TRAUMA, SEXUAL ASSAULT, AND INFERTILITY

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Let’s talk about the ways trauma, sexual assault, PTSD, neglect, and childhood adversity affect your fertility.

We intuitively understand that things like adverse childhood events (ACES), sexual assault, and other traumas are likely to influence our emotional health. Depression, anxiety, panic attacks, suicidal thoughts, and intrusive thoughts are common both in the aftermath and long-term after suffering these sorts of traumas.

But more and more, research shows traumatic experiences also cause very real acute and long-term physical and social adverse effects too.

Childhood adversity has been linked to chronic inflammation, sub-optimal respiratory, circulatory and endocrine function, cognitive changes, and even decreased life expectancy. PTSD is linked to muscle tension, headaches, chronic pain, hyper vigilance, sleep and digestive issues, and heightened addiction disease risk. Trust issues, low self-esteem, control and perfectionism tendencies, and more, are social ripples from multiple forms of trauma.

Of course, there are so many ways these shifts bump into — and also influence — our ability to get pregnant. Thankfully with awareness and intervention we can absolutely offset and improve mental, physical, and social health all together!

So let’s break it down, starting from the ground up.

How does trauma change your body?

There are loads of immediate changes that make sense when you face a real and self-limiting threat — like facing a tiger!

In Acute Fight or Flight

• Blood moves from the digestive and reproductive organs to the extremities to get ready to fight the threat or run far away

• Adrenalin is released to boost energy giving you a short jolt of strength and awareness

• Insulin and blood sugar spike to allow more energy into the muscles

• The immune system shuts down — after all, who cares if you get a cold when a tiger’s about to attack

• Blood clotting factors increase because there’s a decent chance you might be bleeding soon
  

In Long-term Stuck Trauma

The tricky thing is, when unrelenting chronic stress or ongoing PTSD make us feel like we’re stuck facing a tiger all day every day, these changes start to cause problems.

• Chronic digestive issues and reduced fertility due to the body deprioritizing these functions

• Easily feeling jittery, hyperarroused, hypervigilant, and on edge

• Feeling exhausted because your body is trying to be “on” all the time

• Blood sugar and metabolic changes like insulin resistance and diabetes which feed into PCOS and other metabolic hormone changes

• Immune system issues including autoimmune disease and persistent inflammation which are known factors in infertility and recurrent miscarriage

• Blood clotting and other circulatory issues like high blood pressure, which are bad for getting pregnant and make a pregnancy more likely have complications

Sigh.

It’s clear this isn’t great for our fertility or our quality of life. And so the first step is to notice, and then start to work with, the ways the body is continuing to reflect its sense of chronic threat and lack of safety so it can start to shift back out.

“The two most important phrases in therapy, as in yoga, are ‘Notice that’ and ‘What happens next?’ Once you start approaching your body with curiosity rather than with fear, everything shifts.”
- Bessel Van Der Kolk

So what kind of traumas are we talking about here? Let’s start with the most common two: ACES and sexual abuse.

What are ACES?

Adverse Childhood Experiences

Conventional ACES include:

• Physical abuse

• Emotional abuse 


• Sexual abuse 


• Physical neglect 


• Emotional neglect

• Substance abuse in the family 


• Household mental illness 


• Witnessing domestic violence 


• Incarceration of a close relative
  

Expanded ACES include:

• Death of a parent


• Physical punishment


• Parental separation or divorce


• Poverty


• Racism and segregation


• Community violence


• School violence or bullying 


• Child separation from family


• Natural disaster


• Family member illness or hospitalization

61% of American adults have experienced at least one ACE, and 1 in 6 have experienced four or more.

What constitutes sexual abuse?

Examples of sexual abuse include:

• Inappropriate touching

• Sexual harassment

• Molestation or incest

• Sexual assault

• Sexual battery

• Rape

• Any sexual act without freely given consent
  

The CDC says:

• More than half of women have experienced sexual violence

• Nearly 1 in 3 men have as well*

• 1 in 4 women have experienced rape or attempted rape

• 1 in 26 men have experienced rape or attempted rape

*Non-binary and trans people are more likely to face sexual violence

Many other forms of trauma.

Childhood adversity and sexual assault are two big types of trauma, but there are many more. War, violence, sickness, natural disasters, suicide, miscarriage, traumatic or ambiguous loss. Trauma can also include easy-to-miss things that are lacking. This is especially true in cases of childhood emotional neglect.

“Though we once considered trauma to be exclusive to veterans and people growing up in extreme circumstances, we now know it is widespread. And not only is it all over our society, it’s all over our bodies.”
- Bessel Van Der Kolk

Not all trauma is created equal.

Like anything, there are many factors that influence the outcomes of trauma. Frequency, severity, access to healthcare, supportive adults, education, community, adequate housing and income, and privilege will make traumatic experiences more or less impactful.

