powerful, creative and competent. This may be contrary to what you have learned about your body through your past experiences.
Feelings of fear and lack of control are common to many women's experiences of pregnancy and childbirth, whether or not they have experienced child sexual abuse. You may find that some situations remind you of your childhood trauma, and emphasize negative feelings about your body. You may feel particularly anxious about medical examinations and concerned to have control in these situations. Some women have felt that childbirth was a reminder of being sexually abused.
The medical procedures and events of this time may contribute to you feeling invaded and powerless and connect to feelings of humiliation and lack of control you suffered as a child. These can lead to flashbacks, nightmares, mood swings or feeling disconnected from your body.
You may or may not have conscious memories of the abuse and in some cases pregnancy and childbirth might trigger these memories. It can happen that a first pregnancy is relatively easy, while a second pregnancy may trigger memories and feelings related to the abuse.
Coping with the pain of childbirth may be difficult for you. Some women have found that thinking of the pain as positive pain (pain with a positive purpose) has helped to reduce their anxiety about the pain during labor and childbirth.
Things that may help:
- Take a support person with you to examinations.
- Take someone who will help 'speak up' for your wishes.
- Talk to a friend or counselor about how you are feeling.
- Make a list of questions to ask your health worker.
- Many of the procedures at this time can be invasive. Ask to have procedures and options fully explained beforehand.
- If you experience a flashback or are feeling panicky, it may help to look around at where you are now, talk to someone, and remind yourself that you are an adult now.
- If you don't feel comfortable or you don't feel the care is adequate, trust your feelings and, if you can, speak up about your needs.
- Remember that you have the right to refuse treatment and/or the service of a particular health practitioner at any time.
- You can request that extra staff who may be present (such as medical students) leave the room.
Talking with someone you trust can help you to be aware of your feelings at this time. You may want to see a counselor to discuss what you are feeling and to find out what services are available to you (such as breast feeding assistance, support groups, written material etc). Reading, asking questions and finding out what to expect during your pregnancy and childbirth can all help towards feeling prepared and having a sense of control in the situation.
There are many different options for care at this time. It is worth inquiring about what is available and thinking about what type of setting and support you need. Some examples include: birth in a birth center, private midwifery care, birth at home, standard hospital care, shared care with a GP and the hospital, and so on. You can get more information by contacting your local maternal and child health nurse, women's health center or antenatal services.
The health workers you come in contact with can play a major role in how you experience pregnancy, childbirth and early parenting. Your midwife, nurse or doctor should be willing to:
- listen to you and respect your feelings
- respect your confidentiality
- explain procedures in a way you can understand
- offer you choices
- try to be flexible about how they perform procedures
- ask you how you are coping emotionally, not just physically
- show understanding should you tell them about the abuse
- be able to refer you to support services.
Because of the abuse you suffered you may find it very hard to speak up about your needs. If you do tell your health worker about your childhood abuse, you may also need to let them know what you see as your needs. If you find the health worker to be disrespectful or unhelpful you can ask to see another worker.
Medical examinations are a big part of pregnancy and giving birth. Some procedures (such as pap smears and internal examinations) are to help prevent possible health problems, while others are used when there are urgent health concerns (such as the need for a Cesarean). Many medical procedures feel invasive. Cervical smears, internal examinations, the use of stirrups, the procedures involved with an abortion or a visit to the dentist can be particularly difficult. Generally the anxiety around such procedures can be lessened with the help of a sensitive health practitioner, as well as by knowing exactly what to expect with the procedure, and having choices in your treatment (ie: a less invasive procedure, having a support person with you, having a female practitioner etc). You have the right to refuse any type of medical procedure, at any time. If you refuse a procedure you may be asked to sign a document to say that you were offered but refused a particular course of treatment.
Many mothers face obstacles with breast feeding, such as conflicting advice or lack of support from health professionals. There are often added difficulties for women who have survived abuse. If you have good support and feel comfortable to breast feed, the experience can bring a sense of pride and a new enjoyment in close physical contact with another human being.
You may find that breast feeding provokes anxiety for you, making you feel exposed and unsafe. This is understandable. You may fear sexual arousal and the sensuality of breast feeding, as it may remind you of the abuse.
You do not have to breast feed. It is important to remember this. While it may be preferable to breast feed for a number of reasons, you are not denying your baby a happy and healthy infancy by not breast feeding. Forcing yourself to breast feed is likely to make you and your baby feel tense and uncomfortable.
It is a common experience for women to feel inadequate at this time. A health worker can encourage and support the feeding of your baby.
For many survivors of child sexual abuse, raising a child and creating a family has a special significance. You are probably acutely aware of the preciousness of childhood. Despite the difficulties survivors may face at this time, raising your child can also be 'good therapy'. You have the ability to give love and affection to your child and to be a central contributor to a loving childhood.
If you didn't have a good parental role model as you grew up, it may help to ask for the assistance and support of a friend or family member whose parenting skills you respect. Remember, parenting does not necessarily come naturally and there is help if you need it.
Once you have your baby home, a number of feelings may arise for you. You may feel nervous or wary of touching (eg: at bath time, when changing nappies) or of showing affection for your baby. You may fear that you are a threat to your baby or that someone else will abuse your baby.
Problems may arise at the time your child turns the age you were when you were first abused. This may trigger memories and you may feel distant from your child. Some survivors fear they will hurt their child. Seeing your child's innocence, you may feel angry all over again at what happened to you. You may want to deny your child's vulnerability by distancing yourself from him or her. You may also feel intensely protective toward your child. All of these feelings are understandable given your past experiences. It may help to talk to a friend, get parenting assistance, or to see a counselor.
Advice for supporters
Supporting a partner or friend through pregnancy and childbirth will probably be both rewarding and exhausting. It may be difficult for you to understand her fears and concerns. Your consistent and caring support is very important. The following tips may help you support your partner or friend and experience this time together as enriching of your relationship:
- Reaffirm her feelings. Feelings of pain, fear, anger are all natural at this time.
- Avoid ignoring the effects of the abuse. It is normal that your partner or friend may feel anxious.
- Resist the temptation to take charge. It is important to allow her to make her own choices.
- Ask your partner or friend what she needs from you.
- Help on a practical level, such as by doing housework, bathing the baby, cooking etc.
- Encourage your partner or friend to seek a variety of resources and supports that feel right for her.
- You may find it helpful to understand the effects of the abuse. Talk to her about it and/or obtain information.
- Avoid offering support you can't give, and recognize your limits.
This Information is from the Domestic Violence & Incest Resource Center website in Victoria, Australia, and has been used with full permission from the author.