Childbirth in hospital after rape/sexual violence, wanting a homebirth

[GoldenCarp22]

Apologies if this is long/triggering for people.

I am a rape survivor posting under a new temporary name. I have searched for threads on the subject of giving birth after surviving rape and sexual violence but found nothing on MN or elsewhere.

I am in a loving relationship and expecting my first baby in a few months with my partner. The rape was almost a decade ago. It was a very violent and sadistic stranger rape. Later the attacker was caught and jailed after I gave evidence in court. This month I heard he was to be released on licence after serving 8 years which has unsettled me.

After the rape happened, I was taken to my local inner city hospital and given some emergency care for my injuries and also subjected to a lot of forensic intimate exams by police doctors who needed to gather evidence. The hours I spent post-rape at the hospital were very traumatic and as a result of all the experiences I went on to develop PTSD. I had lots of counselling and recovered well but there are still some things that can trigger flashbacks, even after all this time. Normally my life is fine and I barely think about the rape. But now I am worried because I am having a baby, I am going to be revisiting certain things I would normally do my best to avoid.

Specifically, I am worried that giving birth in hospital, and the poor post-natal lack of care at my local hospital are very likely to cause a recurrence of the PTSD and depression/panic attacks/flashbacks.

So I am booked in for a home birth. I'm apprehensive about the pain of labour, of course, like any first time mum to be. But I'm much, much more afraid of the hospital environment and what could happen to me there.

I believe - I hope - that I can manage the pain of birth without panicking if I am allowed to 'go into myself': that is how I managed to cope with the rape and have coped with other serious and life threatening experiences I have had ( and giving birth is not like being in a bad accident, or being raped, after all!). I will have a birthpool, gas and air and pethidine and experienced women to help, and my partner there. I want to have the baby at home if I possibly can, and if that means I have to do without hospital drugs, so be it.

The specific triggers I have are:

• internal exams
• being 'held down'/wired up/being immobile/legs in stirrups/legs held by other people
• men in the room and strangers in the room generally
• being on my back, with people looking at my private parts not my face
• not being able to communicate
• bright lights in my face, being exposed and naked and frightened

This is not to say I think hospital staff at a birth are intending to be frightening or unkind but just that I have a visceral reaction to the above that is to a large extent, beyond my conscious control.

I was feeling happy with my decision to have a home birth, although still worried about what would happen if I had to be rushed to hospital. I did the research, read the stats, I practice the breathing, do the yoga and try not to worry.

But the recent news stories about the dangers of home births have made me feel even more upset: that I am somehow being selfish and endangering my baby by having one. Not to mention all the reports of risks and being rushed to hospital in an emergency after having problems labouring at home.

All I want is to be safe and for my baby to be safe. I honestly think that me having some kind of bad PTSD birth experience in hospital is very likely to be dangerous to me and the baby, not just during the birth but post-natally too. But I can't find any info about giving birth after rape, or giving birth when phobic about hospitals, and everyone seems to make me feel selfish and stupid for not wanting to go to hospital. All I can find is stuff about having your rapist's baby, which isn't what I am looking for.

Can anyone here offer ideas for managing all these fears and trying to minimise the risk of it all feeling like a rerun of the rape experience? I would be very grateful for any help or pointers to sites, articles etc.

sorry goldencarp, typing too fast there -

I also meant to say, going via the perinatal team gives you a different (much faster and more responsive) access to support for things like post natal depression if you need it. Rather than trying to get an appt at the GP's, waiting a fortnight, getting referred, etc.

I was abused before (nothing on your scale) but I have had problems ever since with intimacy/sex/internal exams/people seeing me naked etc.

I must say that when it came to giving birth, I didn't give any of it a second thought and I am pretty 'prudish' really. It was in my birth plan that I wanted female staff if it was possible. The anaesthatist was male but I wasn't bothered about that. I had to have forceps but I was lucky that the doctor was female, but by that point I really wouldn't have cared. I know everyone is different obviously but I have always had major issues in this area and I just couldn't have cared less at the time. I had an epidural so I wasn't aware of any internals but like others have said, you don't have to have them. No one holds you down. My legs were in stirrups but my baby was distressed and they had to get him out quickly so I didn't even think about anything other than they couldn't find his heartrate and I wanted him to be ok. I think mothering instinct took over straight away.

