Complications During Pregnancy:
It's possible you may develop complications during pregnancy. Dealing with health professionals can be very difficult for someone who's been raped, so be gentle with yourself about this. I hope these links help you understand and feel less out-of-control.
If you're having difficulty keeping anything down and keep throwing up, you might find help here - Hyperemesis Education and Research. Hyperemesis Gravidarum (HG) can also sometimes, paradoxically, cause weight gain as your body tries to compensate for the malnutrition. My sister had a very difficult pregnancy with lots of nausea and vomiting throughout so I really feel for anyone suffering from this. I hope you'll find all the help you need. You can also find help for the more common "morning sickness" of pregnancy at Wikipedia or the Better Health Channel (VIC government site). This pregnancy sickness support page might also be useful. Many people who're traumatized also have trouble with nausea and vomiting. Make sure your doctor understands the double whammy you're dealing with.
This page gives information about other common, and less common, complications of pregnancy and what you can expect. This page from the Merck Manual discusses risk factors that exist before pregnancy.
Here's some information about danger signs, information about possible impending pregnancy loss, early warning signs of problems in pregnancy, more warning signs and symptoms you shouldn't ignore. These pages are no substitute for medical advice. If you experience any of these, talk to your health care provider straight away. Everything might be OK but it's better to be safe than sorry.
You're still in shock after the rape, trying to deal with trauma and that fact that you're pregnant, then you find out that it's not just one baby, but two, or three! What happens now? These pages may help you find information, resources and support, or search for it locally:
Multiple Pregnancy in Australia: Emotions and Support
Preparing for Multiple Births - based in US
International List Multiple Support Services
Advice and Tips for Single Parents of Twins and More
Articles about Multiple Pregnancy and Looking after Multiple Babies - based in Australia Australian Multiple Births Association (AMBA)
Online Forum for Parents of Multiples - based in Australia
South Australian Multiple Births Association (SAMBA) - list of resources available in SA, examples of practical on-the-ground support.
Perth and Districts Multiple Births Association
Twins and Multiple Births Association (TAMBA) - UK
TAMBA Frequently Asked Questions Page - includes a message board, information about support groups, and Twinline (a phone counselling service open from 10AM-1PM and 7-10PM, freephone 0800 138 0509, with out-of-hours number and email)
Twins Online - UK, includes support forum
Preparing for Multiple Births
One thing you may find hard is the need for more monitoring during pregnancy and more medical examinations ...
Physical Examinations and Medical Tests:
Many people who've been raped find any medical examination, and especially obstetric-gynaecological ones, very difficult. You're really not alone. Here are some tips for going to the gynaecologist from Pandora's Aquarium. Some people find that breathing exercises, safe-place visualizations or grounding techniques help. Healing Mind, Healthy Woman: Using the MInd-Body Connection to Manage Stress and Take Control of Your Life pp. 42-88. is an excellent discussion of relaxation techniques, including ones that you can do in only a few minutes to specifically to help you deal with medical exams Here's an example of a "mini" from this book:
Make the shift from chest breathing to abdominal breathing (you should feel your abdomen rise as you breath in and fall as you breathe out - putting a hand on your abdomen can help you feel this). As you inhale count very slowly from one to four. As you exhale count very slowly back down, from four to one. As you inhale, you say silently to yourself, "one, two, three, four", and as you exhale you say silently to yourself, "four, three, two, one". Do this for several breaths and after that as long as you wish.
I've also found it helpful in doctor's waiting rooms to use the technique of counting 5 things you can see, 4 things you can hear, 3 things you can feel, 2 things you can smell, 1 thing you can taste, and then doing it again with 4 things you can see, 3 things you can hear, 2 things you can feel, 1 thing you can smell, then 3, 2, 1 etc. It keeps my mind occupied and helps me not to panic.
This link about coping skills and techniques explains that exercise and many others. You may find it useful. The more ways you can learn to relax, the more techniques and tools you can use to help yourself cope with pregnancy, birth and beyond. It can also help you to bring a trusted friend along with you to the medical appointment. Often you can also get support of this kind from rape crisis services.
