Childhood Sexual Abuse, Sexual Assault, Rape and Its Relevance to Childbearing Fear

  • Kathryn Gutteridge


The history and background of some life events will inevitably place some women at greater risk of anxiety, worry and fear. Experiences in childhood such as violence within the family, sexual abuse during childhood, grief and bereavement episodes are just some of these life events. When the ego of the child is in development, the way in which the child is nurtured and experiences life is critical in how they then make the transitions between each development phase. Having parents who have their own unmet needs will undoubtedly show in the way that they parent and the child or children of those parents will most certainly develop and show deficits that may arise in adulthood. What are the implications of this in reference to anxiety and fear during childbirth? How does it manifest and what are clinicians likely to see when these women are in our maternity health care systems?


Child sexual abuse Rape Loss of hope 


  1. Adorjan M, Christensen T, Kelly B, Pawluch D (2012) Stockholm syndrome as vernacular resource. Sociol Q 53(3):454–474CrossRefGoogle Scholar
  2. Bandura A (1965) Influence of models’ reinforcement contingencies on the acquisition of imitative responses. J Pers Soc Psychol 1(6):589CrossRefGoogle Scholar
  3. Bandura A (1977a) Self-efficacy: toward a unifying theory of behavioral change. Psychol Rev 84(2):191–215. Scholar
  4. Bandura A (1977b) Social learning theory. Prentice-Hall, OxfordGoogle Scholar
  5. Bewley S, Cockburn J (2002) Responding to fear of childbirth. Lancet 359(9324):2128–2129. Scholar
  6. Bowlby J (1969) Attachment. Attachment and loss: vol. 1. Loss. Basic Books, New YorkGoogle Scholar
  7. Burton N (2014) The psychology of humiliation. Psychology Today. 27. Accessed 19 June 2019.
  8. Clark DM (1986) A cognitive approach to panic. Behav Res Ther 24(4):461–470. Scholar
  9. Clark DM, Wells A (1995) A cognitive model of social phobia. In: Heimberg RG, Liebowitz MR, Hope DA, Schneier FR (eds) Social phobia: diagnosis, assessment, and treatment. Guilford Press, New York, pp 69–93Google Scholar
  10. Crown Prosecution Service (2013) Giving victims a voice (PDF). Accessed 10 Dec 2018
  11. Crown Publications (2018) The Rotherham independent review a review into information passed to the home office in connection with allegations of child sexual abuse in Rotherham (1998–2005). Accessed 18 June 2019
  12. Eberhard-Gran M, Slinning K, Eskild A (2008) Fear during labor: the impact of sexual abuse in adult life. J Psychosom Obstet Gynecol 29(4):258–261. Scholar
  13. Ellenson GS (1988) Detecting a history of incest: a predictive syndrome. Social casework. J Contemp Soc Work 66:525–532Google Scholar
  14. Elliott A, Carnes C (2001) Reactions of nonoffending parents to the sexual abuse of their child: a review of the literature. Child Maltreat 6(4):314–331CrossRefGoogle Scholar
  15. Erikson EH (1950) Childhood and society. Norton, New YorkGoogle Scholar
  16. Felitti VJ (1991) Long-term medical consequences of incest, rape, and molestation. South Med J 84:328–331CrossRefGoogle Scholar
  17. Finkelhor D, Shattuck A, Turner HA, Hamby SL (2014) Trends in children’s exposure to violence, 2003–2011. JAMA Pediatr.
  18. Freud S (1923) The ego and the id. SE 19:1–66Google Scholar
  19. Garratt L (2011) Survivors of childhood sexual abuse and midwifery practice. Routledge, LondonGoogle Scholar
