Navigating pregnancy as a survivor: The intersection of trauma and birth

Content warning: Discussion of sexual abuse ahead.

Where is the air? Where has it gone? Those were the thoughts that kept repeating in my mind as I lay on the cold exam table, waiting for the first ultrasound of my first baby. As I tried to adjust to make myself a little more comfortable—even just 2% more comfortable—all I could hear was the crackling of the paper that was annoyingly sticking to my skin, the same paper I used to draw on at The Macaroni Grill as a kid. In my head, I tried to reassure myself, You are not here for comfort; You are here to ensure your baby is healthy and to lay eyes on them for the first time. I thought that if only I could convince myself that this was supposed to be a joyous event, one where I would look at the monitor, see my baby, and hear their heartbeat, then it would all be OK. 

Because that’s what I was always told—in the end, it will all be OK. 

As I waited for the doctor to enter the room, my feelings of panic began to rise. It was as if I could feel every ounce of my skin that was exposed, signaling to me that something bad was about to happen. The activation wasn’t an uncommon feeling to have in these settings where I would have to surrender my body, yet, I couldn’t help but deeply loathe it away. 

Not here, not now, not this. 

I tried reasoning with myself, Just hang on for a few more minutes. Desperately, I began to draw from all of the coping tools that I could think of at that moment: inhale for 4, hold for 7, breathe out for 8, look around the room, find shapes, colors, objects, name five or maybe seven, feel the gravity, notice the discomfort, don’t judge it, breathe, just keep breathing. It was as if I was competing in a coping skills relay race, yet every time I reached for the baton; it would somehow disappear. The paralyzing panic was rising at the same time when I was trying to tell myself, I am safe; just hang on, you’re so close to seeing your baby. 

Once the doctor finally arrived in the room, I was barely enduring but visibly OK enough. She asked me how I was doing, in which I could only answer one-word questions with some occasional nodding. She shared some other information that never made it in, and then… 

Quickly, I thought, This is it; this is the moment I get to see my baby. 

She continued, “And then I will do a vaginal ultrasound.”

First, I heard the word ultrasound, then slowly, the word vaginal appeared, then internal. In utter shock, I thought, How did I not know this? I have already done so much research on this process; how could I have missed this? With a distraught face, I asked questions about why it wouldn’t be like that ultrasound I saw in the movies, the one with the sticky gel on my belly. She explained why, yet I don’t think I was able to comprehend anything at that moment except my internal screaming, which I tried to silence and pretend wasn’t happening. 

I was then instructed to lay back, move down, and place my feet in the stirrups. I scooted myself down, bringing the Macaroni Grill paper with me, as my feet made contact with the metal and plastic U-shaped objects that would hold my feet—and open me up. 

As I lay there for a moment, I couldn’t help but feel as though I was going to fall right through, as if my body would cave in on itself. This uneasiness, this instability, this feeling of hanging on by a thread reverberated throughout my entire body, and as my shaking legs were trying to still—I felt it. I felt the numbness coming. 

One part of me was fighting to stay as embodied as I could. This part began pleading to remain present in the room and my body just long enough to see my baby, while another part was aware of what lay ahead and desperately needed out. 

The part that needed out knew how to leave. Slowly, that part would let the numbness in, the non-feeling would start in my feet, and before I could catch myself, my consciousness would be somewhere else, hovering, trying to keep me safe and feel as little pain as possible. 

As a survivor of childhood sexual abuse, these settings were never easy for me. They always brought on a sense of panic and flooding, often leading to dissociation. A skill that my body turned to as a means of dealing with the experience of feeling powerless, lack of control, or autonomy. 

Even though this profound moment, the first moment I saw my baby, was meant to be a celebration, I still couldn’t attend. 

I couldn’t attend because although I had been on a healing journey for some time, learning tools and embedding myself in science and education, the reality was that the same place that caused me so much pain throughout my life, the constricted place that held my trauma, was the same place where I would carry and birth my baby. 

It was as if it all came to a head on that ruffling exam table, and I quickly realized that this was the first appointment, my first real pregnancy experience. As soon as that thought shot in, another thought barged through, the first of many. 

Many appointments with reproductive care providers, decisions, body changes, unfamiliar sensations, emotional fluctuations, expectations, and identity shifts are all approaching the horizon.

For many years what healing looked like for me was learning how to slow down enough to become intimate with the moment to begin to let myself notice what I was experiencing. What was happening on the inside of my body? How was I trying or attempting to make sense of it or push myself through it? I also learned to track when the activation running through my veins was becoming too intense, so much so that I would eventually begin to notice myself slipping outside of my body. 

At the same time that I was in the process of healing, I had no idea how much being a pregnant survivor would open me up to so many triggers and re-traumatization. I had no idea that these triggers would be like nothing I had felt before because, at the same time, as I was navigating my stress response cycle, I was also fighting to try and stay connected to myself for my child. 

I don’t remember the first moment I saw my baby that day. I don’t remember how it felt. I don’t remember my response or what I thought.

My survival strategies that I had relied on since childhood, the same ones that I had been diligently attempting to manage, made their way in. 

As I walked out of the office with the ultrasound images in my hand, I couldn’t help but begin to wonder how I would stay connected to my body through this time. I also began to wonder why I never thought about how my body’s history of sexual abuse might impact this transformative journey. 

According to the World Health Organization, around 1 in 3 women across the globe experience some form of physical or sexual violence in their lifetime. Many of these women go on to give birth, and many of these women experience the same unique challenges that I did. In addition to the prevalence of women touched by trauma, current research is also reporting that trauma survivors have a higher risk of developing postpartum depression, anxiety, and post-traumatic stress disorder (PTSD) after giving birth. 

It is hard not to look away from these statistics and see myself in them while also seeing so many others who have suffered silently, not knowing what was happening to them. 

If this is you, you are not alone. There is hope where there is understanding, and where there is understanding, change is possible.