Pregnancy can be a joyful, transformative time. But if you’re a survivor of sexual assault or abuse, it can also feel unexpectedly challenging. The many physical changes and invasive exams that come with pregnancy can stir up memories of past trauma, making the experience more complex.
“Anything happening to your body that feels outside your control can be inherently triggering,” says Rachel Stanton, LCSW, a Boston-based therapist who specializes in counseling for survivors of sexual assault and childhood sexual abuse.
“Part of the brain might feel happy and excited about the pregnancy, while another part registers it as a loss of control, which can spark anxiety.”
Any reaction to pregnancy, whether that’s joy, anxiety or anywhere in between, is valid. Know that it’s normal to have multiple feelings at once, says Stanton.
“Any focus on the body at all can be triggering because often the way we cope with sexual trauma is to disconnect from our bodies," Stanton says. Pregnancy’s physical symptoms and changes, like tender breasts, a growing bump and even nausea or headaches, can lead to heightened anxiety or hypervigilance.
“It may not even be a super-specific flashback, but your body feels the sensation, and your brain reacts," says Stanton. "It can feel like a sense of panic."
Fortunately, with the right support system and care team, you can still have a positive pregnancy experience.
If you've experienced sexual trauma in the past, pregnancy can be triggering, both mentally and physically.
These feelings are normal, and finding a compassionate provider can help you better prepare for birth.
Organizations like the Rape, Abuse & Incest National Network (RAINN) can connect you with professionals for guidance and care.
Find a provider who understands your needs
You’ll be spending a lot of time with your OB/GYN or midwife over the course of your pregnancy, so it’s important to find someone who understands how trauma impacts their patients.
Treat your first appointment with a new provider like an interview. Do you feel comfortable around this doctor? Are they open to patient-led care? If so, let them know what makes you feel safest, like learning about procedures beforehand, staying clothed as much as possible or limiting pelvic exams.
Keep in mind that you also don’t need to share your full story to advocate for your needs if you don't want to.
“Many survivors may not feel comfortable or simply may not want to get into the whole story of their history of abuse — and you don’t have to,” Stanton says.
“You can simply say you have a history of sexual trauma or even just leave it at, ‘I have anxiety.’” A trauma-informed provider will know how to be compassionate and respond appropriately.
If you're looking for a provider in your area that may have experience treating patients who have experienced trauma, Postpartum Support International (PSI) has an online directory where you can search by type of provider and location.
You can also call a provider's office and ask whether they have any doctors who have experience providing care to those who have suffered from trauma.
And if you don't feel like your current provider is sensitive to your needs and desires, it doesn't hurt to find someone else who might be better for you if you're able to do so.
Prioritize your mental health care, too
If you don’t already have a therapist or counselor, pregnancy can be a great time to find someone to help you process all the changes to come over the next nine months.
“Caring for your mental and emotional health during pregnancy is just as important as caring for your physical health,” Stanton says. “That’s true for everyone, but especially for those with a history of sexual assault or abuse.”
You can talk to a therapist about how an exam made you feel, and come up with tactics ahead of your next appointment so you can feel less anxious. These conversations can help you combat depression, anxiety and post-traumatic stress symptoms, which are more common in pregnant women with a history of sexual abuse, according to the National Institutes of Health.
If you have insurance, call to learn more about your mental health benefits. You may have in-network options or even coverage for online therapist communities. Your OB/GYN can also recommend mental health experts for you to talk to.
Set boundaries that make you feel safe and respected
If you don’t want to be touched in a certain area or address a triggering topic during your exam, let your provider know. Clear responses — like saying, ‘Please don’t touch,’ or changing the subject — can help you move past uncomfortable situations, says Stanton.
If you know what may upset you, you can list it out for your provider in the communication portal ahead of an appointment, or print it out and ask that an electronic copy be made part of your medical record. But it's also okay if you aren't sure what's going to trigger you, says Stanton.
As you go through your pregnancy, you can adjust what you share — and what you don't — since what you're comfortable with may change as you go along. The best thing you can do is to be honest with your doctor every step of the way.
Prepare for your birth in a way that feels empowering
One of the most triggering parts of pregnancy can be the unpredictability of labor and birth. Feeling out of control can bring up anxiety or even flashbacks. That’s why preparation can be a powerful grounding tool as you approach labor and delivery.
One way to gain control over your labor experience is to have a strong advocate in the room, such as a doula. “I recommend a birth doula for all my pregnant clients because it helps so much psychologically to know that there will be an advocate there whose only job is to support you during birth,” Stanton says. “A doula can help take control of a situation when you can’t and can help you feel safe.”
You can find a doula through a variety of organizations, such as:
If you're unable to hire a doula, you can always task a partner or loved one with acting as your support person during labor and delivery.
You can also take a birth class to learn about different labor experiences. “This can help you understand what to expect and feel more mentally prepared,” says Stanton. But it’s also okay to step out of the class if you notice that certain stories are making you more anxious.
Creating a birth plan that prioritizes your comfort and sense of agency is also key. Think through your birth preferences around pain relief, how you want your care team to approach cervical exams (only if necessary, for example) and whether you'd feel more comfortable scheduling a C-section or getting an epidural. You can also include a brief note about your trauma history in your plan, if you feel safe doing so.
Remember, though, while a birth plan is a great way to think about your ideal birth, most labor and deliveries don't go exactly as planned, but mapping it out so you feel more comfortable can be really helpful. You can also have ideas about what you'd to do if your medical team does have to pivot from the birth plan in the moment.
Resources to help you through your pregnancy
Need more support? Remember, seeking help is a sign of strength. Here are some resources that may be useful for navigating your pregnancy as a trauma survivor.
Rape, Abuse & Incest National Network: RAINN offers confidential, 24/7 support for survivors of sexual violence. You can call the national hotline 1-800-656-HOPE (4673) or visit RAINN's website to be connected immediately with a trained counselor. If you’re dealing with a pregnancy that’s occurred as a result of sexual assault, RAINN can help you get connected with the right support, too.
- Postpartum Support International: PSI has free, specialized coordinators and therapists for those who have experienced sexual trauma. Plus, they have trauma support groups for before, during and after pregnancy so you can connect with others who have been through something similar. All you have to do is fill out their online form, and they will connect you with the appropriate resources within 48 hours.
Yes 
No 
Trending On What to Expect
