Birth Preparation for Sexual Assault Survivors

*Much of the content of this post is summarised from the book:

Sperlich, M. & Seng, J.S. (2008) Survivor Moms: Women’s stories of birthing, mothering and healing after sexual abuse. Eugene, OR: Motherbaby Press.

Being a survivor of sexual assault is not uncommon. In Canada, one in three women experience some sort of sexual violence throughout their lives (Statistics Canada, 2006). But everyone is affected by rape culture. People with female genitalia, with smaller frames and those who look feminine are taught from a young age to cover up, fear rape, and to say no to sex. We are indirectly taught that sex is shameful, yet we are also pressured to be sexy objects of desire. We carry these shameful and fearful messages about our genitals into the birthing experience. Therefore, all of us deserve to be informed, empowered and educated when it comes to choice and consent during birth.

Folks who have experienced sexual trauma (you define what that means to you!), may benefit from some special preparation to make the birthing experience as safe as possible. This page is dedicated to all of us who have had our dignity ripped away, our vaginas and our wombs broken into against our wishes. There are ways to create safety and to have a positive birthing experience. This post is dedicated to you and your birth.

Take care as you read. Have a support person there, a cup of flavourful tea to sip to ground yourself (chocolate is good too ;) ). When you get overwhelmed, look around the room. Breathe. Fill yourself with compassion. You are strong. You are here. You are a survivor.

What is sexual trauma?

I personally like to keep this definition loose. If you feel you have experienced sexual trauma, you have. Sexual violence does not always look violent (Nagoski, 2015). It often looks vague and quiet, and it is usually paired with coercion (Nagoski, 2015). There is also an unequal power dynamic at play. Penis-in-vagina sex does not have to occur to have experienced sexual trauma. In fact, birthers have described some vaginal exams by medical practitioners as sexual trauma even though they may not have been about sex. The body doesn’t distinguish between all these social contexts. YOU know if you have felt sexually violated.

YOU know if you have felt sexually violated.

What to expect in the birth:

Expect triggers: During birth, there is a loss of control, there is vulnerability, and nakedness. Positions during birth may resemble those of your traumatic experience. You are exposed. Keep in mind that triggers can be quite unexpected. For example, you may be left unaffected by a vaginal exam but a touch on the shoulder may bring on a flashback. I remember for me, putting on the hospital gown was a huge trigger.

Expect an out of the ordinary experience: Birth will bring you away. You are bringing a soul through time. It may feel like thunder and lightning is going through you. It is powerful. This can be overwhelming, but it can also bring you healing. Either way, you can be sure that birth will be a unique experience.

Birth's power can be overwhelming and this can be terrifying but has the potential to bring forth tremendous healing.

Expect the unexpected: You can plan many things, but unfortunately there is little we can control during birth. It rarely happens the way we envisioned, but the one thing we can control is our self-talk, and how we interpret the events. (England, 2017)

Practical to do list:

1. Choose a safe care provider

In general, what matters most is to go with your gut on this one. Does the person make you feel comfortable and at ease?

Midwife: A midwife is woman-centered and client-centered. Midwives are trained in anti-oppressive and feminist frameworks and it is their duty to ensure that you give consent, you are empowered and you have the right to informed choices. Midwives offer longer appointments are usually available around the clock for emergencies. You have continuity of care and get to know the person who will be present at your birth.

Physician: Good when you have a high risk pregnancy, when you feel you prefer giving birth in a hospital. Physicians have less time to give to each patient, but they are trained in complicated births and pregnancies. Physicians experience high stress and time pressure and are usually handling more than one client at the same time. Every physician is different and I know several who have the same anti-oppressive mindset as midwives do.

Doulas: Doulas cannot deliver babies but they are there for emotional support. If you already have a support person, the doula is there to guide them and also advocate for you in high stress environments. They know what is normal, they remind you that you have a choice and they will call out staff who aren’t respecting your birth plan.

2. Choose a safe birthing space

Again, where do you feel safest? With my first, I thought I could let go more at the hospital knowing that if something happened, we were already there. With my second, the hospital no longer seemed safe to be so I chose to birth at home. In Canada, you can birth at home, in a birth centre or a hospital. Visit each space and consider where you feel most empowered.

3. Choose a support person

It is so important to have emotional support. You can choose a friend, a romantic partner, the other parent, a relative or a professional doula. You can choose more than one person if you prefer! Go with your gut. When you are with this person, do you feel gentle, soft, relaxed, at ease? If you feel alert or unsafe, this is not the right person. Sometimes someone can seem great in your head, but your body tells you something different. Your body knows. Go with that.

4. Learn about birth

Education about birth is extremely protective. The more you know about the process, the more you can advocate for yourself in a difficult situation. Find out what your rights are, what birth looks like so that you can feel confident to give or withhold consent at any time during your birth. There are tremendous books you can find in my pregnancy books list and you can find wonderful empowering pregnancy groups in Ottawa which I will add below in the resource list. In choosing your group, you want to find something that advocates for you, empowers you and does not act as a training for being a ‘’good patient’’. Unfortunately, many pregnant folks in Ottawa say that the hospital birth classes were not as empowering as they wished and felt they served the hospital’s needs.

5. Write a birth plan

The purpose of the birth plan is not to attempt to control the future but to help you imagine different possibilities and what course of action YOU prefer following different eventualities. It is to get to know what is important to you. Keep it concise for the health care professionals as they might feel overwhelmed otherwise. If you get a doula, I suggest looking over this with them.

6. Coping strategies to practice:

a) Re-orienting and grounding: If you have not already, practice grounding using the 5 senses. This link explains it well: http://www.therapistsb.com/blog/post/5-4-3-2-1-coping-technique

b) Learning to say no and assert yourself: In your daily life, when you are triggered, practice stopping what you are doing, and re-orienting. Practice asserting yourself and saying no to others when they are triggering you. Start small. Be patient.

c) Art: Use art such as poetry, clay work and painting to help loosen up stuck feelings form the trauma. See this post for guidance on how to do this YOU DO NOT NEED TO BE AN ARTIST! :) https://www.empoweredcounselling.ca/blog-and-resources/how-to-create-healing-art

d) Practicing self-care: Can you find ways to include self-care in your every day life? This will serve you well in the postpartum period as well. The more you train yourself to care for YOU, the more habitual it will become. Investing time, money, and space for us is incredibly powerful. Whether you are including time to masturbate, get a massage from a friend or professional, going out with friends, taking a bath, seeing a counsellor, all these things will contribute to your healing and mental health.

e) If all this seems overwhelming, come chat with me or another mental health professional you feel safe with (see below).

Resources in Ottawa

Group for survivors giving birth: https://ottawa.cioc.ca/record/OCR4502

Birth Education:

My Prenatal Empowerment Group: https://www.empoweredcounselling.ca/prenatal-empowerment-group

Ottawa Doula Services Prenatal Classes: https://ottawadoulaservices.ca/classes/

Lilly Bianchi Prenatal Classes: http://lillybianchi.ca/

Books:

Survivor Moms

When survivors give birth

Courage to Heal

See this link for a birth preparation book list: