Am J Perinatol
DOI: 10.1055/s-0044-1779746
Original Article

Intimate Partner Violence Detected during Abortion-Related Visits: A Systematic Review of Screenings and Interventions

Thwisha Sabloak
1   Northwestern University Feinberg School of Medicine, Department of Obstetrics and Gynecology, Chicago, Illinois
,
Isa Ryan
1   Northwestern University Feinberg School of Medicine, Department of Obstetrics and Gynecology, Chicago, Illinois
,
Skylar Nahi
1   Northwestern University Feinberg School of Medicine, Department of Obstetrics and Gynecology, Chicago, Illinois
,
Patrick Eucalitto
1   Northwestern University Feinberg School of Medicine, Department of Obstetrics and Gynecology, Chicago, Illinois
,
Melissa A. Simon
1   Northwestern University Feinberg School of Medicine, Department of Obstetrics and Gynecology, Chicago, Illinois
,
Ashish Premkumar
2   The University of Chicago Pritzker School of Medicine, Department of Maternal Fetal Medicine, Chicago, Illinois
› Author Affiliations
Funding None.

Abstract

Objective To perform a systematic review of screening tools and interventions focused on reducing adverse health outcomes associated with intimate partner violence (IPV) at abortion-related visits.

Study Design Studies were eligible if they included individuals seeking pregnancy options health care services in the United States, screening for or implementation of an intervention for IPV, and were published in English after the year 2000. The primary outcomes were to summarize screening tools, interventions studied, and if interventions led to individuals being connected to IPV-related resources. Secondary outcomes included patient responses to the IPV-related interventions and any other outcomes reported by the studies (PROSPERO #42021252199).

Results Among 4,205 abstracts identified, nine studies met inclusion criteria. The majority (n = 6) employed the ARCHES (Addressing Reproductive Coercion in Health Settings) tool for identification of IPV. Interventions included provider-facilitated discussions of IPV, a safety card with information about IPV and community-based resources, and referral pathways to directly connect patients with support services. For the primary outcome, IPV-related interventions were shown to better inform patients of available IPV-related resources as compared to no intervention at all. For the secondary outcomes, screening and intervening on IPV were associated with improvements in patient perception of provider empathy (i.e., caring about safety) and safer responses by patients to unhealthy relationships.

Conclusion Screening for and intervening on IPV at abortion-related visits are associated with positive outcomes for patient safety and the patient–provider relationship. However, data on effective tools for identifying and supporting these patients are extremely limited. This review emphasizes the unmet need for implementation and evaluation of IPV-specific interventions during abortion-related clinical encounters.

Key Points

  • The abortion visit offers a crucial setting to address IPV among a highly affected population.

  • This study reviews others that analyzed interventions and associated outcomes for IPV at abortion-related visits.

  • Appropriate interventions for IPV can improve patient-provider relationships and connect patients to essential resources.

Note

Several studies have analyzed and demonstrated that there is a large prevalence of IPV in those seeking abortion, few have analyzed what to do about it. This study is a literature review of studies that analyze interventions for IPV at abortion-related visits and associated outcomes. It provides recommendations from previously successful interventions and offers suggestions moving forward. In the limelight of the recent Dobbs decision, this study provides insight into the importance abortion-related health care can play.


Supplementary Material



Publication History

Received: 02 October 2023

Accepted: 22 January 2024

Article published online:
16 February 2024

© 2024. Thieme. All rights reserved.