The way you want your birth sounds lovely and I hope it works out for you. I think the doula is a good idea and if you need to go to hospital, at least there will be someone else there for you.

However, just in case you do need to go into hospital, you need to be prepared and have a loose plan and what you would like. Make sure your DH and doula are ready to speak up on your behalf. They will try and accommodate a birth plan where they can. I did have on mine that I would like to avoid forceps if possible but obviously it wasn't possible, which is why I didn't say exactly what I expected to happen, but just what I would like.

I also wore a large nightdress from Primark so I was covered up and it didn't matter if it got wrecked.

Good luck and I hope it all goes well for you.

Thank you again, especially those who have shared about their own painful experiences.

Poppet, and TheButterflyEffect big thanks for the recommendation about Birth Skills by JuJu Sundin, and 'When survivors give birth' by Penny Simkin. I will order them, and I'm very sorry about what happened to you. And you too, SilverCod, floofers, barkfox,DetectivePotato thank you so much and I am sorry about what happened to you.

It's so powerful to know other women have been through bad stuff and found it was possible to labour and focus on the baby not the bad stuff.

Selena Doula, thank you too for the info about doulas supporting women who have been attacked

Concordia - the long skirt is a good idea, I think I might do that, and a sports bra. I think I will be fairly hot and sweaty but I don't want to be half naked even so.

This has been a really helpful process for me. I'm really grateful. I came into this thinking, right, we've got a problem that can't be ignored - I am pretty sure I want a home birth, because although pain relief options and a crash team minutes away would be great, unfortunately it looks like going to hospital is a recipe for me having big problems labouring naturally.

So on balance, (trying to guess because of course I don't know what I'll be like), labouring at home is likely going to work better - more painful, but less likely to involve my labour grinding to a halt and a cascade of medical interventions being called for because of pain/fear/failure to progress.

I feel comfortable working on my existing pain management techniques, but I'm very dubious about managing PTSD flashbacks when in the throes of labour, and I don't know whether it will be triggering or not, because I've not given birth before. I know wearing hospital gowns, having smear tests and even dentists' chairs have caused flashbacks in the past so I have to assume going into a labour ward will do too.

However, I also realise that the worst could still happen, despite all the careful prep. I think as I am now facing up to my fears and making plans, I now need to find out exactly what the worst that could happen actually IS.
Haemorrhage? Baby inhaling meconium? baby heartbeat slowing right down? Cord wrapped round baby's neck? What are the big red lights? How much time do you get to hit the alarm bell and get an ambulance?

The hospital is 20 minutes drive away. And the traffic is very bad where I live.

I need to weigh up the HB risks - what could go wrong at home where half an hour could be fatal/cause permanent brain damage/disability to me or the baby? Maybe I have to face up to going to hospital from the outset and make a strategy about coping with the hospital and the awful post natal ward.

But I can feel my heart sinking at the thought of a hospital birth. I would like to try a HB, at least at first, rather than assume the worst will happen.

From reading this thread I have decided to ask to be referred for an extra midwife appointment, with a midwife who is in charge of perinatal psychiatric care. I didn't know they had such things but today I called my GP and found out there was one in the community team who deals with vulnerable women, eg: DV survivors, women with mental health issues, substance abusers etc. I felt a bit funny about it at first because I am in a wonderful relationship, do not abuse substances and do not have mental health problems - but my GP seemed to think it was fine to 'take advantage of the service' and was sorry she had not thought to mention it before!

Hopefully this senior midwife can help me put together a flexible birth plan which includes my hospital transfer wishes, as well as HB ideas, and some warnings for medics to be aware of re my PTSD stuff.

