SOHTIS: Supporting women to navigate motherhood after sexual exploitation
Motherhood is a spectrum of experiences – from the prospect of having children, to pregnancy, life after giving birth and childcare. We wanted to find out more about how women involved in selling or exchanging sex navigate pregnancy and what supports exist or not.
We spoke to Linzee, Project Worker at SOHTIS (Survivors of Human Trafficking in Scotland) who shared the experiences of women who have been trafficked into the UK for sexual exploitation. In this interview, Linzee shares the daily barriers challenges by migrant women who have been exploited into the ‘sex industry’ and who are navigating pregnancy. We also reflect on the societal pressures that are placed on mothers in general and specifically on women who have been exploited, and the service responses that can make a difference.
What is SOHTIS and what is your role within the team?
SOHTIS works to prevent, identify and recover victims and survivors of human trafficking, and advocate for systemic changes needed to end the exploitation of trafficked people in Scotland. We have two main projects: Project Light, which focuses on identifying and recovering victims of exploitation, helping them build resilience to trafficking and accessing support. I am part of Project Integrate which offers long-term support to survivors. This service has no end date to the support offered, and we can help with many practical things as well as advocacy like housing, navigating lawyers, attending GP appointments. The overall goal is to help survivors regain their independence and reintegrate back into society, as well as reduce the risk of re-trafficking.
We support clients who’ve experienced all types of trafficking, such as labour exploitation, sexual exploitation, criminal exploitation and domestic servitude. I think what at times is not fully understood is that some people might pay a smuggler to leave their home country for a better life, but in the process they become very vulnerable and the smugglers might take away their passport/ID and it can quickly turn into trafficking for sex, crime or labour exploitation and domestic servitude.
We work with people who have been recovered from trafficking, but they are still very much at risk of being re-trafficked when they disengage. That's why it's important that we have an open service and that at any point survivors can come back.
You work with clients with very reduced options, most of them are migrants who have been trafficked into the UK, which has left them with an insecure immigration status, so very vulnerable. In your experience, what are the challenges that the sexually exploited women you support face when they are pregnant?
For pregnant women, many times they aren't given the same information from the numerous health providers they see when pregnant. Some clients are told they can have certain benefits or grants when they're pregnant, like the £300 maternity payment, and then others aren’t told about it. So there is misinformation and a gap there.
Accommodation is a huge barrier for pregnant women. We've had some women who live in asylum hotels while they're pregnant. And without being pregnant these hotels are the worst situation to be in. Asylum-seekers only receive around £8 a week while living in the hotel. They might get meals provided but these come at specific times and… I mean, if you're pregnant, you've got scans to go to, you've got lawyers, Home Office appointments, if you are out during those mealtimes, you don't get the meal. Only having £8 a week means you can't then go out for a meal or go to Tesco and buy a sandwich because it’s not affordable. We have to consider that, in order to get to that lawyer’s appointment, of course a woman has to pay a bus ticket because she’s pregnant and can't walk far, that's £5.40 of her £8-something a week. The system is sometimes forcing women to choose between food and getting to these appointments, and if you don't attend the Home Office appointments, it can end badly, especially when seeking asylum. Clients need to go to that appointment so then she doesn't eat… and we know how important eating is when you’re pregnant. Pregnant women who maybe are lucky enough to get a house can be housed three or four floors up where there's no elevator. When being so heavily pregnant, they're just left isolated as they don't leave the house often.
Another thing is, no matter the nationality or situation, there's always a sense of shame and guilt about being sexually exploited – either because they maybe don't have contact with their family anymore, they've been shunned by their family, or they can never return to their home country because there is a risk of seeing the traffickers. At the same time, I find that the women just want to feel normal again. They just want to feel like women, not as a victim or a survivor of human trafficking and I think a lot of services can approach them with pity. When I come in, I just chat to them about everyday things – in the end they just want to be girls and women again.
What about the challenges for women when giving birth?