For example, we all likely found the COVID pandemic challenging. But people with enough resources, support, and security — who were inconvenienced but still safe — probably didn’t suffer a lot of physical or mental changes as things settled down. But a nurse in the ER who was cursed at by patients, in constant physical threat, working long taxing hours, and witnessing traumatic death may very well need to reprocess and work on the ways this stays in their mind and body.

A holistic note on trauma.

With a history of trauma or adversity, it’s tempting to think “what if” and “if only.” Those thoughts are completely normal. But the truth is, you cannot separate who you are — the wonderful and the challenging — from all of your experiences.

“I love the thing I most wish had not happened.”
- Stephen Colbert

This is not about erasing the past. Rather, it’s about learning to accept and work with the thing you wish would’ve been different and can only control the here and now. This mindset can help you accept your whole self and suffer less. It’s a lovey way to both “work on” and “let go.” Both together.

“Each of you is perfect the way you are. And you could use a little improvement.”
- Shunryu Suzuki

So what can you do to change how your body holds onto trauma?

Thankfully, there’s more and more research showing that mind body modalities and experiences can shift us back into feeling safer and recalibrate both our physical and mental health. Here are three big evidence-backed categories that are worth exploring.

Trauma Specific Therapies

• Eye Movement Desensitation and Reprocessing (EMDR)

• Accelerated Resolution Therapy (ART)

• Internal Family Systems (IFS)

• Narrative Exposure Therapy (NET)

• Psychadelic Therapy

Click here for my list of Twin Cities providers

Mind Body Modalities

• Acupuncture

• Massage

• Yoga

• Breathing

• Singing

• Dancing

• Drumming

• Martial arts

• Physical play

Time In Nature

• Walks and hikes

• Gardening

• Forest bathing

• Eating outside

• Exercising outside

• Being on, in, or near water

If nature and mind body science is interesting to you, check out the links at the end of this blog for further reading.

The take-away for fertility.

As with everything I do, the take-away here is that the very best and more cutting-edge way to improve your unique fertility is to combine a truly whole-you, big-picture approach with the most appropriate specific (reductionistic) fertility treatment.

This is the future of great fertility medicine.

Though you won’t see processing childhood neglect, adversity, or a past sexual assault in the hottest fertility best-seller, this is exactly the sort of work that truly gets to the heart of making your body feel its most safe and ready to say yes to a pregnancy.

So if trauma or childhood adversity are a part of your specific history, that is the best way to get more fertile. Not to mention it truly serves your immediate wellness, relationships, mental health, and quality of life — for fertility, for parenting, and for your whole life.

Gah. It’s so so powerful and important!

So embrace your specific conditions — trauma and all. They make you who you are. And you’re amazing! Then, take a step back and actually do the work and make the changes that serve you as a whole person. I know you intuitively understand this, and I bet you crave it too.

After all, who doesn’t want to feel safe and whole? Know you can. Even if life has been hard. Here’s to noticing and making small, appealing shifts that help your mind, body, and fertility all together!

I’m here for it,

Nicole

FURTHER LEARNING LINKS

If you have ACEs read Nadine Burke Harris’s book Toxic Childhood Stress (Previously titled ‘The Deepest Well’)

Nadine Burke Harris also has a fabulous TED Talk about how childhood trauma changes health across the lifetime

If you’ve experienced childhood emotional neglect, check out Adult Children of Emotionally Immature Parents by Lindsay C Gibson or Running on Empty: Overcome your Childhood Emotional Neglect by Jonice Webb

Seth Porges — the son of the Stephen Porges founder of PolyVagal theory — gives a great ‘Nerd Nite’ talk about your body feeling safe (or not) after experiencing trauma

I think Peter Levine is such a compassionate teacher on the mind body trauma connections and ways to improve, start to learn a bit from him about self-soothing in this video

The Body Keeps the Score by Bessel Van Der Kolk is the best known book on embodied trauma

While The Body Keeps the Score book can feel intense for some, here’s a great video to get a feel for the ideas to start

For Complex PTSD, Peter Walker’s Complex PTSD: From Surviving to Thriving may be a good fit

Domestic Shelters website has a great list of Sexual Violence and Abuse book recommendations

For Racialized Trauma, Resmaa Menakem’s My Grandmother’s Hands and the styling listed above

If you’re interested in nature, check out the fascinating articles Why Fractals are so Soothing by Florence Williams and Aeon in the Atlantic, and Fractal Patterns in Nature and Art are Aesthetically Pleasing and Stress-Reducing by Richard Taylor in The Smithsonian 

Also check out Blue Mind: The Surprising Science That Explains How Being Near, In, On or Under Water Can Make you Happier, Healthier by Wallace J. Nichols

Nicole Lange

LICENSED ACUPUNCTURIST
HOLISTIC FERTILITY EDUCATOR