Childbirth experience among women with a history of sexual abuse-A meta-synthesis

Sexual abuse is a widespread public health issue with potential long-term physical and psychological consequences for women. Childbirth may be particularly challenging, as aspects of labour, birth, and maternity care can trigger trauma responses and heighten the risk of retraumatisation.

We aimed to synthesise qualitative evidence on childbirth experiences among women with a history of sexual abuse and to identify factors associated with both positive and negative birth experiences.

We conducted a qualitative meta-synthesis using thematic synthesis. Searches were undertaken in four databases. Following screening of 3934 titles and abstracts and assessment of 507 full-text articles, 12 qualitative studies published between 2019 and 2025 met the inclusion criteria. Findings were synthesised using thematic synthesis and interpreted within a trauma-informed theoretical framework.

Three analytical themes were generated: Giving Birth with a Traumatised Body, Rigidity and Powerlessness in Childbirth, and Vulnerability and Strength. Women frequently described childbirth as marked by fear, hypervigilance, loss of control, and vulnerability to retraumatisation, particularly when facing unequal power dynamics, limited autonomy, or inadequate support. Positive experiences were associated with safety, trust, respectful communication, supportive care relationships, and opportunities for choice and control. For some, childbirth became a transformative event fostering healing, confidence, and empowerment.

Maternity care plays an important role in shaping childbirth experiences for women with a history of sexual abuse. Integrating concrete trauma-informed principles, such as ongoing consent, control over examinations, and continuity of care, into routine maternity services may help prevent retraumatisation and support positive birth experiences.