Anyone who has known me since I became a midwife knows that I don’t just like to talk about the good. Everyone always talks about the baby cuddles and the smiles on new parents’ faces, the older sibling witnessing birth for the first time,etc. They don’t talk about the heavy stuff that comes with service in the birth world. April is Sexual Assault Awareness Month and I’m sure you’re thinking, “Okay yeah it’s a women’s issue so it makes sense to talk about it,” but it is SOOOOOO much more than just the surface words.

1 in 3 women and 1 in 6 men experience some form of sexual assault in their lifetime. Many times, survivors go unheard or unsupported. Many never tell another living soul and many continue to endure repeated assaults quietly.

Trauma sometimes seems to disappear, but often it is just hiding and will show up quietly in our most vulnerable moments. It is extremely important for midwives and others who are working with families during and after pregnancy and birth to be aware of ways that trauma from sexual assault and abuse may present themselves.

How does a past sexual assault affect birth? Pregnancy and labor can be extremely triggering for survivors. Sensations and emotions revolving around the pregnancy and birth can bring out negative memories. Certain procedures like cervical exams, and even epidurals, being touched without consent, or being told what to do with their bodies can trigger trauma responses. If there is any kind of feeling of a power dynamic in the birth room it can mimic past abuses, making moms feel unsafe, which can very negatively impact not just her experience, but the labor progression and safety of her and the baby. Trauma responses can show up as disassociation, anxiety, panic, and mistrust and often it gets dismissed, misunderstood, or even belittled.

So what can we do as midwives to support our families? Midwives and birthworkers have a unique opportunity to offer care that is gentle, consensual, and empowering. Asking for permission, explaining every step, and holding space for emotional safety can be transformational. Survivors often find healing through birth when surrounded by respectful, informed care.

Let’s not forget that sexual assault can also be on-going, even in relationships that are seemingly safe. Keep your eyes open to the signs of a mom being abused or who may be at risk of abuse following birth. Unfortunately, there are countless stories of partners who “just couldn’t wait” any longer whether that is because mom didn’t feel ready at 6 weeks when they thought they should or even just at a week postpartum. Know the resources in your area that can help these families.

And if you are reading this and you are a survivor of sexual assault please remember that your story matters. Your voice matters. You are loved, and there is someone who can help.