Last night at the AMPAC Women’s Safety Class, Strong Orange Violence Prevention instructor (and writer at The Drawing Board), Rachael Heffernan was putting forms of violence on a spectrum from “bothering” to “life-threatening”. Certain types of violence could fit on multiple places in the spectrum depending on a number of factors, including who is perpetrating the violence. She then brought up the subject of a perpetrator that is all-too-often forgotten: ourselves.

Whenever people take self-defense training or women’s empowerment classes, they are often taught about what to do when you experience violence or harassment from strangers (especially) and, less often, from people you know. Of course, the occurrences of violence (both physical and sexual) are statistically lopsided, meaning that you are much more likely to be violated by someone you know (family, friends, colleagues, mentors), but it still stands that all too many violence prevention courses focus on outward violence and neglect what happens when we internalize violence and direct it at ourselves. Statistics about self-violence (including negative self-talk) simply do not exist.

Before we go there, I want to talk about something else that Rachael brought up because it is an important factor in all of this, especially in “getting home safe” which is the mantra of the class. Very often, our ability to be assertive and stand our ground in the face of external oppression or violence is directly connected to how we value ourselves. Rachael put it best on the car ride home when she said that conceding to anothers’ whims (even if they violate our rights) because we don’t want to “upset them” or because “we can bear the brunt of the pain” is fundamentally flawed logic because it causes or is rooted in self-devaluation. The other person’s worth is deemed to be more than your own.

This is the first instance in which negative self-talk can harm you: in how you deal with harmful situations perpetuated by others. If you are constantly down on yourself, feeling you aren’t worth the time of day for anyone, you are much more likely to put yourself last, even when in life-threatening or dangerous situations. This is a common narrative we hear among victims of sexual assault, particularly when the aggressor is someone they know. Victims can admit that they swallow their pain and just want the whole incident over with, fearing they weren’t “assertive enough” so something like being raped is inherently their fault.

It is never your fault.

And the anxiety and self-rage that comes from feeling like you made a mistake in being assaulted can lead to further self-devaluing and the potential for future vulnerabilities in the face of both external and internal aggressors. This is what we are talking about when we say that people get caught in the cycle of abuse and do not know how to break out.

One place you can start is by stopping violence against yourself first. The way to do this is to recognize it as violence. If you view yourself as an aggressor, you can start to see how violence against yourself also appears on the spectrum from “bothering” to life-threatening. Some specialists recommend viewing your aggressor voice as an adult and your inner self, which it chastises, as a small child. This can help illuminate just how much we bully ourselves.

Bothersome violence might be how you look at yourself in the mirror. Thinking that you have parts that sag or have too much cellulite, or that the body you were given just doesn’t look like every airbrushed magazine or filtered Instagram pic you see online. It could be in how you hear yourself speak in a room full of peers. They are hearing the words flowing out of your mouth and all you hear is how many “ums” and pauses and poor word choices you make and if only you wouldn’t open your mouth in the first place, then you wouldn’t have to worry about it. Or it might be thinking about everything you said and did hours later, or days, or years. At the heart of these ruthless criticisms (which, by the way, we would be very unlikely to accept from anyone but ourselves) is anger.

And anger leads to rage.

And rage leads to more violence.

So much so that you might move along the spectrum from being bothersome to downright dangerous. Negative self-talk gives way to destructive behaviours. It can lead to eating disorders, to binge drinking, to excessive drug use, it can lead to self-medicating with food, it can lead to sex addiction or self-harm like cutting or burning. All of these things are dangerous behaviours that stem from self-rage, that stem from a feeling of anger directed inwards. It might be (and usually is) exacerbated by social isolation – but thinking we aren’t good enough might also cause us to retreat and vice versa.

Dangerous to life-threatening is a slippery slope. These behaviours can easily turn to suicidal ideation or attempts. The slow simmering burn of anger feeds the fires of depression, anxiety and trauma like nothing else.

So, what puts those fires out? How can we stop the violence against ourselves once we recognize it for what it is?

Firstly, realize that this is not intrinsically how your brain works. It has been trained to think this way and it can be trained not to. It is not an easy road, but it is possible and it has to be undertaken to interrupt those negative thoughts and actions while learning to replace them with positive and beneficial ones. It can be an uphill battle with poor self-image messages in society inundating us day after day, but by learning to dampen their voice and raising your own, among other powerful women, we can start to replace those messages.

Getting help is important. Seek out counseling or other mental health-care providers, and do not stop if they tell you that you are fine but you know you still hurt yourself. At my first session on University campus, I told my counselor that I had suicidal ideation in moments of rage which stem from a birth trauma I experienced and she concluded the session by saying that she won’t be seeing me again because I “seem to have it all together”. Another counselor I saw told me I am the highest functioning patient she has ever met and she didn’t know why I needed to see her, even though symptoms of PTSD regularly inhibit my personal joy and daily existence. Do not stop looking for someone to help you. There are problems with the system and how people access it, but continuing to ask for help is a sign that you are healing and removing the obstacle of isolation.

