After oodles of talking and careful planning, my husband and I have decided to try to conceive our first baby. There’s one thing that is making me really nervous — it’s not about the child so much as the pregnancy. And not so much the pregnancy itself, but seeing an OB/midwife.
To explain: when I was a teenager, I was raped. It’s been nearly ten years, but since then, I’ve been dealing with the ramifications, namely a profound fear of being touched by anyone other than my closest friends, family, and husband.
One of the scariest places for me is the OBGYN. Now, I’ve been mostly good about going to regular check ups, though they often end in tears and are followed by an emotionally rough day. Once pregnant though, I know that I will have to go routinely, and there will be lots of people involved in my care. Everyone always says, “Oh you get used to everyone seeing you splayed out and naked,” but I can’t see how I would ever get used to it.
I’ve talked to my husband and I’ve talked to a therapist and now I thought I would share my question to see if I could hear from other people who may have been there before or are looking down a similar path. Do you have any coping suggestions for dealing with OB/midwifes and pregnancy for a rape survivor?
I am beyond thankful for your time and your thoughts. Thank you!
Comments on How do you make the invasiveness of pregnancy less scary for a rape survivor?
My advice would be to always have a buddy go with you so you don’t feel so alone and you have a hand to squeeze when the appointment gets intense for you.
Also I am about 22 wks pregnant now with my first & I chose to see a midwife rather than an OBGYN for prenatal care specifically because they tend to give more personal care and also to be a bit less invasive. I could count the number of pelvic exams I’ve had on one hand and other than that the only thing that has been particularly invasive outside of my future delivery is the internal wand they use in early pregnancy to check the little wiggly bean and measure size for dating.
Find a care provider you can be open with about your past experiences and someone you can let know when you need a minute if you’re feeling overwhelmed and who won’t mind taking things slow so you stay in control of your space and your body.
Hope some of that helps! And congratulations on deciding to add to your family!
I am not a rape survivor, but: Depending on your pregnancy and your care, you may not be examined in a naked-y way as often as you’re imagining. I had a midwife and there were belly measurements, and ultrasound, blood pressure, etc. But until I was actually in labour and she needed to check my cervix, she’d never been near my genitals. She checked again once I was ready to start pushing. Then afterward she checked for tearing an stitched me up. Lots of people did see me naked, but you could certainly choose to wear something. Hopefully you wouldn’t need to be checked until you’d had a chance to get comfortable with your caregiver.
First of all I’m very sorry you had to go through that.
Like others have said I would definitely see a midwife and not an OBGYN, I’ve had two children, my first pregnancy I went to an OBGYN and had to get naked and have him check my uterus at every appointment whereas for my second baby I went to a midwife she never asked for full nudity and as long as everything was evolving nicely she never checked my uterus until labour
Just to echo what the other commenters have said, my experience of pregnancy did not include invasive examinations ever, until actually in labour, and even then they keep them to a minimum because of the risk of infection. I did see lots of different people and I am sure you would certainly find it better to see the same person and also know in advance who would be attending your delivery. Make sure your carers are aware of your needs at all times and never be afraid to tell someone No. Women need to learn not to be so deferential to the medical profession. Educate yourself and trust your body, it knows what it is doing. Best of luck with your pregnancy.
I needed one internal ultrasound with the wand during pregnancy to check the placenta location, and I was allowed to insert it myself, and then the tech took over. It felt much less invasive that way. I’d suggest asking if you could do that, if you need that kind of ultrasound. Maybe there are other things yoi could do too, to regain a feeling of control (squeeze the iltrasound jelly? Place the stethescope on your stomach first before the doctor listens?). I am not a rape survivor so maybe that is a silly suggestion!
Another advocate for midwives vs. OBGYN here–but also want to point out that there ARE doctors who respect the midwife practices and work in conjunction with them. I’ve had very positive experiences with both; the biggest thing you can do is talk with your provider beforehand to find out their philosophy and how their practice works.
