Refreshing as it is (well, kind of) to hear domestic violence and sexual assault talked about more frequently in the media today, there is an aspect of that violence that is long-lasting and sadly, seldom mentioned. That is how the violence of an assault can impact a woman during pregnancy.

Pregnant survivors of violence have more challenges during their childbearing years than non-survivors do. Those challenges not only depend on the kind of abuse that the woman suffered but also when the abuse happened. Let's look at two examples of how this might look-

An adult survivor of childhood sexual abuse becomes pregnant and decides to keep the baby. She learns the baby is a boy. She starts finds herself repulsed by the baby. She cannot stop thinking about how she has been abused by men and begins fixating on how this future man might end up hurting her too. Although she originally wanted the baby, the idea of something growing inside her is beyond horrifying. She is ashamed to tell anyone of these feelings but starts (often unconsciously) to make decisions that reflect that disengagement like skipping her prenatal appointments and not talking about the pregnancy with anyone.
A domestic violence survivor who was abused by much older men including her father is untrusting of anyone and has difficulty maintaining relationships. She becomes pregnant and finds herself at a ob/gyn practice where there are older male doctors. At her appointments, she is unable to advocate for herself and ask questions when it comes to routine care. Or perhaps the exact opposite: she is very high maintenance, demanding with a highly detailed birth plan, only to turn around and at the next appointment announce that she wants to schedule a csection.

A background of abuse has a huge impact on how a pregnant survivor thinks about herself and how she sees/thinks about others. This is not something that can be disregarded, either by the pregnant survivor or practitioners, friends, or family who interact with her.

One of the issues that I work on with Trauma Counseling survivor clients is identifying the core issue for their visit and developing supportive tools to help them as they move through their pregnancy with confidence. We also work together to talk about what she might expect as her pregnancy continues. An adult rape survivor, for example, might call not because she's having fear around a vaginal delivery, although she really wants to "go natural".

Emotional and physical changes as well as socioeconomic issues can complicate how any pregnant woman copes on a regular basis. But all of those are compounded and amplified in scale for the pregnant survivor who is already less emotionally equipped to deal with her changing identity.

This is the first in a series that will look at how abuse impacts a woman in her childbearing years.

Thank you for reading.