Nursing Care for Domestic Violence during Pregnancy - Research Paper Example

? Nursing Care for Domestic Violence during Pregnancy COLLEGE Domestic violence during pregnancy is extremely dangerousfor the mother and the child and is fairly common with estimates ranging from 0.9% to 20.1% of mothers. This suggests that the nurse needs to be familiar with the signs and symptoms of domestic violence during pregnancy, as well as the complications for both mother and child. It is important for nursing care to be considerate during the assessment because it is an extremely personal and difficult situation. Assessment and treatment needs to be done with responsibility, confidentiality and compassion because of the nature of the issue. Introduction Domestic violence is an important social issue, but also plays a huge role in the health of the expectant mother and her child. There is a number of ways that nurses can assess and deal with domestic violence. A pregnant woman who has been victim of domestic violence needs to be treated with confidence, care, and confidentiality, particularly because domestic violence can have a number of unfortunate physical and mental effects on the victim. The purpose of this paper is to explore the relationship between domestic violence and pregnancy, and the impact that battering can have on the expectant mother, both physical and mental. It will also explore how the nurse should deal with cases of domestic violence, including the assessment and care of these women, as well as what to expect from physical and mental examination of these patients. A final section will cover how I, as a future nurse, plan to address the issue in a clinical setting taking into account all the information covered within this paper. Provide an Overview of Domestic Violence as it Relates to Pregnancy Estimating the number of women that are affected by violence during pregnancy is extremely difficult for a number of reasons, but estimates place it from anywhere between 0.9% and 20.1%. Statistics also suggest that it is most prevalent in women earning under $20,000 a year (Jasinski). The women who are most likely to experience this type of violence have a history of victimization, so taking a history of the patient may help to clarify whether domestic abuse has occurred. There are a huge number of problems which are associated with domestic violence and pregnancy, both for the mother and the unborn child. For the baby, these include premature birth, low birth weight and foetal trauma. These may be compounded by the effects on the mother, which may be psychological and cause maternal behaviour changes, or physical causing health changes (Jasinski). Nursing Care Considerations Related to Domestic Violence Assessment Considering the important consequences of domestic violence for the mother and the baby, there has been some debate about whether healthcare professionals should screen for domestic violence as the norm (O’Reilly, Beale and Gillies). This is based on findings that areas in which screening is present have a higher identification rate, and therefore it could be possible to prevent some of the problems associated with domestic violence in pregnancy. It also suggests that a nurse should consider the possibility of domestic violence during pregnancy, as the health of the mother and the child are paramount to nursing care. Discuss the Impact of Battering to the Individual Client, Newborn and the Family The impact of battering varies from individual to individual, although there are almost certainly physical, psychological, or a mixture of both effects on the women involved. It also affects the new born and the family of the victim. The woman’s mental health is likely to be affected. She is likely to suffer from anxiety, depression and a number of other disorders (Nasreen, Kabir, Forsell and Edhborg). This can lead to problems for the child, as the woman may be unable to care for herself or the new born. If the violence is aimed towards the womb of the victim, then there may be direct damage to the baby or premature birth (Devries et al.). Low birth weight can also occur for a number of reasons, primarily if the woman is suffering from mental health problems. The family of the victim could suffer a variety of psychological effects, including anxiety and depression. The perpetrator of the violence may also be suffering from some mental health problems. What are the Physical and Mental Assessment Findings that the Nurse may observe in a Client who has been Recently Battered or Battered in the Past? During the assessment, a nurse would expect to find some physical evidence of battering. These could include any trauma injuries, such as bruises, puncture wounds, or broken bones (Devries et al.). Looking through the history may help to illustrate physical injuries from battering in the past, although these may not be evident if the woman has not reported any injuries. The mental assessment findings may be less obvious. The woman is likely to be distressed, particularly about the health of her baby. This could lead to sub-clinical or clinical levels of anxiety, depression or other mood disorders (Nasreen et al.). The woman may also not be taking care of herself properly, so could be of lower or higher weight than would be expected of a pregnant woman at the appropriate stage. There may be a combination of any of these factors, although it should also be noted that battering may not leave any obvious signs. As a Future Nurse, How Would You Plan to Address this Issue? As a nurse, I think the most important thing to do in any situation is to be a figure of trust and responsibility. As domestic violence can be extremely distressing to the patient, the nurse needs to be particularly aware of how to deal with the mental health of the patient. Personally, I would make sure to be calm in these situations to reassure the patient. Another thing that I would do as a nurse in this situation is to carry out the assessment for domestic violence in a quick and confidential manner to allow the woman to feel safe and protected in the clinical environment. The impact of the battering on the woman and the unborn child also need to be monitored throughout the pregnancy and the health of the baby should be of the utmost priority immediately after birth. It is important to inform the physicians and other healthcare professionals as soon as possible to ensure that the best treatment is being administered to the patient. As a nurse in this situation I would recommend dealing with any complications from the domestic violence as quickly as possible to reassure the victim that the best possible job is being done of caring for her and the baby. Conclusions Domestic violence during pregnancy is an extremely important topic for a nurse to be aware of. This is because it is fairly common and can lead to a number of physical and mental health problems for the woman and the child, which need to be dealt with in a calm and compassionate manner. The assessment needs to be completed with the aim of discovering these physical and mental symptoms, which include trauma wounds, anxiety and depression as well as weight outside the normal range for a pregnant woman. It is important that, as this is an extremely personal problem, the nurse carries out the assessment privately, continually reassuring the patient as much as possible. The nurse also has a responsibility to report the incidence of domestic violence to other healthcare professionals so the appropriate care can be given to the victim and that the situation can be resolved accordingly. Works Cited Devries, K. M., Kishor, S., Johnson, H., Stockl, H., Bacchus, L. J., Garcia-Moreno, C., & C. Watts. “Intimate Partner Violence Dduring Pregnancy: Analysis of Prevalence Data from 19 Countries.” Reproductive Health Matters, 18(36), 158–170. 2010. Print. Jasinski, J. L. (2007). “Pregnancy and Domestic Violence.” Trauma, Violence, & Abuse, 5(1), 47–64. 2007. Print. Nasreen, H. E., Kabir, Z. N., Forsell, Y., & M. Edhborg. Prevalence and Associated Factors of Depressive and Anxiety Symptoms During Pregnancy: A Population Based Study in Rural Bangladesh. 2001. Web. O’Reilly, R., Beale, B., & D. Gillies. Screening and Intervention for Domestic Violence during Pregnancy Care: A Systematic Review. Trauma, Violence, & Abuse, 11(4), 190–201. 2010. Print. Royal College of Nursing. Domestic Violence: Guidance for Nurses. 2009. Web. www.rcn.org.uk/__data/assets/pdf_file/0008/78497/001207.pdf Read More