Teen girls report abusive boyfriends try to get them pregnantSeptember 21, 2007UC-Davis researcher urges healthcare providers to look for signs of intimate partner violence SACRAMENTO, Calif. -- Seven years ago, Elizabeth Miller was a volunteer physician in a community-based clinic in Boston, Mass., which offered confidential services to teens. She is still haunted by the memory of a 15-year old girl who asked her for a pregnancy test. It was negative, but two weeks later the girl was treated for a severe head injury in a nearby emergency room. The girl's boyfriend had pushed her down a flight of stairs. "I assumed all she needed was to be educated about her contraceptive options," Miller recalled. "Later, I wondered what I had missed. Could I have asked a question that would have identified that she was in an abusive relationship""
That nagging question inspired Miller, now a pediatrician with UC Davis Children's Hospital, to dedicate her career to trying to understand the unique characteristics of adolescent partner violence. In a new qualitative clinical study published in the September-October issue of the journal Ambulatory Pediatrics, Miller and her research colleagues report that a quarter of the teenage girls interviewed for the study - all of whom had histories of abusive relationships - say their partners were actively trying to get them pregnant. The study, available online today, is the first in the general adolescent health literature to document the role of abusive partners in promoting teen pregnancy. "Physicians are trained to think about domestic violence in adult terms," said Miller, a physician trained in both adult and pediatric medicine who specializes in treating adolescents. "Our study suggests that health-care providers who come in contact with teens, especially those seeking pregnancy testing and emergency contraception, should ask about the possibility of abuse in the relationship and specifically whether the young woman's partner may be trying to get her pregnant." Miller's study is based on interviews with 61 girls from a variety of racial and ethnic backgrounds with a known history of intimate partner violence living in the poorest neighborhoods in Boston. The analysis included 53 girls between the ages of 15 and 20 who reported being sexually active and involved in relationships that included recurring patterns of physical, sexual or emotional abuse from a male partner. Twenty-six percent of these girls reported that their partners were actively trying to get them pregnant by manipulating condom use, sabotaging birth control use and making explicit statements about wanting them to become pregnant. "We were floored by what these girls told us," Miller recalled. "You think of forced sex as an aspect of abusive relationships, but this takes that abuse a step further to reproductive control of a young woman's body." Despite the small sample size, Miller describes the current study as a critically important first step toward understanding the nuances of control in intimate relationships and its role in teen pregnancy. "Our study suggests that those providing care, especially reproductive care, to adolescent girls need to ask questions that reveal the complexities of partner violence, specifically whether a partner is actively trying to get her pregnant when she doesn't want to be," Miller said. "Historically, assessments in clinical settings have focused on physical and sexual violence - and for good reasons. However, our data argues for including questions, for instance, about whether a boyfriend is flushing birth control pills down the toilet or saying he used a condom when he didn't. And pregnancy prevention programs should include discussions about reproductive control as a form of abuse in relationships." "This study demonstrates for the first time that abusive boys and men often actively promote pregnancy including contraceptive nonuse in their relationships," said Jay Silverman, director of Violence Preventions Programs for the Harvard School of Public Health and senior author on the study. "The implications are clear - when we see girls who cannot consistently use contraception, who are requesting frequent emergency contraception or who seek repeat pregnancy testing, we need to be asking very directly about abuse from male partners and find ways to support them and promote their safety." Miller added that she and her colleagues will next look at the phenomenon of reproductive control in a larger study and at the population level. They just completed a clinic-based survey of 825 youth in the Boston area designed to address the prevalence of intimate partner violence and related behaviors among boys and girls seeking confidential care, and they are in the process of designing a national study to address these same issues. Miller has also designed a study that would test interventions for partner violence in family planning clinics among women ages 16 to 24 years, and she is planning a study of dating violence intervention to be conducted in school-based clinics in California and Massachusetts. These interventions involve identifying intimate partner violence through screening questions and include a protocol for providing referrals to appropriate resources, such as advocacy groups, shelters, counseling and agencies that can address safety. "Our work is aimed at documenting the severity and prevalence of intimate partner violence in teens," Miller said. "Ultimately, we want to reduce teen pregnancy and the devastating effects of partner violence." University of California - Davis - Health System | |||||||||||||||||||||
