Jump to ContentJump to Main Navigation
Show Summary Details
More options …

Journal of Perinatal Medicine

Official Journal of the World Association of Perinatal Medicine

Editor-in-Chief: Dudenhausen, MD, FRCOG, Joachim W.

Ed. by Bancalari, Eduardo / Chappelle, Joseph / Chervenak, Frank A. / D'Addario , Vincenzo / Genc, Mehmet R. / Greenough, Anne / Grunebaum, Amos / Konje, Justin C. / Kurjak M.D., Asim / Romero, Roberto / Zalud, Ivica

9 Issues per year

IMPACT FACTOR 2017: 1.558
5-year IMPACT FACTOR: 1.653

CiteScore 2017: 1.26

SCImago Journal Rank (SJR) 2017: 0.594
Source Normalized Impact per Paper (SNIP) 2017: 0.684

See all formats and pricing
More options …
Volume 41, Issue 4


Prenatal care in adult women exposed to childhood sexual abuse

Brigitte Leeners / Ruth Stiller / Emina Block / Gisela Görres / Werner Rath / Sibil Tschudin
Published Online: 2012-12-25 | DOI: https://doi.org/10.1515/jpm-2011-0086


Aims: Several case reports show a negative impact of childhood sexual abuse (CSA) on prenatal care. The study aimed to systematically investigate this association in a larger study group.

Methods: CSA was investigated by face-to-face interviews and by a modified questionnaire developed by Wyatt. All study participants completed a self-administered questionnaire designed to investigate the consequences of CSA on prenatal care during adulthood. Data from 85 women after CSA were compared to those of 170 matched women without such experiences.

Results: Women exposed to CSA had fewer than five prenatal consultations more often than unexposed women (26%/7%; P<0.0001). Of the 85 women with a positive history for CSA, 9.4% had been asked for such antecedents, 36.5% had intense memories on original abuse situations during pregnancy, 56.6% mentioned specific consequences of CSA on prenatal care and 61.2% were satisfied with obstetrical support. Exposed women (62.4%) felt significantly less prepared for labor than unexposed women (75.9%) (P<0.0001).

Conclusions: CSA experiences are associated with impaired prenatal care. These results underscore the compelling need to improve prenatal care in women exposed to CSA through better education of obstetricians regarding the effects of CSA and in their ability to provide empathetic professional support.

Keywords: Adverse childhood experiences; childhood sexual abuse; consequences; flashbacks; prenatal care; pregnancy


  • [1]

    Bartoi MG, Kinder BN, Tomianovic D. Interaction effects of emotional status and sexual abuse on adult sexuality. J Sex Marital Ther. 2000;26:1–23.PubMedGoogle Scholar

  • [2]

    Bengtsson-Tops A, Tops D. Self-reported consequences and needs for support associated with abuse in female users of psychiatric care. Int J Ment Health Nurs. 2007;16:35–43.CrossrefGoogle Scholar

  • [3]

    Briere J. Child abuse trauma. Theory and treatment of the lasting effects. Newbury Park, London: Sage Publications; 1993.Google Scholar

  • [4]

    Eberhard-Gran M, Slinning K, Eskild A. Fear during labor: the impact of sexual abuse in adult life. J Psychosom Obstet Gynaecol. 2008;29:258–61.CrossrefGoogle Scholar

  • [5]

    Fiscella K, Kitzman HJ, Cole RE, Sidora KJ, Olds D. Does child abuse predict adolescent pregnancy? Pediatrics. 1998;101:620–4.CrossrefPubMedGoogle Scholar

  • [6]

    Fisher WA, Singh SS, Shuper PA, Carey M, Otchet F, MacLean-Brine D, et al. Characteristics of women undergoing repeat induced abortion. Can Med Assoc J. 2005;172:637–41.Google Scholar

  • [7]

    Grimstad H, Backe B, Jacobsen G, Schei B. Abuse history and health risk behaviors in pregnancy. Acta Obstet Gynecol Scand. 1998;77:893–7.CrossrefPubMedGoogle Scholar

  • [8]

    Grimstad H, Schei B. Pregnancy and delivery for women with a history of child sexual abuse. Child Abuse Negl. 1999;23: 81–90.PubMedGoogle Scholar

  • [9]