I had the privilege of supporting one woman who asked me to be her birthing partner. She did have a doula, however, on this occasion she felt more comfortable with me as I had been supporting her for a long time. The experience of being with her and witnessing her experience of the maternity care was quite shocking to me.
She was scheduled for a C-Section but prior to going to theatre she was questioned four times by different staff about her immigration status and why she wasn’t on birth control, and I found myself reassuring her about things that I hadn’t even considered before entering that ward.
English was not the client’s first language; however, she was a fluent English speaker who struggled at times with the Scottish accent and so throughout the consultation and the surgery, I continually requested staff to speak slower and tried to assist with explaining and translating what was happening. It was a terrifying experience for my client.
The cultural practices and birth plan which was in place for the client and her baby were disregarded which caused much distress and resulted in us trying to carry these out without the support of the staff team. Advocating for support when trying to breastfeed was also extremely difficult, in the end we did manage to latch the baby, but at the end of a long, stressful, and hurtful day my client although having managed brilliantly was so upset and frustrated.
This is my experience of supporting a woman giving birth and although this is not part of my regular work, I can see in other areas of my work the challenges that women have accessing healthcare services.
And what are some challenges for women once they have the child?
For new mums, isolation, in my opinion, would be the top challenge. There are so many organisations, groups, classes and colleges, but a lot of them don’t or can’t provide childcare. This leaves the mum isolated as she can't attend things, she can't go out, it is a struggle to learn English in some cases. Many of these new mums don't have any support, they are dealing with their own trauma and internal struggles, their fear of the unknown. The fact that they’re an asylum-seeker and they don't know when they’ll get a decision, they don’t know if it will be negative or if they’ll move homes, they don't have any money, they haven't slept, and then they have the responsibility to look after a baby 24/7. There's just no reprieve. Whenever I visit the women, I try and spend time with the baby and just let them rest.
We know that some women will become pregnant from their abusers or exploiters. Could you say more about those experiences?
I would say, in my experience, women in this situation carry more guilt. Overall, when you have a baby, the emotions are so intense, and you don’t necessarily feel how society has told you to feel. Sometimes the child may have some of the appearance of the perpetrator, so even just looking at the baby may be heartbreaking for the mother. Women may not feel attachment to the baby, or may not feel love for that baby, this adds more pressure– “why am I feeling like this? Everyone said this would be brilliant and all I can feel is all the memories of the trauma from how this baby was conceived.”
As a society, we need to understand that becoming a mother isn't always an easy thing for a person and a woman doesn’t always have to feel happy and full of joy. It's tough and it's hard and it's OK to feel any emotion that you feel. It doesn't make you any less of a mum or any less of a woman. Validating their emotions and their feelings just allows them to breathe. I’ve also found with the women I’ve supported that when the baby is older and they’ve got time to process some of the trauma, they understand that it wasn't something wrong with them – it was the situation and they're still here, fighting for their child. They do love their child although at the start it was maybe more rocky than they imagined. I think just letting them know that that’s OK, really takes so much pressure off them.
What is your approach when supporting pregnant women whom, as we’ve discussed, come from very traumatic situations?
Everyone is so different and they need different levels of support. The first thing I do is make sure I don't bring any judgement or biases that I may have. I don't ask her about the details of her exploitation so soon. Instead, I come in, let her know what I do, how I can help and then let her lead me as to what she needs. I try and keep it very honest – what I can do and what I can't do. I make sure that I'm always consistent and I always do what I say I'll do.
Having patience and the importance of having a service that offers that long-term support is also essential. Survivors don’t need to feel forced to tell me about their exploitation because there's no end date to the support and I think that makes a huge difference, because they don't need to tell everything in one or two appointments.
It’s also about making them aware of their choices and letting them know that even though their agency was taken away, that's ended now, and every decision they make now can be for them. Giving them the space to hear their own voice again and tell you what they want and what they don't want is a huge thing for women. Whatever they feel or whatever they choose, I never push my own agenda. I really try and say, “it's your choice, I’m here for whatever you are choosing, there's no wrong decision.” And when they come back and say, “OK I want to do this”, you can see them getting stronger.