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Related Partner Violence Current Events and Partner Violence News Articles Study looks at the lives of boys who commit dating violence A new study sheds light on the lives of teenage boys who abuse their girlfriends. In their own words, the young men often describe facing challenges such as growing up with troubled family lives, having little or no support when they began to fail at school, and witnessing violence in their own homes and communities. Women in India abused by husbands at far greater risk for HIV infection India is home to the third-largest number of human immunodeficiency virus (HIV) cases in the world and, as in the U.S. and many African nations, the rate of infection among women continues to rise faster than that among men. Disclosing violence to primary care or obestetrics/gynecology physicians most beneficial Researchers from Boston University School of Medicine (BUSM) and Boston Medical Center (BMC) found that patients who disclose intimate partner violence (IPV) to their clinicians of any type did not experience serious harm. Sexual violence study finds NY teens victimized at rate higher than national average The New York City Alliance Against Sexual Assault, in collaboration with Columbia University Mailman School of Public Health's Center for Youth Violence Prevention, announced the results of a three-year, comprehensive research project on sexual and dating violence among New York City high school students, and the health impact of that violence on those victimized by it. Victims of child maltreatment more likely to perpetrate youth violence, intimate partner violence Some people are caught in a cycle of violence, perhaps beginning with their own abuse as a child and continuing into perpetration or victimization as an adult. Screening method can play role in disclosure of intimate partner violence Reported prevalence rates for intimate partner violence can vary, depending on the screening method, type of questionnaire used and health care setting, and women prefer self-completed questionnaires, compared to face-to-face interviews. Violence from male partners associated with serious health threats to pregnant women and newborns In the first national study of the effects of intimate partner violence on the health of women during pregnancy and the health of newborn children, researchers from the Harvard School of Public Health (HSPH) demonstrated that violence from male partners, both in the year prior to and during a woman's pregnancy, increases her risk of serious health complications during pregnancy. Low-income Native American women suffer high rates of domestic abuse Low-income Native American women are at least twice as likely to suffer physical or sexual assault at the hand of their partner than the average American woman, according to an article published this week in BMC Medicine. This risk is greatly increased if the women live in very poor socioeconomic conditions. Researchers from the University of New Mexico and University of Oklahoma Health Sciences Center found that more than half of the women questioned reported having been assaulted by a partner during their lifetime; one in eight women had been raped by a partner during their lifetime. Thirty percent of the women that were currently in a relationship had been abused by their partner during Increased HIV risk for women with violent male partners (pp 1410, 1415) South African research published in this week's issue of THE LANCET highlights how women with physically violent and controlling male partners are at an increased risk of HIV-1 infection. HIV/AIDS is more widespread among women in sub-Saharan Africa than any other population. Although violence from a male partner and relationship inequalities are thought to be associated with increased HIV risk among women, no study has yet assessed gender-based violence as a risk factor for HIV after adjustment for women's own high-risk sexual behaviours. Rachel Jewkes and colleagues from South Africa's Medical Research Council studied 1366 women who agreed to HIV testing while attending antenatal care at Violence Against Women (pp 1172, 1232) This week marks the start of a new Lancet series-Violence against Women. Over the next six weeks, the series will discuss current challenges and debates on violence against women and the implications for public health. In the first article, Charlotte Watts and Cathy Zimmerman from the London School of Hygiene and Tropical Medicine, UK, discuss the magnitude of some of the most common and most severe forms of violence against women: intimate partner violence; sexual abuse by non-intimate partners; trafficking, forced prostitution, exploitation of labour, and debt bondage of women and girls; physical and sexual violence against prostitutes; sex-selective abortion, female infanticide, and the d More Partner Violence Current Events and Partner Violence News Articles |
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