Midwives and other maternity care workers may come across survivors of Child Sexual Abuse during their practise. In this article Kathryn Gutteridge Honorary Professor, Independent Consultant Midwife & Psychotherapist, shares part of her personal story and a new book to help prepare carers.
Trigger Warning: this article contains information that may be cause distress.
This book has been a long time in its gestation, in fact most of my life if I am honest. However, I began to write this in earnest in 2021 after I retired from clinical midwifery. The reasons are both personal and political, my lifetime has been shaped by my own personal encounters of child sexual abuse (CSA) but also my clinical career as a midwife and psychotherapist.
Having experienced the ravages of CSA within my family meant that I felt a great empathy with other survivors which at times overwhelmed me. Healthcare systems are not generally driven by compassionate and intuitive services but for the most part are intrusive and impersonal, causing survivors to remove themselves from the system. There is also a cultural behaviour that clinicians subscribe to which is victim blaming. We hear of this often in our news and media for instance when Police adopt a stance that the victim ‘must have put themselves in harm’s way; or that they must have asked for it’.
One of the comments I have heard is ‘why do victims not tell anyone’? This question is both insulting and yet informative. When your life is controlled by an adult who has their own agenda, promises you they are there for you no matter what, it does not take much imagination to understand the issue of power. Sexual abuse of children is rarely just about sex; it is about the power an adult has over a child’s life. It is about coercing and controlling your every move and it is about threats and violence if you step out of line. This is the reality. So why would you tell? Disclosure is also about trust, knowing that you will be believed and then protected; this is not the experience of all survivors. In fact, the evidence from The Truth Project reported that ‘Generally participants shared that they were disappointed with the response of the authorities they reported to’ . One of the common themes noted when disclosure occurred was that children were disbelieved, and their abuse minimised. Over time victims live with the abuse and the shame that inherently goes with this often disclosing well into their adult life when crisis occurs.
This was my experience too. I went to a religious school with nuns as teachers and catholic rituals practiced throughout the day. I remember being around 9 years old talking to another child on my dinner table at school, this was in 1965. I asked her if her dad did things to her, she didn’t like, when she didn’t understand what I meant, I said did he do things to her ‘front bottom’. She immediately said no, and we were overheard by the nun/teacher on our table who came round to stand in front of me, threatening me with soap in my mouth if I said anything disgusting like that again. Never to mention this again I knew that it was my problem and that I would just have to live with this. So, I did until in my early thirties and then it was exposed. Reporting my abuse in 2019 to The Truth Project was the first time I had told anyone fully about my childhood sexual abuse. I was listened to, respected, cared for and made to feel important; it was a long time coming. I was also approached by the panel to ask if I wanted my experiences to be passed on to the police. I agreed and had several interviews with police in 3 counties where my statement was recorded and put on file. My siblings did not want to do their own statements, but they knew they could if they changed their minds. `
Last week Baroness Casey reported back from a governmental audit she was commissioned to perform on ‘grooming gangs’. Within the narrative of her audit, she highlighted that police had arrested children rather than perpetrators and categorized the 10–15-year-olds as child prostitutes. This outraged Baroness Casey, and it did the same for me. How can a child be a prostitute? There is something wrong in society when we label children as such; they need protection and guidance not punishment.
Baroness Casey was critical of many factors in her audit and said that decisions were made that protected the perpetrators rather than the children in the reports. Whistleblowers were isolated and made to feel powerless, one of the main reasons given was not to incite racial disharmony. In short when Baroness Casey reported back to the government it was obvious a national review needed to be commissioned. In the meantime, thousands of young people have been harmed, countless babies born to those young women and the dreams and aspirations of those survivors lost.
The driving force behind my life is to expose sexual abuse for what it is and to meet it when I see it with advice and empathy but also to do the right thing. Midwives, nurses, obstetricians, neonatal staff, anaesthetists and many more are for the best part clueless in how to meet this problem when it is presented to them. There are no programmes of education built into undergraduate education and if lucky a visiting lecturer may give them a one-off session. It is appalling that something so important is never scheduled to be part of medical and midwifery training.
The number of survivors known in maternity is for the best part a mystery, I can estimate how many but that does not do service to survivors. What I am hoping is that in writing my book at least some of the case studies will generate ideas about how to recognise when a survivor is seeking care. The book does not have all the answers and no doubt I will have missed much, however if every labour ward, birth centre, midwife setting and even antenatal clinic held a copy it will be well used. This is a book that will trigger some readers, but I make no apology for that. I know how frightened I was as a small child waiting for the inevitable when my abuser would climb the stairs. Please read this book and recommend it to a friend, give it to someone who is planning to train as a midwife or a doctor. It will serve them well if they start in their careers to serve survivors in a manner that they deserve; compassion, belief and with their dignity preserved.
References
Gutteridge K E A (2025) Stranger in the Birth Room: Maternity Care for Survivors of Child Sexual Abuse. ISBN: 9781780668154; Number of pages: 192; Montag and Martin Publishers. https://pinterandmartin.com/products/stranger-in-the-birthroom-maternity-care-for-survivors-of-child-sexual-abuse Published: July 3, 2025
Independent Inquiry into Child Sexual Abuse. (2022). The Report of the Independent Inquiry into Child Sexual Abuse. London: IICSA. Available at: 185 https://webarchive.nationalarchives.gov.uk/ukgwa/20221215051709/https://www.iics a.org.uk/key-documents/31216/view/report-independent-inquiry-into-child-sexualabuse-october-2022_0.pdf
National Audit on Group-Based Child Sexual Exploitation and Abuse; Baroness Casey of Blackstock DBE CB June 2025. https://www.gov.uk/government/publications/national-audit-on-group-based-child-sexual-exploitation-and-abuse-terms-of-reference/national-audit-on-group-based-child-sexual-exploitation-and-abuse-terms-of-reference
Kathryn Gutteridge Honorary Professor
Independent Consultant Midwife & Psychotherapist July 2025
Kathryn will be a speaker at the forthcoming Northern Maternity and Midwifery festival on July 8th