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A Burden To Share

A Personal Account of the Effect Of Childhood Sexual Abuse on Birth 
by Christine

That was 10 years ago. I had not yet remembered the incest. Now I am remembering: how I was sexually abused in childhood, how I believed it was my fault, how I was told not to notice, not to tell. Now I am trying to take care of myself, to understand my needs, and to talk about it. But then, not knowing where or how to focus the shame, I blamed myself.

My first pregnancy was uneventful. If it had not been for the unrelenting morning (and afternoon and evening) sickness, I would have liked to stay pregnant forever. I loved my huge belly. I loved the private, middle-of-the-night talks with my baby. I loved feeling his kicks and squirms. I read everything I could, asked endless questions, fixed up the nursery, and anticipated my earth mother role with enthusiasm.

I also cried after every prenatal visit. I could not understand the tears,so I hid them. My midwife did not know how difficult it was for me to go to her office. I'm certain she had no idea how many days it took me to recover after seeing her, even though she didn't do another pelvic exam until I was almost at term. Seeing her reminded me that I was going to have to give birth, and I was terrified.

When I was about seven months pregnant, I finally found the courage to quietly mention to her that I was afraid of giving birth. I could not tell her why. The closest I could come to identifying the feeling was to say that I was afraid of being out of control. She tried to calm my fears, and casually said that many women are afraid, especially primips. But, she added, women who are the most afraid usually do the best in labor.

The only time she ever let me down was that afternoon in her sunny office when she minimized my fears and dismissed them so easily. Perhaps if I could have let her see more deeply into my soul she might have had more compassion. Perhaps if I had remembered then that I had been sexually molested from infancy, we could have named my fears and faced them together. But I did not understand it myself, and I was ashamed at having doubts. I dropped the subject and didn't mention it again.

During childbirth classes, my husband and I sat at the back of the room. As soon as we began the relaxation exercises, my tears started. I let them fall silently, pretending no one noticed. Maybe no one did. I cried my way through six weeks of preparation, unable to stop or explain the tears.

Finally, almost a week past my due date, labor began. This child was determined to be born, whether I was ready or not. My labor was slow, not fitting into the normal curve. Thank goodness for a patient midwife who was not intimidated when hour after endless hour my cervix was still 4 centimeters. She suggested breaking the bag of waters and I agreed, but I cried and cried. I felt like my body had failed me.

My labor finally progressed and soon I had the urge to push. "Check me and see if I can push!" I begged my midwife. "Just do what your body tells you," she replied. But I did not trust my body, would not, could not let myself push without her permission. She had to reassure me over and over that it was OK, that I could do it. After two and a half hours of hard pushing, my conehead, posterior son was born. He was beautiful, and I was ecstatic: what an incredible, empowering, holy experience! But I was not prepared for what was to come.

Within hours of my son's birth I felt depressed. Had I done it right ? Did my midwife still like me ? Did my husband respect me ? I had complained--a lot! Was I a whiner ? Was everyone making fun of me behind my back ? I convinced myself that my unmedicated spontaneous vaginal delivery had been a failure. I was not good enough. My baby was so good, so beautiful, so perfect. I was so bad, so ugly, a failure. The crying began again. I read more books, this time on postpartum depression. Nothing I read sounded right to me. I could not explain my feelings of loss and shame. And so I did what I always did with my feelings--I hid them.

Only my husband knew how disabled I was by my depression. With everyone else I was a competent, happy first-time mom. Alone, I cried and cried. I couldn't cope with anything. I went over the details of my birth compulsively, incessantly looking for all the signs of failure. I relived the care and kind touch of my midwife and I fell in love with her. But I never told anyone. Instead, I kept it all inside, considered myself needy, evil, selfish, thought I was not worthy of my baby, even contemplated suicide. My husband didn't want to have any more children. He did not think we could endure another bout of postpartum depression. He was wonderful, he let me lean on him, but (as he later told me) he was scared.

Life went on, and slowly, I recovered. We did have two more babies, each with a different midwife. Each time I had severe hyperemesis, I cried after every prenatal visit, I went past my due date. Each time I had slow labors and became "stuck" at 4 centimeters. Each time I had a beautiful vaginal delivery and disabling postpartum depression. Each time I bonded with my midwife and was certain that she thought I was ugly, stupid, bad, demanding. And each time, I never let it show.

Now that I am coming to terms with my history of childhood sexual abuse through therapy I am also looking at my birth experiences in a new way. I am much kinder to myself these days. I am beginning to understand the tears and the shame, the fear of being powerless. I try to understand my intense attachment to the women who took care of me during a time of vulnerability, who touched me in a gentle way and did not hurt me but empowered me. I am beginning to accept my need for control, my distrust of my body and the belief that it will betray me. And I am so sorry that I did not have this understanding 10 years ago, on that first day, during that first prenatal visit, when I cried through that first vaginal exam and was ashamed and could not talk about it.

I used to think that I had no story to tell, that my birth story was not worth talking about, not worth listening to. Now I know that I do have a story, and I want to tell it. I want to help women who have been abused realize that they are not alone, and they are not to blame, whatever their birth story, whatever the outcome. I offer this advice to you, if you are pregnant and have a history of sexual abuse. Talk about it. Tell your midwife. I say this with great respect, knowing how difficult it is to overcome the shame and the fear. I believe it will help to name your fear and share your shame. I have learned from my own experience that it is so much harder to hide the pain and never ask for what you need. That is what we learned in childhood, but we are adults now, and a midwife is often a very safe person to talk with. Go slowly. Be kind to yourself.

If you are a midwife, my advice to you is to ask each one of your women if she has been sexually abused. Ask with the courage to know. Listen with the compassion to really hear. Not every woman who comes to you with a history of incest will remember or know about her abuse, but she may tell you in other ways. She may tell you with her tears, her pain, her fear. Please treat her gently, lest you repeat the abuse in a more subtle way. If she cannot talk about it, do not force her. She will know when she is ready. Just as in birth, this is about trusting the process. You will not have all the answers for her. That is OK; she is finding her own answers. Support her in that, create safety and make time for her to ask for help (she may not even be able to do that). As you well know, a hand to hold may be all she needs.

This is hard work. But I believe in midwifery. I believe that midwives empower women, teach us to trust our bodies, help us to know ourselves. I believe that midwives can help us heal.

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