Influence of childhood sexual abuse on pregnancy, delivery, and the early postpartum period in adult women

• Published in: Journal of psychosomatic research Vol. 61; no. 2; pp. 139 - 151
• Main Authors: Leeners, Brigitte, Richter-Appelt, Hertha, Imthurn, Bruno, Rath, Werner
• Format: Journal Article
• Language: English
• Published: Amsterdam Elsevier Inc 01.08.2006; New York, NY Elsevier
• Subjects: Adolescent; Adult; Biological and medical sciences; Child; Child Abuse, Sexual; Childhood; Childhood sexual abuse; Childhood traumatization; Delivery; Delivery. Postpartum. Lactation; Female; Gynecology. Andrology. Obstetrics; Humans; Medical sciences; Obstetrics; Postnatal period; Postpartum Period - psychology; Pregnancy; Pregnancy - psychology; Psychological trauma; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Sexual abuse; Victimology; Childhood sexual abuse; Pregnancy; Postnatal period; Delivery; Childhood traumatization; Social environment; Human; Parental behavior; Mental health; Sequela; Victimization; Review; Victimology; Puerperium; Maternal behavior; Child abuse; Risk factor; Early traumatism; Early; Sexual abuse; Woman; Public health; International
• ISSN: 0022-3999; 1879-1360
• DOI: 10.1016/j.jpsychores.2005.11.006

With a prevalence of around 20%, childhood sexual abuse (CSA) is a relevant problem in obstetric care. The aim of our systematic review was to present the current knowledge on the influence of CSA on pregnancy, delivery, and early parenthood. All English, French, or German primary and secondary literature from the reference lists found after screening the data banks Pubmed, PsycInfo, and Psyndex for publications that include the terms CSA or childhood traumatization and pregnancy, birth, delivery, labor, childbearing, breast feeding, or postpartum, and published after 1970 were reviewed for relevant data. Investigations of psychological/medical data banks and cross references revealed 43 relevant studies. Given the paucity of data on this important subject, we opted to review all of these studies. Although research projects on this topic are rare and the methodological quality of studies published to date is generally poor, women with a history of CSA seem to present a variety of long-term sequelae referring to pregnancy, delivery, and early parenthood. These sequelae include risk behaviors during pregnancy and disturbance of delivery by sudden memories of sexual abuse situations. Prenatal care is often complicated by the tendency to avoid situations that can trigger memories. As effective treatment programs to improve sequelae of CSA are available today, the question of such abuse experiences should be raised as early as possible and adequate interdisciplinary models to care for victimized patients should be established. However, to improve knowledge on the long-term effect of sexual abuse experiences in obstetrical care, methodologically well-designed research projects focusing on the kind and incidence of sequelae, mediating factors as well as prophylactic and therapeutic options are needed.