Care for Sexual Violence Survivors

Hitomi Takemoto

Reiwa Health Sciences University, Japan

Title: Professional Care Guide: Supporting Sexual Violence Survivors in OB/GYN Outpatient Settings in Japan

Abstract

In Japan, the clinical management of sexual violence survivors in obstetrics and gynecology (OB/GYN) outpatient settings presents a complex challenge that requires specialized intervention from nurses and midwives. Standard protocols often fail to adequately address the unique legal and neurobiological needs of survivors, making the refinement of clinical practices an urgent priority.

We developed professional care protocols for midwives and nurses supporting sexual violence survivors in OB/GYN outpatient settings in Japan. This guide was rooted in research results from police participants, ensuring the protocol meets the practical demands of the criminal justice system. This guide aims to bridge the gap between immediate medical care and forensic preservation, ensuring that clinicians support long-term recovery while maintaining the integrity of the survivor’s forensic narrative. This work was supported by JSPS KAKENHI Grant Numbers JP19K10995 and JP23K10076.

The key components are as follows:

Ensure strict environmental privacy, such as providing private waiting areas to prevent survivors from encountering general patients.
Facilitate effective information sharing among medical staff to anticipate forensic needs without requiring survivors to repeatedly disclose traumatic experiences.
Avoid redundant questioning, which is clinically inappropriate, causes severe psychological distress, and increases the risk of “memory contamination,” potentially compromising legally reliable testimony.
Conduct comprehensive documentation and photographic recording of whole-body, non-genital injuries. Address critical gaps in forensic evidence collection, including inconsistent DNA sampling from the oral mucosa, gums, and under fingernails, as well as failure to obtain toxicology samples in cases of suspected drug- facilitated assault.
Provide referrals to specialized facilities such as One-Stop Support Centers.
Preserve the survivor’s dignity by maintaining a compassionate attitude and providing thorough explanations prior to any clinical procedures, thereby restoring a sense of control to the patient.
Practice communication minimalism based on judicial interviewing principles, limiting inquiries strictly to what is clinically and forensically necessary to prevent memory contamination.

The mission of OB/GYN outpatient care is dual: to provide immediate medical support while preserving legally sound forensic evidence. As forensic healthcare professionals, clinicians serve as guardians of survivors’ future access to justice.

Furthermore, healthcare professionals must actively manage their own emotional “landmines,” including personal biases or triggers related to sexual violence, to prevent compassion fatigue. Providers must recognize their internal vulnerabilities and maintain the professional boundaries necessary to deliver dignified and restorative care to every survivor.

(This work was supported by JSPS KAKENHI Grant Numbers JP19K10995 and JP23K10076.)

Audience Takeaways:

Clear understanding of standardized care protocols: Participants will learn evidence-based, structured approaches for supporting sexual violence survivors in OB/GYN outpatient settings.
Practical application in clinical settings: Attendees will be able to immediately apply step-by-step care protocols (e.g., initial response, trauma-informed communication, documentation, and referral pathways) in their daily practice.
Improved patient-centered and trauma-informed care skills: The presentation will enhance clinicians’ ability to provide sensitive, ethical, and survivor-centered care, improving patient trust and outcomes.
Framework for interprofessional collaboration: Participants will gain strategies for coordinating with multidisciplinary teams (e.g., social workers, legal services), strengthening continuity of care.
Foundation for education and further research: Faculty and researchers can use the presented protocol as a basis for curriculum development, simulation training, or future studies evaluating care quality and outcomes.

How This Helps the Audience in Their Work?

Enhances clinical competence in responding to sexual violence cases with confidence and consistency
Reduces variability in care, leading to safer and more equitable patient support
Improves documentation and legal preparedness, which is critical in forensic contexts
Supports teaching and training, especially for nursing and midwifery educators
Provides a scalable model that can be adapted across institutions or cultural contexts

Speakers - 2026

Title: Professional Care Guide: Supporting Sexual Violence Survivors in OB/GYN Outpatient Settings in Japan

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