Hinden, P. K. (2006). Journal of Midwifery and Women's Health, 51, 216-220.
Does every pregnant woman get screened for intimate partner violence as recommended by many U.S. nursing, midwifery, and physician professional organizations? Universal screening is recommended at four times during pregnancy and postpartum: at the initial prenatal visit, once during the second and third trimesters, and again during a postpartum visit. The aim of this study was to determine the practice of CNMs regarding this screening. Eight CNMs who were in full-time clinical practice responded to the recruitment letter and were interviewed for the study.
The results indicated that the midwives were concerned about, interested in, and knowledgeable about the screening, and all conducted screening at the initial patient interview. Further screenings during pregnancy and postpartum, however, were inconsistent. The reasons were that the midwives did not find time in their busy schedule or that they were "saving the woman" from the questions. When further screening was done, it was often because of a midwife's gut reaction or clues. Among these clues were behavioral clues indicating that "something is not right" and cultural clues and physical signs and symptoms, such as bruises. The midwives felt that they established a trusting relationship with the pregnant woman, which was important for successful screening. At the same time, however, they feared asking about violence because they were not sure how to respond to a positive answer.
This important study shows us that screening for violence is a difficult part of taking care of a pregnant woman, despite the many studies that have supported the recommendations. We do need to screen every woman for intimate partner abuse, regardless of her socioeconomic status, educational level, or ethnicity.
Sigridur Sia Jonsdottir