A Qualitative Study of Pregnancy and Childbirth Experience for Women with a History of Sexual Trauma [37B

Abstract

INTRODUCTION: Women with a sexual trauma history are more likely to perceive pregnancy and childbirth as traumatic. Our objective was to identify triggers that provoke anxiety or flashbacks for women with a sexual trauma history in order to design interventions to improve their labor and delivery experience. METHODS: Semi-structured qualitative interviews were conducted with 20 adult women who reported a sexual trauma history, and 10 without a sexual trauma history. All delivered since 2014. Interviews focused on antenatal, intrapartum, and immediate post-partum experiences. RESULTS: Triggers included language reflective of that used during a past sexual assault, the presence of unfamiliar providers, and cervical exams and vaginal repairs that were not adequately explained. Some women found regional anesthesia helpful, while others were triggered by a perceived lack of control. Women who disclosed their sexual trauma history to prenatal providers expected appropriate documentation so that subsequent providers were aware. Some participants desired elective cesarean section due to their sexual trauma history. Many described pregnancy, childbirth and breastfeeding as healing through the creation of positive connections to their bodies. They found advocates in family, trained birth support and medical staff. Our control group suggests that many of these findings are specific to women with a history of sexual trauma. CONCLUSION: Women with a sexual trauma history have unique priorities and needs during pregnancy and childbirth. Discussing medically safe delivery preferences during prenatal care, documenting sexual trauma history and clear communication during exams may improve labor and delivery experiences for this group of women.