Break the Silence is a charity based in Ayrshire, Scotland who have been providing support for people affected by childhood sexual trauma since 2004.
The charity provides counselling for people who have experienced childhood sexual abuse and rape, which is a much needed service. According to the National Society for the Prevention of Cruelty to Children (2021), 1 in 20 children will have experienced sexual abuse and the World Health Organization (2021) reports that globally, an estimated 30% of ‘women worldwide have been subjected to either physical and/or sexual intimate partner violence or non-partner sexual violence in their lifetime’. In addition to abuse, there are often people who have been re-victimised in their adult lives (Coid et al, 2021).
Re-victimisation can take the form of physical abuse, coercive control or sexual abuse, to name a few. The shame that the charity's clients carry is something that they live with each day. Many experience a sense of self-blame and, when they are raped as adults or subjected to physical assault, they often tell us that they feel they are still to blame. Many relationships are impacted by their trauma and some people lack a safe and stable person who can offer the support and connection needed.
Ali et al (2024) discussed the longer term impacts of sexual abuse, including the psychological effects that can often lead to post-traumatic stress disorder. Having experienced interpersonal trauma, it is understandable that interpersonal relationships are impacted. These relationships may be with family and friends, but how safe a person feels with therapists, midwifes and other helping professionals, who see them at a vulnerable time, can also be impacted by trauma.
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Within relationships, the charity's clients regularly say that they either were coerced into having sex with a partner or felt that they would be abandoned if they did not agree to go along with the requests for intercourse. In some cases, clients have experienced violence and been made to fear for their lives. Butterby and Butterby (2022) estimate that each year in the UK, there are between 2080 and 3356 children born as a result of rape in England and Wales. As of yet, there are gaps in the literature for statistics in Scotland and Northern Ireland.
As counsellors with Break the Silence, we provide a safe relationship with no judgement for clients. Once we establish trust, we are often told by clients that their child was conceived through rape or coercion. Working with a woman who is pregnant through rape or coercion (clients often prefer to use this terminology as they process their experiences), we see a huge increase in anxiety and flashbacks are often are triggered by smells, touch and even a person's tone of voice. The fear of giving birth and experiencing loss of control over their body can even, at times, make clients feel suicidal. Gavin et al (2011) highlighted that the impact of high psychosocial stress can greatly increase the risk of suicidal ideation in pregnant women.
In addition, some may fear that the baby will resemble their abuser or rapist and are apprehensive about how they will connect and attach with the baby if they see facial similarities. One such client at Break the Silence had experienced childhood sexual abuse from her grandfather and was also raped by her brother. Her fear of her partner finding out the baby was not his and the overwhelming feelings of shame and being ‘dirty’ caused her to contemplate suicide.
This particular client could see her brother's eyes in her own child, which hindered her in forming an attachment. While she provided for her child physically, she recognised that her child (who was an adult at the time of her therapy) was not nurtured or given warmth by her through her life. Understandably, this impacted their relationship, as her daughter could observe her sister receiving love and care, and this led to irreparable fracture in their relationship. The client wished she could explain, but did not want to pass on the shame of being conceived through rape to her daughter, and was therefore left with feelings of guilt and failure.
This case highlights the importance not only of earlier access to therapy for people who have experienced sexual abuse and rape, but also the need for understanding and kindness, and to avoid directing blame and shame at the person who experienced abuse.
The role that society plays in the treatment of women who have conceived as a result of rape is out of our control. However, as midwives, it is important to be aware not only of the prevalence of these issues but also some of the factors involved when working with vulnerable women, and why their behaviours, which are safety seeking, may be difficult to engage with. This awareness can aid in building trust and giving control back to the woman. This is hugely worthwhile and rewarding to both the midwife and the woman, who may then be referred to specialist services for support.
Many clients will come to Break the Silence many years after a traumatic incident, as a result of the impact of their trauma or life circumstances. Some have also been recently raped as adults. The charity works with clients to process current and past trauma, in order to enable them to connect and form secure attachments with their children and have better relationships with others and themselves.