Child sexual abuse is a challenging but critical area that midwives and healthcare workers need to confront and understand. Many women survivors will make use of maternity services, and midwives and healthcare workers need to be fully prepared and aware of the difficulties these women may face. This chapter provides information about the definition and prevalence of childhood sexual abuse, the long-term effects and the specific issues related to pregnancy and childbirth. The relationship between child sexual abuse and adolescent pregnancy, preterm labour, labour and birth, language, mental health problems and breastfeeding is considered. This chapter does not discuss the specifics of midwifery and healthcare professional practice.