Harare – Health-care workers play a critical role in protecting the lives, well-being, and dignity of survivors of rape. For a child or adolescent who becomes pregnant as a result of rape, that role becomes even more important. Pregnancy following rape is not merely a medical condition requiring antenatal care; it is often a continuation of trauma that affects every aspect of a survivor’s life, including their physical health, mental wellbeing, education, relationships, future aspirations, and social standing. For many pregnant rape survivors, the first professional they encounter after disclosure is a nurse, doctor, midwife, psychologist, or counsellor.
In those critical moments following trauma, the response and demeanour of a healthcare worker can make the difference between fear and safety, silence and disclosure, hopelessness and recovery, and in some circumstances, life and death. Survivors need someone who will listen with empathy, patience, and without judgment. Sometimes, simply giving a survivor time to speak, responding with understanding, and allowing her to make informed decisions about her care can be more powerful than any medication or clinical intervention. This is particularly important for children and adolescents who may already be overwhelmed by fear, confusion, shame, and uncertainty.
Recognising the need for compassionate and survivor-centred care, the World Health Organization (WHO) developed the Clinical Management of Rape and Intimate Partner Violence Survivors guidelines. Central to these guidelines is the LIVES approach, a first-line support guide involving the following five simple elements:
Listening
Inquiry
Validate
Enhancing Safety
Supporting
The World Health Organization (WHO) notes that first-line support is an essential component of care and may be provided whether or not a survivor chooses to undergo physical examination or pursue additional medical treatment. For pregnantrape survivors, the LIVES approach provides a critical foundation for holistic care.
Listening
The first element of the WHO framework is Listening. Healthcare workers are encouraged to listen attentively, observe carefully, and respond with empathy and without judgment. Listening is more than hearing words; it is creating a safe space where a survivor feels heard, respected, and believed.
For a pregnant rape survivor, this may mean allowing her to express fears about the pregnancy, concerns about family reactions, worries about school, or uncertainty about her future. The WHO recognises listening as the foundation of good communication and emotional recovery. Healthcare workers can demonstrate empathy through statements such as:
“I hear how difficult this has been for you.”
“What happened to you should never have happened.”
“Thank you for trusting me with this information.”
Simple affirming statements can help survivors feel supported during one of the most vulnerable moments of their lives.
Inquiring About Needs and Concerns
The second element is Inquiring. Pregnant rape survivors often have multiple and interconnected needs extending beyond clinical management of pregnancy. They may require psychosocial support, child protection services, legal assistance, educational support, shelter, financial assistance, family mediation, or safeguarding interventions.
The WHO emphasises that understanding a survivor’s needs and concerns allows healthcare workers to provide meaningful and tailored support. For example:
Does the survivor feel safe where she lives?
Is she still at risk from the perpetrator?
Does she have family support?
Has she stopped attending school?
Does she understand the options available to her?
Does she have access to basic necessities?
By asking these questions sensitively, healthcare workers can identify critical risks and connect survivors to appropriate services.
Validating
The third element is Validating. Many pregnant rape survivors carry a heavy burden of guilt, shame, and self-blame. They may have been told that the violence was their fault or may blame themselves
for circumstances beyond their control. Validation communicates that the survivor is believed, respected, and supported.
Healthcare workers should reassure survivors that:
The rape was not their fault;
They are not responsible for the pregnancy;
Their reactions are understandable;
They deserve protection and support;
Their future remains valuable and worth investing in.
The WHO highlights that validation helps survivors understand that their feelings are normal and that they have a right to live free from violence, fear, and abuse. For many survivors, hearing the words, “I believe you,” can be a transformative moment in their healing journey.
Enhancing Safety
The fourth element is Enhancing Safety. Pregnant rape survivors may continue to face significant threats to their safety. Some remain in contact with perpetrators. Others face family rejection, emotional
abuse, forced marriage, community stigma, or threats intended to silence them. Healthcare workers have an important role in helping survivors assess risks and develop practical safety plans. This may involve referrals to Social Welfare, child protection services, legal aid providers, safe shelters, police services, or community protection structures.
Safety planning should also address emotional safety, educational continuity, and long-term wellbeing. For children and adolescents, maintaining access to education, supportive caregivers, and protective environments can significantly improve recovery outcomes.
Supporting
The final element is Supporting. The needs of pregnant rape survivors often extend beyond what can be provided within a clinic setting. Healthcare workers therefore play a critical role in helping survivors access information, services, and social support.
Support may include referrals to:
Mental health and psychotherapy services;
Child protection services;
Social Welfare support;
Legal assistance;
Educational support programmes;
Parenting preparation services;
Adoption counselling services where appropriate;
Economic empowerment programmes;
Community support groups.
Pregnant rape survivors often require long-term support that extends beyond delivery. Some may struggle with parenting responsibilities. Others may experience grief, separation anxiety, or emotional distress if a child is placed for adoption. Ongoing counselling and psychosocial support are therefore essential. The reality is that the consequences of rape-related pregnancy can persist for years if survivors do not receive comprehensive support. Educational disruption, poverty, social isolation, poor mental health, and ongoing trauma can affect survivors long after the immediate crisis has passed.
This is why healthcare workers must view their role as extending beyond clinical management. Every interaction represents an opportunity to restore dignity, promote healing, and strengthen resilience. By responding with compassion, empathy, and professionalism, healthcare workers can help survivors navigate one of the most difficult periods of their lives. While the WHO’s LIVES framework provides clear guidance on supporting survivors, it is equally important to ensure that health personnel remain aware of these guidelines and are continuously trained on their application, particularly when caring for pregnant rape survivors who often require complex, multidisciplinary support.
Lives can indeed be saved through a coordinated approach, and it is heartening to note that Zimbabwe continues to localise these international standards through national protocols, multisectoral response systems, and the work of institutions such as the Adult Rape Clinic. By strengthening survivor-centred care, investing in healthcare worker capacity, and ensuring access to comprehensive services, we can
help ensure that pregnant rape survivors receive not only medical treatment, but also the compassion, protection, and support they need to heal, recover, and reclaim their futures.
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