When A Survivor Is The Midwife

The current statistic for women who experience sexual or physical violence - most likely from their intimate partner - is one in three women. That number is only for what is reported, and the likelihood is higher for women of color and marginalized women around the world. Women who have been physically and sexually abused are more likely to contract HIV/AIDS, to have an abortion, to get depression, injuries, alcohol use disorders and pregnancy complications, according to a World Health Organization report from last year.

I am one of three women in my immediate family. I have experienced sexual abuse in childhood and in adulthood. It is a topic that I have gone back and forth with in therapy and on my healing journey because of how deep it affects me and my relationships. It is at the forefront of my consciousness lately because my work as a midwife has initiated another phase of my healing journey: learning to be present for women in their childbearing years.

It is very easy to be triggered in my line of work. I share intimate moments with women who I often have just met and was aware when I started my midwifery training that this would be hard for me. I requested that my first vaginal exam be done by my former roommate because she was someone I trusted and knew about my past. I remember being uncomfortable with the idea of having to do pap smears and vaginal exams. I wanted to avoid them because I was afraid to trigger someone else. I was afraid to hurt them and traumatize them, especially because of the aforementioned statistic.

I avoided addressing this discomfort until a series of events happened. My former roommate moved out. The events around her departure coupled with family issues brought up a lot of my traumatized feelings. I spent the end of last year upset and terrorized, suddenly having memories of past pain and drama. I knew that I needed to go back to counseling when the flashbacks started. I knew that something was off when I would spend more and more time sleeping and taking less care of my physical appearance. I began to feel depressed and withdrawn.

During this time, I was the primary midwife at a birth and felt upset by it. I originally got angry at the licensed midwife because I felt like she hadn’t listened to me when I wanted her to come in and supervise. That anger turned into sobbing on her shoulder as I realized that I was angry with myself for not listening to the young woman. I felt like I had failed. I failed at listening to a woman and her body, the one thing I strive so hard for women to fight for and I felt like I didn’t honor her or me.

Then the time came that I began to start learning how to check for dilation. All my trauma came to a head when I was asked to do another supervised vaginal exam. I almost didn’t do it and said, “That’s okay. I don’t want to do it today. You (the licensed midwife) would have to check her too to make sure I’m right and I don’t think she wants two women checking her.” I ended up doing the exam and sat in a chair after questioning why I was feeling so upset. It dawned on me when I shared with my classmate that I was projecting my own discomfort on someone else.

I started to cry that night and told another midwife that I realized my sexual trauma was coming up strongly. That I wanted the trauma to just leave me alone. That I didn’t want to deal with it anymore. That I was petrified of giving birth, not for the pain but because I am scared the trauma would come up and block me. I asked if I would ever be a good midwife with this trauma I have in the very place I spend so much time healing for other women. I asked, what if I hurt a woman by checking her for dilation? What if I traumatize her? What if I fail at empowering her? I was told now is the time to heal more and that I am an exceptional midwife, that these wounds would heal as I do this work that I have been called to because of the same said wounds.

I have gone back to counseling to address my sexual trauma because I don’t want it to control my way of caring for myself and for women. I make sure to breathe before I perform a vaginal exam of any sort so that I am present for the woman and make it as gentle as possible. I talk to my sister friends on the regular, keeping them updated on my journey and opening up to them about my struggles. A midwife lent me the book, “When Survivors Give Birth”, which has given me more insight as to how to be a midwife with my experiences.

Knowing all this, I also make sure to not treat women as fragile and delicate beings. I know I wouldn’t want this just because of my history. I treat women with respect and patience, regardless of what memories their bodies have. I share this because I know I am not the only midwife to experience sexual abuse and understand now more than ever how aware I must be of myself to do this work. Anyone working with trauma is subject to being triggered, and they need support to decompress after they are done being a pillar of strength for someone else. It is important for those of us who are midwives, doulas, obstetricians and gynecologists to be aware of our own history so that we don’t project it on our clients. It is important that we are gentle and caring with all our women, regardless of their past, so that we can continue to create safe spaces for healing and empowerment. Below are some links and resources for birthworkers and mothers:

When Survivors Give Birth: Understanding and Healing the Effects of Early Sexual Abuse on the Childbearing Woman - https://www.pennysimkin.com/shop/when-survivors-give-birth/.

Domestic Abuse Guidelines for Public Health Nursing, Midwifery, and Children’s Nursing Services - http://www.northerntrust.hscni.net/pdf/Domestic_Abuse_Guidelines_for_Pub...

The Effects of Sexual Abuse on Pregnancy and Birth - (http://www.ourbodiesourselves.org/book/excerpt.asp?id=77)

Childhood Sexual Abuse and Its Effects on Childbirth - (http://www.gentlebirth.org/archives/abusepaper.html)

Healing the Trauma: Entering Motherhood with Post Traumatic Stress Disorder (PTSD) - http://www.midwiferytoday.com/articles/healing_trauma.asp