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Pregnancy, birth and parenthood after childhood sexual abuse

Elsa Montgomery – Senior Lecturer, King’s College, London

Nearly four years ago I wrote a blog for Sheena called ‘Voicing the silence’ in which I explored the experiences of ‘Elizabeth’ one of the women who spoke to me during my study of the maternity care experiences of women who were sexually abused in childhood (CSA). I shared the animation of Elizabeth’s first birth, created by film production company, JMotion.

This animation is a powerful, hard-hitting reminder of how disempowering birth can be for women. We feel Elizabeth’s pain when, looking through her eyes we hear her words too:

I, I felt almost like an animal

I had everyone just looking at me

I felt embarrassed

I felt degraded

I felt dirty

I felt horrible! Horrible!

I just wanted to run away

I couldn’t

It is uncomfortable viewing for midwives who have found themselves attending forceps births in busy obstetric units, but sadly reflects the experience of many women.

For women with histories of CSA, birth can be a particularly frightening, lonely experience. Survivors report ‘re-enactment’ of their abuse during pregnancy and birth in ways that they may not have anticipated and that may be very perplexing at the time (Montgomery et al 2015a). They have indicated that it would have helped them to know that their experiences are shared by other survivors. Many of these women report guilt and shame in relation to their childhood history and although they feel scared and alone during their childbearing journey, they dare not ask for help from those providing their care because they fear judgement (Montgomery et al 2015b).

In response to these observations we have co-produced an e-resource that is funded by a Wellcome Trust People’s Award and hosted on The Survivors Trust website. It will help prepare those who have experienced CSA for pregnancy, birth and early parenthood. It is a resource that can be accessed in private and at a pace that feels appropriate for the individual. Our collaboration with JMotion has continued and short film clips have helped to bring alive the words of Elizabeth, Helen, Jane, Linda, Mia, Sam and Sue (pseudonyms chosen by the women). We also hear from women who have helped us produce the resource. The topics covered were identified by them as important for those who have experienced CSA and who are contemplating pregnancy and birth. The main sections are:

  • Introduction
  • Pregnancy
  • Labour
  • Becoming a parent
  • Further Resources

One of the highlights is an animation of Elizabeth’s second birth, which was a very different experience. In response to the question ‘Is labour always like this?’ that we ask after sharing the experience of her first birth, we are therefore able to answer with confidence that it does nothave to be like that – even if things don’t quite go to plan. Elizabeth didn’t get the home birth she desperately wanted second time round, but nevertheless, she felt safe and in control. In the second animation, we see a caring midwife facilitate a birth for which Elizabeth is kneeling on a mattress that the midwife has pulled onto the floor. Afterwards Elizabeth was able to say:

“it was warm and it was safe and it was dark and there wasn’t people staring at me and um I did it exactly how I wanted to do it.  No one told me … how I should kneel or sit or lay or whatever, I did exactly what I wanted to do.  Umm… I did – yeah, I – apart from being at the [hospital], I had everything my way and [the midwife] really listened to me.”

Our hope is that this resource will help to empower women to approach pregnancy, birth and parenthood feeling safe and in control and that afterwards they will be able to say ‘the midwife really listened to me’.

The resource can be found at: www.thesurvivorstrust.org/pbpaftercsa

Elsa Montgomery, Senior Lecturer, King’s College, London

Email: elsa.montgomery@kcl.ac.uk        Twitter @elsamwm

 

References

Montgomery, E., Pope, C., Rogers, J. (2015a) The re-enactment of childhood sexual abuse in maternity care. BMC Pregnancy and Childbirth 15:194 DOI: 10.1186/s12884-015-0626-9

Montgomery, E., Pope, C., Rogers, J. (2015b) A feminist narrative study of the maternity care experiences of women who were sexually abused in childhood. Midwifery, Vol. 31, No. 1 pp 54-60

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