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.
Key words
prostitution - Prostitute Protection Act - high-risk pregnancy - sexual violence -
preterm birth
