Carry out research on the extent of sexual abuse and involuntary pregnancy among girls aged 8-14: Part 3

International Campaign for Women's Right to Safe Abortion

21 August 2015

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Carry out research on the extent of sexual abuse and involuntary pregnancy among girls aged 8-14. Start a campaign for their right to access safe abortion as an emergency – to protect their lives and avoid too-early motherhood : PART IIIIt seems from the information in this week’s newsletters (though not based on an exhaustive search) that almost no one has done research on the extent of pregnancy following sexual abuse among 8-14 year-old girls, nor what the outcomes were. Several of the studies below do not even consider abortion as an outcome,or indicate whether it ever took place. While it seems pregnancy is a common outcome of abuse and rape, there is mostly only anecdotal evidence. It also seems that in countries where most abortions are illegal, girls whose cases have come to light are not being allowed abortions on grounds of risk to life or health, even under laws where that is legal. Of course, there may well be more cases that have not come to light where someone has quietly arranged an abortion, but that is impossible to know. What can be said with certainty is that sexual abuse is extensive, that boys who experience sexual abuse may become abusers and may be more likely to make girls pregnant, and that care for the girls concerned ought to include access to safe abortion on both health and human rights grounds. Above all, the message is that it is not the children’s fault, action should be taken to stop the abuse, and the children should not be made into the victims.

USASexual abuse as a factor in adolescent pregnancy and child maltreatmentBoyer D, Fine D.Family Planning Perspectives 1992 Jan-Feb;24(1):4-11,19. of a sample of 535 young women from the state of Washington who became pregnant as adolescents had been sexually abused: Fifty-five percent had been molested, 42 percent had been victims of attempted rape and 44 percent had been raped. Compared with adolescent women who became pregnant but had not been abused, sexually victimized teenagers began intercourse a year earlier, were more likely to have used drugs and alcohol and were less likely to practice contraception. The abused adolescents were also more likely to have been hit, slapped or beaten by a partner and to have exchanged sex for money, drugs or a place to stay. Young women in the abused group were also more likely to report that their own children had been abused or had been taken from them by Child Protective Services.

USAThe effects of childhood sexual abuse on minority adolescent mothers Esparza DV, et al.Journal of Obstetric, Gynecologic & Neonatal Nursing 1996 May; 25(4):321-328;jsessionid=7F351659C105B8BC4BC19F1066D6DF2A.f02t01AbstractThe objective of this exploratory descriptive study was to examine the incidence and effects of childhood sexual abuse experiences on the lives of 124 adolescent mothers aged 13-20 years who were Mexican American and African American. Specifically, the personality characteristics of the adolescent mothers who experienced sexual abuse as assessed using the Millon Adolescent Personality Inventory were compared with those of minority adolescent mothers who were not abused sexually.Setting: Four public agencies caring for adolescent mothers in two urban centers in Texas.Main outcome measures:The Millon Personality Inventory, the Life Event Scale-Adolescents, the Childhood Sexual Experience Survey, and a demographic data sheet.Results: Forty-four percent (n= 54) of the respondents reported childhood sexual abuse experience. Data from 111 subjects (two groups, abuse and non-abuse) were analyzed by MANCOVA techniques. Significant differences were found between the two groups in self-concept, personal esteem, body comfort, sexual acceptance, peer security, family rapport, academic confidence, social conformity, scholastic achievement, and attendance consistency. The mothers in the abuse group had consistently poorer scores than those in the non-abuse group.Conclusion: These findings suggest that childhood sexual abuse may be related to vulnerability for adolescent motherhood.

USATeenage pregnancy and associated risk behaviors among sexually abused adolescentsSaewyc EM, Magee LL, Pettingell SEPerspectives on Sexual and Reproductive Health 2004;36(3):98-105 research suggests a link between adolescent pregnancy and sexual abuse history, but most studies have used clinical samples of females only and single measures of abuse.Methods: Associations between pregnancy involvement, risk behaviors and sexual abuse were examined in sexually experienced teenagers from the Minnesota Student Surveys of 1992 (N=29,187) and 1998 (N=25,002). Chi-square tests assessed differences in pregnancy involvement and related risk behaviors among four groups of adolescents, categorized by type of abuse experienced: none, incest only, nonfamilial only, or both. Odds ratios for pregnancy involvement and risk behaviors, adjusted for grade level and race, were calculated for each gender by using logistic regression analysis.Results: Sexual abuse was reported by 6% of males and 27% of females in 1992, and by 9% and 22% in 1998. Reports of pregnancy involvement were significantly more common among abused adolescents (13-26% of females and 22-61% of males, depending on type of abuse) than among non-abused adolescents (8-10%). Abused adolescents were more likely than others to report risk behaviors, and teenagers reporting both abuse types had the highest odds of pregnancy involvement and risk behaviors. The differential in the odds of pregnancy involvement and most behaviors was larger between non-abused and abused males than between non-abused and abused females.Conclusions: Teenage pregnancy risk is strongly linked to sexual abuse, especially for males and those who have experienced both incest and non-familial abuse. To further reduce the U.S. teenage pregnancy rate, the pregnancy prevention needs of these groups must be adequately addressed.From the text:Each year in the United States more than one million adolescent pregnancies occur, and more than four million adolescents receive a diagnosis of a sexually transmitted disease (STD). The risk of becoming pregnant or getting someone else pregnant is higher for some teenagers than for others, and continued progress in reducing unintended pregnancy and risky sexual behaviors among teenagers requires targeting interventions to groups at greatest risk.One group potentially at increased risk is teenagers who have been sexually abused. Sexual abuse can alter perceptions about sexual behavior and influence judgment in forming intimate relationships, and thereby lead to earlier sexual debut, more sexual partners and an increased risk of sexual violence in intimate relationships. Sexually abused adolescents have experienced the violation of their most intimate boundaries, which can create a sense of powerlessness in relationships and may impair their ability to negotiate contraceptive use. As a result, sexually abused adolescents are less likely than their non-abused peers to use condoms or other forms of birth control.

