Sexual assault and ELCS (may be triggering)

[AnotherWeekAnotherName]

I've namechanged for this thread, but I am a regular poster.

I was sexually assaulted in my teens and haven't had any therapy or anything for it. I tried to put it from my mind and get on with my life, which has worked well for me until now.

I am 19 weeks and feeling increasingly anxious about the birth - I don't think I can cope psychologically with the idea of a vaginal delivery, and having lots of people I don't know doing things to my vagina. I keep thinking about the sexual assault (I never normally think of it these days) and it is tangled up in a loop of anxiety about the birth.

Only DH knows about the assault - I have never discussed it with anyone, and I am dreading having to tackle this with hcps. I have a consultant appointment in a couple of weeks (I am high-risk) and I think I need to broach the topic of the birth with him then, but I am extremely worried about having to discuss it at length with lots of people from now on throughout my pregnancy.

I suppose I am looking for advice from people with similar experiences - did you have to keep discussing what happened to you with lots of different people or is it possible for your notes to be "flagged" in some way? How can I bring it up with the consultant, and how do I put into words this rather jumbled feeling of anxiety I have about the birth and the sexual assault? Will I get a c section under these circumstances?

Thanks in advance.

I am so sorry about your situation. I haven't been in a similar situation, but I do advise vulnerable people at work.

I would be surprised if you needed to explain this to a lot of people. I would assume that the consultant would be enough and would be able to say yes to a c section. If it was me I would write down all my concerns and feelings ahead of time. Then they will feel less jumbled. If there is any chance of needing to explain it repeatedly just put that piece of paper in your notes. Then you can pull it out as needed and hopefully not need to repeatedly explain.

I found I had vivid flashbacks to my own childhood assault during pregnancy. I was determined to try to have a vaginal birth anyway, but ended up needing an ELCS for medical reasons, and I think it was a good thing, as the one time I had a sweep, I couldn't cope at all, and I think frightened the consultant. Explain directly to your consultant and request an ELCS. Best wishes.

Make a bullet point list before your consultant appt. if you get upset and dnt feel you can talk then pass the consultant the list and let them read it.

I have a similar background and was petrified of birth, completely petrified. I later found out that was normal, or at least not unusual.

I wanted a vaginal birth and had one (ended up with an epidural which hadn't been my "plan" but it was all good). My birth experience completely changed how I felt about my body. I felt like I'd taken something back that had been stolen from me. It was incredible and I had no idea that was possible.

What made it work for me was INCREDIBLY sympathetic and supportive midwives and later the obstetrician.

You have lots of choices during pregnancy and labour, you can ask not to have internals for example, or only female medics where possible.

There is no right choice in any of this, only right for you.

However, there is "wrong" and that is medical staff not being 100% supportive. You help them in being sensitive to your case by letting them know where you are uncomfortable etc. this can be put in your birth plan.

Definitely mention your concerns and an outline of the reasons why to your dr. Soooo many women have these experiences and so you're not alone, unusual or the first they'll have met.

I was determined to have my kids vaginally !!!' It wasn't going to be another thing he fucked up in my life!
I've had 3 beautiful births xxx

Depending on your local healthcare trust you may have to really fight if you want an ELCS. I have been granted one but it was a battle as my HCT is very anti-ELCS. Despite the NICE guidelines they do not grant maternal request C Sections but I was fortunate that they eventually agreed my physical health problems were enough. My advice would be to make the request as soon as possible as it can take several appointments to get it granted. You may need to see a midwife to discuss your reasons independent of the consultant and her job is to highlight the risks talk you out of it. Definitely go with a list of bullet points you want to say as it can get emotional. Good luck

If you're feeling anxious you can see how your consultant feels about an ELCS

Not sure if this helps but I had a vaginal delivery and I didn't have all sorts of people messing around down there. You can refuse any vaginal examination or sweeps in the end I only had one ve after refusing others

I have no experience in what you've mentioned here but wanted to say congratulations.

I think everyone who get pregnant hauls over the past. I found so much of my childhood was churning around in my head. I put it down to my mind making plans for how I was going to parent by calling on my own experiences.
Some hospitals will give you a section if requested. I'd suggest telling one midwife you trust and faking it from there.

Hope you're ok x

Thank you all for your responses. It does bother me that I feel that this is another thing which he is dictating - and perhaps I need to consider some counselling to work through that anger a bit - but because of existing medical conditions I won't be able to have a very hands-off, unmedicalised vaginal delivery anyway, and so the ELCS seems like the next best option for me.

I like the idea of writing things down and being able to hand that to the consultant instead of having to actually put it into words while I'm in there, and I think it will help me to clarify my thoughts as well, which will be helpful.

DragAct flashbacks is a really good way of describing what has been happening to me, and I feel a bit out of control about it at the moment, so although I am very sorry that something awful happened to you too, it is useful to know that I am not alone in experiencing this.

Just so you're aware, an elcs may not help your anxiety as there will still be stuff happening to your vagina, you just won't be able to see or feel it which I can imagine might be worse. Obviously a vaginal delivery can be unpredictable but there's a good chance of no intervention. You can decline any sweeps or examinations. Your midwife will be experienced in supporting you through this 💐

Sorry just seen you said there's little chance of no intervention 😔 Knowledge is power so I hope discussing it helps.

Ispy I know they'll want to insert a catheter - is there anything else that they would need to do while I was having the section do you know? Would be good to be able to speak to the consultant about it if so.

