Modern obstetrical practice has accomplished much in the way of alleviating pain often associated with childbirth, and reducing unwanted perinatal outcomes. Advances in analgesia/anesthesia, maternal/fetal monitoring, medications, and obstetrical procedures have been accompanied by improvements in education and counseling to better prepare expectant mothers for the experiences of pregnancy, childbirth, and newborn care. Despite this progress, however, significant numbers of women continue to experience negative expectations of labor and delivery. Twenty to 75% of pregnant women report fear of labor (Eriksson, Westman, & Hamberg, 2005; Geissbuehler, & Eberhard, 2002; Melender, 2002; Zar, Wijma, & Wijma, 2001). Recent studies have suggested that sexual abuse may exacerbate the challenges of pregnancy and childbirth, and be re-experienced as a form of abuse, triggering stress. Depression and anxiety may contribute to fear, leading to loss of control and difficulty coping. These vulnerabilities to which sexually abused women may be subject, in turn, can potentially exacerbate expected labor challenges, and necessitate further medical intervention. The current correlational study explores the impact of sexual abuse on emotions and anticipated childbirth, and hypothesizes that sexual abuse is related to anxiety, depression, more negative labor outlook, and decreased perceived support and perceptions of control. Prospective participants were recruited during their third trimester through childbirth classes in Southern New Hampshire. Participants completed a questionnaire comprising questions on demographics, outlook for labor, perceptions of emotional and social support, depression, anxiety, past sexual experience, and perception of control. Just under half (47.8%) of the 46 participants experienced sexual abuse, and scored higher on depression, anxiety, and lower on perceptions of support, personal efficacy and control, than women with no unwanted sexual experiences. Although sexual abuse had no direct relation to outlook for labor, it was significantly related to higher scores of state anxiety, which in turn was related to outlook for labor. Implications for care are suggested. Given the links between sexual abuse and anxiety, supportive services may be warranted. Prenatal screening may identify those at risk, and facilitate initiation of timely supportive services.