Hopefully also, once I have explained it all to the psych midwife she can do something with my notes, and maybe tip off relevant colleagues at the hospital in advance so I and my DH don't have to keep explaining on the birth day that I am a rape survivor, because that will really put a downer on things! And I know my DH will be very stressed at the thought.

I am also going to ask if my DH can attend the birth plan meeting too, so he can ask his questions and be reassured about what he has to do on the day. He is worried about a HB going wrong. He is also worried about me having a terrible hospital birth and doesn't know what is best - it is very worrying for him.

At the meeting I will also ask if the midwives will mind me having a doula there, if not I will see about hiring one for extra back up if I find someone DH and I get on with.

Hopefully my partner and I can just get on with focussing on the baby coming when I go into labour, like normal first timers!

I do feel very angry with the rapist right now, that almost a decade later I have to go through all this crap because of him. Piss off out of my head, rapist! This is not about you!

Finally, I'm also going to try natal hynotherapy,and have looked at the Cds on amazon - the only problem is the CDs seem to be EITHER preparing home birth OR hospital, and I don't know where I will end up - is there a general non-specific one?

Phew. You are all stars. This has been so helpful.

Hi there
I am sorry for the experience you have been through. I am currently in therapy for PTSD after a violent stranger rape.
the one thing I wanted to add to all the fabulous advice you have had on here is to encourage you to find your safe place in your head. and tell your birth partner what it is so that if you can they can help you get there.

My DH now knows what my safe place is and when I get trapped back there, re experiencing things dh tries to help me by gently talking about my safe place and trying to get me there.

I gave birth at home in a birthing pool (pics on profile) both times and the community midwives were awesome. they knew the reasons why I was worried, they knew why I wanted to be in a pool and why I did not want to be in hospital. I only had internal examinations upon my request (never thought I would but I did ask twice with ds1) I spend time in the pool from 4/5cm and got out after the placenta had been delivered.

for me, the hardest part was being stitched afterwards but the euphoria of giving birth and a head full of entonox allowed me to relax enough.

I hope my honesty hasn't made anything worse for you, I can honestly say that having my boys was the most amazing fabulous experience of my life (both times) to the extent that I feel envious of all the pregnant ladies that I see, it is awesome!!

I hope you manage to find your way through to enjoying the end of your pregnancy.

About your fears over what could go wrong, the only one I have experience of one of them. DS's heartrate couldn't be found and they had to get him out quickly via forceps. They only knew about this as I had an epidural and was wearing a belt to monitor DS. From when I started to push, it was within a matter of minutes they couldn't find his heartrate and called in the doc. I don't remember anyone entering the room. I just thought the belt had moved a bit. He was out within 15-20 minutes of me being fully dialated. Obviously most births are ok but you did want to know and I just wanted you to be aware of my experience.

A friend of mine had a homebirth and she loved it, I have another friend who is wating to go into labour now and has planned a homebirth.

I'm not a survivor, but just responding to a few of the home birth points...

Remember that an ambulance can blue light you to the hospital if necessary so traffic is no where near as much of an issue for them.

NCT and NHS advice is that it takes about 30 minutes to prep a team for a c-section anyway, unless they're already on standby (and if you're that high risk, you'll have transferred already). So if you could get to hospital from home (or MLU!) within about 30 minutes, it doesn't make much difference in an emergency as they could be prepping while you transfer.

Home birth doesn't have to be more painful as the only thing you really can't have is an epidural (which it sounds like you wouldn't want anyway) and the lower stress can mean you deal with the labour pains far better anyway (stress means you feel more pain, whatever the cause).

Midwives are trained and carry equipment for resus. They're also trained to deal with issues such as the cord around the baby's neck. If you're bleeding a lot after birth, they carry drugs to try and help stop it (my CMWs carry 2 lots of injections to homebirths - if the first doesn't work, they try the 2nd), but it may mean transferring if the drugs don't stop it fast enough.

If there is meconium in your waters, your MWs may not support a home birth anyway (it's policy in my area). Whilst it is your right to give birth where you want, most people would follow medical advice. SO do be aware that while many issues with birth aren't actually issues with homebirth as you'd be transferred, it might mean you end up in hospital anyway.

