Intimate partner violence (IPV) is a social reality occurring as physical, psychological or sexual abuse. Among women, and pregnant women in particular, prevalence varies by country and clinical setting but is recognized as a significant health problem. Risk factors are identified as age, socioeconomic status, minority status and marital status (Bailey, 2010). In gravid women, IPV has been associated with undesirable pregnancy outcomes arising from physical trauma, mental health issues, STD and genitourinary infections, as well as unfavorable health behaviors. To address IPV, universal screening coupled with zero tolerance policies has been recommended but current clinical practice varies across health care settings. This is due to time constraints and attitudes on the part of health care professionals and the reluctance of women to disclose information. However, studies show that using an appropriate method of questioning promotes disclosure so that interventions focusing on the patient and the perpetrator can be done. Providers need further training for them to effectively assess and manage pregnant IPV. Additional research should generate evidence on the efficacy of current interventions.
The study relates to nursing in that nurses have a role in enhancing the health and wellbeing of women experiencing IPV. Being in the frontline of care, nurses are in the position to elicit information on IPV and facilitate its management. Moreover, nurse managers have the capacity and authority to initiate policy changes, educate staff nurses and formulate practice guidelines in compliance with present recommendations. In summarizing what is known about IPV among pregnant women, the paper provides comprehensive information which can guide practice and allows gaps in information to be identified.
The author holds the opinion that routine screening must be implemented along with interventions if these are warranted and to this end, provider training and research-based guidelines must be addressed. (Bailey, 2010). Although I agree that pregnant IPV is a significant issue, having training and guidelines are not enough to support nursing care in this area. With current nurse-patient ratios, nurses often experience work overload. They lack the time to investigate especially since the issue is a sensitive one. Rapport needs to be developed in order for patients to have enough trust to open up about the abuse. With time constraints, assessment and management cannot be accomplished. Therefore, training and practice guidelines should be within the context of sufficient staffing.
On the whole, the paper is descriptive and very informative covering the definitions of IPV, its prevalence among women in general and among pregnant women in particular, the risk factors, the effects on pregnancy outcomes and how these take place, current recommendations, screening practices, provider attitudes, screening tools, and management. The author is a physician but the content of the article is also useful to nurses. The paper underscores the need for further studies from the perspective of nurses in the areas of enhancing practice through the generation of research evidence on the efficacy of interventions, and also organizational changes so that policies and systems support nursing care for IPV.
References
Bailey, B.A. (2010). Partner violence during pregnancy: prevalence, effects, screening and management. International Journal of Women’s Health, 2010(2), 183-197.
