Can sexual, physical, or emotional abuse affect a woman years later, when she becomes pregnant?

Pregnancy, birth and baby care may remind a woman of feelings or experiences from previous abuse. The effects vary according to the nature of the abuse, the woman’s age at the time, how long the abuse continued, who the abuser was (or abusers were), and whether she had adults in her life with whom she felt safe and cared for.

Rapid bodily changes, people’s intrusive attention to her growing belly, and the enormous impending life change may shake her usual way of coping from day to day. She may feel vulnerable and out of control when medical procedures and tests that require her to get undressed and allow touching and probing by authority figures who are strangers. The unpredictability of labor—when it will start, how long will it last, how much it will hurt, how she might behave—along with the focus on her sexual parts and policies that require the use of many machines, an IV line, and limited ability to move around out of bed may bring up disturbing feelings.

The thought of pushing her baby through her vagina may cause tension and fear. Afterward, with her physical recovery (that may take weeks) and the 24/7 responsibility for her baby may make her feel exhausted, resentful, or controlled by her circumstances.

For the abuse survivor, such challenges may evoke the same feelings and fears that she had during her abuse. She may react as she did when she was a vulnerable child with limited or no ways to control the abuse.

If a woman finds herself upset, anxious or fearful, it helps if she can address these feelings with an empathetic and knowledgeable doctor or midwife or a counselor who can help her develop ways to understand and deal with troubling stresses that may come with childbearing. A doula who understands and who will remain with her and her partner throughout labor and birth can also address issues as they arise and instill confidence.

A combination of awareness and sensitive care can help women who have experienced past abuse to have a childbearing experience that is not only nontraumatic but also fulfilling and empowering.