[Editor’s Note: As I teen, I experienced a date rape. It was a one time incident, but it rocked my mental health in ways I never knew possible. In fact, its the event that brought my chronic mental illness to the surface. It affected my self image and sexuality in ways I don’t care to admit.

I never considered that one time thing could have also impacted me during the process of getting pregnant, birthing my children, and the subsequent postpartum depression and anxiety that resulted. But after recently discussing it during the #sexabusechat on Twitter, I started to think about it in a different light.

These kinds of sexual assaults are so common, and I’m willing to bet a lot of you are shaking your heads right now because it happened to you too. I spoke about it once at a retreat and afterward several women came up to tell me they had lived through it too.

I’m also quite sure a few more of you have also experienced more long-term childhood sexual abuse. It’s sadly way too common, and when you’ve lived through that kind of pain, it can absolutely have a lasting impact on your lifelong sexual experiences, pregnancy and motherhood.

So I reached out to Kathy Morelli, a Licensed Professional Counselor and author who focuses on Maternal Mental Health, Family Systems, and trauma from sexual abuse and medical intervention. Today she’s sharing with us how we can start to move beyond sexual abuse before and during motherhood.

So without further ado, I want to welcome Kathy to Postpartum Progress. -Cristi]

Childhood sexual abuse and a woman’s subsequent reproductive years, including menstruation, pregnancy, birth and ongoing sexuality, occur years or even decades apart. Yet, in my clinical practice, I have found these issues to be intertwined.

Sexual themes resonate with a woman on multiple levels: Within her body, her emotions, and her psychology. And distress from childhood sexual abuse can resurface during the emotionally and hormonally charged time of pregnancy and postpartum. What research exists finds that women who suffered from childhood sexual abuse have an elevated risk of postpartum depression, besides other physical and emotional symptoms.

Related triggers around reproductive health

During Pregnancy

Body-based feelings in pregnancy can be re-triggering to a woman who has deep, somatic memories of childhood sexual abuse. Simple things such as the position of your body during vaginal exams can bring back emotional memories of past abuse. The baby moving inside your body might cause intense joy, but might also create an underlying uneasiness.

During Birth

Childbirth is an intense experience; a time of hormonal, physical and emotional exertion. Early trauma can be triggered by a particular scent for example, or a body position. If you feel powerless, not heard, or disregarded by your healthcare providers during childbirth, it can activate the symptoms of post-traumatic stress and flashbacks of your past trauma.

During Postpartum

There are many physical, emotional and psychological factors feeding your emotional health during this time. And it’s true that a pre-existing personal depressive or anxiety disorder, or pre-existing PTSD, sets your body up for another episode postpartum.

Intense physical and hormonal changes, plus adjusting to a new lifestyle caring for an infant is physically and emotionally challenging. Feelings of frustration emerge as you adjust your schedule to accommodate your baby. The endless touching may leave you feeling like your body isn’t your own anymore. Breastfeeding may feel triggering to some, as it too may cause confusing sexual feelings.

What can you do to proactively manage your mental health during these phases of motherhood?

First, I want you to know that your childhood sexual abuse does NOT define you. Your past does NOT have to be your destiny. With perseverance, you can move beyond being a survivor towards thriving and blooming beautifully.

It’s not an easy task, but your self-esteem is worth the fight! Managing the effects of an abusive childhood is an on-going deeply personal experience. It’s honorable life work, and highly individualized. As you move along your healing path, you’ll choose what’s right for you.

Tips to help enhance your experience of pregnancy, birth, and postpartum

1. Recognize that post-traumatic stress is a real disorder, not some fake diagnosis.

2. Practice Self-Love. Self-love is not just an empty cliché, it’s something worth fighting for. Allow yourself to rest and be gentle with yourself during all three stages of motherhood.

3. Try to make time to get help with a licensed mental health professional before pregnancy. It’s best to put in your emotional work before starting a family, but it can also be done if you are already pregnant or postpartum (see below.) It’s never too late to begin.

4. Face your fears and past, at your own pace, in a safe and professional environment.

5. Work with a gynecologist/obstetrics/midwifery provider with whom you feel comfortable enough to discuss your history of trauma. Investigate the hospital or birth center where your provider practices to make sure it’s the right fit for you. If your provider or institution don’t meet your needs, feel empowered to find another. It’s important to advocate for your own health care.

6. Find an experienced childbirth educator who is accepting of your personal choices. Birthing and breastfeeding classes really do help on an emotional level as well.

7. Remember that birth is an unpredictable experience. If your birth experience doesn’t follow your birth plan, you can still feel good about it. You are not less of a woman or mother, no matter how your birth happens.

8. Honor the achievement of childbirth and motherhood. You are growing a life! That is a huge accomplishment.

9. Understand that your hormonal balance takes awhile after birth to come back to pre-pregnancy levels.

10. Honor and protect yourself during “the fourth trimester” and beyond, as your body shift towards balance:

    1. Rest; develop the mindset of being, not doing.

    2. Practice good nutrition with whole foods and good supplements.

    3. Get help. If you can afford it, set up some time with a postpartum doula or a baby nurse so you can rest. Enlist the help of family or friends. You don’t have to do this on your own.

    4. Don’t underestimate the power of sleep. Work out a sleep plan. Even if you are breastfeeding, don’t be the only one getting up to feed the baby.

    5. Practice mindfulness and relaxation to counteract the inevitable challenges of caring for a newborn and the emotional change of identity in motherhood.

11. Nurture yourself with complementary care. Safe touch such as shiatsu and acupuncture can re-balance your body and mind.

12. Expect some emotional ups and downs and realize these are normal.

13. Social support is important. Women who “Tend and Befriend” in real life and online feel supported.

14. If you feel very sad or anxious, there is a lot of professional help available to you. You are not less of a mother if you see a doctor or therapist. Taking care of you makes you a better mother.

A beautiful book about healing from child sexual abuse that I highly recommend is A River of Forgetting by Jane Rowan.

If you had the experience of childhood sexual abuse, know that post-traumatic growth is possible. Don’t wait to honor yourself by doing the emotional work. You can ask for and get help. You and your family are worth it.

And know that you are not alone.

Reference:

Perez-Fuentes, G., Olfson, M., Villegas, L., Morcillo, C., Wang, S. & Blanco, C., (2013). Prevalence and correlates of child sexual abuse: a national study. Comprehensive Psychiatry, 5(1), 16-27.