I’d also highly, highly recommend HypnoBirthing. We took a class and not only did it calm my fears around labor and teach relaxation techniques, it helped lay down groundwork for how you can specify what you do and do not want–from choosing a provider to establishing a birth plan. And most importantly, for you, a huge part of the HypnoBirthing philosophy is that just because a woman is pregnant doesn’t mean her body is no longer her own; it is treated as a sacred space and not a medical specimen. There are no unnecessary pelvic exams, YOU decide who will be present with you during labor & delivery, there’s no revolving door while you’re lying exposed. I always loved this aspect because, I’m sorry, just because you’re having a baby doesn’t mean your body is now public domain, and it shouldn’t be treated that way.
I’m sure you can find a provider who would be sensitive to these needs and be able to treat you with minimal invasiveness.
Hi OP, I’m so sorry that happened to you, and that it’s affecting your experience of pregnancy. I agree with the other responders that a midwife is likely a good option for you, if it’s doable, but getting into care with a midwife can be a challenge. Are you comfortable disclosing your past abuse to your caregiver? If yes, I think it would be good to disclose as soon as you can, and let them caregiver know how that has impacted your feelings around being touched. A good caregiver will take this into consideration and do everything they can to make you comfortable. Bringing a friend or your partner along might also help you to feel safe. Any caregiver that doesn’t give your disclosure sufficient weight doesn’t deserve your business.
If you don’t feel comfortable disclosing yourself, would you be ok with sharing in writing, or having your partner tell the caregiver?
Finally, I recommend a couple of books that might help you problem solve: When Survivors Give Birth, by Penny Simkin (founder of DONA International) and Survivor Moms: Womens’ Stories of Birthing, Mothering and Healing After Sexual Abuse, by Mickey Sperlich and Julia Seng.
I’m 32 weeks, using a midwife, doula & Hypnobabies. I love this combo. I did one internal ultrasound, & otherwise have not been asked to lower my pants the entire time. You can also decline cervical checks during labor, which I plan on doing. Hypnobabies has been fantastic for helping me feel confident & safe going into birth, & I am glad to have my doula to help hold my boundaries during birth (with a birth plan too).
All in all, I feel like it is possible to plan for the things you need (though $ for a doula & taking a course helps-) also, a large number of women are sexual assault survivors. I feel like a good midwife/doctor starts with the assumption that a patient has been violated in some way & asks before touching, describes procedures & asks for your consent, etc. One midwife I’m working with even asks before offering her hand to help me up from a lying down position- everyone else assumes I need & want help, which annoys me.
Hopefully you find someone already attuned, but you can also tell people what you need with minimal reference to your experiences. It can be tough though, with the socialization we get as women to be nice & deferential & then with an abuse/assault history on top of it- having someone with you to help you advocate can be great if that’s a challenge too.
You’ve got this.
I’m also 32 weeks along. Yay for possible Halloween babies!
I have been seeing an OB throughout my pregnancy and I am currently 22 weeks. I did have the 8 week vaginal ultrasound and have only had one vaginal exam and won’t have another until 36 weeks, unless any issues arise. All other appointments have included the doctor feeling my belly, but I didn’t even have to change out of my clothes. This is now common practice as doctors don’t see the need to disrupt anything if it’s going well in there. I hope that helps! Best of luck to you!
While not a rape survivor I have severe anxiety and panic attacks surrounding obgyn appointments and have had to use sedatives for Pap smears and general anesthesia for colposcopy and leap so I do not cope well with being touched.
I had a vaginal ultrasound at 8 weeks to confirm pregnancy (due to a previous miscarriage) and inserted the wand myself and did not undress until the tech was in the room (somehow, lying there in a paper gown waiting makes my anxiety worse) I just wore a dress and removed my underwear.
But you can skip this ultrasound and wait til 12 weeks when abdominal ultrasound can show clearly.
I take a buddy to appointments with me and before every appointment I would hand the receptionist a piece of paper explaining my anxiety and giving a clear list of ways to make this easier for me. No medical equipment in view, wait in the waiting room until the OB is ready rather than the appointment room. Having this in writing and handing it over every time meant I didn’t need to verbally ask for any of these accomodations and I didn’t need to worry that they had forgotten to check my chart.
During pregnancy and delivery I refused all cervical checks. And told my providers that they would not be happening. Only one tried to insist that they were necessary and I didn’t see her again.
