title: Bad experience, good birthing: Dutch low-risk pregnant women with a history of sexual abuse.
abstract: OBJECTIVE
  The long-term effects on women in childbirth with a history of sexual abuse have only been studied to a limited degree. We estimated the prevalence of lifetime experience among low-risk pregnant women (non-clinical) in The Netherlands as well as the association with (1) psycho-social outcomes, and (2) the birth process.
  
  
  METHODS
  Study of 625 randomly selected low-risk pregnant women. At 20-24 weeks gestation, participants completed a questionnaire covering socio-demographic variables, sexual attitude, and psychological determinants. Midwives recorded details of the birth process.
  
  
  RESULTS
  Nearly one-in-nine (11.2%) women had experienced sexual abuse. They were on average younger, more likely to smoke, and had lower household income. They reported more conflicting feelings about sex than women who did not report a history of abuse (p = 0.02). Multiparous women with a history of sexual abuse reported more emotional distress (p = 0.037), more internal beliefs concerning health (p = 0.004), and they were also more likely to suffer pelvic pain (p = 0.045). Sexually-abused women reported higher levels of autonomy (p = < 0.001). Referral rates to secondary care were equal. Sexually-abused women were less likely to receive episiotomies (p < 0.005).
  
  
  CONCLUSIONS
  Little difference was observed in major birth-related technical interventions between women with and without a history of sexual abuse.
authors.affiliation: Department of Gynaecology and Obstetrics, Academic Medical Centre, University of Amsterdam, The Netherlands.
authors.forename: Leonie A M
authors.initials: LA
authors.lastname: van der Hulst
authors.forename: Gouke J
authors.initials: GJ
authors.lastname: Bonsel
authors.forename: Martine
authors.initials: M
authors.lastname: Eskes
authors.forename: Erwin
authors.initials: E
authors.lastname: Birnie
authors.forename: Edwin
authors.initials: E
authors.lastname: van Teijlingen
authors.forename: Otto P
authors.initials: OP
authors.lastname: Bleker
mesh_terms: D000328:Adult; D002648:Child; D002650:Child Abuse, Sexual / Q000706:statistics & numerical data*; D003710:Demography; D005260:Female; D006801:Humans; D008016:Life Change Events; D009426:Netherlands / Q000453:epidemiology; D007744:Obstetric Labor Complications / Q000453:epidemiology*; D036801:Parturition; D026684:Personal Autonomy; D011247:Pregnancy; D015995:Prevalence; D011446:Prospective Studies; D011584:Psychology; D012424:Rural Population / Q000706:statistics & numerical data; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D014505:Urban Population / Q000706:statistics & numerical data