Fear of Pregnancy After Sexual Assault

I was sexually assaulted when I was 17. I'm 22 now, the assault left me with an extreme fear of pregnancies. The following day after it happened, I didn't take any EC pills because of what I remembered, no penetrative sex had taken place, yet I started to get really worried, full blown panic attacks, thinking that maybe I did have sex and could be pregnant. I ended up not being pregnant, yet the incident left me with a lot of anxiety regarding sex. I've been sexually active since the last year, and the anxiety around pregnancy always creeps on me. I always have protected sex, I always use a form of birth control, such as condoms or hormonal. What can I do about this? I recently discussed it with my therapist, since the sexual assault was something I was very ashamed of.
Mo Ranyart replies:

First off, I'm sorry to hear about your sexual assault. If it helps to hear this, having a strong fear of pregnancy after a sexual assault isn't unusual, especially when someone is feeling shame over it or worrying that they caused or deserved it in some way. Pregnancy can feel like an inevitable punishment or further violation in such a situation, and that fear can linger and impact consensual sex in the future. Just because this isn't uncommon doesn't mean it isn't upsetting, though, and I do sympathize with your situation. It can be tough to be comfortable being sexual after an assault, and having pregnancy anxiety adds another layer of complication that doesn't help any.

For now, I think it might be a good idea to stick to only those sexual activities that don't leave you feeling anxious afterwards. That might mean taking a break from intercourse but keeping things that carry no risk of pregnancy, like oral or manual sex, on the table; or it might mean stepping back from any kind of sexual intimacy, if you find that you're worried about pregnancy whether or not a risk was actually present. It can be frustrating to take a break from sexual activities you otherwise enjoy, but ideally sex is going to be something you feel good about not just as it's happening, but afterwards as well. Putting things on hold for now will give you a chance to get a little bit of distance from these pregnancy fears while you address and work through them. It can be a lot tougher to handle a source of fear or anxiety when the cause is ongoing, so I do think this will be a helpful first step.

I don't know whether you've talked with your partner or partners about your assault or your pregnancy fears, but if you haven't, this may be a good time to think about doing so. A partner should respect your desire to pull back a bit from sexual activity no matter what, but having the context for your decision may help them understand it better, and will give them the opportunity to find other ways to support you. If you want some thoughts about how to begin that conversation, we have an article about communicating with a partner about sex here. If it feels intimidating to talk to a partner about your assault, or about changing what kinds of sexual activity you're engaging in for now, keep in mind that a kind and caring partner will want to know if anything they're doing is inadvertently causing you anxiety. Even if it's a tough conversation, being open about how you're feeling and what changes you might want to make in order to manage your anxiety better is likely to be helpful for you both, in the long run. If you don't feel comfortable talking about your assault at the moment, you could focus on your fears about pregnancy, and on what specific things they can do to make sex (or a break from sex) feel less stressful for you right now.

While anxiety isn't always swayed by facts, I think it could help for you to take some time to learn a bit more about birth control, and make sure you're not absorbing falsehoods or pregnancy "horror stories" of dubious origin. Learning just how your preferred method of birth control works, and how effective it is, might help you feel a bit more confident in it when you do feel up for sex that carries a risk of pregnancy in the future. You may also want to explore other birth control options; methods like an implant or an IUD, which are extremely effective, might feel like a better choice than a birth control pill, which is still quite effective but leaves a bit more room for human error. Here is our guide to different birth control methods; you can also ask your doctor for more information about any of these that sound appealing to you.

Also, you mentioned using condoms; combining condoms with another birth control method is incredibly effective and something we recommend for anyone who definitely doesn't want to become pregnant, especially if they struggle with anxiety around pregnancy. If you aren't in a habit of using two forms of birth control every time you're having intercourse, that could be something to start doing for extra confidence in your birth control. You can learn a bit more about just how effective it is to use two forms of birth control at once here.

I'm glad to hear that you felt safe talking about this with your therapist. Hopefully they were able to give you some pointers around working through feelings of shame after a sexual assault, and that's something you can continue to work on together. In case they didn't mention this to you, I think it's important to say that shame after an assault is a common reaction. Even though the blame lies squarely on the shoulders of the person who chose to assault someone else, not on the survivor of that assault, feelings of guilt and shame are something that many people struggle with afterwards. I certainly wish this wasn't the case, of course, but it's true, and common myths about rape and widespread victim-blaming certainly don't help.

Your therapist is also a great resource for helping you cope with anxiety, around sex in general or pregnancy risks in particular, so if you haven't mentioned that angle to them I suggest you bring it up when you have the opportunity. As I mentioned above, anxiety won't always be swayed by facts, but mental health professionals can help you work out tools and strategies to help you combat it. It can take some time, but it's likely that they'll have some good ideas of things to try when your anxiety around pregnancy starts to flare up. We have collected some anxiety-related resources here if you'd like to take a look; there may be a few options there that will dovetail nicely with the plan your therapist sets up for you.

Above all, even if you're feeling frustrated or upset about this situation, I hope you can show yourself as much kindness and patience as you'd show a close friend or family member who was struggling with anxiety or the aftereffects. Recovery after a sexual assault can be difficult, and you deserve to be treated with compassion by everyone, including yourself. Even when it's tough to show yourself love, I encourage you to really put effort into it, or to lean on your loved ones for a little extra support; you really are worth it.

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