Finally, not rushing women and not taking their disengagement as them not being interested. Services sometimes expect survivors to come in and thank them for the help, but we need to know that these women have been through so much that we will never understand, and that support is not always straightforward – women will go through constant struggles and daily challenges.
What has been helpful when supporting women who have children?
For the women that I have supported, the first priority is always their child or children. When we first go in and meet clients, we ask them what their dreams and hobbies are, just to try and help reintegrate them into society with classes or community activities. I’ve found that most mothers can't even think about what they want to do or what they used to enjoy, instead it’s about whether their child is OK. Women might seem disengaged because initially they can’t think of themselves. I found that supporting the child at the start, and once the mum can see her child is happy and is progressing, then she can begin to think about herself and her internal struggles.
What external supports have the pregnant woman you’ve supported found helpful and is there anything you feel is missing?
I haven’t mentioned how excellent the doula service is. Although in the case I described the doula service wasn't needed, I think it’s a brilliant service to make sure no woman goes through the experience of birth alone. They support women from nearing the end of the pregnancy and help them to prepare a birth plan. They advocate for women’s needs while they’re in the hospital and they're very knowledgeable.
In terms of what is missing, I do think that one thing lacking is support for mothers after birth when the babies have been the result of sexual exploitation or trauma. There are lots of great supports for the babies, but when health visitors ask the women “how you’re doing, are you OK?”, the woman is unlikely to tell her whole story. Having specialised services that know how to support a woman to manage her emotions would certainly help the women to heal that guilt and shame.
What would you advise to staff in non-specialist services who are supporting a mother who is or has been involved in selling or exchanging sex?
Don't judge them for anything they disclose or any situation they have been in or are continuing in. We've not lived their life or walked in their shoes. Some women have had all agency taken away from them. We need to be there and help them move forward. It’s about giving them back that power that they've lost, and in turn that will build their trust in you. That then allows you to support them further or signpost them to other services that can meet their needs. We are here to walk beside them and be a support network for them.
We spoke to Linzee, Project Worker at SOHTIS (Survivors of Human Trafficking in Scotland) who shared the experiences of women who have been trafficked into the UK for sexual exploitation. In this interview, Linzee shares the daily barriers challenges by migrant women who have been exploited into the ‘sex industry’ and who are navigating pregnancy. We also reflect on the societal pressures that are placed on mothers in general and specifically on women who have been exploited, and the service responses that can make a difference.
What is SOHTIS and what is your role within the team?
SOHTIS works to prevent, identify and recover victims and survivors of human trafficking, and advocate for systemic changes needed to end the exploitation of trafficked people in Scotland. We have two main projects: Project Light, which focuses on identifying and recovering victims of exploitation, helping them build resilience to trafficking and accessing support. I am part of Project Integrate which offers long-term support to survivors. This service has no end date to the support offered, and we can help with many practical things as well as advocacy like housing, navigating lawyers, attending GP appointments. The overall goal is to help survivors regain their independence and reintegrate back into society, as well as reduce the risk of re-trafficking.
We support clients who’ve experienced all types of trafficking, such as labour exploitation, sexual exploitation, criminal exploitation and domestic servitude. I think what at times is not fully understood is that some people might pay a smuggler to leave their home country for a better life, but in the process they become very vulnerable and the smugglers might take away their passport/ID and it can quickly turn into trafficking for sex, crime or labour exploitation and domestic servitude.
We work with people who have been recovered from trafficking, but they are still very much at risk of being re-trafficked when they disengage. That's why it's important that we have an open service and that at any point survivors can come back.
You work with clients with very reduced options, most of them are migrants who have been trafficked into the UK, which has left them with an insecure immigration status, so very vulnerable. In your experience, what are the challenges that the sexually exploited women you support face when they are pregnant?
