The SATELLITE Sexual Violence Assessment and Care Guide for Perinatal Patients

Sexual violence (SV), including childhood sexual abuse (CSA) and adult sexual assault (ASA), is a major public health problem that affects the lives of millions of females every year.1 A large-scale study reported that 11.7 million girls and women were forced to have sex during their lifetime and that, among these females, 64% (~7 million) were aged ≤17 years at the time of the first forced sexual experience.2 Another study showed that 11.5%–14.6% of women had a history of CSA when they presented for prenatal care.3 The perinatal period, which begins at 20 weeks’ gestation and ends at 28 days after delivery, is a time when women who have experienced SV have been shown to be at risk for a variety of health problems and poor pregnancy outcomes.4,5 Many SV-exposed women do not obtain early and/or adequate prenatal care and are likely to experience perinatal complications, including hyperemesis, hypertension, bleeding, preterm delivery, low-birth-weight infants, low infant Apgar scores, and perinatal death.3,6–9 Women with a history of SV, compared with women lacking such a history, are at greater risk for developing depression and anxiety during the postpartum period;8,10 of note, some women experience their first recollection of past abuse during the postpartum period.11,12 Although they are twice as likely to demonstrate an interest in breast-feeding and to begin breast-feeding as their non-abused counterparts, SV survivors who recall their abuse for the first time during the postpartum period have indicated that this recall affects their ability to nurse their infant.12 Although screening for SV is recommended or mandated by various healthcare organizations,13–15 an SV assessment and care guide for use during the perinatal period does not exist. The purpose of this article is to describe the development and use of an SV assessment and care guide for NPs caring for women in the perinatal setting.