At the end they would clean you up as there would still be vaginal bleeding. This is usually wiping on the outside and some swabbing internally. This is basically small pads on the end of small 'forceps' (look more like tongs) as many as needed to remove any bloods/clots. I don't want to worry you more but feel it would probably be useful for you to be aware. Staff are always careful to ensure your dignity but can imagine it doesn't feel that way when you're exposed. Disclaimer, I've never had a section but worked in theatres and participated in many....

I hope that you find the consultant and midwives supportive (which I am sure you will). To add on from ipsy, post section, my catheter was in until the following morning and until I mobilised, I needed help cleaning myself (around groin and vulva) on the bed (no knickers as catheter, so on a conti pad for blood that was changed by the staff when needed).
It may be useful to have a full, comprehensive birth plan that all your carers have access to (it does not need to detail any of your history). I am currently doing similar with a supervisor of midwives (water VBAC but low threshold for section). I obviously don't know your medical history and why this would mean little chance of an unmedicalised birth, but discuss this with your consultant/supervisor of midwives as things that you presume may happen, may not happen with your particular care providers and whether you ultimately decide for the section or be reassured that you could have a positive vaginal birth, everyone involved should make it a positive experience.

And when I was cleaned up in theatre, I couldn't actually feel what they were doing so had no idea I was being cleaned up down there!

Just to add that while the sweep was awful, my ELCS was a calm, pleasant, dignified experience which caused me no disstress/flashbacks at all. The staff asked at every point about what they were doing eg the insertion of the catheter, which I couldn't feel at all, either going in or out, and none of it felt exposed or unsafe. It was a thoroughly positive way to give birth, and if I'd known how it would be, I would have saved myself a lot of worry.

It might reassure you to hear, too, OP, that I haven't had a flashback since my pregnancy. Sorry you're finding it so awful - I've no solution to offer, only that it went away after I'd given birth. And that for some reason doing natal hypnotherapy made it worse while I was pregnant. The teacher kept wittering out about safe spaces and childhood.

Thanks for your helpful descriptions ispy and Lumpy.

Having thought through this more as a result of this thread, I think what really frightens me isn't necessarily people doing things to my vagina, it is the idea of an out of control situation where I have no power to stop it or have a break for a few minutes.

I have coped with smear tests in the past because I know at any moment I can ask the nurse to stop and that she will. What frightens me about a vaginal delivery is that I won't necessarily be able to do that - my body will continue to labour regardless, and in an emergency there may not be time for me to ask people to stop what they're doing.

DragAct you have been very reassuring. Thank you.

That has always frightened me too op, especially after my first birth. With the 2nd I felt better as had a debrief that reassured me and a supportive one to one midwife. My baby had other ideas and turned breech at the last minute so I had an elcs- it was a positive experience!
I think you would benefit from just seeing one midwife all the way through (I have seen 6 so far this pregnancy!) as I know that in my 2nd pregnancy, having one person who knew me and my history was so beneficial (especially as my mum was diagnosed with terminal cancer during this time, having someone to support me and not have yo explain things over again was a godsend). Most trusts do have some caseloading midwives- see if you can be allocated one.
I also recommend hypnobirthing to help relieve some of your stress and anxiety. I have found it so relaxing during pregnancy and it helped keep calm whilst having spinal before section (I actually didn't feel it go in).
Before your consultant appointment, I recommend that you research sections and the associated risks to show him/her that you are making an informed decision.

And just read dragact, the hypnobirthing that I did made no mention of childhood and safe spaces. It was really helpful for relaxing.

Thanks Lumpy. I have actually been seeing the same community midwife so far, and she is very nice, but I haven't mentioned anything about the sexual assault to her (yet). I just find it very difficult to find a way to get the words out iyswim?

Did you use a hypnobirthing cd or did you go to a class? I think a cd might be better for me because it may be a bit less intense and I can stop it if it starts setting off my anxieties!

I'm very sorry to hear about your Mum.

Thanks another
It must be really difficult bringing it up. Would it help if your partner was with you when you did so he could support you? If you have discussed your elcs with him as well it might be worth ensuring he is at the consultant appointment as well for support.
With my first pregnancy I paid for private lessons, read the book and listened to cd. 2nd pregnancy I re-read the book and had a refresher with a hypnobirthing teacher and this pregnancy just doing the cd.
Some midwives do it or can signpost you to someone who could help so it might be worth asking yours.
I think it's worth getting the book and cd (you will pick it up off ebay) as the book goes through the different relaxation techniques and how to do them.

Hi OP, don't know if you are still around- if you are certain you would like an ELCS I am happy to offer advice. I have had two ELCS, in two different HCT's actually, in 2012 and 2015. I have tocophobia (fear of childbirth). I actually had my sections under general anaesthetic as well. I will happily share my experiences if it would help- please PM me if you would like.

Hi Electra, thanks for your offer. I will PM you.

I had an ELCS for a baby conceived by rape. My consultant was made aware by my midwife, I had to have a pre consent counselling session but that was relatively straight forward and not detailed, just an outline of the reasons and an explanation of risks.

I did have to have a vaginal examination (well not had to but it was important iyswim) due to spontaneous Labour and bleeding. They were supportive, I was on my own with no birth partner and a lovely midwife let me crush her hand.

The catheter scared me senseless but actually wasn't that bad. And they took me through everything step by step.

Some of it is a little undignified - haven't to remove my knickers in front of them once in theatre squicked me out but I look back and realise they were supportive and understanding.

I was lucky in that I could stand for short periods just a couple of hours after mine so I changed bed pads myself but it is something to keep in mind.

If you want to know anything else please feel free to pm me