I'm writing a birth plan specifically for if I have to go into hospital (as well as my home birth plan) as I have some issues that are only relevant if I have to transfer. For me it's physical issues to do with local anaesthetics, epidurals etc not working, but there's no reason why you couldn't have a page of your birth plan (titled in big letters "hospital birth") on issues that would only affect you in hospital (e.g. male staff, stirrups).

A doula sounds like a great idea for you TBH as then you'd have someone to advocate for you and explain things if necessary without you having to get involved or your partner needing to break off from concentrating on you.

HTH! Sounds like you're a really strong woman and you're doing the right things to make this not an issue for you. Best of luck!

I'm sorry about your experiences, and I think it is excellent that you are thinking things through in this way and I wish you all the very best.

My experiences in no way relates to yours, but in the past (not related to pregnancy/birth) I had been sexually assaulted by a male doctor.

There were two things that really helped me:

I discussed my concerns with my midwife, and was essentially on a special list at the hospital to ensure I had an experienced / sentitive midwife.

Secondly considered in advance (in theory) under what circumstances I would find a male doctor acceptable. I started off with a 'no male staff' viewpoint, but on putting this down on my birth plan I felt very uncomfortable - what if there was an emergency and there were only male staff available. In the end I made a decision in advance that, if the health or safety of my baby or myself was at risk then I would happily see a male doctor if no female dr was available. Essentially, in advance I decided that if my baby was about to die I didn't mind what they did to me.

As it turned out I had a lovely calm intervention free birth with just a midwife, but having thought it through in advance really helped.

I hope this helps, and I realise my experience is trivial compared to what you ahve described.

Katy

Goldencarp, my understanding is that the concerns recently raised about the safety of birth at home have been mainly in response to research undertaken in the US and in Canada, research which is considered to be flawed by many, and whose findings might not in any case easily replicated in the UK where our system of maternity care and our geography are so very different.

The Royal College of Obstetricians and Gynaecologists current statement on homebirth is this:

"The Royal College of Midwives (RCM) and the Royal College of Obstetricians and Gynaecologists (RCOG) support home birth for women with uncomplicated pregnancies. There is no reason why home birth should not be offered to women at low risk of complications and it may confer considerable benefits for them and their families. There is ample evidence showing that labouring at home increases a woman's likelihood of a birth that is both satisfying and safe, with implications for her health and that of her baby.1-3"

"However, this is not to define safety in its narrow interpretation as physical safety only but also to acknowledge and encompass issues surrounding emotional and psychological wellbeing. Birth for a woman is a rite of passage and a family life event, as well as being the start of a lifelong relationship with her baby. "

Hope you find this reassuring. Best wishes for your birth, wherever it takes place.

Oh, and I second the recommendation of Juju Sundins Birth Skills - fantastic book. Will help you go into the birth with a feeling of confidence and optimism.

golden, your post has stayed with me

so first of all kudos to you to moving on and upwards after such a horror

I echo others to say be aware that you might just have to go to hospital. so do try and have a plan B

I agree that you need to enrol your midwifery and ob gyn, let them know what happended and ask them to support you. I am 100% sure that they will

I am reading a book that says the more scared you are, the worse it is! Now there must be a grain of truth in that, you do have some time so I strongly advise you do what you can ref reading/hypnotharapy to ensure you are as calm as possible

best of luck my dear, I very much doubt that the awful scenarios you had will occur again

xx

GoldenCarp22, it sounds to me like you are doing fantastically well planning to give birth in the safest environment for you and your baby. I am a survivor of childhood abuse, and shared many of these concerns approaching birth. I wanted to tell you that I had no flashbacks during my homebirth, and coped ok with the pain, in the hope this will reassure you that this can be your, your dp's and your new baby's day, without the past needing to intrude. I do believe reasoning through your fears and triggers now is what will enable this to be.

