Physicians' screening practices for female partner abuse during prenatal visits

Abstract

Objective: Our purpose was to examine physicians' screening practices for female partner abuse during prenatal visits and to identify barriers to screening.

Methods: A self-administered questionnaire was developed to collect data on physicians' screening practices and their beliefs about screening for female partner abuse. The survey was mailed to all primary care physicians practicing in Alaska. The response rate was 80% (305/383). These analyses were limited to physicians who indicated that they provided prenatal care (n = 157).

Results: More than one-half of respondents providing prenatal care estimated that 10% or more of their female patients had experienced abuse. Less than one-half of respondents had recent training on partner abuse. Only 17% of respondents routinely screened at the first prenatal visit and 5% at follow-up visits. Respondents were more likely to screen at the first prenatal visit compared to follow-up visits. Multivariate analyses failed to support any associations between physicians' characteristics and screening practices. Physicians' perception that abuse was prevalent among their patients and physicians' belief that they have a responsibility to deal with abuse were the only variables that were independently associated with screening at prenatal visits. Other barriers frequently cited in the literature were not predictive of screening.

Conclusion: Most Alaskan physicians do not routinely screen for abuse during prenatal visits. Medical education should increase physicians' index of suspicion for abuse, emphasize physicians' responsibility to address partner abuse, and reinforce the importance of routine screening throughout the pregnancy. More research is needed to identify barriers to screening and strategies for integrating routine screening into prenatal care.