I have precipitous labours so I don’t have long enough laboring in hospital for them to want to check me then.
With one delivery a nurse did reach between my legs to position the monitor on my belly (I was hands and knees) and I slapped her hand away so she moved herself and was able to position it from the side instead.
Think about what laboring positions may feel empowering for you. Lying on my back with my feet in stirrups would not be good for me so I delivered one baby on my hands and knees and the other side lying
I wish you all the best
I see that many people have already said what I was coming here to add — there is no need for multiple internal exams (unless perhaps for complications). I’ve had three children and have always had an internal exam at the beginning, and nothing until labor (and have only been checked 3-5 times during each labor.) The GBS test at around 35 weeks requires an internal swab, but you can do this yourself. I’ve never had a vaginal ultrasound, either. unless there are complications, you will most likely not need an ultrasound so early that it has to be internal. One pregnancy I only had the 20 week scan and no others at all.
I agree with the recommendation of midwives, but I would say — I have had a few terrible midwives and a few wonderful OBs, so … it really can vary with the individual.
I am a certified nurse midwife and I have worked with several women in this capacity. There are so many ways to make the exams and care tolerable, and hopefully even joyous! For exams that require a speculum or vaginal ultrasound, I offer women to self-insert the device if they feel more comfortable doing so. I also have people leave as much of their clothing on as possible, and work hard to maintain modesty with a warm sheet rather than paper pr plastic. I don’t use stirrups unless the woman is more comfortable using them. If the woman needs me to slow down, pause, or stop, I do. Immediately. You can request your first visit be a meet and greet with no physical contact or exams. If you have trigger words, tell your provider. We tend to say things like “relax this muscle” but for some women that word is triggering and if I know, I won’t say it.
I had a midwife during my pregnancy because they are less hands on unless absolutely necessary and that was exactly what i wanted. I had just gone through 2 very invasive IVF cycles so I didn’t want anyone touching my vagina unless absolutely medically necessary. Most of my OB visits i didn’t get undressed at all. They just measured my belly and listened to baby’s heartbeat. I probably only had 2-3 internal exams, 2 of which were during labor to check things and i absolutely didn’t care at that point lol!
As a woman with a history of s/abuse I can relate a bit. I was really worried when we started ttc, my smear tests are always difficult and triggering. But, I’m nearly half way through amd I’ve only had one internal scan, because I had some early bleeding – the others have all been abdominal. I also have real trouble with people who say you get used to having ‘everything splayed out’ – just no, not me!
I’m in the UK where we are primarily midwife led,but I really recommend the Positive Birth Movement book and Fb page – you have rights to your body, even in pregnancy, reading through the book has started to really calm my fears over loss of control in labour, you don’t need to be an expert obgyn to make decisions about YOUR body, at any point in time, and a calm and in control mama makes for a better pregnancy I think. Best of luck. X
Evidence-based Birth is a really good resource to help you consider what standard practices you do want to consent to. I had an OB that I thought I liked, but during my first pregnancy (that ended in miscarriage), they treated my comfort and concerns as nonissues and were particularly unkind during a painful pelvic exam. That experience led me to start investigating what parts of “standard prenatal care” were actually evidence-based and eventually led me to find how safe and wonderful homebirth with a midwife can be (assuming a low risk pregnancy). During my 2nd (successful) pregnancy, I found an excellent midwife who was very sensitive to my feelings, provided pros and cons of any care options and respected my decisions. For example, cervical exams run the risk of introducing bacteria and potential infection and they really don’t provide any useful information since everyone dilates at different rates (except if you have an epidural and your body cannot tell when to push). I didn’t have any internal exams… though after labor, she did have to examine the tearing (and determined we should go to the hospital for repairs because she only does up to 2nd degree at home and I was bordering on 3rd degree). I had enough feel- good-hormones that it wasn’t painful and had a very understanding OB do my stitches (it’s okay to let them know more lidocaine is needed if you need repairs!) Mostly, my advice is to educate yourself and find a provider that appreciates that you are well-informed and respects that you are a person who must provide consent throughout your care. I also second the suggestion to start Hypnobabies now and keep with it!