I would also suggest, just in case, that you make your mw aware of the background reasons (just a general comment should be enough), and draw up a plan of what will happen should you need to go to hospital. Just in case.

Good luck.

Thanks once again everyone.

I am especially moved to have had so many survivors of abusive sexual acts coming onto the thread with kind and reassuring words.

I am still looking into which natal/hypnobirthing CD will work best and have also taken out Ina May Gaskin's guide to Childbirth which is incredibly exciting and inspiring to me.

I am going to make 2 plans with DH over the next couple of weeks: a home birth plan and a hospital intervention plan and put plan B into an envelope to be opened in case of emergencies and handed over by DH.

So overall I feel much more hopeful and more calm and a lot of that is due to this thread!

x to you all and a hug and big thanks

Congratulations on your pregnancy.

I think that a Doula would be a good option for you. I've supported many women in different situtations and sometimes have been able to step outside the room to remind (or inform) the MW/Dr about the situation briefly.

There's no reason why your homebirth shouldn't be a good one. I think that the Hypno birthing CD will help and the books recommended are great.

I also think it's worth talking to the Consultant MW about what would happen should you transfer in. She can let the relevant people know. It's something that a recent client and I did and it was very very useful. You should have the same conversation with the Head of the Homebirth team.

I'm sorry that you had that awful awful experience. If you'd like me to help you with your birthplan then please email me mars at mammydoula dot co dot uk.

GoldenCarp - regarding hypnotherapy, are you in Scotland? I might be able to help you if so.

Goldencarp I am amazed and truly in admiration of the way that you are approaching the birth of your baby after your truly horrendous experience. You are one amazing person.

I will give you my experience, it might help you or not.

I was sexually abused by a trusted adult when I was 16. This experience left me very vulnerable around men and I had little self esteem. In my early 20's I was groomed by a member of staff where I worked. He seemed to understand and I trusted him. Our relationship developed and then he became controlling and violent and abused me. I got out somehow, and he is now serving life for murdering a partner. I was very lucky to escape.

All this was a long time ago and I am now very happily married. When I first became pregnant I did not show half the maturity you are doing and buried my head in the sand. I knew I would be afraid of hospital but went through with it for my DH's sake and I didn't believe I was strong enough to have a HB. I went to hospital, no one knew of my history. I endured numerous internals and was given pethidine. I felt totally out of control. My daughter was born which was amazing but then I had to endure stitches and stirrups and I panicked and shouted at the mw (oops). In the end I had an epidural for the stitches which was just as traumatic as I was totally powerless while a man poked around trying to make small talk. I suffered after the birth and constantly relived the birth experience over and over in an unhealthy and negative way.

I had my second daughter at home. I still didn't reveal my history but I was in control. I knew the mw's, I felt empowered to refuse internals. I felt in control at all times. Afterwards I refused stitches and healed fine. I coped with gas and air at the end and this birth experience was totally different. Afterwards I felt totally empowered and it was nothing but positive and a healing experience for me.

I hope this helps you in some way. I am a wimp and a coward and still find it hard to talk about with strangers so I have made things hard for myself. I can't tell you how much I admire you for facing up to this.

I am now expecting my third and am planning another homebirth. I wish you the very best I really do, you so deserve a happy, healing birth experience.

Once again, I am humbled and very grateful for the kindness and support and the bravery on this thread. I really can't thank you all for your words and advice and telling your stories.

I phoned the hospital today where I would need to transfer to if the home birth plan changes at whatever stage, and they are going to set up an appointment for me and DH to talk to the consultant midwife about birth plans and special issues of concern.

I am also going to talk to the homebirth team about it all so everyone will be briefed, then whatever happens, I will feel that I have done the best I can by telling people so they can prepare along with me and DH to cope with changing circumstances.

This has all made me feel much better: I can't predict the future but I can try to get ready for it and ask for help in advance.

XX Thank you.

Well done Goldencarp - really hope things go well for you!
Madasajar - I don't think you're a wimp or a coward at all. I think any woman who went through what you did and has gone on to marry and create her own family is amazing. Wishing you all the best for your DC3 XX

I'm sorry to bump this ancient thread but I haven't found much on this topic and so many of the posts on here really spoke to me.

