I feel a bit strange writing this section, since I've never given birth normally myself.
Warning: this might upset you
I was induced very prematurely, drunk, drugged and in the hands of a doctor who was one of my abusers.
I'm sure, at least, that if I give birth again it'll be in better circumstances!
Ways to Manage the Birth Process:
I hope the information and links here will be useful to you. You'll be able to find out a lot more by linking in with your local pre-natal care and community services.
The main question that bothers me (and perhaps you too) is whether giving birth will cue in memories and cause dissociation, regression and flashbacks, i.e. is it "triggering". These pages might help you:
Childhood Sexual Abuse and Its Effect on Childbirth
Survivors of Childhood Sexual Abuse: Impact on Labor and Birth
Remembering Childhood Sexual Abuse in Labour
I also asked this question of the people at Pandora's Aquarium and their answers are given below.
It seems that any time you don't know what's happening, you're hurt (especially unexpectedly or by someone who's treating you in a way that feels impersonal), you feel trapped in a particular position, or the situation feels out of your control, you're likely to be triggered.
Think about circumstances that particularly upset you and write them down. You can then work out a plan to avoid these situations as much as possible. With a plan, you're more in control. Here are some examples of birth plans, and some more information about birth plans and pre-birth planning.
Remember you'll need to tailor your plan to your own individual circumstances, which will include things like whether you're planning to give birth in a Birthing Centre or a Hospital. Your health care providers can give you information on the different options. It's important to discuss your birth plan with your health care providers and make sure your intentions and expectations are realistic and something they can work with. However you choose to give birth, the main thing (that seems to keep coming back in every conversation about this) is being treated with respect. Do what you can to find people you know will respect you and work with you.
If you can, it's a good idea to tell them you've been raped, so they can respond more quickly and sensitively to any issues that arise during labour. If you find it hard to tell them directly, a letter can be a good way to let them know and make it easier to talk about. I found that giving my doctor a letter worked well for me. I gave it to her in person, she read it, had a brief, sympathetic response, asked a few questions, and has taken extra care to be gentle and consider its effects ever since!
Knowing what you can expect may also help you feel more in control. This site has links to 100 articles on birth, labour and delivery and contains a lot of useful information. These birth stories from Pregnancy Today and this forum which explains common problems in pregnancy to dads might be useful. These links about giving birth and motherhood for women who've experienced sexual violence or a previous traumatic birth could also help:
Survivor Moms: Women's Stories of Birthing, Mothering and Healing after Sexual AbuseSurvivor Moms: Women's Stories of Birthing, Mothering and Healing After Sexual Abuse
Extra Material and Stories from the Survivor Moms book (above)
When Survivors Give Birth: Understanding and Healing the Effects of Early Sexual Abuse on Childbearing Women
Pregnancy to Parenting: A Guide for Survivors of Child Sexual Abuse
Birthing from Within: An Extra-Ordinary Guide to Childbirth Preparation
Healing the Trauma: Entering Motherhood with Post-Traumatic Stress Disorder
Solace for Mothers: Healing After Traumatic Childbirth, an Online Support Group
It can be hard to make your voice heard in the delivery room and I wonder if it's especially hard for teenagers. See below for some personal answers to that. This page, which includes videos of teenagers giving birth, might be of interest and, if you're a teenage mum, help you to feel less alone. This page tells the personal story of one teenage mother. This page about the National Teenage Pregnancy Midwifery Network in the UK might also interest you. This page about teenage pregnancy and possible complications from Australian Women's Health might also be useful. This page about the positive experiences of teenage mothers might encourage you. This page about positive pathways into parenthood for teenage parents might help too. You might also find this Girl-Mom community and its forums helpful.
Even if you're still a child yourself, this is your child you're giving birth to and you deserve to be listened to, respected and involved in all decision-making. Whatever your age, however well-intentioned and kind the people round you, you have every right to decide what happens to you and your child during birth and afterwards. Please keep trying to make your voice heard - you deserve it.
Please see the information about doulas and the link to TeenChoice on the Deciding What to Do page here. You might also be interested in Empowered for Birth - Young Mums Canberra, as a model for services to look for near you, and their links to information and resources.
