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The problem is that the birthing process
stops, according to research from the
Faculty of Health Sciences at the Univer-
sity of Tromsø (UiT). Half of the women
who had birthing complications needed
help from ventouse, or vacuum extrac-
tion, and the other half had Caesarean
sections.
Surprised by the numbers
This is the first study in the world that
looks at the relationship between women
who have been raped when an adult (16
or older) and the outcome of their first
birth. The fact that 80 per cent of the
women had to have medical assistance to
give birth was an unexpected finding for
the researchers.
"The study shows that women who have
been raped stop having strong contrac-
tions towards the end of the birthing
process. Active intervention, such as a
pitocin drip, does not seem to help; in
fact, it seems to make things worse," say
Lotta Halvorsen and Hilde Nerum, PhD
candidates at UiT.
"We were very surprised by these high
numbers. It appears that common medi-
cal techniques and procedures that are
used during childbirth may be involved
in reawakening the trauma of rape," says
Nerum.
Halvorsen explained that the woman
may first begin to re-experience her
trauma when she is on her back and is
undressed. She is surrounded by stran-
gers who are "having their way" with her
body, Halvorsen says.
"It is not hard to imagine that this can
awaken memories of the abuse," adds
Nerum. "Those who have not been the
victim of a rape have a completely dif-
ferent experience of the assistance they
receive during childbirth. Those who
have been abused are more vulnerable.
And this awful experience has generally
been locked away, but manages to come
forward during the birth," says Halvor-
sen.
Halvorsen and Nerum are both midwi-
ves at the University Hospital of North-
ern Norway (UNN), and have studied
outcomes for the first births of women
who have been raped. The midwives
emphasize that the babies that were born
to the women in the study were not con-
ceived as a result of the rape. The study
involved 50 women who all had been ra-
ped as adults. All were first-time mothers
at UNN. In addition, the researchers
recruited a control group of 150 women
who were giving birth for the first time.
Greater focus
The two midwives believe that doctors
and midwives who care for pregnant
women should have a greater focus on
sexual abuse and rape. The issue can
shrouded in silence and shame, and
before the study neither women or birth
attendants would have thought that a
previous rape could have negative conse-
quences for birthing.
An estimated 8000-16000 people are
subjected to rape or attempted rape in
Norway each year. Rape is one of the
most violent and traumatizing types of
abuse to which a woman may be subjec-
ted. These numbers suggest that rape can
be an issue for many young women and
poses a public health problem.
The 50 rape victims who were in the stu-
dy have all been in contact with a mental
health team at the UNN maternity clinic.
Halvorsen and Nerum have worked with
the health team for ten years, and have
heard women's stories over the years.
The researchers believe that midwives
and obstetricians must understand that a
woman's life story also has an impact on
how the birth proceeds. An experience of
rape seems to be a hidden reason for the
different challenges that can arise during
labour, both for the woman giving birth
and for midwives.
"It is important that the midwife knows
the woman's history, and it is especially
important that these women are given
the time and space they need to give
birth without interference. That will help
them to deal with their trauma," says
Halvorsen.
"It is important to create a sense of peace
and security during the entire birth.
Intrusions and unnecessary intervention
lead to stress and can make it difficult to
give birth. A woman needs help to focus
at birth to prevent the memories from
her rape from taking over," adds Nerum.
The researchers are scheduled to defend
their doctoral theses in 2012.
Eight out of ten women who have been raped as an adult have
complications during their first birth. There are suggestions that giving
birth re-awakens the trauma caused by rape.
Birth
can reawaken the trauma of rape
University of Tromsø –
Labyrint E/11
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Text: Elisabeth Øvreberg