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• W339806366 abstract "ABSTRACT: Current estimates of the incidence of childhood sexual abuse range from 12% to 40%, indicating that a significant number of women enter pregnancy, labor and birth with past experiences of trauma. Recent quantitative research results have revealed little significant difference in rates of obstetrical complications and pregnancy outcomes in women reporting histories of childhood sexual abuse and those reporting no history of childhood sexual abuse. Empirical data and anecdotal reports of women's experiences during pregnancy, labor and birth, as well as health practitioners' experiences of providing prenatal and obstetrical care, indicate that a history of childhood sexual abuse can have a psychological and behavioral impact on the woman that may be evidenced throughout the prenatal and birth process. An awareness of the individual needs of survivors of childhood sexual abuse during this critical time has implications for the care provided by prenatal and obstetrical health care practitioners. KEY WORDS: childhood sexual abuse, pregnancy, labor, childbirth, prenatal care, obstetrical care. INTRODUCTION Current estimates of the incidence of childhood sexual abuse in the United States range from 12% to 40%, but the actual prevalence is unknown due to the fact that many survivors never disclose their experiences as a result of the shame and stigma associated with the abuse (American College of Obstetricians and Gynecologists, 2001). Based on these statistics, it is likely that a significant number of women enter pregnancy, labor and birth carrying the effects of past trauma. The impact of prior trauma, particularly childhood sexual abuse, on pregnancy, labor and birth has been evaluated in both quantitative and qualitative research. H. Grimstad and B. Schei (1999) and M. I. Benedict, L. A. Paine, et al. (1999) have conducted quantitative studies examining the impact of childhood sexual abuse on pregnancy, labor and birth outcomes. These studies are contrasted with the anecdotal reports of survivors' experiences giving birth, health care providers' experiences attending them and qualitative studies. The anecdotal reports provide significant information regarding the implications of histories of abuse for prenatal and obstetrical care (Courtois, C.A. & Riley, C.C., 1992; Grant, 1992; Kitzinger, 1992; Rhodes & Hutchinson, 1994; Simkin, 1992). Although the quantitative studies do not support evidence of significant differences in obstetrical outcomes between birthing women with histories of childhood sexual abuse and those without such histories, the potential behavioral and psychological impact of labor and birth on these women, and in turn on their babies, is significant and should inform the care provided to women and their babies during this critical period. Acknowledgement of this fact is addressed in The American College of Obstetricians and Gynecologists' (ACOG) official educational bulletin (2001) entitled, Manifestations of Sexual Abuse. Changes in prenatal and obstetrical care that respect and are sensitive to survivors' particular needs at this time, a time that can often trigger memories of past abuse experiences, will help prevent women from experiencing birth as a reenactment of the violation they experienced in the past. DEFINITION OF CHILDHOOD SEXUAL ABUSE, DISCLOSURE AND PREVALENCE As described in ACOG's educational bulletin, Childhood sexual abuse can be defined as any exposure to sexual acts imposed on children who inherently lack the emotional, maturational, and cognitive development to understand or to consent to such acts. These acts do not always involve sexual intercourse or physical force; rather, they involve manipulation and trickery. Authority and power enable the perpetrator to coerce the child into compliance (2000, p. 311). Finkelhor describes legal and research definitions of child sexual abuse for which two elements are required: sexual activities involving a child; and an abusive condition (1994, p. …" @default.
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• W339806366 title "The Impact of Childhood Sexual Abuse on Pregnancy, Labor and Birth" @default.
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