The question can make all the difference

Just imagine you are sitting in your doctor’s office waiting for the doctor and chatting with the medical assistant. Maybe it’s your yearly physical or maybe this is your first visit and you just want antibiotics for a relentless chest cold. All of a sudden she starts running through this list of questions:

  • Have you ever been emotionally or physically abused by your partner or someone important to you?
  • Within the last year, have you been hit, slapped, kicked or otherwise physically hurt by someone? If YES, who? Husband, Ex-Husband, Boyfriend, Stranger, Other? Total number of times?
  • Since you’ve been pregnant, have you been slapped, kicked or otherwise physically hurt by someone? If YES, who? Husband, Ex-Husband, Boyfriend, Stranger, Other? Total number of times?

I would probably answer “no” to all of these questions even if I was experiencing abuse. It is so alienating to boil down the complexities of any relationship to these questions. And besides after I answer these questions, reproductive-coersion-flyerwhat happens? Where does this information go? Will you look at me differently? Judge me and my partner? Do you have any help to offer if I take a risk and tell you anything?

Current healthcare research shows that both finding the right way to ask and connecting a patient to resources is the two-step golden ticket for effective support.

Offering support starts with showing you have some idea about what living in a coercive and abusive relationship might feel like. Futures Without Violence offers a Safety Card with these questions:

Ask yourself: Are you in a healthy relationship?

  • Is my partner willing to communicate openly when there are problems?
  • Does my partner give me space to spend time with other people?
  • Is my partner kind and supportive?

If you answered YES to these questions, it is likely that you are in a healthy relationship. Studies show that this kind of relationship leads to better physical and mental health, longer life, and better outcomes for your children.

Ask yourself: Are you in an unhealthy relationship?

  • Does my partner shame me or humiliate me in front of others or in private?
  • Does my partner control where I go, who I talk to, and how I spend money?
  • Has my partner hurt or threatened me, or forced me to have sex?

If you answered YES to any of these questions, your health and safety may be in danger.

Their information also includes national hotline resources and where to get advocacy services.

I may still hesitate to answer these questions, but I know that the person in front of me is ready to have a deeper conversation and has some resources. Screening for, asking about, or listening for abuse in a relationship is not an end in itself. Providing support and connection is what survivors tell us they want.

If healthcare professionals really want to help, they have to take the time to learn the right questions and get comfortable connecting their patients to advocacy services. Consider helping by taking a stack of Safety Cards (they’re free) to your next doctor’s appointment.

News you can relate to

Some news stories that caught our eye this week:

The high school senior that was kicked out of her prom for her dress tells the story of her experience:I was told that the way I dressed and moved my body was causing men to think inappropriately about me, implying that it is my responsibility to control other people’s thoughts and drives.” (explicit language)

Families receiving public assistance are often criticized for how they spend their money. The actual data, however, shows just how uncalled for this criticism is.

As doctors debate whether screening for domestic violence helps or not, I’m wondering why—given how prevalent it is—they don’t just routinely provide information about local domestic violence advocacy programs. That way, patients will know where they can get help regardless of whether they choose to disclose to their doctor.

Don’t ask, just tell

Lately, I have been learning about reproductive coercion—all the ways someone could interfere with your birth control, or pressure you to get pregnant or end a pregnancy. I read this surprisingly personal post by a doctor sharing her experience with a female patient where she missed identifying that her boyfriend was preventing her from using birth control.

reproductive-coersion-flyerI asked my friend who is a doctor if she’s had similar experiences. She said she routinely underestimates the lack of control women have around their reproductive choices. “I talk to my patients as if they have control and they may not.” She told me doctors need scripted, short questions, like “Are your decisions around birth control and pregnancy respected? Do you want information on birth control that can’t be interfered with?”

When I was pregnant, health care staff didn’t wait for me to ask about things that could happen, like preeclampsia, they just routinely gave me the info I needed to be safe and healthy.

Reproductive coercion is far more common than preeclampsia. Healthcare providers are missing an opportunity. They don’t have to ask patients to disclose abuse. They should just routinely tell every woman of reproductive age about birth control that can’t be seen, felt, or interfered with, and places they can get support if they, or a friend, might need it.

My doctor friend and I both have teen daughters. Our girls roll their eyes when we try to talk to them about birth control. So we need someone else to do it. It would be a relief to know that their doctors will tell them about undetectable forms of birth control and emergency contraception—not wait for them to ask.