Jenny’s Pennies

Intimate partner violence and violence against women is an area where crimes are underreported. Shame, guilt and societal responses (shaming, trivializing, blaming) makes it hard for women to speak out about being abused by their partners.

Research from year 2000 found that about 2000 women each year in Sweden are subjected to violence by their partners during pregnancy and the first year thereafter. This is of course 2000 too many. Many antenatal clinics have therefore made the habit of routinely asking pregnant women if they have been abused by their partner, even when there are no indications of abuse. But is routine screening really a good way to address the problem?

Hanne Kjöller, editorial writer for Dagens Nyheter, Sweden’s largest newspaper, thinks that routine screening isn’t a good idea. For once, I am agreeing with her.

Three researchers have written a letter to the editor in Läkartidningen, newspaper for the Medical Association of Sweden, regarding the screening for partner violence. They are critical of the process and calls for an ethical analysis of the practice, which takes into account both positive and negative aspects, for women who are subjected to violence as well as for those who aren’t.

Studies have shown that many women find it uncomfortable to be asked about partner violence. I understand them. I was asked the question, seemingly out of the blue, during a visit to get my prescription for the pill refilled, and my reaction was like “what? no!”. The doctor simply looked at me, ticked the box in her questionnaire and got to the next question. I often wondered what her reaction would have been if I had answered yes (I have never been a victim of intimate partner violence, but let’s say that I was). Should she have taken time out of her busy schedule to have that long and hard conversation? Simply ticked “yes” in her questionnaire and moved on? Handed me some brochures and the phone number of a women’s shelter and thought that was it?

That’s my second objection to this routine screening thing. What should be the ob/gyn’s response? If the woman answers yes and explains that the father of her child is abusing her, what should the ob/gyn do? It places them in a very difficult situation. As expressed by a midwife in a survey on the subject by the Swedish National Board of Health and Welfare (Socialstyrelsen): “It takes too long time to ask. You need time to listen to their response. You find those who have already gotten out of the relationship. It’s hard to catch those who are in it right now”. If the woman answers yes and then comes to the next visit with her partner with her, what does the doctor do? Legally they are obliged to report the abuse to the police, but it may put the abused woman in a much more dangerous situation. Without clear policies on how to handle “yes”-answers, it is quite contra productive to have ob/gyns and midwives ask the question.

The article in Läkartidningen also raises the issue that routine screenings for partner violence can make women skip their appointments at the antenatal clinic. There is a risk that women who are subjected to violence will face even more violence if their partner finds out that they have told someone about it, or that they have even been asked.

Obviously the ob/gyns and midwives try to ask the question on a visit when the partner is not present (in Sweden it is increasingly normal for the father to be present during the antenatal clinic visits). In the article, a midwife explains her strategy for keeping the partner away for one or more visits (apparently if a woman answers “no” to the question the first time, she is to be asked again), like saying that “he is not needed”. That just seems really dishonest to me.

And after hearing a radio program yesterday about the heteronormativity within our health care system, I can’t imagine what the response would be if a woman confessed to having been abused by her same sex partner.

As Hanne Kjöller points out, you’re always in a subordinate position when you seek health care and therefore it is the moral obligation of your caregiver to explain to you why they are doing or asking one thing or another and what relevance it has. If the reason for routine screenings of pregnant women regarding partner violence is to get statistics (which aren’t very reliable - reliability would increase somewhat if the woman was given a totally anonymous questionnaire), then I think that is a quite cynical way to treat these women - ask them about something so personal and then really offer nothing in return (e.g. counseling and legal advice). If the reason is to truly help women to get out of abusive relationships, then the state should instead put money into shelters, counseling, legal advice, education and so on, instead of, as it is today, rely on volunteers, charities and idealistic forces to provide those services.

This entry was posted on Thursday, March 20th, 2008 at 5:04 pm and is filed under Body and Soul, Crime, Health, Relationships, Reproductive rights, Sweden, Violence against women. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.