When Survivors Give Birth


I’m doing this training this week from Selena Shelley, a doula and psychotherapist, like me.  I attract a lot of clients who are survivors (some disclose, some do not).  It can be difficult for me to differentiate sometimes when a client is in the “zone,” as opposed to dissociating.  Being present in your body helps labor progress.  Sometimes, mamas don’t want to feel anything/be numb during birth, or once the feelings become intense, the fear of sensation/overstimulation causes them to physically clench tight, and slows or halts labor.  An epidural or fentanyl can be that intervention that allows the mother to relax and I have witnessed mamas dilate from 4 to 10 cm within minutes when they can finally let go.  That’s why I’m a doula that will support whatever works to get you to your goals.

When I did my doula training, a survivor talked about how birth was transformative for her and allowed her to reclaim her body and that spoke to me.  I wanted to be a part of that!
Here were my WOW moments from the training that I didn’t yet know, or needed to be reminded of:
94% of prostitutes experienced childhood sexual abuse (CSA)

70% of teen pregnancies experienced CSA

Asthma (a constriction and tightening) can be a red flag for CSA, especially when the abuse was oral

Somatic infertility (woman unconsciously may not want to bring a child into an unsafe world), as well as infertility due to physical abuse, can occur

GI issues, chronic pelvic pain, vaginismus, TMJ, fibromyalgia, chronic fatigue, migraines: all possible impacts of CSA – “the body tell us things we need to know”

Red flag: women not attending dental/prenatal appointments (due to fear)

A survivor’s daughter reaching the survivor’s age of abuse, can precipitate memories

Birth trauma rates increase in survivors (process as soon as appropriate)

Impact of CSA on pregnancy, labor and birth:

  • fear of being “ripped apart” or damaged
  • exaggerated symptoms of pregnancy (body is triggered)
  • pelvic exams can progress slowly and be narrated by providers with permission from survivor
  • hyperemesis gravidarum and CSA survivors have a high correlation (80%, wowowow) – “vomiting is a rejection phase”
  • fear of having a girl who could potentially be abused
  • fear of having a boy, another penis inside the woman without permission
  • fear of blood draws, IVs, catheters, stripping of membranes, artificially breaking water, insertion/penetration (some survivors feel comfortable in an open room)
  • fear of blood and secretions (triggers around liquids, messiness, stickiness)


Helpful tips:

  • move bed if woman is exposed toward door
  • make a sign for the door: please knock and introduce yourself
  • “meet the pain and press it out with the baby”
  • request nurses wipe often during pushing with permission, change pads while dilating
  • ask what to do if dissociation occurs
  • “when you are pushing your baby out, you are pushing trauma out with your baby”
  • “relax” or “let go” may be triggering, rather than helpful
  • prepare women that breastfeeding can be arousing and give oxytocin rush and is normal, healthy, not sexual

We can offer survivors choice, which was missing from their childhood.

The training is based on a book by Penny Simkin.


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