I was raped at 19 but also coerced into an intimate examination when I was just under 12, by a male dr.

With my first baby, I had a horrendous time MH wise with flashbacks and really awful nightmares. It took over my head until I decided on a homebirth which was probably the best decision I have ever made.

Pg again and it is twins, and I am being told I must have a highly medicalised birth with a clip on the baby's head, so tethered to the bed with the monitoring equipment, I will be induced with a pessary stuck into my vagina, I will have to have lots of staff in the room but it's okay bc all the male doctors are 'nice' etc.

I am crying at the thought. I have an appt with the specialist twins consultant in 3 weeks, who is a woman thank God, but I've no idea what to say to her or if she'll listen.

I am really struggling and have spent today in tears after reading the "multiple births care pathway" leaflet they put in my notes. Don't know what to do for the best.

Johnny. Didn't want to read and run.

I think the old thread also holds good advice for you, specifically the idea of writing it all down and making your feelings a key part of your notes. If you can discuss this with your obstetrician and say "this would be a massive issue for me, can we please ensure it is done like that instead?" I think communication is the way forward.

I'm so sorry you have this shadow over your joy and have admiration for you (and the previous posters) for the strength you continue to show.

Johnny, please try to speak with an independent midwife who has experience of multiple births in a home birth context, and get their thoughts. You don't 'have to' do anything, there is no 'you must' or 'you will'. IT IS YOUR CHOICE.

Birthrights may also have some useful resources that enable you to understand your rights and choices in pregnancy and labour.

And finally there are some resources relating to twins and home birth here, which may give more food for thought (slightly out of date but still good stuff): www.homebirth.org.uk/twins.htm

Thanks both. shivery I had forgotten about Birthrights! Thanks.

Am feeling better today but am going to try and write some stuff down before I see the consultant. I just feel torn between the thought of hurting my babies because I am too weak to get over this stuff v feeling that I would honestly rather not survive the birth than live with memories of being forced into stirrups and violated.

Ugh ugh ugh. I don't know how to say that in a way which makes me not sound like some hysterical melodramatic 12yo though.

Hi Johnny, I have no specific experience to share but I too think that a lot of the advice for golden would be helpful for you including engaging with the specialist midwife/ perinatal mental health team and getting your preferences and triggers thoroughly documented.

I don't know what type of twins you have and any other factors going on but there are midwives and other professionals who support home birth of twins in the right circumstances. You do have control and no-one should force you to do something you don't want. I hope you can get some sensitive and informed support which can help you to build the right plan for you.

Ps. I don't think you're being melodramatic at all to share that sentiment and anyone who does can fuck right off IMO. I think it's fine to write down and share it as you have done here

I ws sexually abused as a child and had a really healing, empowering home birth with support from perinatal mental health. I refused internal exams and had my husband primed to advocate for me.

The thing that threw me was actually the postnatal stuff - I got an infection days later and had to go to hospital. Like you, postnatal services in my area were very bad and because I hadn't really planned for this I did find it traumatic. What I think would have helped was having a postnatal doula to do the advocating as my husband had no idea what was going on at this point. I was also able to call my mental health midwife to come in and see me/inform the staff which was good but basically I would suggest planning for the postnatal period too.

You sound amazing btw.

Oh and also - perinatal MH are there precisely for people like us. Their job is about preparation and prevention of MH issues arising from giving birth - mine saw me for months after the actual birth so seriously, you're not 'taking advantage' you're using a service designed for you!

Thanks everyone. Off the back of this I have decided to remain registered with the home birth team - I was with them before we knew about the twins. I will say to the hospital I am still considering HB.

I have seen photos of my own HB MW delivering twins at home so I guess she would support me.

The twins are DCDA and so far bang on for dates though I am only just into the second tri so who knows what will happen.

Thanks everyone again and I will update after speaking to the consultant in case my experience is useful to anyone