Too Few Pregnant Women Are Screened for Partner Violence, Claims Study

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Too Few Pregnant Women Are Screened for Partner Violence, Claims Study

Screening for intimate partner violence occurs infrequently during prenatal care visits, according to a study published in the November/December issue of the Archives of Family Medicine. The authors of the study analyzed data from the North Carolina Risk Assessment Monitoring System survey of 2,189 women to measure the prevalence of partner violence screening among pregnant women. They also examined the data to determine whether there was an association between screening status and sociodemographic characteristics, health system factors (timing of prenatal care initiation, participation in WIC, source of prenatal care, and source of payments for prenatal care), and experiences of partner violence.

The study's findings include the following:

• 37% of the women reported being screened for partner violence during prenatal care;
• Women were more likely to have been screened if 1) they were unmarried rather than married, 2) they were unemployed rather than employed, 3) they received some type of public assistance (compared to those receiving no public assistance), 4) they were under 20 rather than 20 or above, 5) they received WIC (compared to those who did not receive WIC), 6) their prenatal care was paid for by a public source (compared to those whose was not), and 7) they received their prenatal care from a public provider (compared to those who did not); and
• African-American women were more likely than women of other racial ethnicities to have been screened.

The authors acknowledge the following study limitations: 1) the findings may be confounded because women receiving public prenatal care may also have been receiving WIC, 2) self-reported data may have resulted in recall and response bias, and 3) the sample was representative of women in North Carolina but may not have been representative of women in other states.

The authors suggest that clinical environment, connections with social service organizations, and provider type (e.g., physicians, nurse practitioners, certified nurse midwives) may be barriers to screening. They conclude that we need a "multilevel approach of increased provider training, standardized and effective tools for screening, and appropriate and effective referral and interventions to decrease the occurrence of partner violence."

Clark KA, Martin SL, Petersen R, et al. 2000. Who gets screened during pregnancy for partner violence? Archives of Family Medicine 9(10):1093-1099.

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MCH Alert. 2001. Arlington, VA: National Center for Education in Maternal and Child Health. http://www.ncemch.org/alert.