When Childhood Sexual Abuse Trauma Resurfaces: What Perinatal Therapists Need to Know

Without warning, the perinatal period can unexpectedly reactivate trauma symptoms in survivors of childhood sexual abuse. This resurfacing often goes unrecognized, leading to challenges in care and support. Trauma is not only psychological but deeply embodied, influenced by relationships and context. When the body prepares to bring new life into the world, it may also recall past trauma in profound ways. Recognizing these dynamics is essential for providing trauma-informed perinatal care that supports survivors effectively.

Why Does Childhood Sexual Abuse Trauma Resurface During the Perinatal Period?

Survivors of childhood sexual abuse face unique challenges as they begin their reproductive journey. This trauma can be activated before, during, or after pregnancy, increasing the risk of perinatal post-traumatic stress disorder (PTSD) and other mood or anxiety disorders. As trauma therapist and instructor, Lacey Castilleja Fisher, LPC-S, RPT-S, PMH-C, RST-C/T explains, “Many people are unaware of how memories or symptoms of their sexual trauma will resurface in the perinatal period and question why it is coming up again after all this time.”

The perinatal period involves profound bodily changes and medical procedures that can trigger unconscious memories and trauma responses.

“Pregnancy is, in many ways, a return to the body—a body that remembers everything. For survivors, this process can feel like coming home to a place they once had to leave, where the inner child still waits. And that child doesn’t stay silent when the body is preparing to become a parent.” - Lacey Castilleja Fisher

These embodied experiences often awaken emotional and physiological reactions tied to childhood abuse, even if the trauma is not consciously recalled.

Recognizing Trauma Symptoms in Pregnancy and Postpartum

Survivors may show signs during the perinatal period that are often misunderstood or overlooked. Lacey adds, “A perinatal client may suddenly seem overwhelmed, anxious, or disconnected, feeling like they’re in the past and it’s hard for them to identify why.”

These reactions may be misread as resistance or noncompliance in obstetric care or childbirth. However, they often stem from trauma-related responses to medical procedures or loss of control, which can feel retraumatizing to survivors of childhood sexual abuse.

Lacey reminds us,

“Many people are shocked when they learn that a childhood trauma that hasn’t been fully processed can come flooding in after so many years of not being triggered or even thought about.” - Lacey Castilleja Fisher

Recognizing these signs requires a trauma-informed lens that understands clients’ behaviors as protective survival responses rather than simple defiance or anxiety.

The Clinical Importance of Trauma-Informed Perinatal Care

Research shows that survivors of childhood sexual abuse are at least twice as likely to develop perinatal PTSD, especially related to birth trauma or loss of control (Seng et al., 2011). Furthermore, among individuals with perinatal PTSD, a significant portion have trauma histories rooted in childhood sexual abuse, even if the trauma is not consciously recalled at first (Choi et al., 2015).

This underscores the importance of trauma-informed care in perinatal mental health, which includes recognizing the potential for trauma reactivation and responding with attunement and support.

Supporting Survivors: Practical Steps for Clinicians

As Lacey emphasizes, reclaiming agency in perinatal care can be vital to reducing retraumatization and fostering safety. Clinicians are encouraged to be mindful of how loss of control may trigger trauma responses and to work collaboratively with clients to ensure they feel empowered and respected throughout their care.

The perinatal period can be both a trigger and an opportunity for healing for survivors of childhood sexual abuse. Recognizing how trauma resurfaces during pregnancy, childbirth, and early parenting is essential for effective perinatal mental health support.

If you’ve ever wondered why a perinatal client seemed triggered or overwhelmed, you’re not alone. Lacey’s upcoming course, Echoes of Trauma: Navigating Perinatal Mental Health and Sexual Abuse, illuminates the profound and often hidden ways in which childhood sexual abuse shapes the reproductive journeys and parenting experiences of survivors. There is much to learn about providing trauma-informed care that honors survivors’ experiences with compassion and clarity.

Echoes of Trauma: Navigating Perinatal Mental Health and Sexual Abuse

🗓️  April 23, 2026

Learn how childhood sexual abuse can resurface during the perinatal period and impact the transition to parenthood and how to support survivors on their reproductive journey.

LEARN MORE AND REGISTER

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References

Choi, S.-W., Kim, D.-J., Choi, J.-S., Ahn, H., Choi, E.-J., Song, W.-Y., Kim, S., & Youn, H. (2015). Comparison of risk and protective factors associated with smartphone addiction and internet addiction. Journal of Behavioral Addictions, 4(4), 308–314. https://doi.org/10.1556/2006.4.2015.043

Seng, J., Low, L., Sperlich, M., Ronis, D., & Liberzon, I. (2011). Post-traumatic stress disorder, child abuse history, birthweight and gestational age: A prospective cohort study. BJOG: An International Journal of Obstetrics & Gynaecology, 118(11), 1329–1339. https://doi.org/10.1111/j.1471-0528.2011.03071.x