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ACOG Committee Opinion No. 777 Summary

Sexual Assault

doi: 10.1097/AOG.0000000000003179
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ABSTRACT: Sexual violence continues to be a major public health problem affecting millions of adults and children in the United States. Medical consequences of sexual assault include sexually transmitted infections; mental health conditions, including posttraumatic stress disorder; and risk of unintended pregnancy in reproductive-aged survivors of sexual assault. Obstetrician–gynecologists and other women’s health care providers play a key role in the evaluation and management of sexual assault survivors and should screen routinely for a history of sexual assault. When sexual violence is identified, individuals should receive appropriate and timely care. A clinician who examines sexual assault survivors in the acute-care setting has a responsibility to comply with state and local statutory or policy requirements for the use of evidence-gathering kits. This document has been updated to include model screening protocols and questions, relevant guidelines from other medical associations, trauma-informed care, and additional guidance regarding acute evaluation of survivors and evidence-gathering kits.

This information is designed as an educational resource to aid clinicians in providing obstetric and gynecologic care, and use of this information is voluntary. This information should not be considered as inclusive of all proper treatments or methods of care or as a statement of the standard of care. It is not intended to substitute for the independent professional judgment of the treating clinician. Variations in practice may be warranted when, in the reasonable judgment of the treating clinician, such course of action is indicated by the condition of the patient, limitations of available resources, or advances in knowledge or technology. The American College of Obstetricians and Gynecologists reviews its publications regularly; however, its publications may not reflect the most recent evidence. Any updates to this document can be found on www.acog.org or by calling the ACOG Resource Center.

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Number 777 (Replaces Committee Opinion Number 592, April 2014)

For a comprehensive overview of these recommendations, the full-text version of this Committee Opinion is available at http://dx.doi.org/10.1097/AOG.0000000000003178.

Scan this QR code with your smartphone to view the full-text version of this Committee Opinion.

Committee on Health Care for Underserved Women

This Committee Opinion was developed by the American College of Obstetricians and Gynecologists’ Committee on Health Care for Underserved Women in collaboration with committee members Serina Floyd, MD, MPH, and Joy Anderson, MD.

Full-text document published online on March 26, 2019.

Copyright 2019 by the American College of Obstetricians and Gynecologists. All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, posted on the internet, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without prior written permission from the publisher.

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Official Citation

Sexual assault. ACOG Committee Opinion No. 777. American College of Obstetricians and Gynecologists. Obstet Gynecol 2019;133:e296–302.

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Recommendations

The American College of Obstetricians and Gynecologists makes the following recommendations and conclusions regarding sexual violence:

  • Sexual assault and rape are pervasive problems in the United States, creating a major effect on public health.
  • Obstetrician–gynecologists and other women’s health care providers should screen all women for a history of sexual assault.
  • Clinicians who evaluate survivors of sexual assault in the acute phase must comply with certain medical and legal requirements.
  • Clinicians should recognize the short-term and long-term health consequences of sexual assault, such as infection, pregnancy, and mental health conditions and manage them appropriately.
  • Clinicians should incorporate a trauma-informed care framework when assessing the needs of sexual assault survivors.
© 2019 by The American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. All rights reserved.