Online Program

Falling through the cracks: Missed opportunities to counsel victims of partner violence during prenatal care

Tuesday, November 5, 2013 : 10:30 a.m. - 10:50 a.m.

Susan Cha, MPH, PhD, Department of Family Medicine and Population Health, Division of Epidemiology, Virginia Commonwealth University, School of Medicine, Richmond, VA
Saba Masho, MD, MPH, DrPH, Department of Family Medicine and Population Health, Division of Epidemiology, Virginia Commonwealth University, Richmond, VA
Background: Five million women are physically, sexually, and emotionally abused by intimate partners in the U.S. each year. Despite the severe health consequences and costs associated with intimate partner violence (IPV), a vast majority of cases go unreported and most health providers fail to assess patients for abuse. Objectives:To assess the extent to which women who experience IPV actually receive education on partner violence from health care providers during any prenatal care (PNC) visits. Methods:This study analyzed the 2004-2008 National Pregnancy Risk Assessment Monitoring System which included 202,367 women who delivered a live birth in the U.S. IPV victimization was measured using four items that addressed physical abuse by a current or former husband/partner in the 12 months before or during pregnancy. Responses were categorized as preconception, prenatal, and preconception and/or prenatal IPV. The outcome was receipt of IPV education by a health care worker during PNC. Separate logistic regression models provided crude and adjusted odds ratios and 95% confidence intervals. Results:Women who reported prenatal IPV were less likely to receive IPV education during PNC (OR=0.81,95%CI=0.70-0.94). Among racial/ethnic minorities, women who experienced preconception IPV were less likely to receive IPV education. Further, Medicaid recipients who reported preconception and/or prenatal IPV were less likely to receive IPV education (OR=0.76,95%CI=0.70-0.83). Conclusion:Results underscore a public health problem and missed opportunity to connect battered victims to necessary services and care. Results from the study can elucidate the state of current clinical practice and better inform policies on incorporating universal IPV screening/education into routine care.

Learning Areas:

Advocacy for health and health education
Other professions or practice related to public health
Provision of health care to the public
Public health or related public policy
Public health or related research

Learning Objectives:
Identify vulnerable populations who are not receiving education on partner violence from health providers (Medicaid recipients and racial/ethnic minority groups) Discuss missed opportunities by health care providers to help women who are victims of partner violence during preconception or prenatal period

Keyword(s): Violence, Pregnancy

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a pre-doctoral candidate in epidemiology at Virginia Commonwealth University with experience in teaching and research. My prior work as a Congressional health fellow for a federal legislator included helping to pass a national teen pregnancy and dating violence prevention bill in 2011. My interests are in the areas of partner violence, maternal and infant health, and disparities in access to health care.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.