Objective: The purpose of this study was to investigate characteristics of abuse suffered by children exposed to sexual abuse resulting in pregnancy, the features of those pregnancies, and the scale of the psychological impact involved.
Materials and Methods: Patient records for 111 children under the age of 18 who became pregnant as a result of sexual abuse and were referred for reports and examination to the Ondokuz Mayıs University Mdical Faculty Forensic Medicine Department over a 6-year period were investigated.
Results: Mean age at first pregnancy was 14.51.3 (11-17) years. Of the victims, 41.4% reported that sexual abuse took place due to threats, deception or compulsion, 68.5% reported abuse was repeated, 13.5% fell pregnant as a result of abuse by a member of the family, approximately half of the pregnant children gave birth, approximately half of the babies were placed in care away from the mother and three were adopted. Psychological pathologies due to their experiences developed in half the pregnant victims of abuse, and threats/deception, repeated abuse and presence of incest were identified as risk factors for psychological pathology.
Conclusion: Victims of abuse who fall pregnant are exposed to long-term and permanent effects, not just in terms of physical and mental health, but also in the social sphere, such as economic dependence. It should therefore be remembered that these adverse effects in victims of sexual abuse presenting in the acute period can be overcome through the administration of emergency contraception. In victims presenting after the acute period, however, the presence or otherwise of pregnancy must be investigated early, and pregnancies must be terminated under appropriate conditions if so desired. In addition, these children must be placed under monitoring for the rehabilitations of psychological pathologie.
Keywords: Child sexual abuse, Pregnancy, Psychological pathology.
Yılmaz E, Çelikel A, Değirmenci B, Zeren C, Gören S. Diyarbakır'da cinsel suç mağduru olguların değerlendirilmesi. Adli Tıp Bülteni 2011; 16(3): 93-103.
Balcı Y, Erbaş M, Işık Ş, Karbeyaz K. Muğla Adli Tıp Şube Müdürlüğü'ne başvuran cinsel saldırı olgularının değerlendirilmesi. Adli Tıp Bülteni 2014;19(2): 87-95.
Jewkes R, Sen P, Garcia-Moren C. Sexual violence. In: Krug EG, Dahlberg LL, Mercy JA, Zwi AB, Lozano R (eds). World report on violence and health. World Health Organization, Geneva, 2002:149–81.
(http://www.who.int/violence_injury_prevention/violence/world_report/en/full_en.pdf) Erişim tarihi: 16.03.2015
Ovayolu N, Uçan Ö, Serindağ S. Çocuklarda Cinsel İstismar ve Etkileri. Fırat Sağlık Hizmetleri Dergisi 2007; 2(4): 13-22.
Köse S, Aslan Z, Başgül ŞS, Şahin S, Yılmaz Ş, Çıtak S, ve ark. Bir eğitim ve araştırma hastanesi çocuk psikiyatrisi polikliniğine yönlendirilen adli olgular. Anadolu Psikiyatri Dergisi 2011; 12: 221-5.
Guidelines for medico-legal care for victims of sexual violence, World Health Organization, Geneva, 2003: 75-93.
(http://whqlibdoc.who.int/publications/2004/924154628X.pdf) Erişim tarihi: 16.03.2015
Maniglio R. The impact of child sexual abuse on health: a systematic review of reviews. Clin Psychol Rev 2009; 29(7): 647-57.
Kendall-Tackett KA, Williams LM, Finkelhor D. Impact of sexual abuse on children: a review and synthesis of recent empirical studies. Psychol Bull 1993; 113(1): 164-80.
Holmes MM, Resnick HS, Kilpatrick DG, Best CL. Rape-related pregnancy: Estimates and descriptive characteristics from a national sample of women. Am J Obstet Gynecol 1996; 175(2): 320-5.
Kaufman J. Child abuse and neglect. In: Martin A, Volkmar FR, eds.Lewis’s Child and Adolescent Psychiatry: A Comprehensive Textbook.4th ed. Philadelphia: Lippincott Williams & Wilkins, 2007: 693-9.
Bernet W. Çocuğa kötü muamele. Sadock BJ , VA Sadock VA, editörler.Kaplan&Sadock’s Comprehensive Textbook of Psychiatry (Türkçe), 8. Baskı. Çev. ed: Aydın H, Bozkurt A, Ankara: Güneş Kitabevi Ltd, 2007: 3412-25.
Brahmbhatt H, Kågesten A, Emerson M, Decker MR, Olumide AO, Ojengbede O, et al. Prevalence and Determinants of Adolescent Pregnancy in Urban Disadvantaged Settings Across Five Cities. J Adolesc Health 2014; 55 (6,Supp): 48–57.
Ulibarri MD, Ulloa EC, Salazar M. Associations between Mental Health, Substance Use, and Sexual Abuse Experiences among Latinas. J Child Sex Abus 2015; 24(1): 35–54.
Warner LA, Alegria M, Canino G. Childhood maltreatment among Hispanic women in the United States: An examination of subgroup differences and impact on psychiatric disorder. Child Maltreat 2012; 17(2): 119–31.
Soylu N, Ayaz M. Adli değerlendirme için yönlendirilen küçük yaşta evlendirilmiş kız çocuklarının sosyodemografik özellikleri ve ruhsal değerlendirmesi. Anadolu Psikiyatri Dergisi 2013;14 (2): 136-44.
Pallitto C, Murillo V. Childhood Abuse as a Risk Factor for Adolescent Pregnancy in El Salvador. J Adolesc Health 2008; 42(6): 580–6.
Noll JG, Shenk CE, Putnam KT. Childhood Sexual Abuse and Adolescent Pregnancy: A Meta-analytic Update. J Pediatr Psychol 2009; 34(4): 366–78.
