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

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.

Longitudinal study of pregnancy intention and its association with pregnancy occurrence among female sex workers in Benin and Mali

“…FSWs have the same desire when it comes to future fertility as other women. To accompany FSWs into fulfilling their fertility desires, we need to consider that sex work practice is associated with a lot of risks [ 66 ] and many of those women engage in sex work practice during pregnancy [ 67 ] and wish to have children [ 14 ]. These women face multiple challenges working while pregnant: violence from clients, difficulties findings clients, fear of HIV acquisition and transmission [ 68 ].…”

Reproductive History and Pregnancy Incidence of Malian and Beninese Sex Workers Before and Suring Sex Work Practice

“…In West Africa, it is estimated that one in 20 women has ever practiced sex work [6] and most African female sex workers (FSWs) are mothers [7,8]. Sex work is associated with many risks that increase pregnancy complications, as well as maternal mortality and morbidity [9]. Among FSWs, HIV prevalence is 12 times higher than in the general population [8], sexually transmitted diseases are frequent [8], violence is common [10] and access to health services is difficult [11].…”

Reproductive History and Pregnancy incidence of Malian and Beninese Female Sex workers before and During Sex Work Practice

“…In West Africa, it is estimated that one in 20 women has ever practiced sex work [11] and most African female sex workers (FSWs) are mothers [12,13].. Moreover, sex work is associated with many risks that increase pregnancy complications, as well as maternal mortality and morbidity [14]. For example, HIV accounts for 5.5% of the maternal mortality [15] and among FSWs, HIV prevalence is 12 times higher than in the general population [13].…”