For pregnant women, many times they aren't given the same information from the numerous health providers they see when pregnant. Some clients are told they can have certain benefits or grants when they're pregnant, like the £300 maternity payment, and then others aren’t told about it. So there is misinformation and a gap there.
Accommodation is a huge barrier for pregnant women. We've had some women who live in asylum hotels while they're pregnant. And without being pregnant these hotels are the worst situation to be in. Asylum-seekers only receive around £8 a week while living in the hotel. They might get meals provided but these come at specific times and… I mean, if you're pregnant, you've got scans to go to, you've got lawyers, Home Office appointments, if you are out during those mealtimes, you don't get the meal. Only having £8 a week means you can't then go out for a meal or go to Tesco and buy a sandwich because it’s not affordable. We have to consider that, in order to get to that lawyer’s appointment, of course a woman has to pay a bus ticket because she’s pregnant and can't walk far, that's £5.40 of her £8-something a week. The system is sometimes forcing women to choose between food and getting to these appointments, and if you don't attend the Home Office appointments, it can end badly, especially when seeking asylum. Clients need to go to that appointment so then she doesn't eat… and we know how important eating is when you’re pregnant. Pregnant women who maybe are lucky enough to get a house can be housed three or four floors up where there's no elevator. When being so heavily pregnant, they're just left isolated as they don't leave the house often.
Another thing is, no matter the nationality or situation, there's always a sense of shame and guilt about being sexually exploited – either because they maybe don't have contact with their family anymore, they've been shunned by their family, or they can never return to their home country because there is a risk of seeing the traffickers. At the same time, I find that the women just want to feel normal again. They just want to feel like women, not as a victim or a survivor of human trafficking and I think a lot of services can approach them with pity. When I come in, I just chat to them about everyday things – in the end they just want to be girls and women again.
What about the challenges for women when giving birth?
I had the privilege of supporting one woman who asked me to be her birthing partner. She did have a doula, however, on this occasion she felt more comfortable with me as I had been supporting her for a long time. The experience of being with her and witnessing her experience of the maternity care was quite shocking to me.
She was scheduled for a C-Section but prior to going to theatre she was questioned four times by different staff about her immigration status and why she wasn’t on birth control, and I found myself reassuring her about things that I hadn’t even considered before entering that ward.
English was not the client’s first language; however, she was a fluent English speaker who struggled at times with the Scottish accent and so throughout the consultation and the surgery, I continually requested staff to speak slower and tried to assist with explaining and translating what was happening. It was a terrifying experience for my client.
The cultural practices and birth plan which was in place for the client and her baby were disregarded which caused much distress and resulted in us trying to carry these out without the support of the staff team. Advocating for support when trying to breastfeed was also extremely difficult, in the end we did manage to latch the baby, but at the end of a long, stressful, and hurtful day my client although having managed brilliantly was so upset and frustrated.
This is my experience of supporting a woman giving birth and although this is not part of my regular work, I can see in other areas of my work the challenges that women have accessing healthcare services.
And what are some challenges for women once they have the child?
For new mums, isolation, in my opinion, would be the top challenge. There are so many organisations, groups, classes and colleges, but a lot of them don’t or can’t provide childcare. This leaves the mum isolated as she can't attend things, she can't go out, it is a struggle to learn English in some cases. Many of these new mums don't have any support, they are dealing with their own trauma and internal struggles, their fear of the unknown. The fact that they’re an asylum-seeker and they don't know when they’ll get a decision, they don’t know if it will be negative or if they’ll move homes, they don't have any money, they haven't slept, and then they have the responsibility to look after a baby 24/7. There's just no reprieve. Whenever I visit the women, I try and spend time with the baby and just let them rest.
We know that some women will become pregnant from their abusers or exploiters. Could you say more about those experiences?
