The Effects of Abuse during Pregnancy and Labor
by Cathleen Grunwaldt, Doula
While pregnancy and the birth of a child are suppose to be joyous times for women, survivors of abuse may not share that opinion. Survivors may feel as if they are being abused all over again due to the lack of control they have over their body during pregnancy and labor. Some survivors may not even realize the unique impact that the abuse has on them during this time and even into their mothering techniques with their children. There are a number of ways that previous abuse and also current abuse manifests itself during this time. Common themes and behaviors from a study in Madison, WI conducted by Jennifer Burian and Sara Williams include but are not limited to are a lack of willingness to disclose the issue, avoidance of health care, somatic discomfort, control issues, dissociation and flashbacks.
Most women do not readily disclose the fact that they have been or are currently being abused. Their abuser as well as society has probably made them feel shame and embarrassment. They may not want that information in their medical record. They may not feel a personal connection to their provider. They may not feel safe that once the information is revealed it will be handled appropriately.
Avoiding health care is also a common theme among survivors. Going for a prenatal exam in some ways mimics abuse knowing that unwanted and foreign objects will be inserted into her vagina as well as the anticipation for it to happen such as waiting in the lobby and then waiting some more in the room until the provider arrives. If the survivor makes the appointment they may find it difficult to keep.
Survivors may also have problems that manifest themselves as somatic disorders. Chronic headaches or migraines, back, neck and or abdominal pain, recurring vaginal infections, pelvic pain and even eating disorders are among some of the manifestations. Survivors react with the disease at the site of the abuse. (Blume, E.S.) For example, women forced to give oral sex may have a gag reflex that is triggered easily or even suffer from spontaneous vomiting.
Retaining control is very important to survivors since this is taken away from them while they were being abused. These control issues may present through aggression, submission, rituals or living in a state of crisis. Many do not consider compromise, as that is to give up their power and control.
Survivors also relate the sensation of feeling numb and not a part of their own body as a coping mechanism. This dissociation response is common during labor when pain triggers abuse memories.
Flashbacks to the abuse can happen anytime and anywhere. Almost anything can set them off. It could be something as simple as a smell. Some women have suppressed the abuse and when they experience a flashback they have no idea what is happening.
If you are currently pregnant and you know you are a survivor of abuse, it is recommended that you find a care provider, a doctor, midwife or doula, that you feel safe disclosing this information to. These care providers are not necessarily trained to aid you in counseling but they do know ways to help you get through your pregnancy and birth that will alleviate added discomfort. If you would like a place to turn to you can start by calling RAINN (Rape, Abuse, Incest, National Network) at 1-800-656-4673.
Reference:
Ronnie Falcao, LM MS, Abuse Issues in Pregnancy and Labor, n.d., Blume, E.S., Secret Survivors: Uncovering Incest and Its Aftereffects in Women. New York, Ballantine Books, 1989.