  20. Gilchrist E, Johnson R, Takriti R, Weston S, Beech A, Kebbell M (2003) Domestic violence offenders: characteristics and offending related needs. Findings 217. Home Office, LondonGoogle Scholar
  21. Gray MJ, Litz BT, Hsu JL, Lombardo TW (2004) Psychometric properties of the Life Events Checklist. Assessment 11:330–341CrossRefGoogle Scholar
  22. Gutteridge K (2001) Failing women: the impact of sexual abuse on childbearing. Br J Midwifery 9(5):312–315CrossRefGoogle Scholar
  23. Gutteridge K (2009) From the deep: surviving child sexual abuse into adulthood: consequences and implications for maternity services. MIDIRS Midwifery Digest 19:125–129Google Scholar
  24. Gutteridge K (2014) Resolving the fear factor. Midwives 17(1):21–23Google Scholar
  25. Handelzalts JE, Fisher S, Lurie S, Shalev A, Golan A, Sadan O (2012) Personality, fear of childbirth and cesarean delivery on demand. Acta Obstet Gynecol Scand 91(1):16–21. Scholar
  26. Handelzalts JE, Becker G, Ahren M-P, Lurie S, Raz N, Tamir Z et al (2015) Personality, fear of childbirth and birth outcomes in nulliparous women. Arch Gynecol Obstet 291(5):1055–1062. Scholar
  27. Herman JL (2001) Trauma and recovery: from domestic abuse to political terror. Pandora, LondonGoogle Scholar
  28. Hildingsson IM, Haines H, Karlstrom A, Nystedt A (2017) Presence and process of fear of birth during pregnancy—findings from a longitudinal cohort study. Women Birth 30(5):e242–e247. Scholar
  29. Hofberg K, Brockington I (2000) Tokophobia: an unreasoning dread of childbirth. A series of 26 cases. Br J Psychiatry 176:83–85. Scholar
  30. Home Office (2003a) Safety and justice. The government’s proposal on domestic violence. Home Office, LondonGoogle Scholar
  31. Home Office (2003b) Female Genital Mutilation Act 2003 (Commencement) Order 2004Google Scholar
  32. Jokić-Begić N, Zigić L, Nakić Radoš S (2014) Anxiety and anxiety sensitivity as predictors of fear of childbirth: different patterns for nulliparous and parous women. J Psychosom Obstet Gynecol 35(1):22–28. Scholar
  33. Jülich S (2005) Stockholm syndrome and child sexual abuse. J Child Sex Abus 14(3):107–129. Scholar
  34. Kampusch N (2010) 3096 days. Penguin, Great BritainGoogle Scholar
  35. Kelly L, Karsna K (2017) Measuring the scale and changing nature of child sexual abuse and child sexual exploitation: scoping report. Centre of Expertise on Child Sexual Abuse, BarkingsideGoogle Scholar
  36. Kendall-Tackett K (1998) Breastfeeding and the sexual abuse survivor. J Hum Lact 14(2):125–130CrossRefGoogle Scholar
  37. Kendall-Tackett K (2002) The health effects of childhood abuse: four pathways by which abuse can influence health. Child Abuse Negl 6/7:715–730CrossRefGoogle Scholar
  38. Kendall-Tackett KA (2007) Violence against women and the perinatal period: the impact of lifetime violence and abuse on pregnancy, postpartum, and breastfeeding. Trauma Violence Abuse 8(3):344–353CrossRefGoogle Scholar
  39. Klein DC (ed) (1991) The humiliation dynamic: viewing the task of prevention from a new perspective, special issue, Journal Of Primary Prevention, part I, 12, no. 2. Kluwer Academic, New YorkGoogle Scholar
  40. Lukasse M, Vangen S, Oeian P, Kumle M, Ryding EL, Schei B (2010) Childhood abuse and fear of childbirth-a population-based study. Birth 37(4):267–274. Scholar
  41. Lukasse M, Vangen S, Øian P, Schei B (2011) Fear of childbirth, women’s preference for cesarean section and childhood abuse: a longitudinal study. Acta Obstet Gynecol Scand 90(1):33–40. Scholar