Be holistic in your approach and put your mental health first. Yes, before anything else. Before your family, before your kids, before your job, before your career. None of that matters if you are suffering daily violence and are at risk of hurting yourself. Everything else can wait. Yes, ladies, even your children. Lean on family, on friends, on childcare providers. Get to your appointments, get to the gym, make time to eat well and sleep well. Be shameless about this. These things are just as important for you as they are for your family. Stable mental health creates stable home environments and stability means that your children and spouses won’t ever have to face a day without you on this earth. Do not listen to the lies in your head that everyone is better off without you. That you always screw things up. Your family never, ever, ever wants to see a day on this earth without you. Ever. Just ask them: they will testify to that truth. And if they don’t, or your spouse tells you to jump off a bridge, walk out. You are worth walking out for. You are worth your own safety.

Even though it seems like I am just getting started, I want to conclude with this: be gentle with yourself. Perfection is not an ideal anyone should strive for. Fail and try again. Succeed and try again. Be gentle with yourself as you would expect a kind, loving parent (whom you may have never had) to be with you as a child. Be gentle with yourself as you would expect a respectful spouse (whom you may have never had) to be with you as a lover. Be gentle with yourself as a child intuitively is with their own parents. Be gentle with yourself.

This earth is vast. Its history is long. Its space is immense. Take up your rightful place on this journey and work towards being well. I am with you on that path and I know you are with me too.


This article was written by Nakita Valerio, owner and editor in chief of The Drawing Board. Nakita  is an academic, activist and writer in the community. She is currently pursuing graduate studies in History and Islamic-Jewish Studies at the University of Alberta.  Nakita was named one of the Alberta Council for Global Cooperation’s Top 30 under 30 for 2015, and is the recipient of the 2016 Joseph-Armand Bombardier Canada Graduate Scholarship from the Social Sciences and Humanities Research Council, as well as the Walter H. Johns Graduate Studies Fellowship. She has also been honoured with the State of Kuwait, the Queen Elizabeth II and the Frank W Peers Awards for Graduate Studies in 2015. She has been recognized by Rotary International with an Award for Excellence in Service to Humanity and has been named one of Edmonton’s “Difference Makers” for 2015 by the Edmonton Journal. Nakita is also the co-founder of Bassma Primary School in El Attaouia, Morocco.


For more information on mental health services in Edmonton, Alberta: click here. For everywhere else, please contact your local health service provider.

If this is an emergency, please get help by calling 911 or medical professional immediately.

This article was written by Nakita Valerio, owner and head writer at The Drawing Board.

Trigger Warning: This article contains graphic information related to assault, rape and birth trauma that may be upsetting to some readers. Prepare yourself for what you are about to read, or abstain until you are able to continue.

Recently, there has been an online movement from survivors of birth trauma in which they are sharing their stories of disempowerment and assault at the hands of members of the medical establishment. These stories are extremely horrific and very graphic in their descriptions. Reading them leaves you with an unsettled feeling in your stomach and an aching heart as you empathize with their pain.

Clicking on these images will reveal highly graphic descriptions. Please be mindful.

I find these stories particularly relevant and powerful for me, as a survivor of birth trauma myself – and as someone who survives the effects of PTSD from that trauma daily. I am proud of these individuals, putting their stories up there for all to see, witness, read, digest… for everyone to stop for a moment and think about a continuing horrific phenomena which knows no global boundaries and has no face, is largely (if not completely) unreported and is all wrapped up in the politics of medical authority and the control over women’s bodies in particular.

There are few other times in an individual’s life which are more vulnerable than pregnancy and birthing. It is not an indicator of weakness to be vulnerable; rather, vulnerability is signified externally by the fact that their bodies go through enormous transformations during this period and the process of birthing happens in such a way that they are more likely to be marginalized in their voice, body and preferences than they would in regular circumstances. A birthing person may have their voice, preferences and body submitted to authorities who use their position to take over the natural process. I want to be clear when I say that in emergency instances, this is critical because intervention can mean the difference between the deaths of the mother and the baby or their lives.

However, such instances also offer the opportunity for serious abuses, particularly because the line between medical necessity and abuse of authority is highly ambiguous and can involve the collision of paradigms, worldviews and approaches to birthing that are highly incompatible. Without getting into that discussion because it tends to be too binary for me (either villainizing mothers or villainizing medical professionals), I want to talk about some of the terminology used in the campaigns for Birth Trauma survivors.

