As things currently stand, primary care doctors don’t routinely ask women about intimate partner violence during their primary care visits. Well, the American College of OB/GYNs has just gone against other organizations by recommending primary care doctors screen patients for intimate partner violence during regular and prenatal visits.
In many ways, I like this. I know for a fact though that some of my patients would be offended if I even asked them about this. We do need to be reminded how common intimate partner violence is, and the long term health consequences for women.
More than 1 in 3 women (36%) in the United States have experienced rape, physical violence, or stalking by an intimate partner at some point during their lives, according to recent data. Read that again. It is shocking and painful to see those numbers.
The consequences of intimate partner violence include chronic headaches, sleep and appetite disturbances, and recurrent vaginal infections among many other things.
Women of all ages experience intimate partner violence, but it is most prevalent among reproductive-age women. Because of this, should we take advantage during routine visits for pap smears and contraception to identify and help women who are being abused? This would mean asking questions about intimate partner violence to ALL of our female patients during their visits.
Why the debate? A 2009 report in JAMA found that screening for intimate partner violence produced a small benefit to abused women in quality of life and depression. Many trials have concluded that many women had to be screened in order to identify a single woman who disclosed abuse. So the problem here is that current evidence does not demonstrate that universal screening improves women’s health or well-being, or decreases their exposure to violence.
The other side would say that until evidence emerges in support of routine screening, primary care doctors become knowledgeable about the signs and symptoms of abuse, and screen for intimate partner violence only in those cases.
- Dr O.