Trauma-Informed Doula Support: Navigating Childbirth After Sexual Assault

Childbirth is an incredibly vulnerable experience—one that can bring forth deep emotions, memories, and even past trauma. For survivors of sexual assault, labor and birth may feel overwhelming, triggering, and even frightening. Having a trauma-informed support system in place can make all the difference in ensuring a mother feels safe, respected, and empowered throughout her birth journey.

As a survivor of sexual assault and a doula, I know firsthand how difficult this process can be. The fear of being touched, the flood of emotions, the feeling of losing control—it can all come rushing back in ways you might not expect. My own experience left me wishing I had someone to ground me, to remind me that I was safe, that I had a voice, and that I was in control of my body and my birth.

This is why I am passionate about trauma-informed birth support. A doula can be more than just a guide through labor; they can be an anchor in the storm, offering emotional reassurance, advocacy, and practical techniques to create a safe and empowering birth experience.

Creating a Safe and Supportive Birth Environment

Safety is everything. When a mother feels unsafe—whether physically or emotionally—her body responds. Stress, fear, and anxiety can stall labor, making the process more difficult. This is not just a theory; it is a biological response deeply rooted in history. Our ancestors needed to feel secure in their environment before giving birth, and our bodies still react in the same way.

As a doula, my role is to help create an environment where the mother feels safe, heard, and supported.

This might mean:
-Asking someone to leave the room if their presence is making her uncomfortable.
-Playing music or using calming techniques to regulate the energy in the space.
-Holding her hand and offering words of encouragement.
-Ensuring that her birth preferences are respected.

Too often, survivors of trauma feel unheard. I know what it’s like to feel as if no one is listening or respecting your needs. As a doula, my goal is to amplify the mother’s voice and make sure her choices are honored.

Advocacy and Communication

Birth should always be a source of empowerment and peace, never something that invokes fear or triggers anxiety. However, for survivors, certain medical interventions or even well-meaning healthcare providers can become triggering.

A doula acts as a bridge between the mother and the medical team, ensuring that:
-Informed consent is always obtained. No procedure—whether it’s a vaginal exam, a cervical check, or an intervention—should be done without clear, respectful communication.
-Boundaries are clearly communicated. This might mean requesting minimal vaginal exams, choosing only female providers, or advocating for specific birth positions that feel safer.
-Triggers are acknowledged and respected. If certain medical terms, touch, or situations are triggering, a doula can help communicate these concerns to the birth team.
-Most importantly, you have the right to say no. No one—your doctor, your nurse, your doula, your partner—should pressure you into anything that makes you uncomfortable.

Emotional and Psychological Support

Labor is an intense experience, and for a survivor, it can sometimes trigger past trauma. It is easy to become overwhelmed, lost in memories, or disconnected from the present moment.

As a doula, I use grounding techniques to help keep mothers present and centered:
-Deep breathing exercises to regulate the nervous system and reduce anxiety.
-Visualization techniques to help focus on something comforting and reassuring.
-Positive affirmations to reinforce safety, strength, and empowerment.
-Physical support can also be grounding, but only if it feels safe. Gentle hand-holding, counterpressure, or massage can help—but only if the mother is comfortable with it. This is why discussing comfort levels before labor is key. And remember: it is okay to change your mind.

Another essential role a doula plays is recognizing signs of dissociation. If a mother appears disconnected, unresponsive, or lost in a triggered state, a doula can gently guide her back to the present and ensure her birth team respects her need for space.

Encouraging a Sense of Control

For survivors, loss of control can be one of the most triggering aspects of childbirth.

A doula can help restore a sense of power by:
-Helping create a birth plan that prioritizes trauma-informed care.
-Encouraging decision-making throughout labor to prevent feelings of helplessness.
-Using reassuring affirmations to remind the mother that she is in charge of her body and her birth.

Even if the birth does not go as planned, a doula can help ensure that choices are still being made with the mother’s consent, giving her a sense of agency in the process.

Postpartum Support

Healing doesn’t stop after birth—it continues into the postpartum period. For many survivors, childbirth can unearth trauma they didn’t even realize they were holding. For me, it felt like a door unlocking and flying open, revealing memories and emotions I wasn’t prepared for.

Postpartum support from a doula can include:
-Processing the birth experience. Whether it was a positive or difficult birth, having someone to talk to can help make sense of the emotions that arise.
-Supporting the transition into motherhood. PTSD can manifest in different ways postpartum, and having ongoing support can make a huge difference.
-Assisting with breastfeeding. For some survivors, breastfeeding can bring up unexpected triggers. A doula can help navigate these challenges with sensitivity and care.
-Providing emotional validation. Everyone’s healing journey is different, and it’s okay to struggle, to grieve, or to feel conflicted. There is no right or wrong way to feel.

You Are Not Alone

As a doula, my presence alone is meant to be a source of strength. I’ve walked this path, and I know how hard it can be. But I also know that it is possible to have a birth experience that feels safe, empowering, and healing.

Everyone’s story is different. Everyone’s birth experience is different. Everyone’s way of coping is different. And that is okay.
It is okay to be scared.
It is okay to ask for help.
It is okay to not be okay.
It is okay to take time to heal.

My heart aches for anyone who has endured the trauma of sexual assault. It is not an easy road, and you did not deserve what happened to you. But you have survived, and you are here now, taking steps toward reclaiming your body and your birth experience.

As a doula, I am here to help ensure that your birth is not something that retraumatizes you—but rather something that reminds you of your strength, your power, and your resilience.
Healing is possible. There is light at the end of the tunnel. You are powerful. You have a voice. You are not alone.

-Elle Daniels

Doula and Childbirth Educator

More Resources

Exploring the intersection of childbirth and post-traumatic stress disorder (PTSD), especially in the context of sexual assault, is crucial for understanding and supporting affected individuals. Below are some resources, including books, articles, and podcasts, that delve into these topics:

Books:
-"When Survivors Give Birth: Understanding and Healing the Effects of Early Sexual Abuse on Childbearing Women" by Penny Simkin and Phyllis Klaus
This book addresses the challenges that survivors of sexual abuse may face during childbirth and offers guidance for both survivors and healthcare providers to facilitate healing and support.
-"Trauma and Birth: Understanding and Treating the Effects of Birth Trauma in Mothers and Babies" by Sarah Buckley
Sarah Buckley explores the concept of birth trauma, its impact on mothers and infants, and provides insights into treatment and support strategies.


Articles:
-"Trauma-informed perinatal healthcare for survivors of sexual violence"
This article discusses the importance of integrating trauma-informed care into perinatal healthcare settings to support survivors of sexual violence during childbirth.
-"Unseen Trauma: Recognizing and Understanding Childbirth-Related PTSD"
This piece highlights how childbirth can be a triggering event leading to PTSD, emphasizing the need for awareness and appropriate care strategies.


Podcasts:
-"Providing Trauma-Informed Care to Pregnant Patients" by Cleveland Clinic
This podcast episode discusses the M-Power program, which aims to improve the perinatal experience for patients who have survived sexual assault or violence, emphasizing the importance of trauma-informed care.
-"After: Surviving Sexual Assault"
A 10-part series featuring discussions between survivors of sexual abuse and assault about their experiences and coping mechanisms.
-"Finding OK - Healing After Sexual Assault and Abuse"
This podcast provides a platform for survivors to share their stories and healing journeys, offering insights into recovery and support.

These resources offer valuable insights into the complex relationship between childbirth, sexual assault, and PTSD, providing support and information for survivors, healthcare providers, and those seeking to understand these experiences.