What is Intimate Partner Violence (IPV)?
Intimate partner violence (IPV) is the actual or threatened physical, sexual, or psychological harm by a current or former partner or spouse. The pattern of assaultive or coercive behaviors is characterized by the control or domination of one person over another.
Examples of IPV include:
· Physical violence
o hit, slap, scratch, choke (strangle), bite, push, kick
o use of restraints or one’s strength against another person
· Sexual violence
o unwanted kissing or fondling
o rape or forced sexual acts
· Psychological abuse
o stalking, degradation, intimidation, name-calling,
isolation
o threats of physical or sexual violence (words, gestures,
weapons)
o limiting or controlling access to money, family, friends, food,
transportation, medicine, healthcare
Highly associated with IPV:
· Reproductive coercion
o refusal to use contraception or condoms resulting in unintended
pregnancy or exposure to sexually transmitted infections
o control over pregnancy options
How common is IPV?
IPV is common. More than one-third of women and one-fourth of men in the U.S. have experienced rape, physical violence, and/or stalking by an intimate partner at some point in their lifetime. Nearly three in ten women and one in ten men in the U.S. reported at least one measured impact (such as symptoms of post traumatic stress disorder, being injured or needing health care or legal services) related to the violent behavior [National Intimate Partner and Sexual Assault Survey: 2010 Summary Report].
Violence occurs in all socioeconomic groups and to individuals among every culture, race, ethnicity, gender, and religion.
In Maryland, the leading cause of death among pregnant and postpartum women is homicide [Cheng and Horon. Obstet Gynecol 2010]. The majority of these homicides are perpetrated by a current or former intimate partner. According to self-reported postpartum survey data, 7% of mothers were physically abused by an intimate partner during pregnancy or in the year before pregnancy [Maryland PRAMS Focus on Intimate Partner Violence, 2011].
Can IPV affect health?
Current or past IPV can result in acute injuries, mental health problems such as depression, post traumatic stress disorder (PTSD), chronic medical disorders such as migraine headaches, chronic pain, and reproductive health problems such as infertility, adverse pregnancy outcomes.
With such a large impact on health, shouldn’t women be routinely screened in the health care setting?
Yes! It is recommended by every major professional medical organization including the American Medical Association (AMA), American Academy of Family Physicians (AAFP), American College of Physicians (ACP), American College of Obstetricians and Gynecologist (ACOG), American Academy of Pediatrics (AAP) and the American Psychiatric Association (APA).
Health care providers are often the first and only professionals seen by women who are in a violent or abusive relationship. Domestic violence assessment is not an option; it is a standard of care. Women do not mind being asked about IPV.
Any tips for doing an IPV assessment?
1) Assess for IPV in private, without anyone who accompanied the patient.
2) Avoid the use of stigmatizing terms such as “abuse”, “rape”, or “battered”.
3) Be nonjudgmental and employ culturally relevant language.
As a health care provider, how can I assess for IPV?
Educate everyone, whether abuse is disclosed or not.
Even if abuse is not acknowledged, providing all patients with educational materials normalizes the conversation, making it acceptable for women to receive information without disclosure. Convey to all women that:
o information is available (keep brochures/posters in bathroom, exam
room, waiting room); hand out a small IPV resource card that can fit
in patient’s shoe or other concealable area. Safety cards may be
ordered from http://bit.ly/S2OqfF
o you/staff are available for help and support
o abuse is wrong and it is not the victim’s fault
o everyone has the right feel safe
ORDERING IPV MATERIALS
DHMH ordered a large quantity of safety cards from Futures Without Violence. We are making them available for free to Maryland organizations. These cards are an excellent way to assess for relationship safety. Just fax this order form and check off the quantity of relationship safety cards (available in English and Spanish) you would like.
Many other materials are available from:
Maryland Network Against Domestic Violence
Maryland Health Care Coalition Against Domestic Violence
DOMESTIC VIOLENCE/INTIMATE PARTNER VIOLENCE PROGRAMS IN MARYLAND