If Penny Simkin, author of When Survivors Give Birth, is right, between 25% and 40% of all women may be survivors of early sexual abuse.
And if that’s the case, many women of child-bearing age may face an often invisible barrier to breastfeeding.
You would think that histories of abuse would cause the rates of breastfeeding among survivors to be lower, but in fact they are comparable – or even higher than -the rates among non-survivors.
We also know anecdotally that some moms must fight against the long arm of their abuse to do it. “For many survivors,” Penny Simkin writes, “some of the greatest challenges in the postpartum period occur with breastfeeding.” And those challenges may be faced alone, as fear, shame, and stigma may lead mothers not to share their history with their providers and other support people.
If a woman’s abuse was related to her breasts, breastfeeding may (or may not) cause difficult feelings to emerge. In some cases they’re strong enough to make a woman not want to breastfeed. Penny Simkin noted in a podcast interview with me that survivors sometimes have “distorted” views of their body, and feel a strong need to have control over them. This may lead to uncomfortable feelings about that sharing their bodies with their babies, who as we know can be demanding! Sometimes the needs of the baby can even begin to feel like the demands of the perpetrator. Mothers may feel that breastfeeding is form of abuse of the baby because the baby can’t consent, or that their bodies are dirty and incapable of making good milk. Sometimes these connections are conscious and sometimes they aren’t, and sometimes they are strong enough to make women choose not to breastfeed. And of course, sometimes these feelings don’t emerge at all.
We also know that for some women breastfeeding has the potential to be healing – a very powerful reclaiming of their bodies and self image. In the words of one mother quoted in a study, “Breastfeeding has helped me overcome the negative image of myself and my body.” Another mother described breastfeeding as “giving my breasts a positive story.” And other mothers find breastfeeding a protective act by fostering close relationships with their children.
New research also shows that, while women with a history of sexual assault are at higher risk for sleep difficulties and depression in the first year having a baby, exclusive breastfeeding appears to offer some protection against these problems.
The authors found that “sexual assault survivors who were [exclusively] breastfeeding were at lower risk on all of the sleep and depression parameters than sexual assault survivors who were mixed or formula feeding.”
But all of this leaves some women in a tough spot. Do you disclose your abuse in order to explain why you don’t want to breastfeed, or so that the care you get is takes into account your history? Do you explain your specific breastfeeding problems to peers or providers who might not understand or know how to help? If your abuser is still in your life, do you speak the truth to get help? What do you do if your provider knows of your history and assumes that you won’t want to breastfeed? What if the “medical touch” of a lactation consultant is disturbing? If breastfeeding makes you feel very exposed, how do you do it in public?
There is cause to be optimistic. Skilled and sensitive people like Penny Simkin have supported moms through breastfeeding challenges related to their abuse, and as the issue becomes better known, more will do the same.
My favorite story Penny tells is of breastfeeding mother who had survived early sexual abuse. This mother found herself very disturbed by night feedings. Her abuse had taken place at night, and being awakened by her baby to feed was eliciting disturbing feelings related to the abuse. The solution they found? Set an alarm clock. Once the mother was awakened by the clock instead of a person, she was able to feed her baby at night without distress.
Another story she recounts in When Survivors Give Birth is of a breastfeeding woman who would recoil when her baby touched her other breast in the course of feeding. Exploring this feeling with her lactation counselor led to her recalling early abuse related to her breasts, for which she sought counseling. Her lactation counselor helped her find ways to prevent this behavior – a nursing necklace, wearing clothing, holding the baby’s hand – and she continued to breastfeed.
For other mothers, pumping may provide enough control over the process of providing milk for their babies that they can sustain lactation. With the right support, creative solutions can sometimes be found.
With acceptance, sensitivity, and understanding – qualities of care everyone deserves – providers, breastfeeding support people, and peers can support survivor moms who want to breastfeed.
Did you or someone you know breastfeed after sexual abuse? As a support person, have you worked with breastfeeding women who are survivors? How did it affect their experience, if at all?