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Published on: February 16, 2011
Health Care Providers' Experiences, Perceptions, and Challenges in Addressing Perinatal Intimate Partner Violence
Jeanne L Alhusen1, Maggie Hughes1, Jordan Gear1
1School of Nursing, University of Virginia, Charlottesville, Virginia.
Background:
People with disabilities experience intimate partner violence (IPV) at two to three times the rate of those without disabilities yet are routinely underscreened and underserved within perinatal health care settings. Health care providers play a critical role in IPV identification and intervention, but limited training, systemic bias, and ableism may hinder effective, equitable care.
Objective:
We explored health care providers' experiences, perceptions, and challenges in screening and intervening for IPV among people with disabilities during the perinatal period.
Methods:
Semistructured interviews were conducted with 44 nurses, midwives, physicians, and doulas providing perinatal care to people with disabilities across diverse clinical settings in the United States. Interviews were transcribed verbatim and analyzed using inductive content analysis to identify recurrent themes related to IPV screening practices, knowledge gaps, and attitudes toward disability.
Results:
Analysis revealed three interrelated themes: 1) lack of awareness and training regarding disability-related abuse; 2) implicit bias and ableist assumptions shaping health care provider perceptions; and 3) discomfort, avoidance, and missed opportunities for IPV inquiry. Participants described uncertainty, time pressures, and systemic barriers that limited effective screening. They also identified ableism as operating across interpersonal and structural levels, including colleagues' devaluing of disabled patients and institutional care environments that remain difficult to navigate, which collectively hindered trauma-informed, disability-inclusive care.
Conclusions:
Discomfort, inadequate preparation, and ableist beliefs among health care providers undermine equitable IPV screening for people with disabilities. Integrating trauma-informed and disability-inclusive approaches into education, policy, and practice will be critical to enhancing identification, trust, and safety in perinatal settings.
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