Content Warning: Sexual Assault / Sexual Abuse / Incest
This week is Birth Trauma Awareness week.
For many women, the birth itself is traumatic because of how they are treated during labour and birth. For women who have been sexually abused as children, however, labour and birth can compound the trauma they have suffered.
While she was growing up, Orla’s* father ‘played’ with her by playing ‘tickling’ with her. He would chase her, catch her, and then hold her down tickle her, kiss her, and – as she hit puberty – touch her breasts, buttocks, and genitals.
Like many people who are abused over a period of time, Orla started to recognise the ‘cues’ from her father that an abusive incident was coming. She would try, desperately, to get away from him, but she was never successful. Orla felt helpless, but still, when he tickled her, she laughed. This would result in him calling her ‘a little flirt’ and saying things like ‘you’re just pretending you don’t want me to do it.’
Orla couldn’t get away from her dad because he was too strong. Her laughter would give away to tears, and then to crying, and eventually to screaming. Finally, he would stop.
When Orla grew up, she did not look back on her father’s actions as abusive, because it was labelled as ‘play’, and she remembers laughing at the time.
Years afterwards, however, when she was in labour with her first child, she was hooked up to a foetal monitor, had a canula inserted, and a blood pressure cuff. She had a panic attack on account of the restrictions on her movements. Her reaction seemed disproportionate until later, when Orla connected the events during childbirth with being restrained while her father abused her.
Like Orla, many women are surprised by the degree of their distress over routine aspects of maternity care. For abuse survivors, distressing or traumatic events can bring up the same feelings of helplessness and fear that they felt with the original abuse. It can be difficult to understand, however, why seemingly innocuous or helpful interventions can also bring up feelings of helplessness and fear. If the trauma of the original abuse was never correctly addressed, they are at risk for re-traumatisation, and may end up suffering from chronic post traumatic stress disorder (CPTSD).
Much of this distress can be alleviated for pregnant women survivors of CSA if, before labour, they have an opportunity to explore some of the features (events, procedures, and care policies) of childbirth that might bear similarities to their abuse, and to plan strategies for avoiding, or coping with, them.
Women often dread the prospect of deeply exploring the origins of abuse-related symptoms. Once they do take that step, with the support of understanding health-care practitioners / birthworkers, they usually feel relieved and unburdened of guilt and responsibility. Our capacity for healing is enormous, through it requires hard work perseverance, and courage. Finding the time, and the energy, for that is hard at any stage – harder again when you’re pregnant. A birthworker who brings compassion, and understanding of the trauma of CSA will make the biggest of differences to her client.
*Not her real name