  42. Lukasse M, Schei B, Ryding EL, Bidens Study G (2014) Prevalence and associated factors of fear of childbirth in six European countries. Sex Reprod Healthc 5(3):99–106. Scholar
  43. Madsen L (1994) Rebounding from childbirth. Bergin and Garvey, New YorkGoogle Scholar
  44. Marsh S, Pancevski B (2011) The crimes of Josef Fritzl. Harper ElementGoogle Scholar
  45. Maslow AH (1943) A theory of human motivation. Psychol Rev 50(4):370–396CrossRefGoogle Scholar
  46. Mayer L (1995) The severely abused woman in obstetric and gynaecological care. Guidelines for recognition and management. J Reprod Med 40(1):13–18PubMedGoogle Scholar
  47. McNeish D, Scott S (2018) Key messages from research into institutional child sexual abuse. Centre of Expertise on Child Sexual Abuse, EssexGoogle Scholar
  48. Office for National Statistics (2017) Domestic abuse in England and Wales: year ending March 2017. Accessed 10 Dec 2018
  49. Office for National Statistics (2018) Births, deaths and marriages. Accessed 10 Dec 2018
  50. Piaget J (1936) Origins of intelligence in the child. Routledge, LondonGoogle Scholar
  51. Rachman S (1977) The conditioning theory of fear-acquisition: a critical examination. Behav Res Ther 15(5):375–387. Scholar
  52. Rothschild B (2000) The body remembers. The psychophysiology of trauma and trauma treatment, 1st edn. W. W. Norton & Company, New YorkGoogle Scholar
  53. Ryding EL, Wirfelt E, Wängborg I-B, Sjögren B, Edman G (2007) Personality and fear of childbirth. Acta Obstet Gynecol Scand 86(7):814–820CrossRefGoogle Scholar
  54. Salomonsson B, Gullberg MT, Alehagen S, Wijma K (2013) Self-efficacy beliefs and fear of childbirth in nulliparous women. J Psychosom Obstet Gynecol 34(3):116–121. Scholar
  55. Schroll A-M, Tabor A, Kjaergaard H (2011) Physical and sexual lifetime violence: prevalence and influence on fear of childbirth before, during and after delivery. J Psychosom Obstet Gynecol 32(1):19–26. Scholar
  56. Swahnberg K, Wijma B (2004) The NorVold Abuse Questionnaire (NorAQ): validation of new measures of emotional, physical, and sexual abuse, and abuse in the health care system among women. Eur J Public Health 13(4):361–366. Scholar
  57. Tudiver S, McClure L, Heinomen T, Scurfield C, Kreklewetz C (2000) Women survivors of childhood sexual abuse: knowledge and preparation of health care providers to meet client needs. Final Report. Centre of Excellence in Women’s Health Program, ManitobaGoogle Scholar
  58. Utting W et al (1997) People like us: the report of the review of the safeguards for children living away from home. Stationery Office/Great Britain. Department of Health/Great Britain. Welsh Office, LondonGoogle Scholar
  59. van der Kolk BA (2014) The body keeps the score: brain, mind, and body in the healing of trauma. Chicago Style Citation, New YorkGoogle Scholar
  60. Walker M (1999) The inter-generational transmission of trauma: the effects of abuse on the survivor’s relationship with their children and on the children themselves. Eur J Psychother Couns Health 2(3):281–296CrossRefGoogle Scholar
  61. Weathers FW, Blake DD, Schnurr PP, Kaloupek DG, Marx BP, Keane TM (2013) The Life Events Checklist for DSM-5 (LEC-5). Instrument available from the National Center for PTSD at
  62. World Health Organisation (2000) Women’s mental health: an evidence based review. WHO reference number: WHO/MSD/MDP/00.1Google Scholar

Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  • Kathryn Gutteridge
    • 1
  1. 1.Sandwell and West Birmingham Hospitals NHS TrustBirminghamUK

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