Planned Parenthood of the Pacific Southwest staff screens their patients for intimate partner violence (IPV).
IPV is a pattern of abusive behavior within a relationship. Abuse often includes more than physical violence. About one in four women and one in nine men experience IPV in the form of physical violence, sexual violence, and/or stalking. Emotional abuse is also a form of IPV.
Health center staff ask every patient about their relationships and if they feel safe within them.
“Nine times out of 10, patients say there is no problem,” said Monica, regional director of operations.
But a few years ago, a patient came to our City Heights health center looking for help. She’d been a patient and therefore had been screened for domestic violence several times. She’d never mentioned any problem.
Her relationship had segued from emotional abuse to physical abuse over the years. But she’d never self-identified as a domestic violence victim.
One night, after being beaten by her partner, she escaped and came to the City Heights health center. She circled around the building all night until it was unlocked in the morning when the health center staff arrived for work.
“She had her pajamas on—that’s all she had with her,” Monica said.
Health center staff called the police, and her partner was arrested.
A growing body of research indicates that there is a strong association between IPV and unintended pregnancy, abortion, and sexually transmitted disease, resulting from male coercive behaviors around sex and contraception.
In other words, domestic violence is closely tied to reproductive health.
“Most people experiencing IPV do seek out reproductive health care — which shows why it’s so important for agencies like Planned Parenthood to screen in a trauma-informed way,” said Chrissy, education outreach program manager.
Here are some of the significant ways IPV intersects with reproductive health:
Those who experience IPV are at greater risk of all STIs and unintended pregnancies.
Women disclosing physical violence are nearly three times more likely to experience an STI than women who don’t disclose physical abuse.
One in 3 adolescents tested for STIs and HIV have experienced domestic violence; young woman who have been abused by a boyfriend are 5 times as likely to be forced into not using a condom and 8 times more likely to be pressured to become pregnant.
People who experience IPV are at greater risk for contracting HIV.
There’s a clear link between HIV and IPV for women. Women who experience intimate partner violence are at greater risk for HIV, often because abuse makes it difficult or dangerous to negotiate boundaries or condom use. More than half of women with HIV have experienced IPV; for many, abuse comes after they reveal their status. IPV can also be a barrier to accessing regular treatment, putting these women’s health at even greater risk.
Some partners try to exert control via reproductive coercion.
Reproductive coercion can include interfering with birth control methods, coercing a partner into having unprotected sex, impregnating a partner against their wishes, and/or controlling outcomes of a pregnancy.
According to the CDC, homicide is a leading cause of death for women 44 years old or younger, and nearly half of all victims were killed by a current or former intimate partner. Young women, especially young women of color, are disproportionately likely to be killed as a result of IPV.
Planned Parenthood believes that every person deserves to have safe, healthy relationships. People who have experienced IPV deserve to feel empowered to take control of their health and recovery. No one should be blamed for their own assault, belittled, or brushed aside when they decide to come forward about their experiences.
“Our City Heights patient needed time to think,” Monica said. “Later, when she needed help, she remembered that we care about her,” said Monica.