Geburtshilfe Frauenheilkd 2017; 77(04): 366-376
DOI: 10.1055/s-0042-124045
GebFra Science
Original Article/Originalarbeit
Georg Thieme Verlag KG Stuttgart · New York

Psychosocial Stress, Course of Pregnancy and Pregnancy Outcomes in the Context of the Provision of Sexual Services

Article in several languages: English | deutsch
Elisabeth Simoes
1   Department für Frauengesundheit, Universitätsklinikum Tübingen, Tübingen, Germany
2   Forschungsinstitut für Frauengesundheit, Universitätsklinikum Tübingen, Tübingen, Germany
3   Stabsstelle Sozialmedizin, Universitätsklinikum Tübingen, Tübingen, Germany
,
Johannes Gostomzyk
4   Gesundheitsamt Augsburg, Ltd. Medizinaldirektor a. D.
,
Sara Yvonne Brucker
1   Department für Frauengesundheit, Universitätsklinikum Tübingen, Tübingen, Germany
2   Forschungsinstitut für Frauengesundheit, Universitätsklinikum Tübingen, Tübingen, Germany
,
Joachim Graf
1   Department für Frauengesundheit, Universitätsklinikum Tübingen, Tübingen, Germany
2   Forschungsinstitut für Frauengesundheit, Universitätsklinikum Tübingen, Tübingen, Germany
› Author Affiliations
Further Information

Publication History

received 25 August 2016
revised 15 November 2016

accepted 16 December 2016

Publication Date:
26 April 2017 (online)

Abstract

Introduction There has been very little medical research into pregnancies which occur in the context of prostitution, even though the associated health risks for mother and child, e.g. violence or maternal drug abuse, are well known. The aim of this study was to compile and summarize what is known (inter-)nationally about this topic and identify key points of support as part of a uniform standard of healthcare in pregnancy.

Material and Methods A selective search of the literature was done in Pubmed and Livivo/Medpilot and in the databases NIH, Cochrane, DARE, NHSEED and HTA on the factors influencing preterm delivery.

Results There are no systematic studies on pregnancy risks in the context of sexual services. But there is data available on specific risk factors, for example the increased risk of prematurity associated with sexual/physical violence (OR = 1.28–4.7). The Prostitute Protection Act provides only limited protection for affected women, and statutory maternity protection regulations also have little impact as they require a formal contract of employment which rarely exists even in the context of legal prostitution.

Conclusion Approximately 400 000 women are currently working as prostitutes in the Federal Republic of Germany. The number of unreported cases is high. Nevertheless, there is little concrete data available on the probable health risks if these women become pregnant. The existing laws that should offer protection fall short of the mark. There is a need for more research into the future implementation of the Prostitute Protection Act which should focus on health counselling, health promotion and additional protective legislation. Low-threshold healthcare services offered in the context of prenatal care could be an opportunity to improve care.