Sometimes you can have the examination or procedure in a specialized setting with people who understand sexual assault and are well-trained in what might upset you and how to deal with that. I had my first pap smear in a forensic sexual health clinic and the nurse was wonderful! Make sure you consider, though, whether this might remind you too much of examinations in the immediate aftermath of the rape.
Some GPs now have special training in dealing with people who've experienced sexual assault. You may be able to get a list of trained GPs by talking to your local rape crisis service or your community mental health unit (whose phone number can be found in the front section of your phone book). If you know you're going to need medical tests perhaps you can write your doctor a note asking her or him to do whatever you think might help you. My doctor (like many doctors now do anyway) is always very careful to ask my permission before touching me. It really does help. This page of general information for survivors of child sexual abuse who're pregnant might also help you. It contains some information on how to handle medical tests and have your voice listened to in medical settings.
See also the Pregnancy Developing page here for information and links about depression, anger, fear, a deep sense of violation, bonding with your baby during pregnancy, eating disorders, body image and the use of drugs, herbal treatments and medications.
Feelings and Thoughts:
Please be aware that this section may be upsetting and contain graphic details.
Question I asked:
Does anyone have any tips for how to deal with triggering physical exams? (OB/GYN)
One thing I did was carry a seashell with me; it helped me to have something in my hand to calm me down. And also my boyfriend's (now husband's) army fatigue shirt since he couldnt go with me.
I wish I could give good sound advice for this. I still have not been able to get to the OBGYN since my rape.
I have the doctor talk to me the entire time even if she has to talk about nothing. I ask the nurse to turn the other way so I don't feel like somebody is staring at me. I also ask someone to go with me like my husband but not in the room it helps me to know he is just there supporting me. One time I kept having flash backs so badly it was hard for the doctor to do the exam so I asked her to get a piece of ice. I held it in my hand so all my focus wasn't on what the doctor was doing. It seemed to help. I hope this helps.
I visualize my safe place that I have developed with my therapist (on beach with soft waves hitting the shore) and practice taking deep breaths to help me be calmer. I use positive self-talk such as reminding myself that I am safe now, I'm old enough to advocate for myself now, I have choices, I'm in a safe place, etc. I also try to bring someone I trust to help keep me safe to be with me. I sometimes discuss recent or past events that I find humorous with that person to help me relax.
I try to breathe more slowly. I also took a friend who is very down-to-earth and great! When I couldn't handle it at one point, the nurse asked what I'd like them to do and I said just please talk among yourselves while I get it together again - so they had a conversation about movies they'd seen and it really helped me calm down and be able to try again with the investigation. I think I might take my husband now, if he'd come. He could hold my hand and that would help a lot. I also have a little toy bear that he gave me and I take it with me sometimes when I'm scared and just hold it in my pocket for comfort. I've also asked people online to kind of virtually hold my hand and it helps knowing people are thinking of me and caring. Sometimes I've worn a special necklace to make myself feel better. I also try to think of things to do afterward that might help - like having a nice lunch or something. Something to look forward to. Hope this helps. I've just moved and trying to find a new GP is hard. I'm thinking a little about what would happen when I need to get a pap test or if I get pregnant in the next few years (like I hope to). I think I might need to make sure those intimate examinations are done by a woman, even though the GP I think I've found is a man. I'm sure he'd do it very professionally, but ... I'm hesitant about having a man examining me there. Maybe if my husband was there too it would be OK. I'm glad that it's also possible to get pap tests and general examinations done by the sexual health clinic and probably also by the forensic sexual health team I went to for my first test. They were great - the nurse there really understood how traumatic it might be and was very flexible, letting me control what happened and going at my pace. My sister made me feel a bit better about going with my own choices when it comes to exams during pregnancy. She said something like, "I don't care what people say, how much they treat it like a clinical, medical thing - pregnancy is a sexual experience, and I have every right to decide who's part of that and who isn't! If I'm more comfortable with one person than another for any reason then that's good enough! If it's a good enough reason not to have sex with someone that I just don't want to, then it's a good enough reason to not involve someone in my pregnancy or labour". I think we all deserve that kind of respect for how we feel and I hope I'll be able to find ways to look after myself like that if and when I get the chance to be pregnant myself.
Pandora's Aquarium page Tips for Going to the GYN.