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Case 96 - A 26-Year-Old Presents Late to Prenatal Care with Her Partner and Has a Flat Affect and Limited English Proficiency

from Section 11 - Psychosocial Considerations

Published online by Cambridge University Press:  08 April 2025

By
Deepti Sharma
Edited by
Peter F. Schnatz ,
D. Yvette LaCoursiere ,
Christopher M. Morosky ,
Jonathan Schaffir ,
Vanessa Torbenson  and
David Chelmow
Peter F. Schnatz
Affiliation:
The Reading Hospital, Pennsylvania
D. Yvette LaCoursiere
Affiliation:
University of California, San Diego
Christopher M. Morosky
Affiliation:
University of Connecticut School of Medicine
Jonathan Schaffir
Affiliation:
The Ohio State University College of Medicine
Vanessa Torbenson
Affiliation:
Mayo Clinic Alix School of Medicine
David Chelmow
Affiliation:
Virginia Commonwealth School of Medicine
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Summary

Human trafficking is an international problem that involves involuntary or forced labor. This can occur in a range of settings including sex work, agriculture, manufacturing, and hospitality. Patients may present in the gynecology office with sexually transmitted infections, pregnancy, mental health conditions, poor health or neglect, substance use disorders, and injuries. Providers should be familiar with red flags for trafficking and screen patients appropriately. With a positive screen, the patient’s safety needs to be immediately assessed. Trafficking can be reported to the National Human Trafficking Hotline. Providers should be aware of and follow local laws for reporting. Appropriate care should be provided to the patient based on presenting symptoms, including a history and physical exam, sexually transmitted infection testing, imaging, and mental health screenings as indicated. There are limited data regarding outcome of pregnancies in people who are trafficked. Care should be provided using trauma-informed principles.

Keywords

human traffickinglabor traffickingsex traffickingtraumatrauma-informed care
Type
Chapter
Information
Pregnancy Complications
A Case-Based Approach
 , pp. 301 - 303
Publisher: Cambridge University Press
Print publication year: 2025

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References

ACOG Committee Opinion #787: Human Trafficking. Obstet Gynecol. 2019;134:90–95.CrossRefGoogle Scholar
National Human Trafficking Hotline. Recognizing the Signs. https://humantraffickinghotline.org/en/human-trafficking/recognizing-signs (accessed August 2, 2023).Google Scholar
Family Violence Prevention Fund. Turning Pain into Power: Trafficking Survivors’ Perspectives on Early Intervention Strategies 2005. www.futureswithoutviolence.org/userfiles/file/ImmigrantWomen/Turning%20Pain%20intoPower.pdf (accessed August 2, 2023).Google Scholar
Prakash, J, Oriola, B, Kurtzer, T, et al. “Praying for Freedom”: A Story of Labor Trafficking during Pregnancy. Am J Obstet Gynecol MFM. 2023;5:100873.Google Scholar
Tracy, EE, Macias-Konstantopoulos, W. Identifying and Assisting Sexually Exploited and Trafficked Patients Seeking Women’s Health Care Services. Obstet Gynecol. 2017;130(2):443–453.CrossRefGoogle ScholarPubMed
Simich, L, Goyen, L, Powell, A, et al. Improving Human Trafficking Victim Identification: Validation and Dissemination of a Screening Tool. Final Report. Washington, DC: National Institute of Justice; 2014. www.ojp.gov/pdffiles1/nij/grants/246712.pdf (accessed October 20, 2024).Google Scholar
Adult Human Trafficking Screening Toolkit and Guide. Washington, DC: US Department of Health and Human Services; 2018.Google Scholar
National Human Trafficking Hotline. Framework for a Human Trafficking Protocol in Healthcare Settings. https://humantraffickinghotline.org/en/resources/framework-human-trafficking-protocol-healthcare-settings (accessed August 2, 2023).Google Scholar
ACOG Committee Opinion #825: Caring for Patients Who Have Experienced Trauma. Obstet Gynecol. 2021;137:94–99.CrossRefGoogle Scholar
Engler, LA, Mercer, L. Assessment of Human Trafficking Knowledge among Staff in a Tertiary Care Academic Medical Center [05G]. Obstetr Gynecol. 2020;135:71S–72S.CrossRefGoogle Scholar

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