Words Make and Break Experiences

Women who have experienced sexual rape and trauma need a specialised pathway in pre-conceptual care and in planning for birth. In the Royal London hospital, we set a clinic for women who have been subject to rape and abuse.... [ view full abstract ]

Women who have experienced sexual rape and trauma need a specialised pathway in pre-conceptual care and in planning for birth. In the Royal London hospital, we set a clinic for women who have been subject to rape and abuse.  This was set up following gaps for pregnant women in the sexual health clinic whereby My Body Back Charity, a volunteer service supported women attending sexual health follow ups. We also identified fear women expressed contemplating pregnancy following their traumatic experiencing and also following first birth experience. Our consultation sessions revealed the flashbacks of the rape or abuse women experienced often during birth. 

Health care professionals needs to be aware of the words we use during intimate procedures such as vaginal examinations may trigger such flashbacks for women. Women have been referred to the clinic via the charity once a month with hourly consultations. We see women from around London and book them if they are at the early stage and also provide pre-conceptual care. We also get referrals from women late in their pregnancies and discuss their triggers and services they could access back in their maternity services.

The subject is still a stigma and often not disclosed to midwives due to fear of reprisal and abandonment often from their current partners and cultural factors. Many women have carried this abuse in silence. 

During consultations which is often long periods of silence for women wanting to find the right words. It is important for midwives to understand the space required for women to feel safe and not plug in the silence and talking on their behalf.

The model of continuity is important as trust develops and 'triggers'  then shared which is powerful as plans are developed with women highlighting triggers which could be language used, environment surrounding and sensitivity from midwives. They have shared with previous pregnancies words used by health care professionals an often treatment especially in emergency situations which have triggered flashbacks. 

These often impact on their postnatal bonding with their baby and often experience elements of detachment. My work is still in infancy and we are looking into training the volunteers to support women as an advocate if she wishes in her antenatal consultations and as her birth support.