Domestic Violence Maternal, Infant & Child Health Care
Developed by the
NYS Office for the Prevention of Domestic Violence
Our Agenda
- Impact of domestic violence
- Screening/identification
- Documentation
- Appropriate treatment and referral
Importance
- Impact on your patient population
- Standard of care
- Costs of not identifying and treating
Who Are The Victims
- Could be anyone
- Most victims are women
- Lesbian, bisexual and transgender victims
Domestic Violence
- Pattern of coercive tactics
- Physical abuse
- Psychological abuse
- Sexual abuse
- Economic abuse
- Emotional abuse
- Perpetrated against an intimate partner
- Power and control
Health Care Manifestations of Domestic Violence
Physical Abuse
- Bruises and lacerations to breasts or abdomen
- Delay in seeking prenatal care
- Use of cigarettes, drugs or alcohol
- Poor nutrition
- Hemorrhaging, placental separation
- Miscarriage, stillbirth
- Pre-term labor
Psychological Abuse
- Depression
- Suicidal or homicidal ideation
- Substance abuse
- Anxiety, hypertension
- Psychosomatic illness
Sexual Abuse
- STDs, HIV
- Multiple pregnancies
- Injuries to abdomen, breasts and genitalia
- Spontaneous abortion
Economic Abuse
- Reluctance to schedule additional tests, appointments or accept needed prescriptions
- Depression
- Headaches, Migraines
- Anxiety
Emotional Abuse
- Depression
- Hypertension
- Substance abuse
- Suicidal or homicidal ideation
- Psychosomatic illness
Your Roles & Responsibilities
R A D A R
- Routinely screen female patients
- Ask direct questions
- Document your findings
- Assess patient safety
- Review options and referrals
Routine screening
- Conduct screening at:
- Routine ob-gyn visits
- Pediatric visits for any of her children
- Family planning visits
- Preconception visits
Routine screening
- For pregnant women, conduct screening at:
- First prenatal visit
- At least once per trimester
- Postpartum checkup
- Pediatric visits for any of her children
Routine screening
- Ask about relationship(s) with partner and former partners
- Review medical history
- Observe patient behavior
Ask Direct Questions
- Universal approach
- Be prepared to hear the answer
Validation
- Believe the victim
- Empathize
- Offer positive message
Document
- Document:
- Patient’s complaint/symptoms
- Patient’s injuries
- Your observation/assessment
- Patient’s explanation of injuries
- What you did
Assess Patient Safety
- Conduct quick assessment of safety
Review Options and Referrals
- Identify in-house options
- Provide domestic violence hotline numbers
- Provide patient with Are You and Your Baby Safe?
- Provide Victims Rights Notice, if applicable
Support
- Support victim’s decisions
- Become familiar with resources
- Link patient/victim with those services
R A D A R
- Routinely screen female patients
- Ask direct questions
- Document your findings
- Assess patient safety
- Review options and referrals
Thank you