Deciding to have a baby is a big decision for anyone but can feel particularly daunting for someone with a history of abuse.
In England and Wales, 12% of adult women have reported experiencing some form of sexual abuse before they were 16 years old1. While this statistic gives an indication of how common childhood sexual abuse is, it does not fully represent the scale of the issue, because it often goes unreported.
For some survivors, having children or considering having children can be a difficult and lonely time. It can raise concerns, confusing feelings and be a trigger for traumatic memories.
Dr Elsa Montgomery is a Senior Lecturer at King’s researching the health care experiences of women who were sexually abused in childhood. Based on in-depth interviews with survivors, Dr Montgomery uncovered reports of ‘re-enactment’ of their abuse during pregnancy and birth in ways that they may not have anticipated and that may be very perplexing at the time2. They indicated that it would have helped them to know that their experiences are shared by other survivors.
We recognise that everyone will have had individual experiences, but we also know that pregnancy can be a scary and lonely time. We believe that learning from others who may have had similar experiences to you can be helpful.– Dr Elsa Montgomery and Dr Yan-Shing Chang
Collaborating to create online support
In response to what survivors had told her, Dr Montgomery led a collaboration to create an online resource which aims to help women who have experienced childhood sexual abuse to prepare for pregnancy, birth and parenthood. It is called Pregnancy, Birth and Parenthood after Childhood Sexual Abuse and is available on The Survivors Trust website.
Working with women who have experienced childhood sexual abuse, The Survivors Trust as well as midwives and other researchers, the online resource is based on the words and experiences of women who have taken part in research about what pregnancy, birth and parenthood are like when you have experienced childhood sexual abuse. As well as being for anyone who has experienced childhood sexual abuse, it is also to help their partners or friends support them too.
It is amazing to see some of my own feelings, thoughts and experiences reflected by other women. It would have been such a relief to have known this at the time!– Feedback at the outline stage of the project from a survivor of childhood sexual abuse
Creating a safe space to explore the information
The multimedia resource is based on the experiences of women who were sexually abused in childhood, alongside helpful advice from researchers and midwives. The experiences of the women in the resource are powerful and can be hard to hear. They may also be triggering and remind people of a traumatic event in their past. To ensure that the user can go through the information at a time and place that suits them and at a pace that feels safe, the resource is separated out into small sections covering topics related to pregnancy, labour and becoming a parent. It also includes ‘trigger warnings’ ahead of information which is especially sensitive, so the user knows to skip it or be prepared.
Helping identify questions as well as finding answers
The resource goes into detail by exploring areas such as dealing with physical examinations, feelings of control during pregnancy and labour and fears survivors of childhood sexual abuse may have about becoming an abuser themselves.
For every part of the resource, the experiences of the women are provided, alongside reassurance and guidance from researchers and midwives. There are also suggestions for the user to consider about how they may feel or act about the areas covered. This is to help people identify questions and issues to think about if they are pregnant or thinking about having a baby.
Our hope is that this resource will help to empower women to approach pregnancy, birth and parenthood feeling safe and in control.– Dr Elsa Montgomery
Published in June 2019, Pregnancy, Birth and Parenthood after Childhood Sexual Abuse is part of information from The Survivors Trust aimed at helping survivors understand what happened, how they feel or what to do next. The resource is also helping professionals and students expand their knowledge of this sensitive issue in maternity care.
The development of this resource was funded by a Wellcome Trust Engaging Science People Award.
- Office of National Statistics Child sexual abuse in England and Wales: year ending March 2019
- The re-enactment of childhood sexual abuse in maternity care: a qualitative study Montgomery et al, 2015, BMC Pregnancy and Childbirth
- A feminist narrative study of the maternity care experiences of women who were sexually abused in childhood, Montgomery et al, 2015, Midwifery
- Pregnancy, Birth and Parenthood after Childhood Sexual Abuse, Elsa Montgomery blog, June 2019, All4Maternity
- New resource for women giving birth as survivors of abuse, Elsa Montgomery blog, September 2019, Positive Birth Movement