This first appeared on Dr. Tracey Vogel is an amazing OB-Anesthesiologist and Sexual Assault Counselor we work closely with. She runs the Empowerment Equation and helps to prevent traumatic births. 

Kailee’s story: 

I remember the exact day. But only because it was New Year’s Eve. And each time I try to think of the year I have to start with the year I graduated high school and count forward two years. Or one? I know it was after the first Mike I dated and before the second. Yeah, okay, it was 2008. I was 19 years old. Yes, 19. I was a virgin when I ended 2008. In the morning, I was not. 
 I’ll spare you the details not only to avoid saying Trigger Warning, but because I don’t fully remember. Somewhere in between clinking red solo cups and kissing a stranger in the new year, I woke up, naked, in the middle of a chokehold. 

 That was my first sexual assault. The others line the streets in Shadyside, sit in Fenwick with friends, and the others fall somewhere in the years I can’t remember in college. 
 Eleven years later, when I found out I was pregnant with my son, I felt the stars rise and my breath leave me the moment I took the first pregnancy test. I walked out of the bathroom and into the small hallway between our bedroom and the stairs. My husband had me take a second pregnancy test, just to be sure. The second one, it was clear- in little pink letters: P.R.E.G.N.A.N.T.
 I knew before I got pregnant that my trauma would shape the way I gave birth. I had seen how even just fear and anxiety surrounding birth could stall labor, make labor more painful, and even prevent a vaginal delivery.
I was determined not to let this happen. 

 I put it all out on the table at my first Midwife Appointment. “Just let us know what we can do to support you.” We spoke of it in several subsequent appointments. When I presented my birth plan after months of body and mind work and research with the words “do not offer any pain medications,” the midwife with the mousy brown hair and kind face, looked down at me with her hands on my belly said, “you really should consider an epidural”

 I found others to support me. 
 I knew from the moment I saw a birth in a movie that I wanted to wait to find out the sex of my baby until the doctor lifted the baby up in the delivery room and exclaimed, “it’s a ___” but my husband wanted to know and not knowing, I found myself somehow putting space between myself and my baby. 
 Most of my nights were spent in the bathtub, my fingers moving the skin on the belly that connected to my ligaments, to my uterus, creating space and symmetry for him. I explored the cavern of my vagina, stretching the walls with my fingers. I repeated “The only way out is through. You are safe. You are safe.” I focused on the sensation of the air massaging the inside of my nostrils as I imagined the sensation of Matteo crowning. 

 I took my own knowledge further. People always talk about the mind- body connection, but what about the body-mind connection? I knew my muscles and bones held things. I knew that I would need to unhinge these memories, these fears from my body if I wanted to approach birth with confidence. 
 I re-read research articles from my Obstetric training, “ Fear causes tears—perineal injuries in home birth settings”—a Swedish study. I knew my fear could stall labor, could cause my pelvic floor to tighten instead of open. It could cause me to tear. This is what I feared the most. If I tore, this would be the proof I needed. It would be proof that I was broken. 
 So I did the work that I do with my clients. I practiced pushing in positions that would put my pelvis in the best position to push out my baby. I did specific stretches for my pelvic muscles and uterine ligaments. I meditated. I breathed deeply. I journaled. I walked my dog up and down the streets of Greenfield and spent time strengthening my core. 

 On January 1 (I’ll always remember this exact date), after a week of prodromal labor, I went into real labor. I rocked on my birth ball at home, requested The Foo Fighters, called my doula, and headed to the hospital at 9:45 PM. 
 Things slowed when I got to the hospital, giving me ample time to get settled in the labor and delivery room. My doula filled the tub with water, waved essential oils under my nose, and massaged my back through a few contractions. Things started to speed, swell, and squash together after that. 
 I was so tired. I made it back into bed and lied on my side to labor through the night. I was able to sleep for minutes at a time, but it was a restless sleep. Contractions woke me up. Twice, I woke up and screamed, “NO, NO, NO.” Opening my eyes felt like a slap each time, the room spiraling around me, but I settled as my doula and husband gripped my hands and repeated “You are safe. You are safe.” 
 I slept for a little longer the next time. When I awoke in the middle of a contraction, my eyes still closed, I heard my voice echo in the room: “It’s not my fault.” 
 Closer to morning, labor intensified and the weight of it started to blur things even more. Warm hands on my face, a sip of water through a straw, blood running down my leg, the brown black of the shades colored by night. 

I heard myself groan low, long, again, again as the sun started to make its way around the earth and yellow light started to color the room. I looked down at my belly, the lack of Matteo high in my belly looked funny, foreign. I stared at my leg as it moved up and down against the scratchy hospital sheet. I focused on the sensation, up and down, scratchy smooth. Low groans echoed. My doula, with her face inches from mine: “ breathe, breathe.” I did. I heard my voice again through the din: “I’m going to be okay if I tear.”
 I groaned and pushed and pushed some more, and at last, the pressure was gone and we were separate for a moment as my midwife caught him. I can’t remember how long it took him to cry, but I will never forget the weight of him on my belly, the feeling of him: slimy, warm, wet, yet soft. I tried to pull him up to my chest, but the cord was too short, so I curled into him. 
 I felt the world move away for a moment as I held him. Relief spread over my body like warmth from a fire. I brought him to my breast as my midwife checked my perineum. “Just a few brush burns. No tearing.”

I felt something change deep in my bones. 
 Later, I re-hashed the moments after Matteo was born. My husband was both shaken up by my cries for help and amazed at how calm I was afterward. It took me time to process. I wrote, talked to therapists, and wrote some more. At first, I attributed the calm to hormones. Oxytocin, I quipped. Yes, of course, but after more reflection, I think, something more: A reprieve. A reset. A kind of healing. 

 The sun rose outside my hospital room window when Matteo came bloody and full into this world. As cliché as it sounds, his birth was a new beginning. 
 I knew that the work I did during pregnancy would make me confident to give birth. But I never expected it to help my birth be so incredibly empowering and healing. 

*I never want to discount the role that mental health practitioners play in helping to heal after trauma. Thank you to my Psychiatrist and counselor who helped me immensely during my pregnancy. 

Dr. Vogel’s thoughts: 

 I am so grateful that Kailee shared this story with us. Her story highlights the impact rape in adulthood has on childbirth. Research now shows that 70-80% of women with this history may have difficulty in the second stage of labor. Additionally, it is important to understand that differences exist between survivors of childhood sexual assault and survivors of rape in adulthood in their risks for requiring a cesarean section or instrumental vaginal delivery (forceps or vacuum delivery).

 With awareness of a woman’s history, providers could discuss options, expectations, and preferences well in advance of delivery. Trauma-informed care planning and pelvic floor physical therapy would also be incredibly valuable to help a woman navigate the stressful circumstances surrounding childbirth. As Kailee expresses, addressing her fears and preparing for childbirth gave her the confidence to give birth. But, what she didn’t expect was how it could lead to a birth experience that was “incredibly empowering and healing.”

My thoughts 2 years later: 

I never could have done it without the Resilient Motherhood method I developed. I unfortunately did not learn of Dr. Vogel until after my son’s birth, so I was dependent solely on my midwifes, mental health providers, and doula. They had great tools, but did not give me what I needed to prevent perineal tearing and have a healing birth. I had to lean into my own knowledge as a Pelvic Physical Therapist and my innate wisdom as a mother to find and develop the tools I needed. I want EVERY mom, EVERY survivor of trauma, small or big to have the tools that I did.  Now, we work with moms every week to help prevent traumatic childbirth and emerge from labor healed and whole.