Bad experience, good birthing: Dutch low-risk pregnant women with a history of sexual abuse

Abstract

Objective. The long-term effects on women in childbirth with a history of sexual abuse have only been studied to a limited degree. We estimated the prevalence of lifetime experience among low-risk pregnant women (non-clinical) in the Netherlands as well as the association with (1) psycho-social outcomes, and (2) the birth process.

Methods. Study of 625 randomly selected low-risk pregnant women. At 20–24 weeks gestation, participants completed a questionnaire covering socio-demographic variables, sexual attitude, and psychological determinants. Midwives recorded details of the birth process.

Results. Nearly one-in-nine (11.2%) women had experienced sexual abuse. They were on average younger, more likely to smoke, and had lower household income. They reported more conflicting feelings about sex than women who did not report a history of abuse ( p = 0.02). Multiparous women with a history of sexual abuse reported more emotional distress ( p = 0.037), more internal beliefs concerning health ( p = 0.004), and they were also more likely to suffer pelvic pain ( p = 0.045). Sexually-abused women reported higher levels of autonomy ( p =<0.001). Referral rates to secondary care were equal. Sexually-abused women were less likely to receive episiotomies ( p < 0.005).

Conclusion. Little difference was observed in major birth-related technical interventions between women with and without a history of sexual abuse.

Keywords:

• The Netherlands
• midwifery
• sexual abuse
• psycho-social outcomes
• long-term effects