image: Dr. Linda Bullock is a professor at the University of Missouri Sinclair School of Nursing. "Domestic violence is a major heath problem for women and children as well as a significant social issue. My research has focused on domestic violence in a population of pregnant women and has included collaborating with nurses nationally and internationally and with members of other disciplines on the MU campus. Specifically I have investigated the prevalence of intimate partner violence, its consequences to mother and fetus, and intervention strategies to improve health outcomes in both the woman and child. This research not only addresses a gap in knowledge but also is providing evidence-based practice recommendations for clinical practice. It has also been useful in advising legislators and policy makers in their development of programs to aid this vulnerable population." view more
Credit: MU Sinclair School of Nursing
COLUMBIA, Mo. – Pregnant women who experience intimate partner violence (IPV) before, during or after pregnancy often suffer adverse health effects, including depression, post traumatic stress disorder, anxiety and chronic mental illness. Now, University of Missouri researchers have found that women who experience intimate partner violence are more likely to seek health care for their infants than non-abused women. Awareness of mothers with frequent infant health concerns can help health care providers identify and provide aid to women in abusive relationships.
"Health care providers should view frequent calls or visits for common infant health concerns as red flags," said Linda Bullock, professor in the MU Sinclair School of Nursing. "Although it can be difficult for providers to see beyond immediate concerns, the findings suggest that considering only voiced concerns may represent lost opportunities to intervene on more critical health matters that impact mothers and children. Providers have a chance to help mothers who may not voice concerns about intimate partner violence."
In the study, more than 60 percent of women who experienced intimate partner violence sought health consultations for their infants. Abused women were more likely to seek infant care, reported more stress, were more depressed, and had less support than non-abused women. Less than 54 percent of non-abused women sought infant health consultations. Bullock said significant maternal stress may be a contributing factor to increased infant care. Additionally, women may use their children's health care problems as a way to seek help for themselves.
Bullock recommends that pediatric and women's clinics have a routine policy of IPV screening and education for all women. Women may not voice concerns about their own safety, but multiple calls and visits to physicians can be signs of IPV.
"The most powerful intervention may be as simple as repeated screening for IPV throughout pregnancy and post-delivery visits," Bullock said. "Providers have a chance to help mothers who may not directly seek the necessary resources to help themselves. Referrals to support programs such as battered women's services, counseling, parenting support and financial services can make a positive impact on the lives of women and infants."
According to the U.S. Bureau of Justice Statistics, IPV is difficult to measure because it often occurs in private, and victims are reluctant to report incidents because of shame or fear. In the study, MU researchers analyzed data from a larger study of a smoking cessation intervention in pregnant women called Baby BEEP (Behavioral Education Enhancement of Pregnancy) conducted through rural Women, Infant and Children Nutritional Supplement (WIC) clinics in the Midwest. The women were identified by their responses to the Abuse Assessment Screen, a stress scale, a psychosocial profile and a mental health index.
The study, "Rural mothers experiencing the stress of Intimate Partner Violence or not: Their newborn health concerns," was published in the Journal of Midwifery & Women's Health in November.