    Halbreich U. The association between pregnancy processes, preterm delivery, low birth weight, and postpartum depressions – the need for interdisciplinary integration. Am J Obstet Gynecol. 2005;193:1312–22.PubMedCrossrefGoogle Scholar

  • [10]

    Heimstad R, Dahloe R, Laache I, Skogvoll E, Schei B. Fear of childbirth and history of abuse – implications for pregnancy and delivery. Acta Obstet Gynecol Scand. 2006;85:435–40.PubMedCrossrefGoogle Scholar

  • [11]

    Heritage C. Working with childhood sexual abuse survivors during pregnancy, labor, and birth. J Obstet Gynecol Neonatal Nurs. 1998;27:671–7.PubMedCrossrefGoogle Scholar

  • [12]

    Hoffman S, Hatch MC. Stress, social support and pregnancy outcome: a reassessment based on recent research. Paediatr Perinat Epidemiol. 1996;10:380–405.CrossrefPubMedGoogle Scholar

  • [13]

    Jacobs JL. Child sexual abuse victimization and later sequellae during pregnancy and childbirth. J Child Sex Abuse. 1992;1:103–12.Google Scholar

  • [14]

    Kellogg ND, Hoffman TJ, Taylor ER. Early sexual experiences among pregnant and parenting adolescents. Adolescence. 1999;34:293–303.PubMedGoogle Scholar

  • [15]

    Kesmodel U, Olsen SF. Smoking habits among pregnant Danish women: reliability of information recorded after delivery. J Epidemiol Community Health. 1999;53:239–42.PubMedCrossrefGoogle Scholar

  • [16]

    Kramer MS, Lydon J, Seguin L, Goulet L, Kahn SR, McNamara H, et al. Stress pathways to spontaneous preterm birth: the role of stressors, psychological distress, and stress hormones. Am J Epidemiol. 2009;169:1319–26.Web of ScienceGoogle Scholar

  • [17]

    Leeners B, Neumaier-Wagner P, Quarg AF, Rath W. Childhood sexual abuse (CSA) experiences: an underestimated factor in perinatal care. Acta Obstet Gynecol Scand. 2006;85:971–6.PubMedCrossrefGoogle Scholar

  • [18]

    Leeners B, Neumaier-Wagner P, Schierbaum V, Rath W. Beratung werdender Eltern zur Sexualität in der Schwangerschaft. Geburtsh Frauenheilkd. 2002;62:60–5.Google Scholar

  • [19]

    Leeners B, Richter-Appelt H, Imthurn B, Rath W. Influence of childhood sexual abuse on pregnancy, delivery, and the early postpartum period in adult women. J Psychosom Res. 2006;61:139–51.CrossrefPubMedGoogle Scholar

  • [20]

    Leeners B, Stiller R, Block E, Gorres G, Imthurn B, Rath W. Effect of childhood sexual abuse on gynecologic care as an adult. Psychosomatics. 2007;48:385–93.Web of ScienceCrossrefGoogle Scholar

  • [21]

    Leeners B, Stiller R, Block E, Gorres G, Imthurn B, Rath W. Consequences of childhood sexual abuse experiences on dental care. J Psychosom Res. 2007;62:581–8.PubMedCrossrefWeb of ScienceGoogle Scholar

  • [22]

    Leeners B, Stiller R, Block E, Gorres G, Rath W. Pregnancy complications in women with childhood sexual abuse experiences. J Psychosom Res. 2010;69:503–10.Web of ScienceCrossrefPubMedGoogle Scholar

  • [23]

    McFarlane J, Parker B, Soeken K, Bullock L. Assessing for abuse during pregnancy. Severity and frequency of injuries and associated entry into prenatal care. J Am Med Assoc. 1992;267:3176–8.Google Scholar

  • [24]

    Mezey G, Bacchus L, Bewley S, White S. Domestic violence, lifetime trauma and psychological health of childbearing women. Br J Obstet Gynecol. 2005;112:197–204.CrossrefGoogle Scholar

  • [25]

    Moeller TP, Bachmann GA, Moeller JR. The combined effects of physical, sexual, and emotional abuse during childhood: long-term health consequences for women. Child Abuse Negl. 1993;17:623–40.PubMedGoogle Scholar

  • [26]

