Sexual Trauma and Pregnancy: A Conceptual Framework

Abstract

In this paper, we propose that a history of sexual traumatization is associated with pregnancy complications and poor pregnancy-related outcomes. We further hypothesize that this relationship is mediated by the sequelae of trauma (psychopathology, health problems, and increased negative health behaviors). We review the literature linking sexual trauma with psychopathology, health, and health behavior and then outline the impact of these variables on pregnancy. Based on this review, we draw conclusions about the potential impact of sexual trauma on pregnancy outcomes. We suggest future directions for this area of research and discuss the clinical implications of this association, including the development of prenatal intervention and prevention programs.

Sexual Activity during Pregnancy in Childbirth and after Childbirth

“…Recommendations are summarized and adapted from two authors who are well known researchers and professionals on the selected topic; von Sydow [7] and Leeman et al [79].…”

“…Recommendations for taking a sexual history and giving a patient sexual advice in pregnancy or postpartum [7] Research has shown [7] that couples wish to receive more information about bodily changes and sexuality postpartum, and that counselling has been helpful. Leeman et al [79] divides a clinical approach for prevention, evaluation and treatment of postpartum sexual concerns into three parts based on prenatal care, postpartum and postnatal care (see Table 4]. …”

“…Rathfish et al [78] report that women who had episiotomy or second degree tear had lower levels of arousal, orgasm and sexual satisfaction and dyspareunia at three months postpartum, compared to women with an intact perineum. Leeman et al [79] compared the postpartum pelvic floor function of women with sutured second-degree perineal lacerations, unsutured second-degree perineal lacerations, and an intact perineum. At 12 weeks postpartum, no differences were noted between groups regarding complaints of urinary or anal incontinence, sexual inactivity, or sexual function.…”

“…Perineal pain after a laceration is the most common cause of dyspareunia [79]. Dyspareunia is reported by 41%-67% of women two to three months postpartum and strongly associated with degree of perineal trauma.…”

“…Table 4. Clinical approach for prevention, evaluation and treatment of postpartum sexual concerns Leeman et al [79] Leeman and his colleagues [79] have offered the possibility of perineal massage as an option to minimize perineal trauma and postpartum pain. There are also many other things we can advise women to practice in order to minimize the risk of birth injury or to prepare her body optimally.…”