Premature Labour and Birth:
Premature labour can happen to any woman. About half the time no one knows what the reason is. Some established risk factors are also common responses to being raped. For example, smoking and drinking are risk factors. This study found that pregnant women who've been abused are more likely to smoke daily. Many people use alcohol to cope with trauma too. Women with a low body mass index (BMI) or nutritional deficits are more likely to give birth prematurely. Disordered eating is another common response to trauma. Having pregnancies less than 6 months apart is also a risk factor for premature birth. Few people plan this, so there may be an (as yet unproven) association with rape and abuse.
Many of the clearest risk factors have no direct relationship with trauma - for example, having a shortened cervix, multiple babies, being over 35 or under 18 years of age, or having an infection (which could account for between 25 and 40% of cases). It may be comforting to know that there doesn't seem to be any association between childhood sexual abuse and low birth weight babies or other obstetric complications.
Depression and stress are two risk factors that have been getting more attention as new research focuses on the mental health of pregnant women. Depression and stress can be affected by how we think and behave, and therapists and counsellors can really help with that. But depression and stress are also affected by how other people treat us. It's inevitable that a woman who's just been raped and is pregnant as a result will be depressed, stressed and struggling to find ways to cope. Please don't blame yourself for the natural consequences of someone else's actions.
If you think you have any of these risk factors, it's a good idea to talk to your doctor or health care provider about how best to manage them. If you do have a premature birth, please remember that you didn't choose the circumstances, that the causes are complex and largely unknown, and that many risks can be managed but not eliminated. You've done the best you can in a tough situation and you aren't to blame if your baby's premature. You've got enough to worry about without going down that track! So please be very gentle with yourself.
Here's some information, support and resources about premature birth:
American Pregnancy Association Information on Premature Labour
Surviving the NICU: Support, Information and Resources for Parents of Premature Babies
Common Problems Associated with Premature Birth
Caring for your Premature Baby
A Primer on Preemies from Kidshealth
Preemie Parenting: Resources for Parents of Premature Babies
Parenting Your Premature Baby and Child: The Emotional Journey
A Different Journey: Reactions to Premature Birth
Yahoo Groups Discussing Premature Birth
Resources for Parents of Premmie Babies from Austprem - includes products, clothing etc., based in Australia but some international scope.
Premmie Clothing and Gifts in Australia
International Premmie Clothing, based in Australia
Preemie Clothing US
Caesarian sections (C-sections) are another common complication in giving birth. About 30% of deliveries in Australia are C-sections. Here's some information about them:
Information on Caeasarians from ForParentByParents - includes some support links
Giving Birth by Caesarian Section from BabyCenter
What to Expect After a Caesarian
Important Questions Concering Caesarian Sections
Possible Complications of Caesarian Sections
Having a C-section may make recovery slower after giving birth. But there's no clear relationship between C-sections and post-natal depression, which is good because you don't have to worry about that in making your decisions! Many women who've been raped worry about their ability to bond with the baby. This article has some useful things to say about bonding with a baby after a C-section. The hormone oxytocin seems to play a part in bonding and is stimulated by vaginal birth, but also by breastfeeding. It seems that, despite the "accepted wisdom", the scientific community's still not agreed on whether C-sections affect a mother's ability to bond with her baby. For ideas to help you bond with your baby, please see the After Birth page here.
For information about miscarriage, still birth or early neonatal death, please see the Loss page here.
Birth of a Child with a Disability or Special Needs:
This is very difficult both emotionally and practically. Many parents feel frightened and overwhelmed and experience grief when they learn their child has a disability or special needs. So I've put a list of links to resources for parents on the Loss page here. There's also more information about parenting a child with special needs on the A Pregnancy After This page here. These pages can link you to support and other parents who share this experience.
Feelings and Thoughts:
Please be aware that this section may be upsetting and contain graphic details.
Questions I asked:
1. If you've given birth at any time after being raped, did you find it triggering?
2. In what way?
3. What did you do to manage the triggers?
4. Did that work?
I haven't given birth yet.. not due until January, but those are some things I'd like to know also so I can be better prepared. I will also definitely answer about my own experience when the time comes. I know I've had a difficult time so far getting through the pelvic exams. I get through it by focusing on my safe place in my mind, deep breathing, and taking a trusted support person with me so that I'm not alone. Not sure if those will be as effective during birth but it has gotten me through so far.
