Intimate Partner Violence Screening and Pregnant Latinas
Rodriguez, Michael, Shoultz, Jan, Richardson, Erin, Violence and Victims
Little is known about factors associated with health care screening of intimate partner violence (IPV) for Latinas during pregnancy. This study builds on current research examining IPV-associated outcomes among Latinas by analyzing 210 pregnant Latina responses to a patient survey. A multivariate logistic regression model examined factors associated with being screened for IPV. One-third of pregnant women reported being screened for IPV. Factors related to being screened for IPV are reported and did not match those associated with having experienced IPV. While most pregnant Latinas were not screened for IPV, having systematic processes in place for IPV screening and fostering good patient-provider communication may facilitate identification of IPV. Having a greater awareness of the risk factors associated with IPV may also provide cues for clinicians to better address the issue of IPV.
Keywords: intimate partner violence; communication; health indicators; screening
Women who experience intimate partner violence (IPV) are more likely to suffer from health problems than women without IPV (Coker, Bethea, Smith, Fadden, & Brandt, 2002). Each year, morbidity and mortality result from 5.3 million cases of IPV in the United States (Tjaden & Thoennes, 2000). The prevalence of IPV during pregnancy ranges from 6% to 21% (Anderson, Marshak, & Hebbeler, 2002; Gazmararian et al., 1996). IPV is widespread, cutting across all populations; however, it is more prevalent among minorities and women of lower socioeconomic status (Tjaden & Thoennes, 2000). While there is increased risk for IPV among women who are younger or of low income or those who experienced childhood trauma, all women carry some risk for IPV (Tjaden & Thoennes, 2000).
Pregnant women who experience IPV are at increased risk for several adverse health conditions. Depression and posttraumatic stress disorder are common conditions associated with IPV (Bonomi et al., 2006; Flynn, Walton, Chermack, Cunningham, & Marcus, 2007; Lipsky, Field, Caetano, & Larkin, 2005). IPV among pregnant women is of great concern because of the deleterious impact on the pregnancy, such as antepartum hemorrhage, intrauterine growth retardation, perinatal death, abortion/miscarriage, low birth weight, preterm labor, and risk for homicide (Anderson et al., 2002; Glander, Moore, Michielutte, & Parsons, 1998; Hedin & Janson, 2000; Janssen et al., 2003; McFarlane, Campbell, Sharps, & Watson, 2002; Murphy, Schei, Myhr, & Du Mont, 2001). Moreover, pregnant women exposed to IPV are more likely to obtain prenatal care later in their pregnancy, making it more difficult to address potential complications (Anderson et al., 2002; McFarlane, Parker, Soeken, & Bullock, 1992).
The American College of Obstetrics and Gynecology (ACOG) recommends screening all women for IPV because of its high prevalence and associated adverse health consequences (ACOG, 2006). In August 2006, the Committee on Health Care for Underserved Women developed a statement endorsing screening of IPV as part of the comprehensive care that women receive when seeking pregnancy evaluation or prenatal care (ACOG, 2006). Even still, few clinicians routinely screen for IPV, leading to low rates of detection (Glass, Dearwater, & Campbell, 2001; Kaur & Herber, 2005; McCaw, Berman, Syme, & Hunkeler, 2001) despite the availability of brief and valid IPV screening tools for Latinas and other women (Soeken, McFarlane, Parker, & Lominack, 1998; Wrangle, Fisher, & Paranjape, 2008). Moreover, not all professional organizations agree that screening should be conducted universally (U.S. Preventive Services Task Force, 1996).
Factors associated with screening are generally associated with a perceived risk for abuse (Witting et al., 2006). Without universal screening procedures in place, screening generally occurs for those who are suspected of being involved in abusive relationships (Horan, Chapin, Klein, Schmidt, & Schulkin, 1998). …