    Mullen PE, Martin JL, Anderson JC, Romans SE, Herbison GP. The effect of child sexual abuse on social, interpersonal and sexual function in adult life. Br J Psychiatry. 1994;165:35–47.Google Scholar

  • [27]

    Noll JG, Schulkin J, Trickett PK, Susman EJ, Breech L, Putnam FW. Differential pathways to preterm delivery for sexually abused and comparison women. J Pediatr Psychol. 2007;32:1238–48.PubMedCrossrefGoogle Scholar

  • [28]

    Rainey DY, Stevens-Simon C, Kaplan DW. Are adolescents who report prior sexual abuse at higher risk for pregnancy? Child Abuse Negl. 1995;19:1283–8.PubMedGoogle Scholar

  • [29]

    Rellini A, Meston C. Sexual function and satisfaction in adults based on the definition of child sexual abuse. J Sex Med. 2007;4:1312–21.CrossrefPubMedGoogle Scholar

  • [30]

    Rhodes N, Hutchinson S. Labor experiences of childhood sexual abuse survivors. Birth. 1994;21:213–20.PubMedCrossrefGoogle Scholar

  • [31]

    Romans S, Belaise C, Martin J, Morris E, Raffi A. Childhood abuse and later medical disorders in women. An epidemiological study. Psychother Psychosom. 2002;71: 141–50.PubMedCrossrefGoogle Scholar

  • [32]

    Senior R, Barnes J, Emberson JR, Golding J. Early experiences and their relationship to maternal eating disorder symptoms, both lifetime and during pregnancy. Br J Psychiatry. 2005;187:268–73.Google Scholar

  • [33]

    Simkin P. Women’s long-term perceptions of their first birth experience. Part II. Nature and consistency of women’s long-term memories of their first birth experiences. Birth. 1992;19:64–81.CrossrefGoogle Scholar

  • [34]

    Stevens-Simon C, Kaplan DW, McAnarney ER. Factors associated with preterm delivery among pregnant adolescents. J Adolesc Health. 1993;14:340–2.CrossrefGoogle Scholar

  • [35]

    Van Der Leden ME, Raskin VD. Psychological sequelae of childhood sexual abuse: relevant in subsequent pregnancy. Am J Obstet Gynecol. 1993;168:1336–7.Google Scholar

  • [36]

    Vogeltanz ND, Wilsnack SC, Harris TR, Wilsnack RW, Wonderlich SA, Kristjanson AF. Prevalence and risk factors for childhood sexual abuse in women: national survey findings. Child Abuse Negl. 1999;23:579–92.PubMedGoogle Scholar

  • [37]

    Wescott C. Sexual abuse and childhood education. Int J Childbirth Educ. 1991;6:32–33.Google Scholar

  • [38]

    Wyatt GE. The sexual abuse of Afro-American and white-American women in childhood. Child Abuse Negl. 1985;9:507–19.PubMedGoogle Scholar

About the article

Corresponding author: PD Dr. Brigitte Leeners, Division of Reproductive Endocrinology, University Hospital Zürich, Frauenklinikstr. 10, CH 8091 Zürich, Switzerland, Tel.: +41 442555009, Fax: +41 442554376

Received: 2011-04-10

Accepted: 2012-11-28

Published Online: 2012-12-25

Published in Print: 2013-07-01

Citation Information: Journal of Perinatal Medicine, Volume 41, Issue 4, Pages 365–374, ISSN (Online) 1619-3997, ISSN (Print) 0300-5577, DOI: https://doi.org/10.1515/jpm-2011-0086.

Export Citation

©2013 by Walter de Gruyter Berlin Boston.Get Permission

Citing Articles

Here you can find all Crossref-listed publications in which this article is cited. If you would like to receive automatic email messages as soon as this article is cited in other publications, simply activate the “Citation Alert” on the top of this page.

Jenna A. LoGiudice and Cheryl T. Beck
Journal of Midwifery & Women's Health, 2016, Volume 61, Number 4, Page 474
Lena Henriksen, Berit Schei, and Mirjam Lukasse
Midwifery, 2016, Volume 36, Page 14
Nils C. Westfall and Charles. B. Nemeroff
Current Psychiatry Reports, 2015, Volume 17, Number 11

Comments (0)

Please log in or register to comment.
Log in