Personally, I did not find childbirth triggering after the rape. It is such an all-encompassing physical experience, so powerful, that I actually found it to be healing. I felt "born again," especially after the first time. It hurt more than I had imagined possible, but it was a good pain, a pain with purpose. I really was high for about a week after: colors looked brighter, everything was more intense, in a good way. Actually, as I think, that was with the first birth. The second was more problematic, because of the situation: the doctor didn't come right out to the hospital, so they were telling me not to push, when it was really time, and my baby came out "blue," and they had to suction her throat. That evoked bad feelings of being powerless and not taken care of. If I had it to do again- not very likely at 51!- I'd make sure I had someone with me. My hubby was of the old school, where the menfolks sat in the waiting room, tapping their feet and smoking cigarettes! If I'd had an advocate, they could have said, this baby's coming now, whether that doctor's here or not, and helped me see I didn't have to listen to the people telling me not to push. Over all, I found giving birth to be a powerful experience, kind of an undoing of some of the horrible stuff my body went through before. I had not yet recalled the CSA, and I'm not sure if I had totally repressed the rape by the priest or not.
There were definitely parts of being pregnant with my twins that were triggering. Since it was twins there was always extra exams. There was the normal monthly visit, with my regular OB/GYN then there was the visit every three weeks with the specialist. And each and every time they had to do an internal sonogram to make sure my cervix was strong and that the babies were OK. I just constantly had to remind myself it was for the health of V and M. When I did go in to deliver the exams were rough, everyone was trying to prove that my water did break. I think that was the worst part, the most triggering the most awful. When my doctor, who was awesome, got there that morning and had to do an exam that's the only time I cried . Not only did that final exam hurt but it was the most triggering I just felt like I had no control at all. I am really glad that they were born with a section. I don't think I could have handled being checked all the time if I delivered naturally. Once they were born it was amazing and somehow its amazing that when you look into your new babies eyes everything else just fades away. I would just look at them and cry it was truly amazing. Though there were some triggers, sometimes pretty intense I knew it was for my children and that made things bearable. I think maybe one thing I would have done differently is tell them about my past so they could have been a little more understanding, not with my regular doctor but with the specialist. I think it would have made a difference.
1. Surprisingly, yes, I did find it triggering. It caught me off guard.
2. The pain of the contractions and especially during pushing somehow reminded me. Plus the doctor had to do some things which felt very invasive for me, like breaking the water, for example.
3. I tried to focus on the baby and kept talking with those around me about the labour process. That kept me in the present.
4. Yes, it did. It helped lessen the triggers.
I've given birth twice. I loved being pregnant and most of the experience of giving birth was magical and empowering. I was so in awe of the experience and filled with the joy of bringing my sons into the world. Also, my husband was by my side for most of my doctor's appointments and for every minute of both deliveries, and I think that was a huge help in making me feel secure. I know that I'm very lucky that he was so supportive of me. That said, there were two incidents that I can think of during my first pregnancy that triggered me. The first was during a prenatal exam. I was past due and had to see a doctor who wasn't my regular one. She performed a somewhat painful procedure without telling me first that she was going to do it, and I think the combination of having someone I had just met touch me in an intimate area and doing something without warning that hurt me was what triggered me. In retrospect, I wish I had made it clear that I wanted to be told what was going to happen before it did. At the time, I managed the trigger by focusing on the fact that the procedure was meant to start my labor, which meant finally getting to see my baby. The second triggering experience was having an exam performed during labor by an intern who didn't make eye contact with me. It was very impersonal and made me feel like an object, which always triggers me. He seemed very uncomfortable in the situation, which in turn made me uncomfortable. (I found out later he was just on his OBGYN rotation and not intending to specialize in OBGYN, and maybe that's why he seemed uncomfortable himself.) I managed that trigger by talking with the nurses in the room -- they were wonderful, attentive and treated me like a person -- and by holding my husband's hand. I think, if it's possible for you, talking with your OBGYN about your history a little bit might help. It wasn't something I felt able to do until very recently, long after my children were born, but I sometimes wonder if it might have helped me and them if they'd known about my past at the time I was pregnant. I still see the same OBGYN and was finally able to open up to her a couple of years ago about my past. She was always wonderful and had made me feel comfortable, but since I talked with her about my past, she'd gone out of her way to be even more gentle and to forewarn me if some part of a procedure might be uncomfortable.... All in all, I'd say that giving birth is the most physically empowering thing I've ever done, and I hope you'll find that it's the same for you when your time comes.
I asked an additional question of someone else:
Did you find it triggering of memories of losing the baby conceived through rape when you lost the other two?
No, not really. It did bring up the past some but at time time I was more focused on the pain I was feeling at the time. I guess it's possible and I just didn't realise it at the time. So I am not really sure about that. Sorry.
