Citation

Chisholm CA, Bullock L, Ferguson JEJ. Am. J. Obstet. Gynecol. 2017; 217(2): 145-149.

Affiliation

W. Norman Thornton, Jr., Professor and Chair, Department of Obstetrics and Gynecology, University of Virginia, School of Medicine, Charlottesville, VA. Electronic address: jef2a@virginia.edu.

Copyright

(Copyright © 2017, Elsevier Publishing)

DOI

10.1016/j.ajog.2017.05.043

PMID

28551447

Abstract

In the first part of this review, we provided currently accepted definitions of categories and subcategories of IPV, and discussed the prevalence and health impacts of IPV in non-pregnant and pregnant women. Herein we review current recommendations for IPV screening and the evidence surrounding effectiveness of IPV interventions. Screening for IPV may include exclusively identification of victims of IPV, or both the identification of and intervention for victims. Until recently, many professional organizations did not recommend universal screening for IPV, either due to lack of evidence of effectiveness of screening, lack of evidence demonstrating that screening is not harmful, and/or lack of consensus regarding the most effective screening tool. The lack of evidence supporting an intervention posed an additional barrier to screening. The American College of Obstetricians and Gynecologists has been a staunch advocate for universal IPV screening, even when other groups either did not endorse screening or recommended it only for high risk women. Recent published data confirm that screening is more reliable than "usual care" in identifying victims of IPV, both during pregnancy and in non-pregnant women. Likewise recent published data show that there are no apparent harms of screening for IPV, and that the act of screening may have an empowering effect on women and improve their relationship with and trust in their health care providers. Despite these findings, the implementation rate of IPV screening remains low. Most encouraging are the recent data showing that interventions performed after screening for IPV are effective in reducing depression symptoms and episodes of violence as well as improving some outcomes of pregnancy. While there remains a lack of consensus regarding which screening tool may be the most effective, we exhort all obstetrician-gynecologists to screen all women for IPV at regular intervals, and to familiarize themselves with available community resources to assist those women who have been identified as experiencing IPV through screening.

Copyright © 2017. Published by Elsevier Inc.

Language: en

Keywords

barriers; interventions; screening