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As the leading organization of physicians who provide health services unique to women, the American College of Obstetricians and Gynecologists (“ACOG”) supports survivors of sexual assault. ACOG encourages obstetrician-gynecologists to be resources for women who have experienced sexual assault and to provide them with empathetic and high-quality care.1

Sexual assault involves aggression and violence and encompasses a continuum of nonconsensual sexual activity that ranges from sexual coercion to contact abuse (unwanted kissing, touching, or fondling) to rape.2 A woman may experience sexual assault at any age. Obstetrician-gynecologists see firsthand the devastating physical, sexual, and interpersonal consequences of sexual assault in their practices. Often, obstetrician-gynecologists are the first clinicians to hear from survivors about recent and past sexual assault, and it is common for this history to be disclosed during a clinical visit due to the nature of the patient-physician relationship and/or specific clinical symptoms. ACOG recommends that obstetrician-gynecologists and other women’s health care providers screen all women for a history of sexual assault, paying particular attention to patients who report certain symptoms like pelvic pain, dysmenorrhea, or sexual dysfunction.3 Early identification of survivors of sexual assault can lead to prevention of long-term and persistent physical and mental health consequences of abuse. When treating women and girls who have experienced sexual violence, the obstetrician-gynecologist should be familiar with laws and regulations that may require reporting to law enforcement authorities.

ACOG recognizes that the trauma survivors have experienced may hinder their ability to speak openly about their sexual assault, and disclosure may not occur until many years after an assault. Obstetrician-gynecologists should create an empathetic clinical environment that facilitates open communication so that appropriate treatment may be provided. The obstetrician-gynecologist is a powerful ally to survivors by providing trauma-informed care, facilitating referrals for counseling and follow-up, and complying with relevant legal obligations in the gathering of evidence.

References

1Sexual assault, Committee Opinion No. 592, American College of Obstetricians and Gynecologists, Obstet Gynecol 2014;123:905–9; Reproductive and sexual coercion, Committee Opinion No. 554, American College of Obstetricians and Gynecologists. Obstet Gynecol 2013;121:411–5; Intimate partner violence, Committee Opinion No. 518,American College of Obstetricians and Gynecologists, Obstet Gynecol 2012;119:412–7; Adult manifestations of childhood sexual abuse, Committee Opinion No. 498, American College of Obstetricians and Gynecologists. Obstet Gynecol 2011;118:392-5; Empathy in women's health care, Committee Opinion No. 480, American College of Obstetricians and Gynecologists. Obstet Gynecol 2011;117:756–61.

2 Basson R, Baram DA. Sexuality, sexual dysfunction, and sexual assault. In: Berek JS, editor. Berek & Novak’s gynecology. 15th ed. Philadelphia (PA): Lippincott Williams & Wilkins; 2012. p. 270–304;

3 Sexual assault. Committee Opinion No. 592.

Approved by the Executive Board October 2018
Revised and Approved November 2018