Dissertation Creation - The UK's original provider of custom dissertations and dissertation help...

Free Dissertations - Nursing Dissertations

(gazmararian J A Et Al. 1995). We Can Make No Comment On This Point Other ...

(Gazmararian J A et al. 1995). We can make no comment on this point other than it seems to be made in the absence of any convincing evidence base.

A very significant feature of this paper, and certainly one that does appear to have a far more secure evidence base than some of the other statements that we have examined, is the section which deals with the complications of domestic violence in the pregnant state. The paper makes the self evident, but yet very relevant, observation that domestic violence during pregnancy places in jeopardy the health and safety of two individuals rather than the one that would be the case in the non-pregnant state. It points to the fact that domestic violence is associated with an increased risk of miscarriage, premature birth, low birth weight, chorioamnionitis, foetal injury, and foetal death. It cites a number of sources for this information (including the Hilberman paper) but the quote is largely lifted directly from the entirely reputable Berenson paper (Berenson A B et al. 1994). The difficulty in producing statistically significant and reliable data to back up the degree of risk is considerable because, as Berenson points out, the very factors that are known to be associated with domestic violence, such as increased drug and alcohol use together with an increased incidence of smoking, are also the very factors that are associated with increased foetal morbidity and mortality in any event. (Webster J et al. 1996).

Other significant factors are also explored in this particular section of the paper including the fact that the authors suggest that the foetus may be indirectly harmed by the fact that abused women may be (either directly or indirectly) prevented from seeking adequate ante-natal and post-natal advice and care by their abusive partners. (Norton L B et al. 1995). We shall return to a different significance of this point later.

Interestingly, the authors open up a discussion on the current status of the health care policies in the UK in relation to domestic violence. They point to the fact that the recent changes in both the practice of obstetrics and midwifery (which are said to enhance the ability of the healthcare professionals to provide empowerment and education for the pregnant women and to demedicalise child birth (authors term)), are the very changes that may have reduced the possibility of effective intervention. This is a bold statement, as it cites, for support, the fact that the traditional refuge of the women-only status of the antenatal wards and the labour suite is disappearing. it points to the fact that the antenatal clinics are noisy and busy places where a woman is less likely to share her problems with the healthcare professionals particularly if, in the words of the authors, they may be considered difficult, shameful, and risky.

Please note: The above dissertation snippet was written by a student and then submitted to us to display and help others. Thanks to all the students who have submitted their work to us.