An 18-year-old woman presented to her family physician for an initial obstetric examination, accompanied by her 27-year-old boyfriend. Initial history revealed that she was a gravida 1, para 0, at 16 weeks of gestation and living in a mobile home with her partner. She was strongly considering giving up the baby for adoption because of “financial and other” reasons. Answers to screening violence history questions indicated that she had been beaten by her father from preschool age until she was 13 years of age; her parents then divorced. The patient revealed that her present partner had “slapped her around” on several occasions and that once she was “accidentally dragged by his truck” during an argument. He had slammed the driver’s door, started the truck and put it in gear, reportedly without realizing that her dress was caught in the car door. On further questioning the patient stated that she was not happy in this relationship and in fact did not feel safe. However, she conveyed that she is optimistic about the future because her partner beganto attend church and stated that he wanted to be a good father.
CC: “Sometimes I have felt unsafe in this relationship”.
Discuss the elements potential and real domestic violence in this case.
Discuss domestic violence during pregnancy.
What other information might you want from this patient today?
What differential diagnosis is appropriate for this scenario (include all that pertain to this case)?
What would your care approach be for this patient?
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