Background: The American Academy of Pediatrics (AAP) and the American College of Obstetricians and Gynecologists (ACOG) recommend that screening for physical abuse during prenatal care visits become routine. Although prenatal care visits offer a unique intervention opportunity, screening is not yet standard practice. Data and Methods: We used data from the 1996-1997 Pregnancy Risk Assessment Monitoring System (PRAMS) to assess prevalence and factors associated with health care providers' discussion of physical abuse with pregnant mothers in14 states. PRAMS is a state-specific, population-based surveillance system that collects information on maternal behaviors from mothers 2-6 months postpartum. Descriptive statistics and logistic regression models were used to assess the study objectives. Results: Across states, 22%-39% of women reported a health care provider talked with them about physical abuse during prenatal care visits. Among respondents, the prevalence of physical abuse 12-months before pregnancy ranged from 5% to10%. Although we found consistent predictors of discussion of abuse across states (Medicaid use, education, age, ethnicity, race), there were some important state-specific differences. Physical abuse 12-months before the most recent pregnancy, type of prenatal care provider, marital status, pregnancy intendedness, trimester prenatal care started, and drug use by someone close were associated with discussion of physical abuse in one to five states. Conclusion: Across states, most pregnant women did not report prenatal abuse discussion. Provider intervention programs may need to consider both across-state and state-specific predictors to create more effective intervention strategies and to increase discussion of physical abuse during prenatal care visits.
Learning Objectives: A session participant will learn about 1) the guidelines for including counselin about physical violence during prenatal care, 2)prevalence of discussion of abuse during prenatal care accross 14 states, 3) state-specific differences in factors associated with prenatal discussion of abuse.
Keywords: Prenatal Care, Violence
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.