Child sexual abuse and pregnancy are separate occurrences but both are strongly connected to sexuality. Child sexual abuse is related to many negative outcomes but less known is the effect on pregnancy. This review critically examined the literature in relation to this abuse and outcomes during pregnancy/childbirth. Five databases were searched over a 50 year period using an iterative method and the terms pregnancy, sexual abuse/assault, childbirth/labour with 49 studies identified. Of these, 20 different measures were identified with inconsistencies/limitations noted relating to these instruments (e.g., no psychometric data) and methodology (e.g., differing definitions). The prevalence of child sexual abuse was estimated as 7.6% with certain characteristics associated with a higher (e.g., specific questions, low income) or lower (broad questions, higher education) prevalence. The balance of evidence indicates that compared to non-abused women, women with a child abuse history have more adverse experiences in relation to pregnancy, childbirth, and care with their abuse history likely contributing to harmful behaviours and psychopathology. Future research examining the generalisability of the findings (relating to scale limitations) and recommendations (e.g., screening items, scoring) to the broader population is needed. The findings also point to the need for early identification of women with a child abuse history as such women require trauma-sensitive care and consideration. A useful tool is the Pregnancy-related Anxiety Scale which provides insights into specific areas of concern.