In 2017, the latest Crime Survey of England and Wales reported one in five British women were victims of a sexual assault including unwanted touching, indecent exposure, and rape. When women who survived a sexual assault become pregnant, they encounter a radically different pregnancy experience and it is a challenge to find unique ways to cope.
Psychological distress caused by a sexual attack leaves a woman feeling vulnerable and having a complete loss of control of her body. A traumatizing experience, sexual assault, or rape can carry long-term consequences, such as prolonged anxiety, fear of pregnancy, depression, uncontrollable resurfacing of memories of the attack (flashbacks), or chronic post-traumatic stress disorder.
Initial shock and numbness after the assault or rape, together with a chance that the perpetrator is someone close or even a romantic partner, makes a lot of women delay seeking adequate mental health support. When a woman does not cope with the resulting intense feelings, any stressful event can trigger the assault memories and retraumatize her.
Pregnancy is an especially challenging time for survivors of sexual assault or rape because a woman has little control over the physical changes she’ll experience. Under the influence of pregnancy hormones, intense anxiety, fear of pregnancy, sadness, or anger can be overwhelming and tax the woman’s mental coping capacities.
Pregnancy is a physically and emotionally challenging period and women who have been sexually assaulted or raped might find themselves lacking support and having no idea how to cope with this potentially retraumatizing experience.
If you are a sexual assault or rape survivor dealing with a complicated set of feelings about your pregnancy, here is a list of issues you might encounter and strategies to cope with the emotional and physical side of pregnancy more successfully.
Coping with intense negative emotions
Feeling intense fear and anxiety in pregnancy is not rare, even for women who were not sexually assaulted. Feelings like these arise because pregnancy brings many unknowns, especially for first-time moms.
The uncontrollable changing body, potential delivery complications, self-doubt about parenting abilities, or how the relationship with the partner will change after the baby is born are all sources of anxiety and fear in pregnancy.
As an intense physical and emotional experience, pregnancy can also trigger the memories of the assault and reawaken feelings of fear, helplessness, vulnerability, and loss of control over one’s body. The combined intensity of these emotions might be too overwhelming for you to handle on your own. Reaching out for support in a form you find acceptable is essential.
However, what you can do on your own is accept your feelings for what they are regardless of how you think you should be feeling or what is considered “normal” in pregnancy.
The usual image of pregnancy most of us share is one of a glowing mom-to-be experiencing the happiest time of her life. Every pregnancy and every woman is unique, and there are no strict rules on how you should be feeling. Comparing your pregnancy experience to an ideal image or someone’s expectations only fuels the feelings of guilt and self-blame.
Instead, learn to be self-compassionate. Self-compassion is a skill you already have; you just need to practice it. The easiest way to practice self-compassion is to show the same understanding and support to yourself when you feel particularly anxious or sad as you would to someone you genuinely care for.
Coping with emotional numbness
Even though the years might have passed since you were sexually assaulted or raped and you have moved on with your life and are now looking to start your own family, the news that you are pregnant might leave you completely unexcited. You may feel that the pregnancy is happening to someone else and you are just a bystander.
Emotional numbness or isolating your core being from emotional and physical changes in pregnancy is a natural way a victim of a sexual assault defends herself mentally from the potential threat of old trauma resurfacing. By detaching yourself from the experience of pregnancy, you are shielding yourself from potentially overwhelming emotions.
Aside from adding to guilt and self-blame for not feeling like you are “supposed to” during pregnancy, emotional numbness doesn’t translate into not caring for your baby. Women who were victims of a sexual assault and who became mothers later are fully emotionally capable of being great moms, regardless of how different they felt during the pregnancy.
A way to cope with emotional numbness in pregnancy is to try reconnecting with your body in a safe and nurturing environment like meditation or a yoga class conducted by a well-trained professional. Talking about your pregnancy experience with someone you feel confident with can reassure you and help you feel loved.
Managing medical procedures & exams
Many women who were victims of sexual assault or rape find the medical check-ups, vaginal exams and ultrasounds, together with the inevitable hospital stay for the delivery, the scariest part of their pregnancy. The doctor’s office is a direct reminder of a post-assault forensic examination, and a vaginal exam can seem like a direct invasion of privacy.
To ensure your health and your baby’s health, you will need to pay particular attention when choosing a midwife, a GP, or an ob-gyn. It helps to inform them about your traumatic experience, but only with what you’re comfortable sharing.
Most medical practitioners won’t disregard your physical integrity intentionally. Instead, the examinations and various procedures are routine for them. Unless you let them know why they need to show more restraint, they might act automatically and touch you without asking first. By sharing your reasons for feeling anxious or threatened by an unwanted touch, you can gain a sense of control.
Many sexual assault survivors find it more comfortable to have check-ups and consultations with a female practitioner.
A practitioner trained to work with sexual assault survivors will share the details of each procedure with you describing what and why they are doing specific exams including asking to touch you. You can ask your medical provider to do the same.
Moreover, if you do not feel comfortable with your current medical provider, you have the right to seek another.
Preparing for delivery
The physical reality of giving birth is frightening for many women, but the victims of sexual assault can find themselves in a position very reminiscent of the attack. The feeling that the whole process is happening without their active control while in an extremely vulnerable position and surrounded by strangers can be overwhelmingly traumatic.
A way to cope with this situation is to plan the details of your delivery ahead of time.
Consider if you would benefit from prenatal classes if you are a first-time mom or would it perhaps be easier for you to get support from a doula. Doulas are non-medical trained birthing assistants who mainly focus on providing emotional support and guidance pre and post-delivery.
Take into account the different delivery choices available. If you feel you’d be more in control by choosing induced labour, C-section, or epidural anaesthetic during the labour, talk about these options with your ob-gyn or GP.
Some women who find the medical setting stressful choose home birth. However, when considering home birth, take into account the possibility of an emergency where you might be rushed to hospital, so prepare for this alternative, as well.
Detailing your birth plan on paper and sharing it with your partner or your doula so they can ensure your wishes are respected during the delivery can make the process more manageable.
If you have the opportunity, you can also get in touch with specialised support services to tackle the challenges of motherhood after a sexual assault.