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.

I think that home birth will be the perfect antidote to what's happened to you. It's a wonderfully safe option - try to rent a birthing tub - that really helps - and focus on the ecstasy in between contractions, and breathe through the pain. You'll be fine.

Thanks Nk. Tbh I am not worried about pain as my first labour was virtually painless but I think that twin labours are a bit riskier. Still considering it!

Gently. HaHHa

Hi, just thought I would update for anyone in a similar position.

I took some advice off this thread and wrote a simple A4 side of bullet points with 'ideal birth', 'if things look sticky', 'in an emergency' and 'not under any circs' (that one was mostly about having lots of students in to watch).

The consultant was very nice but said she didn't support women who didn't have epidurals and that giving birth flat on your back was 'not necessarily different' from remaining active in labour.

Surely that is bollocks??!

she didn't support women who didn't have epidurals and that giving birth flat on your back was 'not necessarily different' from remaining active in labour.

?!?! I'm honestly confused. What does she mean by the above? That she only treats women who have epidurals in labour?! Surely not. Did you have the chance to ask her what she meant by that?

I suppose she may have meant by the second bit that the outcome isn't significantly different for women who move around in labour vs women who labour on their backs, which may be true in that you have the same chance of getting a live baby out, but I think it's safe to say that many women experience a difference.

I would be a bit concerned by that and would probably want to clarify exactly what is meant by it.

Sorry she meant she didn't advocate women not having epidurals. As in, she didn't want to support or countenance me making that choice.

I also found it odd. I thought epidurals were strongly associated with increased interventions, increased CS, more damage to perineum as a result of instruments etc. Which is totally fine if you are happy to accept those risks as a trade off for no pain but I am not.

Epidurals are not associated with increased C sections (although they are associated with increased forceps delivery).

What it seems is that women with difficult labours and complications (poor position of the baby, long labour, high risk) are more likely to have an epidural and it was whatever reason that the woman had the epidural also makes her higher risk for an epidural, rather than the epidural itself.

In twin deliveries, the balance of risks and benefits changes as well. There is a higher chance of a section for each twin, the second twin might need manually turned once the first twin has been delivered, etc so having the epidural placed in a nice calm situation, rather than in the heat of the moment can be preferable.

One option to consider might be to have a very light epidural placed at the beginning which can then be topped up if needed along the way.

There is also no shame in having an epidural and I'd worry if you went into delivery determined not to have an epidural then you might (unjustifiably of course) feel that you had "failed" by having one if you did. It's not a matter of people being totally fine with risks just to have no pain, but sometimes it is very useful to help a calm delivery when things are a bit more complicated.

This, from the Obstetric Anaesthetists' Association, might be helpful to read through:

www.labourpains.com/FAQ_Pain_Relief

Hi Countess

Thanks for posting. I am guessing by what you have written that you are a medic. It is really interesting to read your post because it very much echoes the consultant's attitude. She kept saying it wad better to be prepared and calm in case an instrumental or CS delivery was needed.

I just genuinely don't understand how that works though? How can it be a calm safe delivery if the mother feels totally violated and is having flashbacks to being assaulted? It is not about an epidural being shameful, it is about the fact that being in a clinical setting sends my anxiety through the roof and being immobilised and unable to get off a bed or couch is in hospital is something I literally have nightmares about on a regular basis.

I really just don't understand why it is so hard to accept that different patients have different risk profiles and that mental health is a health issue. Having a forceps delivery would pretty much destroy me so why would I do anything that would raise the chances of that?

It seems like the nice calm situation is just for the doctors. If I am screaming inside and feeling close to suicidal, tough shit.

Tbh the more I think about this, the more I am leaning towards home birth.

I had hoped the consultant would try to meet me halfway and agree to a more natural birth plan in the circumstances but she just kept giving the party line. I don't feel safe in a place where my wishes are so totally disregarded.

I am totally determined not to have an epidural and increased risk of forceps at the certain cost of my wellbeing. I have a history of giving birth fast and easily so hopefully that will happen again and if not they will just need to use GA.

I'm not an anaesthetist or obs/gynae so my experience comes from a number of deliveries myself.

"t seems like the nice calm situation is just for the doctors."

I've had an early epidural and it meant a nice calm situation for me too.

In my most recent birth, I was high risk for a number of reasons and it was suggested that I should consider placement of an epidural in case I needed a trip to theatre to stop bleeding etc. As it was, things did go a bit pearshaped completely unexpectedly (3 previous normal deliveries before, including a precipitate delivery, so I was just expecting to pop this one out!) and I needed a crash section, which thankfully was pretty easy as the epidural just needed topped up. (I really didn't want a GA.) Things went as smoothly and calmly as they could have done.

With my epidural, I could still move my body around the bed (didn't stand so can't comment there, but other people have had "walking epidurals"). Also having it placed doesn't mean that you need a full block until if and when it is needed.

Perhaps speaking to the Supervisor of Midwives or ask to be referred to another consultant would help to talk through plans and options?

Would an elective section under GA or spinal be something you wanted to consider? So much of birth, as I am sure you are well aware, is unpredictable so would something completely predictable be something that would be helpful for you?

I do hope that you can have a plan that you are comfortable with as it all sounds very distressing for you and that everything goes very, very smoothly for you.

Hi Countess thanks for a thoughtful reply. I am afraid mine to you sounded rather ratty

So I have had one quick (75 min) easy labour and my current pg is DCDA twins, bang on for dates, no indications as of yet of GD, hypertension, IUGR etc etc. If a problem emerges I am happy for elcs with spinal or GA.

But unless and until there is a problem I want to try for an active natural birth. NICE guidelines seem to support this as they say multiple mums should be offered epidurals but if declined, alternative methods should be discussed. And they don't seem to say anything about labouring with restricted movement or on back.

Given that I think epidural or particularly instrumental delivery would give me strong flashbacks to the past, I think it is genuinely dangerous in MH terms to subject a patient to that where there is no obvious clinical need when she's about to be in a postpartum state (ie vulnerable emotionally) with 2 newborns! Just seems bonkers to me to insist on standard care pathway without taking MH into account as a clinical risk factor.

Honestly am I crazy?! My mw says they deliver plenty of twins naturally in this area so not sure why consultant is so dead against it.

Argh!

Just thought I would update again in case anyone in a similar situation finds this.

So after the consultant telling me I had to have a medicalised birth, last week I got TWO letters from her saying she feels we didn't have enough time to support me properly during the appt and of course I can opt not to have an epidural provided I understand the risks, and she is referring me to a psychologist for anxiety.

So complete volte face! I think someone has put a rocket up her.

I am seeing her after 20w scan next week so we shall see what she says in person.

I support women after traumatic births (having had a traumatic birth myself) and although your trauma isn't from birth I do feel like I understand your fears completely. How many weeks pregnant are you now? There a lots of resources to access for having a natural or home twin birth, in fact recently I know someone who had a twin HBAC. I really hope it all goes well for you.