OBJECTIVE: To describe timing and severity of abuse before and during pregnancy for African American, Hispanic, and white Anglo American women. FINDINGS: Among 199 abused women, 18.1% of the women were abused during pregnancy but not the year before, 30.2% were abused the year before but not during pregnancy, and 51.8% were abused both the year before and during pregnancy. The timing of abuse did not vary by ethnicity. The three (ethnicity) by three (timing) factorial analysis of variance showed severity of abuse to vary by timing of abuse. Women reporting abuse both before and during pregnancy reported greater severity of abuse on each of the five measures than did women abused only before pregnancy or only during pregnancy. CONCLUSIONS: Over half (51.8%) of the women reported abuse before and during pregnancy with these women reporting greater severity of abuse on all five severity scores. Timing and severity of abuse did not vary by ethnic group. The majority of women abused during pregnancy were also abused prior to pregnancy, indicating the need for universal screening of all women during each health encounter.

Adolescent↗

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The identification of a US serviceman recovered from the Holy Loch, Scotland.

During February and March 2000, human remains were recovered from the Holy Loch, Scotland. Police enquiries identified 13 males that had gone missing, presumed drowned in the Holy Loch or the adjoining lochs, over the previous 35 years. Osteological examination of the remains established they were from a male, aged between 15 and 23 and 168-174 cm tall. This information eliminated ten of the known missing persons. DNA profiles, both STR and mitochondrial were generated from the remains and compared to the profiles generated from relatives of the missing men. A positive match between the unidentified individual and one of the maternal relatives identified the remains as belonging to a US serviceman who had gone missing 35 years ago. The successful identification led to the repatriation of the serviceman's remains.

Forensic Anthropology↗

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An evaluation of interventions to decrease intimate partner violence to pregnant women.

Prevention of abuse to women is a national priority; however, research has focused on identification of abuse rather than evaluating interventions. To evaluate the differential effectiveness of three levels of intervention, Brief, Counseling, and Outreach, a longitudinal study with repeated evaluation interviews at 2-, 6-, 12-, and 18-months postdelivery was completed at two urban public health prenatal clinics. The participants were 329 pregnant, physically abused Hispanic women. Both physical abuse and women's use of community resources were measured. Repeated measures ANOVA showed that severity of abuse decreased significantly (p < 0.001) across time for all intervention groups. Violence scores at 2-months postdelivery were significantly lower for the Outreach group (p < 0.05) compared to the Counseling only group, but not significantly lower than the Brief intervention group. At 6-, 12-, and 18-month follow-up there were no statistically significant differences among the intervention groups. The use of lay outreach for abused pregnant women merits further research. Abuse screening by itself, however, may be the most effective intervention to prevent abuse to pregnant women.

Adolescent↗

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De Madres a Madres: women building community coalitions for health.

How one group of Hispanic women in Houston, Texas, built community coalitions for primary health care is chronicled from the perspectives of the women. We describe how they formed partnerships with community businesses, health and social service agencies, schools, and churches to develop an outreach network that enables pregnant women to obtain early prenatal care. These women's steps in coalition building are related to feminist theory, with an emphasis on group decision making, shared power for the empowerment of all, and the creation of an environment in which individual worth and dignity are enhanced and risk taking is encouraged and supported.

Community Participation↗

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Mandatory reporting of intimate partner violence: safety or retaliatory abuse for women?

We wished to ascertain abused women's perspectives on mandatory reporting of intimate partner violence. A consecutive sample of 161 abused women accessing the criminal justice system were asked six questions. Most women (81%) thought there should be a law making the nurse or doctor report the abuse, with less than half of the women (45%) reporting they would have been at greater risk for abuse following a mandatory report. Although these 161 abused women support mandatory reporting of partner abuse, it remains unclear if such a law would deter further abuse. Outcome and evaluation studies of mandatory reporting laws are urgently needed.

Adult↗

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Identifying and helping battered pregnant women.

Explore the source record for details and available documents.

Decision Making↗

PubMedDate not supplied

Vaginal bleeding and abuse: assessing pregnant women in the emergency department.

PURPOSE: This study was done to determine the prevalence of physical abuse among an ethnically stratified group of pregnant women experiencing vaginal bleeding. DESIGN: The design of this study was a cross-sectional survey using two screening tools: the Abuse Assessment Screen (AAS) and the Danger Assessment (DA). SAMPLE: The study sample consisted of 261 African-American, Hispanic, and Anglo pregnant women seen for vaginal bleeding in private and public emergency departments in a large (more than 2,000,000 people) metropolitan area. METHOD: All women with vaginal bleeding were interviewed in a private examination room. With the help of an interviewer, each subject completed both screening tools and was later offered information about abuse as well as community resources. Each woman's pregnancy status was validated with either a urine pregnancy test or a serum beta human chorionic gonadotropin, and her discharge diagnosis was obtained from the emergency department record. DATA ANALYSIS: Of the 261 pregnant women interviewed, 87 (33.3 percent) reported abuse, that is, 26.7 percent of the African-American women, 25.2 percent of the Hispanic women, and 58.3 percent of the Anglo women. Overall, Anglo women reported significantly more abuse (X2 = 21.96; df = 2; p < .00002) than non-Anglo women. We found no significant differences in reported abuse among the diagnostic groups. Abused and nonabused women significantly (p < .0005) differed on their DA scores (2.89 vs .55, respectively), but these scores were not significantly different among ethnicities. CONCLUSIONS: Abuse of pregnant women reporting to emergency departments is common and can be detected readily with a two-question, five-minute screen. Once an abused woman is identified, a danger assessment screen can further identify whether she is at high risk for escalating violence in her home.

Adolescent↗

PubMedDate not supplied

Preventing abuse during pregnancy: a clinical protocol.

Routine screening for abuse with appropriate intervention during pregnancy is essential to interrupt the cycle of violence and prevent future trauma. Over a decade ago, the Surgeon General called for routine abuse assessment of pregnant women (10). If women are not assessed for abuse, violence will remain undetected and untreated, placing women at risk for escalating abuse and further trauma. Additionally, if follow-up interventions are not implemented once abuse has been confirmed, the cycle of violence will continue. Routine assessment and expanded intervention strategies that includes case management and multi-agency collaboration must become standard care for all pregnant women.

Confidentiality↗

PubMedDate not supplied

Intimate partner violence. Mothers' perspectives of effects on their children.

PURPOSE: Intimate partner violence not only affects adults but also the children living within that "war zone." The present study expands our understanding about how children are affected when they observe violence in their own homes, as reported by their mothers. STUDY DESIGN: This descriptive study was conducted to describe mothers' perspectives of the impact of the violence on their children. A consecutive sample of 72 mothers attempting to file assault charges were interviewed in a private room by a registered nurse and were asked to describe the effect of witnessing intimate partner violence on their child's behavior. Each response was written verbatim by the interviewer. RESULTS: A majority (72%) of the mothers reported negative behaviors in their children that they believed were as a result of witnessing their mother's violent experiences. The most common negative traits were distress-indicating behaviors such as sleep disturbances, clinging, and fretful behaviors followed by problems with the abuser, problems in school, and problems with mother. CLINICAL IMPLICATIONS: Because intimate partner violence affects children, health care providers should become familiar with behaviors indicative of this problem. To promote the well being and development of children, recommendations for assessment and intervention for women experiencing intimate partner violence are discussed.

Adult↗