Violence Against Women, 1 – 20.
This study investigated women and healthcare providers’ perspectives regarding their experiences with and views of inquiring about gender-based violence (GBV) during perinatal care. Results found that study participants supported inquiry about gender-based violence during perinatal healthcare.
Gender-based violence (GBV) refers to any physical, sexual, psychological, cultural, spiritual, social, mental, or economic violence perpetrated by an intimate partner, family member, or any other person (non-partner violence) as a result of gender identity or gender expression.
Unfortunately, pregnancy does not prevent the occurrence of GBV by a partner (Baird et al., 2013; World Health Organization, 2011). GBV during the perinatal period is one of the leading causes of maternal death (Taillieu & Brownridge, 2010). Furthermore, violence during this time not only jeopardizes a woman’s current health status, but it is also a strong predictor of postpartum violence (Taillieu et al., 2016).
Despite the prevalence of GBV and its known consequences during the perinatal period, the assessment and identification of GBV during healthcare visits is a controversial issue. Some healthcare providers report not wanting to engage with GBV assessment (Edin & Högberg, 2002), arguing it is not part of their role (O’Reilly & Peters, 2018), and they do not have enough time. Some of them do not know how to manage disclosure and mention the lack of instruction on how to ask questions (Guillery et al., 2012). Some provider organizations have made recommendations for screening for GBV (Alshammari et al., 2018; Edin & Högberg, 2002; Knox, 2018; Van Parys et al., 2014); others, however, consider it conditional and argue that asking about GBV is only beneficial if accompanied by interventions, such as counselling to increase safety behaviors, or housing that can support the survivor of the violence (O’Reilly & Peters, 2018). Screening for violence is supported by some health professional bodies such as the Registered Nurses’ Association of Ontario (Registered Nurses’ Association of Ontario, 2005) and the American College of Obstetrics and Gynecology (Deshpande & Lewis-O’Connor, 2013). The study found that “Barriers to disclosure” was one of the main themes coming from the participants. Barriers were rooted in lack of awareness, feeling stigmatized and judged, fear, denial, and feeling that support and benefits would not follow disclosure. These findings confirm previous research that explains how only one-third of abused women disclose a history of violence to their family physicians (Baird et al., 2015; Cherniak et al., 2005). Although there are many opportunities for disclosure of violence in the clinical setting, few women with a current or past history of violence are identified by healthcare professionals; therefore, many women suffer from the experience of abuse in silence, without receiving appropriate help and support (Feder et al., 2006). Women are not likely to disclose abuse unless directly asked (Beynon et al., 2012).
In summary, the study findings suggest that to improve health care providers engagement in GBV identification, more training is needed, and local resources made available to patients experiencing GBV would need to be identified.