If you gave birth when you were a teenager:
Questions I asked:
1. Were you presented with different options about how to give birth?
2. Did people listen to your opinions?
3. Were your wishes respected?
4. What did you do that you think might have helped that happen? or
5. What might have stopped that happening?
I became pregnant with my daughter at 19, just shy of 20, so chronologically I was heading out of my teens. However I was still very emotionally delayed and did not feel like an adult - I felt like a scared kid. Hopefully that makes it okay to answer these questions... Warning for mention of medical procedures. 1. I don't remember being presented with a lot of options about giving birth. It was natural delivery, or have a c-section if it was a dire emergency. The most my OB at the time said was I could deliver a 10 pound baby with no problems if it came to that (thank God it didn't).
2. No, people really didn't listen to my opinions regarding the pregnancy and delivery much. I voiced various ones and my doctor said he'd respect them as much as possible, but he also went against my wishes to have a natural and drug-free birth the minute they admitted me. He put me on Pitocin to augment my labor because "I have a surgery in the morning and I don't want this to conflict." The nurse then put me on an epidural when I was howling in pain.
One thing I wish someone had warned me about is episiotomies. If I had not had one with my daughter I probably wouldn't have torn and bled as horribly as I did with my son... and while I can't say for sure I do wonder if that in part contributed to the medical problems I had that required surgery last fall. If I had known doctors were phasing out giving women episiotomies even back when I had my daughter I would have opted out.
3.. As mentioned, not really.
4 and 5. Not sure if there was anything I could or couldn't have done to make the situation the way it was. I think the only things I could have done to improve things was get away from my ex, and changed doctors.
In contrast, when I had my son 12 years later, I was with a husband who absolutely stood behind the way I wanted to do things, had an OB team who wanted to accommodate me however possible. I drew up a birth plan and except for one or two things that they had to go against for medical reasons (they had to give me an IV antibiotic for my heart, and also if I had to have a C they would have had to knock me out instead of letting me stay conscious), they absolutely did everything I wanted. The nurse even took a copy of the plan and sat down with it at her desk while I labored so she would be in the know. I have to say that was one of the most empowering experiences I had. I felt like I was able to reclaim a lot of things that got taken from me when I delivered the first time, the main one being that I felt like I had my own voice and my own choices involved, instead of a flurry of doctors and nurses shoving the two most important people outside of the baby - the parents - aside to do what they wanted. I felt like I was actually involved in giving birth this time instead of being out of it, shaking, etc. from the epidural (so much I was afraid I was going to drop my daughter), emotionally in shock, etc.
I used a doula. I made sure that I did what I wanted to do, and she and my mom helped make that possible. I did it without any meds, couldn't use a tub though, but for the most part it went how I expected. You should look into the role of the doula, or midwife if you want things to go your way.
I was surprised by my own strong reaction when my mother talked about what she and my father would have done if they'd known I was pregnant when I was 12. She talked about how they would have protected me and looked after me, which was all good! But she also said that they probably would have adopted the baby. I'm not sure if she meant that she and Dad would have adopted her, or that they would have found out about and placed the baby for adoption. She was thinking out loud and it was an initial response from her. But my reaction was: this was my child. I was only a child myself, and definitely needed adult help to look after her and myself, but that didn't make her any less my child or my responsibility. I felt that, whether or not other people gave advice and opinions, any decisions about her had to be made by me and only me.
I had my son when I was 19. I got pregnant my first semester of college and ended up dropping out. The hospital I went to was great about respecting my wishes, I told them I didn't want the epidural and even when I begged for one later, they stood by what I had originally told them (didn't want me to feel bad about it later). In the hospital they don't let you eat or drink during labor just in case you have to go into an emergency c-section and I thought that I might have a problem with that, but during labor eating was the last thing I was thinking about. With my second child (I wasn't a teenager at that point) I did have a birth plan and my doctors followed it to the letter. I think they have an obligation to although, once your in there and everything is happening it's not like there's much you can do about it if they don't.
I revealed the truth about my abuse to my English teacher, Miss M. She was the first person who I was able to talk to about my abuse. Although Miss M could not stop my baby from being given away ( after all it was at this point all legal ) Miss M, decided to help me through my pregnancy and help me find therapy. She was the person who held my hand and helped me in the delivery room, when I gave birth to my baby girl.
Photos from Cepolina.