Identifying Intimate Partner Violence at Entry to Prenatal Care: Clustering Routine Clinical Information

Abstract

Intimate partner violence (IPV) is the greatest trauma-related risk to American women. Pregnant women are no exception, and escalation of IPV frequently occurs during pregnancy. Many studies have linked IPV during pregnancy to adverse maternal and fetal outcomes. This study examined IPV at the beginning of prenatal care to identify correlates of routine entry-to-care information with responses on a validated IPV screening tool, the Abuse Assessment Screen. The purpose of the study was to identify specific data from routine, standard intake information, which could alert clinicians to the potential of violence even in the presence of a negative IPV score or no formally administered screening tool. The point prevalence of abuse, as measured by the Abuse Assessment Screen at entry to care, was slightly in excess of the national mean, reinforcing the need for continual assessment throughout pregnancy. Abused women in this study were more likely to be young, single, and without family or partner support. These women relied on friends for support, admitted to depression, and desired their pregnancies. The findings are consistent with previous studies. Further research needs to be conducted to determine if this cluster of findings at entry to care, with or without a positive score on an IPV screening tool, are consistent markers for an increased risk of IPV.

Depression during pregnancy: prevalence and risk factors among women attending a public health clinic in Rio de Janeiro, Brazil

“…The prevalence of physical violence during pregnancy was similar to that reported in prior Brazilian studies 29,69,70 . This violence is mainly committed by intimate partners, and is an important risk factor for depression in women 5,7,29,70,71,72,73,74 . Additionally, gender-based violence has adverse consequences for fetal and maternal survival 29,69,72,73 .…”

Domestic Violence against Women during Pregnancy: The Case of Palestinian Refugees Attending an Antenatal Clinic in Lebanon

“…[5][6][7][8] A study reports that the prevalence of IPV in the prepregnancy period reaches 23%-25% but increases to 52% during pregnancy. 9 Studies conducted in developing nations report that between 4% and 29% of all women are abused during pregnancy. [10][11][12] A growing body of evidence has linked domestic violence against women to a range of adverse reproductive health outcomes, including nonuse of contraception and unwanted pregnancy, 10,[13][14][15][16][17][18][19][20] as well as obstetric complications and depressive symptomatology.…”

“…Violence against women is a complex problem that cannot be attributed to a single cause but to a diverse set of factors, including demographic, 4,9,29,30 socioeconomic, 4,9,[29][30] and cultural ones. 4,29,[31][32] The link between DV against women generally and specifically during pregnancy has been established, and previous research indicates that many of the same factors are salient.…”

Depression During Pregnancy: Review of Epidemiological and Clinical Aspects in Developed and Developing Countries

“…However, poverty and violence are both independent risk factors for gestational depression, which suggests that maternal mental health prevention strategies should include policies that aim at decreasing violence and offer financial aid to women in low income countries (Lovisi et al, 2005). Domestic violence against women during pregnancy, particularly when committed by the woman's partner, has several negative impacts on the baby's intra-uterine health and the mother's mental health, particularly in the development of gestational depression (Anderson et al, 2002;Ferri et al, 2007;Fisher et al, 2010;Gavin et al, 2010;Leigh & Milgrom, 2008;Lovisi et al, 2005;Patel et al, 2002;Rodriguez et al, 2008). Financial hardships, unemployment, and low education levels stand out as risk factors for gestational depression (Faisal-Cury & Rossi-Menezes, 2007;Fisher et al, 2010;Gavin et al, 2010;Leigh & Milgrom, 2008;Martinéz et al, 2008;Mitsuhiro et al, 2006;Mohammad et al, 2010;Patel et al, 2002;Pereira et al, 2009;Pottinger et al, 2009;Qiao et al, 2009;RichEdwards et al, 2006;Silva et al, 2010;Spoozak et al, 2009).…”