Sequelae of abuse. Health effects of childhood sexual abuse, domestic battering, and rape.

Violence against women is endemic in the United States. One third to one half of all women will experience one or more types of abuse in their lifetime, most often at the hands of a family member or an intimate or formerly intimate partner. One in 12 women is battered during pregnancy. Abuse survivors are disproportionately frequent users of health care services because of acute and chronic physical, somatic, emotional, and behavioral sequelae of abuse. Health care practitioners are often the first contact abuse survivors have with a potentially helping professional. It is, therefore, essential that health care providers learn to identify and to intervene appropriately with survivors of abuse. This article reviews and compares the health effects of three of the most common types of violence against women: childhood sexual abuse, domestic battering, and rape. Sequelae are divided into six categories: physical/medical, somatic, emotional/ psychological, social/interpersonal, behavioral/sexual, and pregnancy-related effects. The health effects discussed in this article include research findings, as well as effects noted in clinical practice. Recommendations are made for routine screening of all women for past and current abuse, as well as for intervention strategies.