Identifying and Assisting Women Who Are Being Trafficked

Background and Objective

Human trafficking (the recruitment, harboring, transportation, provision, or obtaining of a person for labor or services, through the use of force, fraud, or coercion for the purpose of subjection to involuntary servitude, peonage, debt bondage, or slavery [U.S. Department of State]) affects about 400,000 individuals in the U.S. daily, primarily in the commercial sex industry. Trafficked women, adolescents, and children may present for healthcare, affording clinicians the opportunity to identify and help them. Now, ACOG has updated its recommendations regarding human trafficking.

Key Recommendations

• Recognize indicators of trafficking:

  • Scripted or inconsistent history

  • Signs of physical/sexual abuse or torture

  • Hesitancy answering questions about an injury or illness

  • Presence of an accompanying individual who speaks for the patient or insists on serving as an interpreter

  • Excessive concern about pleasing a family member, partner, or employer

  • Fearful, nervous, or hostile behavior

  • Resistance to assistance

  • Inability to provide an address or identification

• Be aware of common presenting health problems (sexually transmitted infections, substance use, mental health issues, and physical trauma).

• Evaluate medical and nonmedical needs in a safe environment (maintain approachable body language, listen without simultaneously note-taking, clarify what services you can offer, build trust).

• Be aware of local laws for reporting suspected human trafficking (however, other than mandatory requirements, law enforcement and social services should not be contacted about a competent adult without consent).

• Provide resources (brochures, pamphlets, and pocket cards) and contact information for organizations and resources that support survivors of trafficking.