Tips for Finding Trauma-Informed Prenatal Support

Content advisory: This post briefly mentions a past experience of sexual abuse in a clinical setting.

It feels surreal to be writing this, but I’m officially 39 weeks pregnant. My body could go into labour at any moment, and each day I wake up wondering if today will be the day I will finally get to meet the little being that has been growing inside me for the last nine months.

My experience with both getting and being pregnant has been an emotional one – I wrote about it here and here. What I’ve yet to write about, however, is the support I’ve received along the way that has helped me manage the anxiety, shame and fear that has surfaced.

Everyone experiences pregnancy differently. For those of us who have endured sexual violence, there’s a good chance we might experience thoughts, feelings or flashbacks related to our past trauma. It can be overwhelming, to say the least.  

The best decision I made when I found out I was pregnant was to begin seeking out trauma-informed prenatal support. Over the past nine months, I’ve built a village of supportive care providers, family and friends around me that has helped make this experience a lot more manageable. Below is a list of the steps I’ve taken, as well as some of the resources I’ve found most helpful throughout my pregnancy journey.

Work with a Therapist

Finding a therapist is always my number one recommendation to anyone who is healing from sexual trauma. Not only can a therapist hold space for everything you’re experiencing, they can also help you identify what you need to feel supported and help you connect with the right resources.

I personally work with a psychotherapist who also has training in a modality called Somatic Experiencing. I like this combination, because not only does my therapist help me look at my thought patterns, she also invites me to explore my connection to my body in our sessions.  

A lot of themes have come up for me over the last few months, like worrying I will be a bad mother, fear that my child will be sexually abused, challenges with family dynamics, feeling like my body is not my own and I have no control, anxiety about attending medical appointments, feeling numb and detached from myself and my baby, feeling ashamed for not “being more present” throughout my pregnancy…the list goes on. I can’t tell you how healing it has been to have someone listen to all of this with undivided attention and without judgment.

If you are looking to connect with a therapist, I recommend the website Psychology Today. You can read some of my other tips for finding the right therapist for you here.

Connect with a Midwife

One of the first things I did after finding out I was pregnant was to begin applying for midwifery care. Midwives are healthcare professionals who provide expert primary care to pregnant people throughout their pregnancies and to their newborns for the first six weeks after birth.

What drew me to applying for midwifery care was the specialized approach they take. Midwives are there to guide you through your options, from testing and medication to pain management during birth. Appointments are not rushed, and they take the time to get to know you on a personal level.

In the province of Ontario, midwifery care is government-funded and completely free. With that said, midwives are in high demand and it can be hard to get matched with someone. That’s why it’s important to apply as soon as possible. You don’t need a doctor’s referral to apply, and you can apply to as many clinics in your area as you like. (I found the clinics in my area through Google.) 

When you apply for midwifery care, you complete an intake form where you have the opportunity to share information about yourself. I mentioned that I am a survivor of childhood sexual abuse and also disclosed that I get anxious when my body is touched without consent.

I ended up getting a call back from one clinic, the Midwifery Collective of Ottawa, who matched me with an experienced, compassionate and trauma-informed midwife named Nora. I felt a connection with her immediately. We both like astrology, are cancer suns and have rescue dogs. Every time I go in for an appointment, she takes the time to answer my questions and puts me at ease. She empowers me to make decisions about the birth of my baby that feel right for me. She is also very conscious of my needs, and always makes sure to ask my permission before touching my body – a small thing that goes a long way.

I honestly wish everyone could have the experience of working with a midwife like Nora. It has been such a positive experience for me and I feel safe and supported as I near the birth of my baby.

If you are looking to connect with a midwife, I recommend considering sharing a bit of your past experience with them. You do not need to go into details about what you’ve been through, but just naming something as simple as feeling anxious when you are touched can go a long way in making sure you receive the care you deserve. Additionally, here’s a list of questions you might want to ask your midwife to help you feel supported.

Hire a Birth Doula

A birth doula is a trained professional who offers emotional and physical support to pregnant individuals and their families. Although they are not medical professionals, doulas can offer a wide range of comfort measures to birthing people during labour.

Unlike a midwife or obstetrician who is there to support your medical needs and your baby’s, a doula is there in the leadup to your birthing day, as well as during the birth purely to provide reassurance and emotional support to you. They can also be a source of great comfort to your birth partner, especially if it’s your first baby.  

While each doula’s offerings vary, doula support typically includes education and preparation for birth. Once you go into labour, your doula will be by your side to support and comfort you. Many birth doulas also offer at least one postpartum visit to support you in your transition into parenthood and caring for your newborn.

It’s important to find a doula you feel safe and connected with. I knew I wanted doula support, but wasn’t sure where to start, so I asked my midwife for a few recommendations. I also did my own research (a.k.a. perused Google and social media). Most doulas have websites where you can read about their birth philosophies to see what resonates with you.

When I stumbled upon Gertrude’s website, I was pretty sure I’d found my match. I was moved by her writing, and there was just something about her that felt approachable. I sent her an email, sharing a bit about myself and asking if she was available near my due date.

As I waited for her response, I prepared a list of questions. I used this resource for inspiration and added a few of my own questions, including: “Have you ever supported anyone who has openly shared that they’ve experienced sexual trauma?” and “What does consent mean to you?”

The moment I got on the phone with Gertrude, it felt like I was talking to an old friend. She was warm and funny, and never made me feel rushed. The conversation just flowed and she was patient with my numerous questions. It was clear she had a lot of experience, and we ended up chatting for almost two hours. By the time I hung up the phone, I knew my search was over.

