Why do natural childbirth & lactation professionals ignore the needs of survivors of sexual violence?


The statistics are staggering. Up to 1 in 3 American women experience sexual violence during their lifetime. Nearly 20% of adult women recall an episode of childhood sexual abuse or assault.

These women often have different needs around childbirth and breastfeeding and those needs are routinely ignored by natural childbirth and lactation professionals.

[pullquote align=”right” cite=”” link=”” color=”” class=”” size=””]Isn’t it a provider’s obligation to support WOMEN, not to promote their preferred method of birth or infant feeding?[/pullquote]

As the paper Responding to Prenatal Disclosure of Past Sexual Abuse explains:

…[T]he perinatal period can be especially challenging for abuse survivors. During pregnancy, bodily sensations resembling disturbing elements of past abuse may lead patients to experience four categories of posttraumatic stress symptoms:

recurrent and intrusive memories;
avoidance of thoughts, activities, and other reminders of the traumatic event;
heightened irritability and other manifestations of autonomic arousal;
and negative changes in mood and cognition.

… Soet and colleagues demonstrated that sexual trauma survivors were 12 times more likely to perceive their childbirth experiences as psychologically traumatic compared to women without this history…

Inter-relationships between sexual abuse, female sexual function and childbirth provides further detail:

Sexual abuse (SA) survivors have been found to potentially experience triggering flashbacks and/or ‘body memories’ of the SA trauma during childbirth. This recalling/re-experiencing of the sexual trauma may be due to a variety of factors such as the similarity in the anatomy involved and the exposure of sexual body parts. Clinical procedures and labour sensations have like-wise been shown to be experienced by SA survivors as triggers, reminding them of the abuse …

Nearly every paper on the topic emphasizes that a subjective sense of lack of control is particularly triggering.

Control/lack of control has also been reported as the main underlying factors influencing SA survivors’ subjective evaluation of the birthing experience in a study by Parratt. Moreover, feelings of powerlessness, betrayal and humiliation have been cited as potential adverse experiences of SA ‘birthing survivors’ – as detailed in a study by Parratt…

Abuse survivors report similar feelings around breastfeeding.

For example:

Some survivors worry that if they choose to breastfeed that breastfeeding advisors will need to touch them when teaching them how to breastfeed their baby…

Certainly no advisor should touch your breasts in any situation without seeking your permission first…

And others find night feedings particularly triggering:

Some survivors mention that they find night time feeds more difficult and are more likely to be triggered and have an unpleasant experience. Obviously, this is more likely if you were abused at night…

Survivors often struggle with feelings of failure that can be exacerbated by breastfeeding difficulties:

…[S]urvivors who breast feed may find themselves saying “My baby lost weight when breastfeeding. I’m useless”. You baby losing weight is not your failure… There are some medical reasons why occasionally a woman may not produce enough milk, or a baby may not take enough milk – and if this is the case then a health care professional will be able to suggest ways forward. It does not mean you have failed…..it is unfortunately one of those things that happens through no fault of your own.

The theme that is repeated over and over again among survivors is a loss of control is especially debilitating for them. Yet natural childbirth and lactation professionals consistently pressure women to give up control to “nature.” They are dismissive when women request epidurals and routinely demean the idea of C-section on maternal request. This despite the fact that women who make these choices are often protecting themselves from sensations they cannot bear and memories that haunt them.

Should women have to reveal a history of sexual violence just to receive the care they need? I always appreciated and felt honored by being taken into my patients’ confidence about past trauma and tried to do anything in my power to make their childbirth experience more bearable. But not every provider is supportive.

… When talking to one midwife about the fact that I would chose not to breastfeed if I had a baby, she replied “Well, you don’t deserve to be a mother then!” – without exploring any of the reasons with me that I may have come to this conclusion. Unfortunately, this attitude is not totally unheard of within the hospital environment, and rather than perhaps supporting survivors to be able to overcome their fears, this attitude can close a survivor down and prevent them from getting the support which may prove helpful to them.

Moreover, if up to one third of women experience sexual violence during their lifetime, shouldn’t ALL providers offer ALL women the option of taking control of their birth experiences by choosing epidural or C-section on maternal request? Shouldn’t ALL providers offer ALL women the opportunity to formula feed if they think that is the best way to protect their mental health.

Why do natural childbirth and breastfeeding professionals routinely ignore the needs of survivors of sexual violence?

Isn’t it a provider’s obligation to support WOMEN, not to promote their preferred method of birth or infant feeding?