Maya* hadn't felt able to tell staff at the hospital where she had her daughter that she was a rape survivor. It wasn’t the sort of thing that came up while a midwife was taking your blood pressure. But when she went into labour, the feeling of being out of control of her body reminded her strongly of the traumatic attack. She had flashbacks of the rape and began actively trying to stop her contractions. “If you relax, it’ll be over more quickly,” a midwife told her - unwittingly echoing a phrase the rapist had used.
Last week, the first maternity clinic for rape survivors opened in London. Designed to help women like Maya, it’s the brainchild of Pavan Amara - who started the My Body Back project after realising that she wasn’t alone in avoiding routine healthcare screenings years after being raped. “I told a Rape Crisis counsellor how I felt unable to visit my GP for things like STI testing or contraceptive fitting and removal,” Amara says. “They said it was totally normal, but it wasn’t being spoken about so I decided to interview other women about their experiences. Half said they hadn’t attended any cervical screening since being raped, a third hadn’t felt able to have the contraceptive they’d wanted, and many hadn’t been for STI testing because it reminded them of the attack.”
What was needed, she decided, was a specialist clinic that would put women in control of procedures such as smear tests. With no clinical background herself, she faced an uphill struggle to set one up, finally receiving an offer of help from Dr Jill Zelin, consultant physician at Barts NHS Trust. The trust launched a pilot project in August last year at St Bartholomew’s Hospital in London, offering smear tests and STI testing in a way that was tailored to rape survivors.
Each woman attending the My Body Back clinic is given an advocate to discuss her needs and wishes, although there’s no need to talk about her sexual assault. Her appointment will last at least an hour rather than the rushed ten-minute slot at a GP’s surgery, and she can control the environment where the test takes place - for example by bringing aromatherapy, comforting items or music from home. She can work up to the appointment itself, coming to look at the room and equipment beforehand if she wants to and the team can even help her to do the test herself if she really doesn't want to be touched.
Feedback from the 700 to 800 women the clinic has helped so far is very positive - but working with them, Pavan Amara was aware that much more could be done. Particularly for women such as Maya, who revealed how hospital staff had been quite angry with her for trying to fight her labour. “She was treated as a very difficult patient. When she finally told them why, she overheard people talking about how maybe she was making it up, using it as an excuse,” Amara says. “By the time her baby was born she felt so awful, she couldn’t bond with him. She avoided her postnatal appointments and couldn’t even bring herself to seek breastfeeding support because she’d had such a difficult time.”
A mum-to-be who goes to the My Body Back maternity clinic will get a radically different experience from what Maya went through. The key element is that where possible she in control of what happens. She’ll first meet with an advocate from the project, to plan the birth and how to avoid any possible triggers. “It might cover body positions, the type of phrases she wants clinicians to use, breathing techniques, how she wants to be touched, how she wants vaginal examinations to proceed,” Amara explains.
The clinic will also offer antenatal classes and breastfeeding support for women who have experienced sexual violence. The first patients were even sent away with goody bags donated by Lush. Everything is geared towards giving mothers a positive and empowered experience of pregnancy and birth.
Patients come from all over the UK and Amara - who is now training as a nurse - admits she finds it tough to turn away those who contact her from other countries, like India and Ireland, who aren’t eligible to use the NHS.
There is hope, though, that the publicity around the opening will remind clinicians everywhere that there’s a good chance any woman in front of them may have experienced sexual violence - and think twice before they tell anyone to (as one woman who contacted My Body Back reported) “grow up and get on with it”.
Giving birth is such a huge moment in anyone’s life. A bad experience can make it so much harder to take on the challenge of becoming a mother; but in the right circumstances, it can change your relationship with your body for the better. It can give you not just a baby, but your body back.