One such term that stands out is “Birth Rape” and it is often red-flagged as a term whose appropriate use is highly contested and may be considered inappropriate in birth-related contexts or others.  These issues can be found in discussion of (more) conventional rape as well and fit into general trends where victims are mistrusted despite the rarity of false allegations (dwarfed by the number of unreported assaults) and the paucity of cases that go to charges and then trial (not always resulting in a conviction). *Breathe* The testimony of women or queer individuals is often disproportionately disbelieved against that of their assaulters or rapists,  with some reserving “I believe you” status for specific demographics who may have been victims of rape.  This skepticism often takes the form of ethnic bias with white people being believed more than people of colour and even less belief being reserved for our indigenous brothers, sisters and two-spirited individuals.

There isn’t enough time in the world to go into the multiple historical narratives that are being enacted as tropes of rape culture in the criticisms of these skeptics and that is not my subject here today. I want to focus on why I accept the term “rape” to describe birth trauma arising from medical assault.

The main reason that I feel people reject this term is because they don’t understand the term rape. Rape does not mean “non-consensual sex.” Rape is a form of sexual assault which involves the penetration of various parts of one’s body against one’s will and without one’s consent. This penetration does not need to occur with an assailant’s genitals to constitute rape.  It can be carried out by violent force, coercion or abuse of authority. It is not “non-consensual sex”. It is not sex.

When stories are told about:

  • doctors who inject women with unnecessary drugs against their will thereby making them less in control, less coherent and more submissive
  • doctors who uttered violent words or performed violent acts on them including swearing at them, berating them, hitting them, jumping on them,
  • doctors who threaten women with C-sections unless they “shut up” (or perform them when they don’t!)
  • or doctors who violently and unnecessarily penetrate women’s bodies with their hands, arms or medical instruments

they are met with reactions that this isn’t rape or that rape is “too serious” an allegation to be related to birthing. I just shake my head. This lack of comprehension hinges on the idea that rape is still somehow about sex. And since birthing is supposedly not a sexual experience, then it can’t be called rape when things go awry, right? These people fail to realize that: non-consensual penetration is rape. There are only sex and birthing on one side, and rape on the other side. There is no in-between.

A contingent reason this is such an issue is because of the stigma attached to challenging medical authorities. The decision about medical necessity is placed entirely in the hands of doctors. And while this is not without some good reason (since they are highly specialized and trained professionals after all), the possibility (and often reality) of transferring total authority over one’s body to other people is deeply problematic. There are a myriad of factors that go into how a medical doctor treats a birthing woman including: personal history, personality, their own abused/abusive pasts, misogyny, ego complexes and much more. Doctors (like all scientists) are not impartial observers as narratives about them would have us believe. They are humans too and they must be humanized – for it is the dehumanized who will perpetuate actions that, in turn, dehumanize others. Doctors carry themselves with them everywhere they go and how they treat someone in such a position as birthing says a lot about their own ethos and attitude.

Do they want to just get the job done or are they willing to spend as long as it takes to ensure a healthy and just birth? Do they not care about the lasting formation of memories that are created for the woman (and her child) in these unique moments? Are they sensitive to the power that they wield and therefore approach such a position with due sensitivities and adequate communications?

Skeptics about birth rape also tend to question if such allegations can actually be brought to criminal charges. Ideally, this would be the case. However, with the current state of affairs, where victims of “typical” sexual assault are rarely believed and therefore rarely report, the added dimension of placing doctors above their patients in terms of authority makes the possibility for criminal proceedings unlikely. Unlikely doesn’t mean impossible. We have a long way to go and the first step towards this is in normalizing these important narratives, in listening to the people they happen to, in believing them first and foremost.

My best friend is an OB/GYN in Cairo. He told me that he had a patient once who came into her birthing experience with a plan and a support team. Internally, he was annoyed because he felt that she was stepping on the toes of his authority and that she might make things difficult for him if things went awry by making too many demands. This friend has an ethos of non-attachment and ego-slaying that I strive to emulate daily. He swallowed those thoughts and gave the woman the space to explain her desires and preferences in a calm manner, without having to make demands that might put someone else’s (ie. his) ego up in arms automatically. The entire time, he continued to check in with her about her plan, letting her know gently where things would have to be altered and changed, leaving her with her power: to digest and understand that these changes were necessary. In other words, he established trust.

This is what is lacking in birth rape. Trust is never formed in such cases. It is annihilated and this is the deepest trauma one can experience. It is the same trauma felt by survivors of rape, by survivors of sexual abuse, by survivors of any form of abuse. For what is being abused but one’s trust? One’s trust that their personhood and dignity will not be violated whether by violence, by penetration, by words or by all three. What is trust but a piece of love placed into the world, sometimes horribly violated?

birth trauma break the silence rape cover

I applaud these individuals for sharing their stories and have been inspired to share my own story publicly as a result. In the end, this experience is just as authentic as anything else and by speaking out about what happened, we might connect the many, many others who have lived through it and are resilient survivors as well. There are a lot of us. May our strength light our paths to a more compassionate and safe future together, and may we strive to respond to the violation of our love placed in the world, the violation of our trust, with justice and more love.