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    • "The Society of Obstetrics and Gynaecology Canada clinical practice guidelines recommend that health care providers ask about intimate partner violence during assessment of new patients, as a part of prenatal care, at annual preventative visits, and if symptoms or conditions are present which are linked with interpersonal violence. However, evidence suggests that only 22.4% and 25.7% of women are asked about emotional and physical abuse, respectively, during pregnancy [73]. Consideration of child maltreatment in screening and follow-up could help to identify women who are at risk, and additional treatment and support may reduce the burden of depression and parenting difficulties in the postpartum period for these women. "
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    ABSTRACT: Background Research has shown that exposure to interpersonal violence is associated with poorer mental health outcomes. Understanding the impact of interpersonal violence on mental health in the early postpartum period has important implications for parenting, child development, and delivery of health services. The objective of the present study was to determine the impact of interpersonal violence on depression, anxiety, stress, and parenting morale in the early postpartum. Methods Women participating in a community-based prospective cohort study (n = 1319) completed questionnaires prior to 25 weeks gestation, between 34–36 weeks gestation, and at 4 months postpartum. Women were asked about current and past abuse at the late pregnancy data collection time point. Postpartum depression, anxiety, stress, and parenting morale were assessed at 4 months postpartum using the Edinburgh Postnatal Depression Scale, the Spielberger State Anxiety Index, the Cohen Perceived Stress Scale, and the Parenting Morale Index, respectively. The relationship between interpersonal violence and postpartum psychosocial health status was examined using Chi-square analysis (p < 0.05) and multivariable logistic regression. Results Approximately 30% of women reported one or more experience of interpersonal violence. Sixteen percent of women reported exposure to child maltreatment, 12% reported intimate partner violence, and 12% reported other abuse. Multivariable logistic regression analysis found that a history of child maltreatment had an independent effect on depression in the postpartum, while both child maltreatment and intimate partner violence were associated with low parenting morale. Interpersonal violence did not have an independent effect on anxiety or stress in the postpartum. Conclusion The most robust relationships were seen for the influence of child maltreatment on postpartum depression and low parenting morale. By identifying women at risk for depression and low parenting morale, screening and treatment in the prenatal period could have far-reaching effects on postpartum mental health thus benefiting new mothers and their families in the long term.
    BMC Pregnancy and Childbirth 12/2012; 12(1):153. DOI:10.1186/1471-2393-12-153 · 2.15 Impact Factor
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    • "The lifetime prevalence of IPV has ranged from 20 to 40 percent among women in North America (Renker, 2008). In the documented cases of IPV in Canada alone, 40 percent of women who have experienced IPV suffered a physical injury, and 15 percent of these cases were serious enough to warrant medical attention (Cherniak et al., 2005). These women present to a wide variety of healthcare professionals including emergency room physicians, orthopedic or trauma surgeons, family physicians, and specialists in obstetrics and gynecology. "
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    ABSTRACT: Health care providers play a vital role in the detection of intimate partner violence among their patients. Despite the recommendations for routine intimate partner violence screening in various medical settings, health care providers do not routinely screen for intimate partner violence. The authors wanted to identify barriers to intimate partner violence screening and improve the understanding of intimate partner violence screening barriers among different health care providers. The authors conducted a systematic review to examine health care providers' perceived barriers to screening for intimate partner violence. By grouping the studies into two time periods, based on date of publication, they examined differences in the reported barriers to intimate partner violence screening over time. The authors included a total of 22 studies in this review from all examined sources. Five categories of intimate partner violence screening barriers were identified: personal barriers, resource barriers, perceptions and attitudes, fears, and patient-related barriers. The most frequently reported barriers included personal discomfort with the issue, lack of knowledge, and time constraints. Provider-related barriers were reported more often than patient-related barriers. Barriers to screening for intimate partner violence are numerous among health care providers of various medical specialties. Increased education and training regarding intimate partner violence is necessary to address perceptions and attitudes to remove barriers that hinder intimate partner violence screening by health care providers.
    Women & Health 08/2012; 52(6):587-605. DOI:10.1080/03630242.2012.690840 · 1.05 Impact Factor
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