Child abuse and perinatal outcomes: Examining prenatal health, intergenerational abuse, motherhood, and childbirth for survivors

This chapter provides an overview of outcomes related to child abuse that may be challenging for child abuse survivors during the perinatal period. In Part 1, general and psychological prenatal health is examined. This includes a discussion on prenatal substance use and eating disorders which have implications for the mother and child. Part 2 of this chapter examines motherhood, particularly the mother-child relationship and the intergenerational implications of child abuse. We discuss attachment, from its early prenatal development to postpartum bonding, and its importance for the infant in forming internal models of caregiving that, if impaired, can contribute to later mental health problems. The important role of breastfeeding in maternal bonding and the difficulties some survivors may encounter are also considered. Next, we examine the influence of previous child abuse on parenting practices and consider intergenerational abuse, that is, the potential of a mother with their own history of abuse to harm their child. Drawing on social learning theory and the parenting literature, it is clear that a parent’s childhood experiences, which may include abuse and harsh parenting, are influential in their parenting practices. This part of the chapter concludes by considering child abuse survivors’ risk of revictimization and the implications this risk poses for pregnant women and their unborn children. Indeed, pregnancy may increase the risk of IPV, and this violence can impact the mother and developing fetus through direct harm and epigenetic effects. The final part of this chapter examines the challenges of childbirth for survivors of childhood abuse and the importance of sensitive care. While childbirth can be particularly traumatizing for some survivors, empirical data suggest that positive birth experiences provide opportunities for caregivers to attenuate negative effects.