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Assessing for violence during pregnancy using a systematic approach.

D L Covington1, S J Diehl, B D Wright

  • 1Coastal Area Health Education Center, Wilmington, North Carolina 28402-9025, USA. covi@med.unc.edu

Maternal and Child Health Journal
|June 1, 1997
PubMed
Summary

A systematic, multiple assessment protocol significantly increased the reporting of prenatal violence compared to a single routine assessment. This method enhances detection of abuse during pregnancy.

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Area of Science:

  • Public Health
  • Obstetrics and Gynecology
  • Social Sciences

Background:

  • Prenatal violence is a significant public health concern.
  • Routine, single-time assessments may underreport the prevalence of prenatal violence.
  • Effective screening protocols are crucial for identifying and addressing violence during pregnancy.

Purpose of the Study:

  • To compare the effectiveness of a systematic, multiple assessment protocol versus a one-time routine assessment in increasing the reporting of prenatal violence.
  • To evaluate the impact of a structured screening approach on identifying cases of abuse during pregnancy.

Main Methods:

  • Implementation of a concise, systematic assessment protocol within the Maternity Care Coordination (MCC) program.
  • Assessing 384 women at three points during pregnancy using a direct question about experiencing harm.

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  • Retrospective analysis of 1056 records from a period using only first-visit routine screening for comparison.

    • Main Results:

    • The systematic assessment protocol increased initial prenatal violence reporting from 6.3% to 10.9% (RR=1.7).
    • Multiple assessments using the new protocol further increased reporting to 14.1% (RR=2.2).
    • The systematic, multiple assessment approach demonstrated a significantly higher rate of violence detection compared to routine single assessments.

    Conclusions:

    • A systematic screening technique with direct questioning and multiple assessments is more effective than single assessments for reporting prenatal violence.
    • This enhanced screening method improves the identification of violence experienced by pregnant women.
    • The findings support the adoption of systematic, multi-stage screening protocols in prenatal care settings.