LITERATURE IN ENGLISH, GERMAN, FRENCHInfluence of childhood sexual abuse on pregnancy, delivery, and the early post-partum period in adult womenLeeners B, et al.Journal of Psychosomatic Research 2006 August; 61(2):139-51 aim of our systematic review was to present the current knowledge on the influence of child sexual abuse (CSA) on pregnancy, delivery, and early parenthood from all relevant English, French, or German primary and secondary literature. If CSA is defined as sexual contact between a child in mid-adolescence or younger and a person at least 5 years older, ranging from fondling to intercourse, the sexual victimization rate is generally considered to be around 20% for females. Prevalences are particularly high in groups of women with known sequelae of CSA, e.g. in adolescent mothers (44%). Although CSA is present in all socioeconomic groups, studies have shown that more severe forms of abuse appear to be associated with lower socioeconomic status. Prevalence of sexual abuse alone is not associated with ethnic background and/or the level of education, and there seem to be no significant differences between countries in rates of abuse as long as the same definitions are applied. The true figure of CSA might be far higher, because even today girls rarely make their abuse public at the time of occurrence, and for retrospective evaluations, only parts of the CSA experiences are remembered.Adolescent pregnancies as such are associated with specific complications resulting from the young age of the mother. In addition, motives to become either consciously or unconsciously pregnant during adolescence may be associated with the experience of CSA. As it was the aim of our review to give health care providers information on the significance of CSA for obstetric care, we did not want to mix these correlations with the specific physical, psychological, and social problems of an adolescent pregnancy. Therefore studies on adolescent pregnancies were excluded from our analysis…

CHILEAbortion denied 11-year-old rape victim in Chile in 2013 2013, then-president of Chile Sebastian Pinera caused an uproar when he praised an 11-year-old rape victim as being “brave and mature” for her decision to carry the pregnancy to term.Healthprofessionals widely criticised the concept of an 11-year-old being prepared to give birth and cited the case as a prime example of why Chilean abortion laws needed to be reformed. The reforms proposed by President Bachelet followed.

SENEGALSenegalese law banned raped 10-year-old from aborting twinsAlex Duval Smith4 April 2014Efforts of human rights campaigners thwarted by Napoleonic law allowing abortion only in life-or-death circumstances 10-year-old girl who was pregnant with twins after she was raped by a neighbour was forced to continue with her pregnancy after human rights campaigners lost their fight to secure a legal route to abortion. The girl was understood to be five months pregnant. She had to go through with the pregnancy, according to Fatou Kiné Camara, president of the Senegalese Women Lawyers’ Association. “The best we can do is keep up pressure on the authorities to ensure the girl gets regular scans and free medical care.”

Senegalese lawyer Fatou Kiné Camara has branded her country’s abortion law one of the harshest and deadliest in Africa. Credit: Zena Zephinie

Under Senegal’s abortion law, a doctor or pharmacist found guilty of having a role faces being struck off, and a woman can be jailed for up to 10 years. “For a termination to be legal in Senegal, three doctors have to certify that the woman will die unless she aborts immediately. Poor people in Senegal are lucky if they see one doctor in their lifetime, let alone three,” Camara said. “We had a previous case of a raped nine-year-old who had to go through with her pregnancy. We paid for her caesarean but she died a few months after the baby was born, presumably because the physical trauma of childbirth was too great.”The women lawyers’ association is lobbying MPs to align Senegal’s abortion legislation with the African charter on women’s rights, which the country ratified 10 years ago. Its provisions – legal medical abortion in cases of rape and incest, or where a woman’s physical or mental health is threatened – have never been added to the statute book.”The greatest unfairness is that the poor are the victims of our archaic legislation,” said Camara, a law professor at Cheikh Anta Diop University in Dakar. “Anyone with enough money can easily have an abortion at a private clinic. But if you are poor you are expected to go through the legal motions or risk your life in a backstreet clinic.”Muslim Senegal is constitutionally secular, but customary law is in widespread use. At least 10% of girls are married before age 14…Camara said terminations in such extreme cases should be made legal. “Senegal must legalise safe abortion so that we never see any more cases like hers. Had we had time and had the girl’s parents been willing, we could have asked a judge to consider guaranteeing immunity from prosecution to a doctor,” she said. “However, the family is poor; the process is difficult enough for them. They were just pleased when the rapist was arrested.”

UKTruancy is a risk factor for teenage pregnancy in EnglandYin Zhou et al.Journal of Public Health 2015; March has been linked to risky sexual behaviours in teenagers, yet no studies in England have examined the association between truancy and teenage pregnancy, and the use of truancy as a marker of teenagers at risk of pregnancy. This article by Zhou and others examines the results of an investigation into the association between truancy at age 15 and the likelihood of teenage pregnancy by age 19 among 3,837 girls who participated in the Longitudinal Study of Young People of England. Findings show that truancy is independently associated with teenage pregnancy among English adolescent girls.***New guidance for physicians to help tackle child sexual exploitationMay 2015 Royal College of Physicians in the UK has produced new guidance to support physicians to help tackle child sexual exploitation. The guidance is designed to assist physicians in recognising potential cases of child sexual exploitation and seeking support to protect vulnerable children and young people.

“Break the silence. When you witness violence against women and girls, do not sit back. Act.”Ban Ki-moon, UN Secretary-General


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