Over the last few months, Gertrude has been an unwavering source of support to me and my partner. We’ve had three visits with her, each one focused on a different area of preparation. She introduced me to the concept of a birth plan, and helped me put one together to share with my care team that reflects my preferences for the birth of my baby. She has also been a godsend in these final weeks of pregnancy, offering reassurance as I anxiously wonder when my labour will begin.

In the same way that I wish every birthing person could have a midwife like Nora, I wish everyone could have a Gertrude. If your budget allows for it, I highly recommend seeking doula support. You are worth the investment, and if finances are an issue, many doulas offer a sliding scale.

Work with a Pelvic Floor Physiotherapist

A few weeks after I found out I was pregnant, I started having some issues with incontinence. The first time it happened, I was throwing up (a regular daily occurrence during my first trimester) when I suddenly peed myself. As the days went on, I noticed it was happening when I sneezed, vomited or laughed too hard. My midwife recommended connecting with a pelvic floor therapist, and while I knew it would be beneficial, I was terrified to reach out.

I had done a bit of research about pelvic floor therapy, and one thing I was afraid of was the internal exam. When I was in my twenties, I was groomed by an older man that I viewed as a spiritual mentor. He told me he was qualifying to become a massage therapist and used clinical language to convince me that touching me internally was necessary during my treatments. It wasn’t until I started therapy that I was able to finally process what had happened and understand that it was sexual abuse.   

The thought of lying on a massage table and allowing another physical therapist to put their hand inside me brought back memories I didn’t want to think about. I tried my best to just ignore my symptoms, but they only got worse. In addition to leakage, I was experiencing pressure and pain in my pelvic area. I finally opened up to a friend who had been through something similar and she recommended a women’s clinic that specialized in pelvic floor issues.

I visited their website and read the biographies of each physiotherapist, scanning for words like “trauma-informed,” “safety” and “consent.” I decided to reach out to one of the PTs whose bio seemed encouraging. In my email, I explained that I had a history of sexual trauma and was very nervous about a physical exam. She reached out within a few hours and we set up a time to chat on the phone. Her voice was friendly and she reassured me that while internal exams can be helpful in diagnosing issues, they are not the only option. We could explore things like my posture and movement which would also give us some clues.

When I went for my first visit, she didn’t pressure me to do an exam. She walked me through some exercises, and validated that what I was experiencing was normal. By the end of the session, I surprised myself by volunteering to do the exam. She helped me feel safe enough to go through with it, took the time to pause and explain exactly what she was about to do, then waited for my consent before proceeding. The whole thing was very professional and nothing like what I had been through in the past.

Not only did working with a physiotherapist help to ease my pelvic floor discomfort, it also helped me prepare my body for labour. My PT also empowered me with information about the postpartum period, and helped me make a plan to support my recovery after giving birth. Knowing I have this set up before I go into labour has helped me feel a sense of safety and control. While the birth of my baby is ultimately an act of surrender, knowing I have people I can turn to helps me feel like I can handle whatever comes my way.

If you’re in the Ottawa area and looking for an amazing pelvic floor physiotherapist, I cannot recommend Michelle at Bloom Integrative Health enough.

Seek Community

Pregnancy can often feel like an isolating experience. Your body is constantly changing, and you are leaving behind one version of yourself to step into another that you’ve not quite become. Finding community to support you makes all the difference.

Here are some ways I’ve connected with community: 

1. I signed up for prenatal classes, including a training called Hypnobirthing, as well as a prenatal yoga class at my local community centre. Both gave me the chance to connect with other expectant parents, and I even made one friend in my neighbourhood who has a due date three days before mine! We text every day, and it’s been so nice to have someone who is going through a similar experience as me.

2.  I reached out to friends and asked for help. If the thought of this makes you cringe, you’re not alone. (Don’t get me started on how women and AFAB people are socialized to put everyone else’s needs before our own…) A book that helped me understand the importance of asking for help is The Fourth Trimester by Kimberly Ann Johnston. This book offers all kinds of suggestions for things to consider as you prepare for labour, such as who you can rely on for emotional support, who can look after your pets/children while you’re in labour, who would be willing to prepare meals for you during the postpartum period, or hold your baby while you shower, or tidy your house when you’re feeling overwhelmed. Asking for help is hard, but I promise it’s not as bad as it sounds. I’ve also found that many people want to help, but don’t know what to offer. When you give them a specific ask, you are helping them help you.

3. I accepted support that was offered to me. One thing I was not expecting was the secret army I was introduced to once people found out I’m pregnant. I joke that it’s a secret network, but really, it’s a loving community of those who have come before you, other parents who know the journey you’re embarking on. I’ve been overwhelmed by the generosity of others, from people gifting me gently used maternity clothes, to baby clothing and supplies, to people organizing meal deliveries for our family during the postpartum period. Things just keep appearing, and while it feels a little odd to just accept so much abundance without doing anything in return, I’m slowly allowing myself to open to receiving. One day, I will pay it forward to another first time parent. For now, I’m grateful to have the support.

As I close out this post, I hope it can be helpful to anyone who is on a pregnancy journey or thinking about embarking on one. There’s a lot of unsolicited advice and information out there, and it can be overwhelming to know where to turn. The best unsolicited piece of advice I can offer is to take what resonates with you and leave the rest. You know yourself better than anyone else and you are worthy of a positive pregnancy and birth experience.