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

 
  • References

  • 1 WHO. Global and regional estimates of violence against women: prevalence and health effects of intimate partner violence and non-partner sexual violence. Geneva: World Health Organization; 2013
  • 2 Richardson J, Coid J, Petruckevitch A, Chung WS, Moorey S, Feder G. Identifying domestic violence: cross sectional study in primary care. BMJ 2002; 324 (7332): 274-274
  • 3 Shackelford TK, Goetz AT, Buss DM, Euler HA, Hoier S. When we hurt the ones we love: predicting violence against women from men's mate retention. Pers Relatsh 2005; 12 (04) 447-463
  • 4 Campbell JC, Pugh LC, Campbell D, Visscher M. The influence of abuse on pregnancy intention. Womens Health Issues 1995; 5 (04) 214-223
  • 5 Baden K. The state abortion policy landscape one year post-roe. Guttmacher Institute. June 16, 2023. Accessed October 28, 2023 at: https://www.guttmacher.org/2023/06/state-abortion-policy-landscape-one-year-post-roe
  • 6 Borrero S, Talabi MB, Dehlendorf C. Confronting the medical community's complicity in marginalizing abortion care. JAMA 2022; 328 (17) 1701-1702
  • 7 Curry SJ, Krist AH, Owens DK. et al; US Preventive Services Task Force. Screening for intimate partner violence, elder abuse, and abuse of vulnerable adults: US Preventive Services Task Force final recommendation statement. JAMA 2018; 320 (16) 1678-1687
  • 8 Short NA, Lechner M, McLean BS. et al. Health care utilization by women sexual assault survivors after emergency care: results of a multisite prospective study. Depress Anxiety 2021; 38 (01) 67-78
  • 9 Frost JJD, Gold RBMPA, Bucek A. Specialized family planning clinics in the United States: why women choose them and their role in meeting women's health care needs. Womens Health Issues 2012; 22 (06) e519-e525
  • 10 Lizdas KC, Durborow N, Marjavi A. Compendium of State and U.S. Territory States and Policies on Domestic Violence and Health Care. 4th ed. Futures without Violence. November 2001. Accessed October 28, 2023 at: https://ipvhealth.org/wp-content/uploads/2019/09/Compendium-4th-Edition-2019-Final-small-file.pdf
  • 11 GA Wells BS. D O'Connell, J Peterson, V Welch, M Losos, P Tugwell. The Newcastle-Ottawa Scale (NOS) for assessing the quality of nonrandomised studies in meta-analyses. Accessed February 1, 2024 at: https://www.ohri.ca/programs/clinical_epidemiology/oxford.asp
  • 12 Page MJ, McKenzie JE, Bossuyt PM. et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ 2021; 372 (71) n71
  • 13 Colarossi L, Breitbart V, Betancourt G. Barriers to screening for intimate partner violence: a mixed-methods study of providers in family planning clinics. Perspect Sex Reprod Health 2010; 42 (04) 236-243
  • 14 Decker MR, Flessa S, Pillai RV. et al. Implementing trauma-informed partner violence assessment in family planning clinics. J Womens Health (Larchmt) 2017; 26 (09) 957-965
  • 15 Hill AL, Zachor H, Jones KA, Talis J, Zelazny S, Miller E. Trauma-informed personalized scripts to address partner violence and reproductive coercion: preliminary findings from an implementation randomized controlled trial. J Womens Health (Larchmt) 2019; 28 (06) 863-873
  • 16 Hill AL, Miller E, Borrero S. et al. Family planning providers' assessment of intimate partner violence and substance use. J Womens Health (Larchmt) 2021; 30 (09) 1225-1232
  • 17 Miller E, Decker MR, McCauley HL. et al. A family planning clinic partner violence intervention to reduce risk associated with reproductive coercion. Contraception 2011; 83 (03) 274-280
  • 18 Miller E, Tancredi DJ, Decker MR. et al. A family planning clinic-based intervention to address reproductive coercion: a cluster randomized controlled trial. Contraception 2016; 94 (01) 58-67
  • 19 Miller E, McCauley HL, Decker MR. et al. Implementation of a family planning clinic-based partner violence and reproductive coercion intervention: provider and patient perspectives. Perspect Sex Reprod Health 2017; 49 (02) 85-93
  • 20 Saftlas AF, Harland KK, Wallis AB, Cavanaugh J, Dickey P, Peek-Asa C. Motivational interviewing and intimate partner violence: a randomized trial. Ann Epidemiol 2014; 24 (02) 144-150
  • 21 Zachor H, Chang JC, Zelazny S, Jones KA, Miller E. Training reproductive health providers to talk about intimate partner violence and reproductive coercion: an exploratory study. Health Educ Res 2018; 33 (02) 175-185
  • 22 Chang JC, Decker MR, Moracco KE, Martin SL, Petersen R, Frasier PY. Asking about intimate partner violence: advice from female survivors to health care providers. Patient Educ Couns 2005; 59 (02) 141-147
  • 23 Liebschutz J, Battaglia T, Finley E, Averbuch T. Disclosing intimate partner violence to health care clinicians - what a difference the setting makes: a qualitative study. BMC Public Health 2008; 8 (01) 229
  • 24 Nash E, Guarnieri I. Six months post roe, 24 US states have banned abortion or are likely to do so: a roundup. The Guttmacher Institute. January 10, 2023. Accessed March 10, 2023 at: https://www.guttmacher.org/2023/01/six-months-post-roe-24-us-states-have-banned-abortion-or-are-likely-do-so-roundup
  • 25 TePoel MRW, Saftlas AF, Wallis AB, Harland K, Peek-Asa C. Help-seeking behaviors of abused women in an abortion clinic population. J Interpers Violence 2018; 33 (10) 1604-1628