window of opportunity






When women present in health care settings, we have a critically important, possibly life-saving chance to talk to them about violence.  New guidelines from the American College of Obstetrics and Gynecology (ACOG) underscore the importance of this opportunity and the duty of those of us in women’s health care settings in particular to follow through and do right by our patients. 

From the introduction (excerpt):

“Over the past two decades, a growing body of research has recognized the connection between relationship violence and poor reproductive health care outcomes for women. More hidden and often undetected forms of victimization involving coercive behaviors that interfere with reproductive health have emerged from this research.

Health care visits provide a window of opportunity to address IPV and coercive behaviors related to patients’ reproductive health. The goal of this resource is to reframe the way in which health care systems respond to IPV and reproductive and sexual coercion. The health care provider is the hub of a wheel in a trauma-informed, coordinated health care response that includes universal education and prevention.

This guide highlights research that demonstrates how a brief intervention using a safety card to educate female patients about reproductive and sexual coercion can improve reproductive health outcomes and promote healthy, safe, and consensual relationships. Safety cards and other resources for integrating and sustaining a trauma-informed, coordinated response to IPV and reproductive and sexual coercion are included in this publication.

In 2011, the Institute of Medicine (IOM) issued guidelines for preventive health services for women that recommend routine domestic violence (intimate partner violence) screening. The guidelines endorsed by Department of Health and Human Services require that new health insurance plans cover domestic violence screening as part of women’s preventive services.

Under the Affordable Care Act, new health plans must reimburse domestic violence screening and counseling as part of preventive health care services at no additional cost. Addressing Intimate Partner Violence Reproductive and Sexual Coercion Guide expands the scope of routine screening for IPV to include assessment for reproductive and sexual coercion. A trauma-informed, comprehensive approach to relationship violence that includes behaviors that interfere with patients’ reproductive health can improve the quality of care and reproductive health outcomes including higher contraceptive compliance, fewer unintended pregnancies, preventing coerced and repeat abortions, and reducing sexually transmitted infections (STIs)/HIV and associated risk behaviors.”

You can get a copy of the new guidelines free at

It’s time to do right by abused women in healthcare settings — time to lift the shade and let the sunlight in.  Women may not always choose to disclose — or to do what we (who know very little of their situation) deem to be the “right thing” to do (i.e. leave) but just conveying that the healthcare provider can offer caring, ongoing unconditional support, and a nonjudgmental attitude is a tremendous intervention.  Connecting women with resources for help and safety planning can go even further.  Get your guidelines today and start things moving in your workplace!