Sexual Assault Awareness & Prevention in the Black Perinatal Space
- Dr. Kesha Nelson
- Apr 1
- 4 min read
Why This Matters in the Black Perinatal Space
1. Higher Exposure to Trauma
Black women and girls experience high rates of sexual violence across the lifespan. Many enter pregnancy with:
Unresolved childhood sexual trauma
Intimate partner violence histories
Reproductive coercion
Pregnancy can reactivate trauma responses, especially during:
Pelvic exams
Labor and delivery procedures
Loss of bodily autonomy
2. The Intersection of Racism + Sexual Trauma
The legacy of exploitation of Black bodies in reproductive healthcare contributes to:
Medical mistrust
Underreporting of assault
Dismissal of pain or distress
Increased vulnerability during prenatal care
Trauma is compounded when survivors feel unheard or disbelieved.
3. Mental Health Impact During Pregnancy & Postpartum
Sexual trauma is strongly associated with:
Perinatal depression
Perinatal anxiety
PTSD
Substance use as coping
Difficulty with breastfeeding or physical intimacy
Increased risk of suicidal ideation
For Black birthing people, these risks are intensified by stigma around mental health and strength narratives (“strong Black woman” trope).
Signs Trauma May Be Re-emerging in the Perinatal Period
Panic during exams
Avoidance of prenatal appointments
Nightmares or flashbacks
Irritability or hypervigilance
Emotional detachment from pregnancy
Fear of labor or medical settings
Prevention in the Black Perinatal Space
Prevention must be layered — individual, relational, community, and systemic.
Individual Level
Trauma-informed prenatal screening
Routine consent conversations before exams
Empowering birth planning
Psychoeducation about triggers
Partner & Family Level
Education about reproductive coercion
Conversations about bodily autonomy
Safe relationship assessments
Community Level
Faith-based workshops
Culturally responsive survivor support groups
Collaboration with Black doulas and midwives
Systemic Level
Implicit bias training in OB settings
Trauma-informed hospital protocols
Clear reporting pathways
What Trauma-Informed Perinatal Care Looks Like
✔ Asking permission before touch✔ Explaining every procedure✔ Offering choice whenever possible✔ Validating survivor experiences✔ Screening privately✔ Avoiding victim-blaming language
How PMHNPs Can Lead
As perinatal mental health clinicians, we can:
Normalize trauma conversations
Use validated screening tools
Create safe referral pathways
Integrate EMDR, CBT, or somatic approaches
Advocate for culturally safe systems
Faith & Cultural Healing Integration
In many Black communities, healing may also include:
Spiritual counseling
Prayer circles
Community accountability
Intergenerational dialogue
Prevention is not just about stopping assault — it is about restoring autonomy, dignity, and safety in Black bodies during one of the most vulnerable life stages.
Statistics & Call To Action
The Reality
1 in 3 women experience sexual violence in their lifetime.
For many Black birthing people, that trauma does not disappear during pregnancy — it can resurface.
Sexual trauma is linked to:
• Higher rates of perinatal depression
• Increased PTSD symptoms
• Greater birth-related anxiety
According to RAINN, sexual assault is widespread — yet underreported. In the Black community, stigma and medical mistrust make disclosure even harder.
Pregnancy must be trauma-informed.
Safety is prenatal care. 🖤
Trauma & Maternal Mental Health
Survivors of sexual violence are 2–3x more likely to experience:
• Depression during pregnancy
• Postpartum depression
• Anxiety disorders
The National Sexual Violence Resource Center reports that sexual violence has long-term mental health consequences — including PTSD and substance use.
In the Black perinatal space, trauma + racism + systemic bias create layered risk.
Screening for trauma should be as routine as checking blood pressure.
Birth Can Be Triggering
Up to 30% of women report childbirth as traumatic.
For survivors of sexual assault, rates are significantly higher.
Procedures like pelvic exams, cervical checks, and loss of control during labor can trigger:
• Flashbacks
• Panic
• Dissociation
Trauma-informed birth practices reduce harm. Consent matters even in labor.
The Silence
Black women are less likely to report sexual assault and less likely to receive mental health care after trauma.
Barriers include:
• Fear of not being believed
• Cultural stigma
• Lack of culturally responsive providers
Silence protects systems — not survivors.
We must build perinatal spaces where Black birthing people feel safe to speak.
Prevention Starts Early
Nearly 1 in 4 girls experience sexual abuse before age 18.
That means many pregnancies occur in bodies that have already experienced violation.
Prevention in the Black perinatal space means:
✔ Teaching bodily autonomy
✔ Addressing reproductive coercion
✔ Screening safely
✔ Providing culturally grounded support
Protection is prevention. Healing is prevention. Community is prevention.
Call to Action (Professional Lens)
As providers, we must:
• Screen privately
• Ask permission before touch
• Explain every procedure
• Believe survivors
Sexual trauma history increases risk for perinatal mood disorders — and untreated perinatal depression impacts maternal and infant outcomes.
Trauma-informed care is not optional. It is ethical care.
Kesha Nelson, PhD, MSN/Ed, RN, APRN-CNP, PMHNP-BC, ADHD-CCSP
Director of Mental Health – BLACK BERRY & JUICE
The BLACK Collaborative Inc.
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