special considerations when you have been affected by abuse
** Trigger warning- domestic violence and sexual assault.
"And have you ever experienced domestic abuse or sexual abuse?" The midwife's question seemed to hang in the air as my chest tightened. Do I answer, "both" or lie and say neither have ever impacted me?
I go with the truth. I know this initial consultation at the maternity hospital is meant to create a catalogue of sorts regarding me, my history and my health. The midwife quickly explains a social worker will be in touch with me at some stage during my pregnancy. Being a survivor of any type of abuse can bring up a variety of emotions and impact one's pregnancy and birth in many ways... but I already know all this. This isn't my first rodeo- I'm pregnant with my fourth baby.
Every person who is a survivor of abuse is unique in how they will feel throughout pregnancy and birth. My journey will be unlike anyone else's, although many will be able to relate.
Without going into detail, my story includes sexual assault at age 14 and 18- two very different times in my life. An intimate partner also physically assaulted me following a verbal disagreement when I was 21. Our relationship ended that evening but the effects of these experiences remain with me. I met my husband when I was 22 and we were married that same year! Involving him in making decisions and explaining why certain choices are important to me has been critical throughout each of my pregnancies.
For me, pregnancy and birth create an extra padding of vulnerability. I'm able to tolerate fewer gynaecological exams in general since my assaults. Everything feels too invasive and sometimes even unnecessary. I've lost sleep before such routine exams and can feel my anxiety increase the day before and of the appointment. Sometimes I choose not to go at all.
During pregnancy I find myself with more unique wishes and preferences that I feel are a direct result of my history. Some of my requests are things other moms might not have considered at all. How I laboured and how I gave birth really mattered to me. There were many times when I wanted to be left completely alone. I did not want to feel watched... and who was (and wasn’t) in my birth space was critical. The people who assaulted me were all men so the idea of a man supporting me while pushing a baby out of my vagina actually made me feel insecure and unsafe. If I had no choice, far enough... but if I did have a choice in doctor, midwife or nurse, I'm choosing a woman every.single.time. and kicking any unnecessary men out of my zone. It's not that I have an inherent dislike or distrust of men... it's that my history of abuse has made me increasingly sensitive to what I call the "male gaze." The idea of a man (other than my husband) watching and supporting me as I give birth is not something I would want.
I realise these wishes are all unique to me. Some people have absolutely no problem with a male supporting them. Others are much like me and want a women-only zone if/when possible.
I have also found myself to be more modest during the whole labour and birth process. I like my body covered versus having everything “on display.” Some people have no problem being nude or almost nude through much of their labour. Nope, not for me. I think this reflects back to vulnerability and feeling as though I am being watched.
The invasiveness of some routine medical practices are also not my jam. For example, I like to limit the number of internal vaginal exams to check for things like dilation, effacement, baby’s position, etc. Point blank: I don’t want anything entering my body unless it absolutely needs to. During my two most recent births, I did not have a single internal exam. Yup- nadda, zero, zip- and that’s exactly how I wanted it! Should there have been a medical reason to check any of these things, then absolutely- but there wasn’t.
My biggest issue surrounding pregnancy and birth is any medical professional that touches me or makes a suggestion regarding my labour, such as a recommended intervention, needs to ask before doing anything. Touching me, inserting anything (like a gloved finger to check dilation) or using equipment- like a foetal doppler, all require my approval. Sadly, one of my doctors did not follow this simple request and it lead to a whole host of birth trauma… but I won’t get into that here. (Click here to read about that).
Knowing myself, my body and what triggers me to feel anxious, overwhelmed or uncomfortable has ultimately helped me make the choices that have felt right for me in the past. After my negative experience in my local hospital, I decided I wanted to try midwife lead support for a birth at home. It was exactly what felt best for me. I have since had two amazing home births and cannot say enough good things about them!
All of our journeys are different. What I have always done is talk out any issues that arise and find a way to work through them that feels right for me.