Oh, and as far as people touching your belly randomly. It’s okay to tell them no and step out of reach…your pregnancy is YOURS and they have no right to rub you. Thankfully that only happened once to me and I have several friends who didn’t have that problem at all…so maybe practice your RBF.
I had similar fears. I am barely 22 weeks along and so far have not had anything internal other than a pap right at my first appointment. I was 10 weeks along so they were able to do an abdominal ultrasound.
See if your husband can come along with you for support.
If it’s possible for you, I’d recommend you mention your discomfort to your Dr early. I said I get nervous because I had experienced sexual trauma as a teen and other than asking if I had seen a doctor since, my OB did not pressure me into expanding more than that.
Don’t be afraid to go to a different provider as well if they do not respect your wishes. You deserve the best care possible.
Allow me to echo the commenter above who suggested a written ‘needs’ list.
From a perspective that less concerns the mechanical elements, may I suggest building a script with your care provider? Encourage them to narrate the process in detail. (This, to me, seems obvious, but I understand it may not be automatic for all care providers.) Every new action should be introduced in detail and preceded by a clear verbal request for consent. E.g. ‘next I’m going to need to touch your stomach all over with my gloved hands. Is that all right?’
This limits the potential for surprises, and puts you in control of the procedure. Consider requesting an extra-long appointment to accommodate the process.
Agreed! Speak up to your health care provider about what you need, and they should work with you. If they do not work with you, find another OBGYN! It’s your body and it is ok to say “I am not comfortable!” I recently found a really great doctor that talked me through all the steps before we even started the exam so nothing was a surprise, and she asked several times if I was ok with everything. Previously I had a doctor that didn’t listen to me and it took some courage, but I stopped going to her, and I’m so much happier. So be clear on what you need!
I recently had my 3rd (and last) child. I’m also someone who’s been through rape, multiple times unfortunately. One of the main things I do is request that I only see female doctors or midwives. I purposely go to a place where up until this last pregnancy there were only female midwives. 2 problems I had come up though: at one exam the one new male midwife came in to see me. All he did was talk to me and check the babies heart rate. But just having to lay back and have him touch my belly…and the fact that I was caught off guard by him being my midwife that day, I had a major panic attack before I could even get to my car when I left. I had to ask again that I only see the women there and I explained why.
Then when my last son was born a male ob/gyn had to deliver him. I was terrified to hear that he was the only one at the hospital that night when I called but it actually was ok. I don’t know if it’s because I knew I was safe because my husband was right there and there were 3 female nurses in the room but I didn’t freak out.
My advise is to try not to be afraid to speak up if something makes you uncomfortable. I was afraid to say anything too often.
While I totally understand why many people recommend midwives vs. OBGYNs I’d like to voice an unpopular opinion. I work in the medical field an have worked with people with anxiety issues.
The thing is: you have a very sad history and now you are afraid that the examiations will trigger those memories, which is totally understandable. You’d be weird if you did not worry about it.
Now, if you have one of those pregnancies where everything is easy you might very well get away with only consulting a midwife and keeping examinations to a minimum. But what happens if you are one of those ladies who face complications? Any kind of complication during pregnancy/birth is scary, and if the then-neccessary examinations are an additional scare, then this will even be MORE traumatizing.
I say prepare for the worst and face your fears. Find an OBGYN who has worked with abuse victims. Find a female OBGYN if that makes you feel better. Get to know her before you even get pregnant, tell her about your history, tell her about your fears. Have her tell you exactly what kinds of examinations might become neccessary, and what exactly she will have to do. It will be so much easier to do with a doc you already know and trust. Then, if you do have so see her during pregnancy and birth, you will be prepared and it will not be so very traumatizing.
There is nothing wrong with seeing a midwife only, but keep in mind that about 4% of all pregnancies do come with complications (which is quite a lot, really!) and personally I’d like to be prepared for those 4%. Also, you mentioned that you talked about this issue with your husband and a therapist, which means you are one of those kick-ass people who tackle their problems and deal with them instead of avoiding them, so I think seen an OBGYN might be the way for you.
All the best!
