240808 Health, Pregnancy and Prostitution

Wednesday, November 2, 2011: 10:50 AM

Amy Raines-Milenkov, DrPH , Department of Obstetrics and Gynecology, University of North Texas Health Science Center, Fort Worth, TX
Claudia Coggin, PhD , Social and Behavioral Sciences, UNTHSC School of Public Health, Fort Worth, TX
Sue Lurie, PhD , Social and Behavioral Sciences, School of Public Health, University of North Texas Health Science Center, Fort Worth, TX
Elena Bastida, PhD , Health Promotion and Disease Prevention, Florida International University, Miami, FL
Ralph Anderson, MD , Texas College of Osteopathic Medicine, University of North Texas Health Science Center, Fort Worth, TX
Background Women involved in street-prostitution face multiple health risks emanating from contextual and behavioral factors. These risks endanger the women's lives, and would also threaten a fetus if pregnancy were to occur. Few studies have focused on these women from a maternal health perspective. Methods Twenty women with prostitution experience were recruited and interviewed in their natural environment. Semi-structured interviews elicited responses on childhood background, prostitution history, reproductive history and outcomes, responses to outcomes, health behaviors and health care access. Results Nineteen participants had been pregnant as a result of intimate partner, rape, and prostitution encounters. Women rarely used contraception with intimate partners or prostitution clients. Although most participants attempted to reduce or eliminate harmful exposures, only 59.7% of pregnancies resulted in infants who lived beyond their first year of life. Similar proportions of pregnancies ended adversely before women entered prostitution (32.4%) and while engaged in prostitution (30%). Over 80% of pregnancies resulting from prostitution encounters ended adversely. Despite numerous health care encounters, participants lacked health insurance, had unmet physical and mental health needs and most were not receiving social services. Conclusion Participants entered prostitution with the burden of adverse childhood experiences, limited resources, and a diminished capacity for obtaining optimal health. Their chances for a healthy pregnancy were thus compromised before prostitution began. The contextual factors of prostitution and lack of resources exacerbated their poor health and increased negative health behaviors and dangerous exposures. Adopting a life course perspective that acknowledges their maternal history and reproductive capability is proposed.

Learning Areas:
Social and behavioral sciences

Learning Objectives:
Identify contextual and behavioral factors influencing the health and pregnancy outcomes of women before and after entering prostitution. Describe the study participantsí pregnancy outcomes and their behavioral and emotional responses to these outcomes. Discuss how applying a life course perspective could guide practice interventions for this vulnerable population of women and their children.

Keywords: Pregnancy Outcomes, Sex Workers

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am qualified to present because I have conducted research on the health and pregnancy experiences of women in prostitution
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.