Response to Battered Mothers in the Pediatric Emergency Department: A Call for an Interdisciplinary Approach to Family Violence

Abstract

Battered mothers are rarely identified in the pediatric emergency department even though the physicians report handling a significant number of child abuse/neglect cases. Education on domestic violence, including the implications of woman battering for childrens' health, should be incorporated in the training curricula of pediatric emergency department physicians to raise awareness of the need to explore for the presence of concurrent abuse in both children and their mothers. Identifying battered women through their children will impact greatly on the welfare of both mother and child.

National Survey of Pediatricians' Violence Prevention Counseling

“…5,6 The AAP recently issued a statement recognizing that family and intimate partner abuse is harmful to children, which encouraged pediatricians to incorporate questions about family violence into anticipatory guidance and to incorporate education in this area into residency training programs and continuing medical education. 26 Previous studies have shown that among other physician groups, including obstetricians and gynecologists, 37 pediatric emergency medicine fellows, 48 and family physicians, 49 most practitioners do not screen for and identify domestic violence in their patients. Lack of education or training was the most common barrier to domestic abuse screening, recognition, and intervention identified by pediatric emergency medicine fellows and obstetricians and gynecologists.…”

“…Lack of education or training was the most common barrier to domestic abuse screening, recognition, and intervention identified by pediatric emergency medicine fellows and obstetricians and gynecologists. 37,48 Other barriers include lack of time, lack of experience with domestic abuse cases, frustration that they cannot help the victim, feeling that abuse is not a problem in their patients, and fear of offending patients. 37,48,49 Wright et al 48 found that 64% of the pediatric emergency medicine fellows whom they surveyed believed that responding to battered mothers did not belong in the purview of pediatrics.…”

Violence Exposure, A Chronic Psychosocial Stressor, and Childhood Lung Function

“…In addition, estimates of domestic violence against women and children indicate widespread exposure to violence in the home (34). Given this, research focused on understanding the possible broader pediatric health effects of growing up with violence is of great public health importance.…”

The Role of the Pediatrician in Recognizing and Intervening on Behalf of Abused Women

“…6 -8 Identifying and intervening on behalf of battered women may be one of the most effective means of preventing child abuse. 7 Abuse of spouses and intimate partners is a pediatric issue even when children are not being physically assaulted. Pediatricians should be aware of the profound effects family violence has on children who witness it or even overhear it.…”

“…social workers or advocacy groups with expertise in assisting and counseling victims. 7 The AMA's 1996 Diagnostic and Treatment Guidelines on Domestic Violence state that optimal care for the woman in an abusive relationship depends on the physician's working knowledge of community resources that can provide safety, advocacy, and support. 9 The AMA and many state medical associations provide directories of agencies that provide services or information about all forms of family violence.…”