Gölge ZB, Yavuz MF, Yüksel Ş. Cinsel Saldırgan Profili. Adli Tıp Dergisi 2006; 20(1): 1-17.
İmren SG, Ayaz AB, Yusufoğlu C, Arman AR. Cinsel istismara uğrayan çocuk ve ergenlerde klinik özellikler ve intihar girişimi ile ilişkili risk etmenleri. Marmara Medical Journal 2013; 26:11-6.
Alpaslan AH. Çocukluk Döneminde Cinsel İstismar. Kocatepe Tıp Dergisi 2014; 15(2): 194-201.
Aydin B, Akbas S, Turla A, Dundar C, Yuce M, Karabekiroglu K. Child sexual abuse in Turkey: an analysis of 1002 cases. J Forensic Sci 2015; 60(1): 61-5.
UNFPA. Motherhood in childhood—facing the challenge of adolescent pregnancy. The State of World Population 2013.
(http://www.unfpa.org/sites/default/files/pub-pdf/EN-SWOP2013-final.pdf) Erişim tarihi: 24.03.2015
Yulaf Y, Gümüştaş FÖ. Çocuk ve Ergenlerde Cinsel İstismarın Psikiyatrik Sonuçlarını Etkileyen Faktörler. Klinik Psikiyatri 2013; 16: 197-205.
Ayaz M, Ayaz AB, Soylu N. Çocuk ve Ergen Adli Olgularda Ruhsal Değerlendirme. Klinik Psikiyatri, 2012; 15: 33-40.
Mıhçıokur S, Erbaş F, Akın A. Çocuk Gelinler ve Beklenen Olumsuz Sonuçları. Sağlık ve Toplum 2010; 20 (1): 3-12.
Özcebe H, Ünalan T, Türkyılmaz S, Coşkun Y. Türkiye Gençlerde Cinsel Sağlık ve Üreme Sağlığı Araştırması, 2007; Ankara: Nüfus Bilim Derneği ve Birleşmiş Milletler Nüfus Fonu.
(http://www.nd.org.tr/custom/odesismc/Turkce_rapor.pdf) Erişim tarihi: 24.03.2015
Hacettepe Üniversitesi Nüfus Etütleri Enstitüsü (2014), “2013 Türkiye Nüfus ve Sağlık Araştırması”. Hacettepe Üniversitesi Nüfus Etütleri Enstitüsü, T.C. Kalkınma Bakanlığı ve TÜBİTAK, Ankara, Türkiye.
(http://www.hips.hacettepe.edu.tr/TNSA_2013_ana_rapor.pdf) Erişim tarihi: 24.03.2015
Uysal C, Kir ZM, Goruk NY, Atli A, Bez Y, Gören S, et al. Being An Adolescent Mother. Acta Med Anatol 2014; 2(1): 14-8.
Malatyalı MK. Türkiye’de ‘Çocuk Gelin’ Sorunu. Nesne Psikoloji Dergisi 2014; 2(3): 27-38.
Bernard-Bonnin AC, Hébert M, Daignault IV, Allard-Dansereau C. Disclosure of sexual abuse, and personal and familial factors as predictors of post-traumatic stress disorder symptoms in school-aged girls. Paediatr Child Health 2008; 13(6): 479-86.
Fis NP, Arman A, Kalaca S, Berkem M. Psychiatric evaluation of sexual abuse cases: A clinical representative sample from Turkey. Child Youth Serv Rev 2010; 32: 1285-90.
Gölge ZB. Cinsel Travma sonrası oluşan ruhsal sorunlar. Nöropsikiyatri Arşivi. 2005; 42: 19-28.
Vural P, Uçar HN, Eray Ş, Çolpan M, Kocael Ö. Uludağ Üniversitesi Tıp Fakültesi Hastanesi Çocuk Psikiyatrisi Polikliniğine Yönlendirilen Adli Olguların Sosyodemografik ve Klinik Özelliklerinin Değerlendirilmesi. Uludağ Üniversitesi Tıp Fakültesi Dergisi 2013; 39 (1): 49-53.
Godinet MT, Li F, Berg T. Early childhood maltreatment and trajectories of behavioral problems: Exploring gender and racial differences. Child Abuse Negl 2014; 38 (3): 544–56.
Lukasse M, Henriksen L, Vangen S, Schei B. Sexual violence and pregnancy-related physical symptoms. BMC Pregnancy Childbirth 2012; 12: 83.
Wosu AC, Gelaye B, Williams MA. Childhood sexual abuse and posttraumatic stress disorder among pregnant and postpartum women: review of the literature. Arch Womens Ment Health 2015; 18(1): 61–72.
The Bulletin of Legal Medicine is an open access scientific journal. Open access means that all content is freely available without charge to the user or his/her institution on the principle that making research freely available to the public supports a greater global exchange of knowledge. The Journal and content of this website is licensed under the terms of the Creative Commons Attribution (CC BY) License. This is in accordance with the Budapest Open Access Initiative (BOAI) definition of open access.
The Creative Commons Attribution License (CC BY) allows users to copy, distribute and transmit an article, adapt the article and make commercial use of the article. The CC BY license permits commercial and non-commercial re-use of an open access article, as long as the author is properly attributed.
The Bulletin of Legal Medicine requires the author as the rights holder to sign and submit the journal's agreement form prior to acceptance. The authors retain copyright of their work and grant the Association for its publication. This ensures both that The Journal has the right to publish the article and that the author has confirmed various things including that it is their original work and that it is based on valid research.
Authors who publish with this journal agree to the following terms:
*Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
*Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
*Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.