The Perinatal Period: the impact of Childhood Sexual Abuse

CONTENT WARNING - This article contains discussion of childhood sexual abuse, and may be triggering for some readers.

There is absolute crickets on this topic… how the epidemic of childhood sexual abuse is impacting women when it comes to conception, fertility, pregnancy, birth and the early years with a new baby, known as the Perinatal Period.

The data is always difficult to obtain, but current estimates are approximately 1 in 3 women have experienced some form of childhood sexual abuse before their 18th birthday.

The impact of sexual abuse on the physical, psychological and spiritual health of survivors can be significant for those who are hoping to conceive, may find themselves pregnant, and throughout the birth and early years stages.

Possible impacts of Childhood Sexual Abuse in Perinatal Period

Child sexual abuse can have significant impacts on pregnancy and birth. Here are some potential effects:

1. Reproductive health problems: Child sexual abuse can cause physical damage to the reproductive organs or lead to infections that affect fertility.

2. Increased risk of miscarriage: Women who have experienced child sexual abuse may be at increased risk of miscarriage due to the physical and emotional stress associated with the trauma.

3. Increased risk of pregnancy complications: Child sexual abuse survivors may be more likely to experience pregnancy-related complications such as preeclampsia, gestational diabetes, placental abnormalities, high blood pressure, and preterm labour

4. Impact on the birth experience: Survivors of child sexual abuse may have difficulty during labor and delivery, such as increased pain, a heightened sense of vulnerability, dissociation and survival responses (fight, flight, freeze) due to trauma triggers.

5. Increased risk of postpartum mental health issues: Women who have experienced child sexual abuse may be at higher risk of developing postpartum anxiety and depression

6. Impacts on parenting: The triggers, stress and impacts on mental health from childhood sexual abuse, may also affect the mother's ability to bond with her baby, cause difficulties with attachment, and caring for baby. This can also illicit feelings of shame, guilt and self-blame.

It's important to note that every survivor's experience is unique, and not all survivors will experience the same impacts during pregnancy and childbirth. However, it is important for survivors to receive appropriate medical and psychological support to ensure the best possible outcomes for themselves and their children.

A message of hope… Trauma-informed Perinatal Care

Whilst there are many impacts to be aware of supporting women who are survivors of childhood sexual abuse, the perinatal period can also be a time of remarkable growth and resilience for survivors who are able to experience conception, pregnancy, birth and beyond as life affirming, empowering, and healing.

Having care providers who are trauma-informed and responsive to the needs of survivors can be key in the resilience of survivors. The following key concepts can help to work towards trauma-informed Perinatal Care:

1. Recognise the widespread nature of sexual trauma - one in three women have experienced sexual violence

2. Recognise the impact of sexual trauma and how it manifests in the perinatal context

   - including increased risk of pregnancy-related health conditions
   - trauma-related distress with pregnancy and birth with triggers of pelvic pressure/pain, fetal movement and bodily changes
   - perinatal care which can be quite intrusive and triggering with frequent examinations of breasts and genitals
   - a heightened sense of vulnerability, lack of privacy and lack of control

3. Response and resist re-traumatisation in policies, procedures and practice

   - modification of procedures which promote safety, privacy, comfort and a sense of control for women

   - being mindful of gender and cultural considerations

   - models which fund continuity of care

   - supporting women to access therapeutic support and care throughout the perinatal period

The Dawn works with women who have experienced childhood sexual abuse, and is able to provide specialist support for women who may be entering, in or surviving the perinatal period.

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Written by Nicole Staats
Principal Counsellor - The Dawn