One of the most saddening topics we discussed in class was obstetric violence. The Han article we read was about intimate partner violence during pregnancy (IVP-P) in Latin America. While re-reading it in preparation for the exam last week, I thought about how fixing IPV-P seems almost like a lost cause. I wondered how screening for it could even be helpful, when many of the women included in the study were from low-income, underprivileged areas and probably did not have access to adequate counseling or protective services, and lacked the resources to leave their partner. In the paper, Han cited an “intervention study”, specific to LAC. I decided to read it to see if it included anything to be optimistic about.
The article is called “Intimate Partner Violence During Pregnancy: A Pilot Intervention Program in Lima, Peru”, by Cripe et al. In their study, they looked at the effectiveness of standard care and empowerment care for pregnant women who were abused. Standard care included receiving a card listing resources and other information to assist them in help seeking, and empowerment care included both a card and a therapy session (those in the standard care group received a therapy session after the post-interview). The researchers looked for differences in safety behaviors, health-related quality of life, and use of community resources by these women by comparing pre and post interviews (before and after birth). They conducted the study at the Instituto Nacional Materno Perinatal in Lima, Peru, which is operated by the Peruvian government and provides services to low-income and high risk women.
Ultimately, their results were not statistically significant, but they found a general trend showing an increase of safety behaviors, health-related quality of life ratings, and use of community resources in women in the empowerment group. While there were a couple of limitations and obstacles in the study, the overarching point is valuable; simply screening for IVP-P is important and should be a regular procedure in prenatal appointments. Even if the consulting physician, researcher, or other health personnel can’t force a woman to seek help or leave her partner immediately, planting the seed in her mind is important and may encourage her to begin thinking about her situation and what she can do to increase her safety and well-being. The authors stress that IPV is a huge problem in Peru, and abolishing it all together is a daunting task. However, it is important that steps be taken to fix this problem. In addition to evaluating existing legal policies and resources for abused women, small interventions in other spheres (in this case, the medical sphere) can help as well. To quote the authors:
“Based on our experiences working with abused women in Lima, Peru, we expect that a combination of intervention methods that include screening, counseling, and advocacy by both health care professionals and community outreach workers may empower abused women to seek help and, subsequently, reduce IPV in Peru.”
I read this hoping to see results for one intervention that worked for everyone and could be realistically employed. I knew that was an unrealistic hope, but I felt these studies mustn’t be useful unless they saw substantial results. I was wrong though – these things must start small. The benefit of simply asking a woman about her situation, looking for suspicious markers that may indicate IPV, an delving deeper into her personal life and hardships she might be going through can really make a difference.
Citation: Cripe, Swee May, et al. “Intimate Partner Violence During Pregnancy: A Pilot Intervention Program in Lima, Peru. Journal of Interpersonal Violence, 2010 25: 2054. February 9 2010.