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  • Title: Abuse of adolescents: what can we learn from pregnant teen-agers?
    Author: Parker B.
    Journal: AWHONNS Clin Issues Perinat Womens Health Nurs; 1993; 4(3):363-70. PubMed ID: 8369764.
    Abstract:
    One of the most perplexing issues for nurses working with abused women is the extent of violence experienced by teen-agers. This article presents research findings from a study of pregnant women and teen-agers in Baltimore and Houston that found 32% of pregnant teen-agers reported having been physically or sexually abused in the prior year. The rate of abuse during pregnancy was 22% for teen-agers. Teen-age violence is discussed in terms of possible reasons for teen-agers to be reluctant to report abuse and nursing considerations in the assessment and intervention of adolescents experiencing abuse. To determine the extent of abuse experienced by pregnant women, especially adolescents, 691 pregnant women recruited from public prenatal clinics in Houston and Baltimore received the Abuse Assessment Screen. Overall, 182 women (26%) reported physical or sexual abuse within the past year (stranger rape or assault excluded). Among the 235 teenagers (mean age 17.5 years) in the sample, 32% reported abuse in the past year. The rate of abuse during pregnancy was 22% for teenagers and 16% for adult women. Over half of study projects abused in the previous year were reabused during pregnancy, making prior abuse a significant predictor of violence against pregnant women. Also correlated with abuse was the attitude of the couple toward the pregnancy. 51% of abused women compared with 31% of their nonabused counterparts reported a negative reaction to the pregnancy. Similarly, 29% of the male partners of abused women had a negative response to the pregnancy compared to only 13% of the partners of nonabused women. Assessment for battering should be incorporated into routine nursing care of all pregnant women. Nurses must be aware of state reporting procedures and resources such as battered women's shelters. Work with abused adolescents demands special sensitivity, since many may be reluctant to discuss this issue with an authority figure or may minimize the frequency and severity of the violence. Those whose identities are grounded in their relationship with a man and lack other sources of self-esteem may be resistant to terminating an abusive relationship. Moreover, adolescents are even less willing than their older counterparts to enlist police protection or enter a shelter service. A useful technique is for the nurse and client to prepare a list of options, discuss the positive and negative implications of each option, and select the best alternative. If a woman elects to remain in an abusive relationship, counseling should be provided on signs of imminent danger and methods of self-protection.
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