Intimate partner violence affects more than one third of the U.S. population and is a preventable public health crisis. It can be physical or psychological harm or controlling behavior of any kind, and is sometimes referred to as domestic violence or family violence,
Family violence costs the U.S. alone an economic burden in the trillions, from law enforcement to incarcerations and court costs to loss of wages and workforce productivity to healthcare costs.
Serious adverse health outcomes in women are strongly linked to intimate partner violence including higher rates of chronic diseases such as diabetes, cardiovascular problems, chronic pain, long-term mental health effects of toxic stress, and even loss of children and families in fatalities.
We sometimes think intimate partner violence only happens in developing countries or in obvious situations like movie scenes, but rates are very high in the U.S. even right here close to home in Utah. The U.S. Preventative Services Task Force and other professional health organizations recognize this crisis and recommend screening reproductive-age women for intimate partner violence in healthcare settings.
Intermountain Health is one of the healthcare systems trying to follow these guidelines. What does this look like? Screening for violence in healthcare is simple; at a clinic or hospital visit, a medical assistant, nurse, doctor or midwife asks a few questions about current relationship safety and any past trauma. For safety, these questions must be asked confidentially.
The goal is to identify women in current unhealthy situations as well as those who have experienced domestic violence in the past and link them to resources like mental health counseling, domestic violence prevention programs, or even temporary shelter housing. Screening all patients as a standard of care allows clinicians to move upstream to identify and diagnose unhealthy relationships earlier, before irreparable harm. It also gives patients a chance to consider what is a safe relationship for themselves or loved ones.
Additionally, screening for intimate partner violence in healthcare is an opportunity to teach women to watch for red flags. One tool used in many clinics is the Power and Control Wheel, a visual aid created to help survivors and allies understand the many ways domestic violence presents. These include intimidation, emotional abuse, minimizing and blaming, financial control, using male privilege, isolation, coercion, or threats, and sometimes worst of all, using children or reproductive control.
Midwives are women’s healthcare providers like obstetricians who offer prenatal care, attend births, see women and girls for gynecology annual exams, birth control and primary care including immunizations and prescriptions. In Utah, one in three women will experience interpersonal violence in their lifetime, and many of these women will have a baby or go to an annual exam, where thoughtful questions from a provider can build trust and help them disclose and get help.
Leah had her own experience as a victim of domestic violence, and it prompted her to become a midwife, to support and advocate for survivors. Her life was saved when trauma-informed midwives screened her for domestic violence in prenatal care. Unfortunately, despite years of efforts, her son was killed by his father last year on Mother’s Day weekend, a tragedy no family should experience.
Leah has connected with the federal Office on Violence Against Women in Washington, D.C., the National Family Violence Law Center at George Washington University, and many others to spread the word about safe relationships, pass legislation to help children get out of violent family environments, and elevate the voices of survivors of domestic violence, especially to support women and mothers.
“We can do better in Utah to create a coordinated community response to family violence and give hope to survivors. Healthcare must be on the front lines to identify violence and abuse. Women should feel safe when they come to a healthcare visit and know we understand we’re here to help both physical and emotional healing,” Moses said. “If we empower a woman to recognize abuse and offer tangible resources – that can carry over to the next generation.”
Each area of Utah has a direct domestic violence service provider staffed with trained advocates. The state Utah Domestic Violence Coalition also staffs a 24/7 hotline anyone can call to ask questions or get immediate help.
To learn more about the Utah Domestic Violence Coalition, visit udvc.org. If you, a friend or family member are impacted by domestic violence, free confidential resources are available. Please contact the UDVC Link Line at 1-800-897-LINK (5465).
To find a women’s health provider, visit the women’s health page at intermountain.org
About Intermountain Health
Headquartered in Utah with locations in six states and additional operations across the western U.S., Intermountain Health is a not-for-profit system of 34 hospitals, approximately 400 clinics, medical groups with some 4,600 employed physicians and advanced care providers, a health plans division called Select Health with more than one million members, and other health services. Helping people live the healthiest lives possible, Intermountain is committed to improving community health and is widely recognized as a leader in transforming healthcare by using evidence-based best practices to consistently deliver high-quality outcomes at sustainable costs. For up-to-date information and announcements, please see the Intermountain Health newsroom at https://intermountainhealthcare.org/news.