I’m a bit confused by this post. Depending on where the OP lives, it is very likely that the OB she sees prenatally will not actually be present for her birth. Even if the OB she sees happens to be the OB on call when she goes into labour, she will mostly see the nurses until right before the baby is about to be born. Also, many OBs book 2 clients per 15 min slots – so I don’t feel that the suggestion to “get to know the OB” is very realistic. Most OBs are very busy and rushed.
On the other hand, midwives (in Canada and the US, it is different in the UK) usually work by themselves or in small teams, so it is likely that the person who does her prenatal visits will be present at the birth. We (I am a midwife) tend to have longer appointments and the OP will definitely have the chance to get to know her midwife and discuss her needs and fears.
Also, we are trained to manage emergencies. Chances are very good that she will never have to see an OB, and if she does, her midwife should be able to explain what is happening (something that, in my experience, many OBs are not very good at) and advocate for her and her needs.
There’s nothing wrong with OBs, and there are fantastic OBs out there who would be great for the OP, but realistically, the OP will have more luck having her needs respected with a midwife.
I also really agree with the suggestion elsewhere to get a doula if you can! You could consider a home birth too – studies here in Canada show they are just as safe for a low risk birth, which may or may not be your situation. The key is to find a team and an environment you will be comfortable with.
Thank you for reaching out! This can be such a scary subject. I’m a trauma survivor as well. After a few traumatic/invasive appointments at our regular hospital, we selected a midwife practice that is very non-invasive. They have done no vaginal exams to-date (we are 37 weeks pregnant) and have assured us that we can decline all exams at the hospital up until the point when I feel the urge to push. (At that point they need to check the cervix to make sure everything is ready for baby to move through.) When I needed a swab test to check for Group B Strep, they gave me the swab and let me collect the sample myself with the help of my husband in a private exam room.
Fortunately, they work with a local hospital for delivery, so we will be at the hospital already if we need to deal with any complications. I’m not sure where you are geographically, we are lucky to live in an area with great alternatives to “regular” hospital care. I hope you can find a similar situation.
I would also STRONGLY recommend getting a doula to support you. Our doula has a lot of experience in working with survivors during pregnancy and has been a HUGE help in terms of helping understand what to expect and advocating for us throughout our pregnancy.
Finally, we are putting a disclaimer at the top of our “birth plan” to remind nurses etc, that I am a survivor and should not be touched without asking first, etc. I would be more than happy to share my experiences, etc. if you’d like to get in touch in person. Please feel free to respond to this comment if you’d like to chat “offline”.
I agree with those who say you may prefer a midwife, but even more than that, I strongly encourage you to interview multiple potential care providers and find one you feel comfortable with. There are good and bad examples of every type of care provider. Ask about declining exams. If any of them seem hesitant or have the attitude that it’s up to them to “let you” decline to be touched or examined, go elsewhere. Legally and ethically, they need your permission to touch or examine you, not the other way around. Even in an emergency, you have the right to decline care if you choose, for you and for your (potential) child. This is true regardless of your chosen care provider, but it will be much easier if you pick a care provider who truly believes this.
For example, in the throws of my unmedicated birth, I started pushing and had not had any internal exams at that point. My midwife asked my permission to check and make sure I was fully dilated, since pushing before then can cause swelling in the remaining lip of cervix and lead to an obstructed birth. I sqeaked out, “I don’t know.” She waited a minute or two and then asked me again. This time I said yes, and she proceeded. I have no doubt that if I’d said no, or if I’d just not answered, she would not have tried to check me without permission. This is how it should be, never feel like you have to settle for less than that.
People often say things like, “oh, by the time you’re in labor, you won’t care how many people see you naked,” and similar. Personally, I found this even more stressful than the idea of strangers seeing me naked and vulnerable. You mean my personality will drastically change, I’ll stop caring about things that are important to me, and my natural mental defense systems to protect myself will be nonfunctioning??? Maybe it’s true for some people, and I’m sure people mean to be reassuring as they say it, but for me, it was not true. I was deep in labor land, but I did still very much care about who was around me, and I was very glad I’d set up everything such that the only people present were people that I knew and had personally decided to have present. Perks of a homebirth.
I am sorry for the abuse you have suffered, and glad you are being such a good advocate for yourself and being proactive. Congratulations on impending attempts at pregnancy, and best of luck!
