Uptake of gynecological consultation following domestic or sexual violence: A case-control study in the context of induced abortion

Objective: The aim of this study was to determine the prevalence of domestic and sexual violence and to characterize the association between exposure to domestic and sexual violence and low uptake of gynecological care, in the context of induced abortion.

Study design: We conducted a case-control study among women seeking abortion care, in mother and child centers and sexual health centers in the Paris, France area (April 2022-March 2023).

Results: A total of 103 women were included in the study during induced abortion care. Physical, psychological or sexual domestic violence was reported by 48.5 % and sexual violence, whoever the perpetrator, was reported by 23.3 %. In the bivariate analysis, a history of physical, psychological or sexual domestic violence was not associated with the absence of a gynecological consultation in the past two years, compared with no history of intimate partner violence (p = 0.09). After adjustment for regular pelvic pain, dysmenorrhea, vulvodynia and dyspareunia, there was no association between a history of sexual violence and the absence of a gynecological consultation in the past two years (OR 1.05; CI95% 0.27-4.13, p = 0.93).

Conclusion: Violence was a common finding among women seeking abortion care. We did not find any association between a history of sexual violence and the absence of a gynecological consultation in the past two years. We suggest investigating multiple or frequent use of gynecological care following violence. The combination of ethical, moral, and psychological constraints associated with violence screening and abortion care is a challenge to patient recruitment in future studies.