Committee opinion no. 498: Adult manifestations of childhood sexual abuse.

Long-term effects of childhood sexual abuse are varied, complex, and often devastating. Many obstetrician–gynecologists knowingly or unknowingly provide care to abuse survivors and should screen all women for a history of such abuse. Depression, anxiety, and anger are the most commonly reported emotional responses to childhood sexual abuse. Gynecologic problems, including chronic pelvic pain, dyspareunia, vaginismus, nonspecific vaginitis, and gastrointestinal disorders are common diagnoses among survivors. Survivors may be less likely to have regular Pap tests and may seek little or no prenatal care. Obstetrician–gynecologists can offer support to abuse survivors by giving them empowering messages, counseling referrals, and empathic care during sensitive examinations.