Having read all the comments. Let me say that I agree with them all. Find a midwife that you are comfortable it. A family member can be trained to help you through childbirth and I believe that would work well for you. One factor that no one has brought up is the hospital birth itself. I don’t know how sensitive you are but it might be good for you to approach the director f the L&D department at the hospital to let you visit ith the nursing staff so that you become comfortable ith them instead of meeting them for the first time when you come in just to deliver yhe baby. If you come to know them as people, you won’t be as uncomfortable with them since they will have to touch you to care for you.
The other concern is the internal exam. It is all very good to say that refuse the internal exam because they are really not needed but if there is an emergency with the baby and an internal exam is needed then you will have to have one to check to see if everything is ok. Desensitization therapy works with your therapeutic plan. So perhaps you and your therapist can develop a plan with the midwife and you and your husband of all aspects of your pregnancy visits, delivery, and post partum care covering all aspects. This plan will allow you be in control and most importantly prepare and practice so that you are comfortable with the whole pregnancy. Your therapist will help you and you will be sure that the midwife is engaged from the beginning since she is cooperating with he therapist.
I was drugged and raped, so I don’t experience as many triggering events, but my pregnancies were still difficult for me. I’ve had two babies, one which was a stillbirth, and I’m currently pregnant. The check ups with the first two babies were really tough and I found after the first ultrasound that I couldn’t do it alone. I brought someone with me to every check up as a sort of “safety in numbers” thing. My 2nd baby, who unfortunately didn’t survive, was high risk. I had to go to fetal specialists who were all male and had to endure cervix checks and transvaginal ultrasounds at each appointment. After handling the last pregnancy and everything it entailed I haven’t had any issues with this pregnancy. I’ve even gone to most appointments by myself!
Both prior pregnancies were difficult and my 2nd one had me so worried about the baby I endured it all for her. That pregnancy showed me I really was strong enough, and I think I’m so worried about this baby I haven’t had much time to reflect on my own personal struggles and trauma. Every positive ultrasound brings so much relief I forget people are touching me and how that usually affects me. One thing that really helped me during my first pregnancy was asking the doctors some personal questions (do you have children, what got you in the business, etc.) really helped personalize the doctors and made them more human and less “scary-stranger”. They were aware of my situation and were happy to ease my stress of the situation.
Everyone here has definitely given great advice. I’ve never been pregnant, but I am a trauma survivor, and one thing I’d like to mention is maybe confronting/changing the triggers that you have control of. For instance, I make my appointments during the day and not near sunset/dusk/darkness (which can come early in the fall/winter) because being in the dark during an exam is triggering. Similarly, I don’t like it to be too quiet, so I either strike up a conversation or sing to myself in my head – you could even ask for a radio to be on. If there are less things going on that are triggering, that might make it easier, and the idea of being in control of certain things might help as well.
Sorry if I sound like a broken record (I didn’t have time to read the comments) but a lot depends on your OBGYN practice. I would love to recommend mine (if you live in South Jersey hit me up) but you can call up, explain your situation, and ask if you can ask a lot of questions about the practice. I think the key is asking for a very minimal experience. I think I got “check out” twice- once to confirm pregnancy with the vaginal ultrasound, and again to figure out how far along the baby was (which isn’t standard, I had irregular periods making it hard to pinpoint the due date) They checked again the last two weeks, but didn’t seem necessary. In fact I was told to undress below the waist by the nurse, met with the midwife, talked, etc, then right as she was ready to say goodbye she said “oh, you aren’t wearing pants…” XD Point is that I am sure if you told them your situation, these could all be avoided.
I am also talking as a person who is not a rape survivor, and had a low risk pregnancy. Most of the uncomfortable stuff happened during the delivery, which you would probably be more comfortable in a birthing center (if you are low risk and are lucky enough to have one near by) I would also hire a doula, or have a friend who is very assertive who knows a thing or two about giving birth. My Mother acted as my doula, which was nice when I was afraid of hyperventilating and asked for an epidural. I was pretty far along and I could tell the nurse was trying to convince me to keep going.
I wish you the best of luck.