Moving beyond the pain: women's responses to the perinatal period after childhood sexual abuse.

INTRODUCTION: Childhood sexual abuse (CSA), a significant public health problem, affects 1 in 9 women presenting for prenatal care. Female survivors of CSA often experience posttraumatic stress disorder. Flashbacks of the trauma can interfere with a survivor's ability to get appropriate perinatal care. The purpose of this study was to construct a theoretical framework describing how CSA survivors manage intrusive reexperiencing of their CSA trauma during the perinatal period.

METHODS: Grounded theory was used to construct the framework of this study. Twelve women, aged 18 to 39 years, who were pregnant or gave birth within 12 months of the interview and self-identified as having experienced CSA were recruited. Open-ended interviews were conducted. Participants were asked to describe the CSA experience and how it affected them during the perinatal period. Constant comparison analysis was used to construct the framework.

RESULTS: The study framework depicts how pregnant survivors of CSA manage the intrusive reexperiencing of CSA triggered during the perinatal period by 3 processes categorized as reliving it, taking charge of it, and getting over it.

DISCUSSION: This framework suggests that survivors can begin to move beyond the pain of posttraumatic stress disorder, a mental health sequelae of CSA, during the perinatal period. Practitioners can use this framework to tailor interventions to the phase of the survivor's current experience.