title: A feminist narrative study of the maternity care experiences of women who were sexually abused in childhood.
abstract: BACKGROUND
  One in five women experience childhood sexual abuse and these women may suffer trauma during childbirth. Their maternity care is often reminiscent of their abuse.
  
  
  OBJECTIVE
  To inform practice by exploring the impact that childhood sexual abuse has on the maternity care experiences of adult women.
  
  
  METHODS
  This was a narrative study from a feminist perspective. The part of the study reported here utilised in-depth interviews with women. Data were analysed using the Voice-Centred Relational Method of analysis and further thematic analysis.
  
  
  METHODS
  Users of one maternity service in the South of England
  
  
  METHODS
  Nine women were interviewed following purposive sampling.
  
  
  RESULTS
  The main themes identified were women's narratives of self, women's narratives of relationship, women's narratives of context and the childbirth journey. The concept of silence linked all these themes and aspects of the study relating to it are reported here.
  
  
  CONCLUSIONS
  Every day midwives will encounter women who were sexually abused in childhood. Most of these women do not disclose to those caring for them and may not respond to a direct question. They will not necessarily be distinguishable from other women accessing maternity services but they may find their experiences deeply traumatic. Silence is a challenge for those providing their care. Open communication and a genuine interest in women as individuals are required. Midwives need to listen for the unspoken messages women are trying to convey. If all women were treated with dignity and respect more may emerge from the experience of childbirth feeling empowered rather than violated.
authors.affiliation: Florence Nightingale School of Nursing and Midwifery, King׳s College London, James Clerk Maxwell Building, 57 Waterloo Road, London SEI 8WA, United Kingdom. Electronic address: elsa.montgomery@kcl.ac.uk.
authors.forename: Elsa
authors.initials: E
authors.lastname: Montgomery
authors.affiliation: University of Southampton, United Kingdom.
authors.forename: Catherine
authors.initials: C
authors.lastname: Pope
authors.affiliation: University Hospitals Southampton, United Kingdom.
authors.forename: Jane
authors.initials: J
authors.lastname: Rogers
mesh_terms: D000328:Adult; D054523:Adult Survivors of Child Abuse / Q000523:psychology*; D002648:Child; D002650:Child Abuse, Sexual / Q000523:psychology*; D004739:England; D005260:Female; D006801:Humans; D008427:Maternal Health Services / Q000592:standards*; D036801:Parturition / Q000523:psychology*; D011247:Pregnancy; D011369:Professional-Patient Relations; D036301:Qualitative Research; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Childhood sexual abuse; Feminist research; Maternity care; Narrative