I would say, in my experience, women in this situation carry more guilt. Overall, when you have a baby, the emotions are so intense, and you don’t necessarily feel how society has told you to feel. Sometimes the child may have some of the appearance of the perpetrator, so even just looking at the baby may be heartbreaking for the mother. Women may not feel attachment to the baby, or may not feel love for that baby, this adds more pressure– “why am I feeling like this? Everyone said this would be brilliant and all I can feel is all the memories of the trauma from how this baby was conceived.”
As a society, we need to understand that becoming a mother isn't always an easy thing for a person and a woman doesn’t always have to feel happy and full of joy. It's tough and it's hard and it's OK to feel any emotion that you feel. It doesn't make you any less of a mum or any less of a woman. Validating their emotions and their feelings just allows them to breathe. I’ve also found with the women I’ve supported that when the baby is older and they’ve got time to process some of the trauma, they understand that it wasn't something wrong with them – it was the situation and they're still here, fighting for their child. They do love their child although at the start it was maybe more rocky than they imagined. I think just letting them know that that’s OK, really takes so much pressure off them.
What is your approach when supporting pregnant women whom, as we’ve discussed, come from very traumatic situations?
Everyone is so different and they need different levels of support. The first thing I do is make sure I don't bring any judgement or biases that I may have. I don't ask her about the details of her exploitation so soon. Instead, I come in, let her know what I do, how I can help and then let her lead me as to what she needs. I try and keep it very honest – what I can do and what I can't do. I make sure that I'm always consistent and I always do what I say I'll do.
Having patience and the importance of having a service that offers that long-term support is also essential. Survivors don’t need to feel forced to tell me about their exploitation because there's no end date to the support and I think that makes a huge difference, because they don't need to tell everything in one or two appointments.
It’s also about making them aware of their choices and letting them know that even though their agency was taken away, that's ended now, and every decision they make now can be for them. Giving them the space to hear their own voice again and tell you what they want and what they don't want is a huge thing for women. Whatever they feel or whatever they choose, I never push my own agenda. I really try and say, “it's your choice, I’m here for whatever you are choosing, there's no wrong decision.” And when they come back and say, “OK I want to do this”, you can see them getting stronger.
Finally, not rushing women and not taking their disengagement as them not being interested. Services sometimes expect survivors to come in and thank them for the help, but we need to know that these women have been through so much that we will never understand, and that support is not always straightforward – women will go through constant struggles and daily challenges.
What has been helpful when supporting women who have children?
For the women that I have supported, the first priority is always their child or children. When we first go in and meet clients, we ask them what their dreams and hobbies are, just to try and help reintegrate them into society with classes or community activities. I’ve found that most mothers can't even think about what they want to do or what they used to enjoy, instead it’s about whether their child is OK. Women might seem disengaged because initially they can’t think of themselves. I found that supporting the child at the start, and once the mum can see her child is happy and is progressing, then she can begin to think about herself and her internal struggles.
What external supports have the pregnant woman you’ve supported found helpful and is there anything you feel is missing?
I haven’t mentioned how excellent the doula service is. Although in the case I described the doula service wasn't needed, I think it’s a brilliant service to make sure no woman goes through the experience of birth alone. They support women from nearing the end of the pregnancy and help them to prepare a birth plan. They advocate for women’s needs while they’re in the hospital and they're very knowledgeable.
In terms of what is missing, I do think that one thing lacking is support for mothers after birth when the babies have been the result of sexual exploitation or trauma. There are lots of great supports for the babies, but when health visitors ask the women “how you’re doing, are you OK?”, the woman is unlikely to tell her whole story. Having specialised services that know how to support a woman to manage her emotions would certainly help the women to heal that guilt and shame.
What would you advise to staff in non-specialist services who are supporting a mother who is or has been involved in selling or exchanging sex?
Don't judge them for anything they disclose or any situation they have been in or are continuing in. We've not lived their life or walked in their shoes. Some women have had all agency taken away from them. We need to be there and help them move forward. It’s about giving them back that power that they've lost, and in turn that will build their trust in you. That then allows you to support them further or signpost them to other services that can meet their needs. We are here to walk beside them and be a support network for them.
