6-25% of pregnant women report physical or sexual abuse during pregnancy
Risk factors:
*women 17-28
*women- single, separated, divorced or planning separation/divorce
*women with h/o abuse as child or witnessed abuse as child
*women who use ETOH and/or drugs or partners who do so
*women whose partners are possessive/jealous
Domestic Violece Effects on PT
Missed appointments
*cancelled by partner
*no transportation, child care
*no access to phone to call and cancel
*limited money for rx
"Therapist hopping"
Non compliant w/ rx
*unable to obtain/take medications, braces
*too tired or stressed to exercise
Partner attends PT sessions and speaks for pt
Partner attempts to influence PT
*intimidating, harassing (rude)
*praise PT and portraying himself as good provider
Domestic Violence Screen
All women should be asked
direct questions about injuries
indirect questions about stress
assess urgency and danger in current situation
Domestic Violence S/S
trunk injuries-throat, chest, abdomen, face
sprial fractures
injuries in various stages of recovery
cigarette burns, teeth marks, etc
somatization of pain and hypersensitivity to touch
What to do and not to do
DO:
mandatory reporting- PT not mandatory reporters unless children present and witnessing the violence; stab wounds, gun shot wounds, or other serious injury
know local resources
have shelter material in women's bathroom
document in objective manner
have clear, functional goals and refer if no progress is made
NOT TO DO:
do not act too quickly- w/out communicating fully w/ pt
do not share personal experiences, speak in broad terms using establised stats when able
do not hug/touch pt w/out asking first bc may increase discomfort
do not approach the partner
Adolescent pregnancy
50% teen pregnancy results in live birth (34% abortion, 14% miscarriage)
Higher risks for mom and baby:
*higher rates of PTL and bleeding
*lower birth weights
*more physical abuse
*lower maternal wt. gain
*more smoking, drugs, ETOH use
*more postpartum depression
Female athlete triad
1. osteoporosis
2. amenorrhea
3. disordered eating
Common Pattern:
negative energy balance
external and internal pressure leads to disordered eating
often lean body fat <12%
decreads estrogen occurs
leading to amenorrhea and eventually osteoporosis
further resulting in - increased illness, increased injury, longer recovery times, decreased performance
Common impairments associated w/ breast cancer rx
decreased should ROM
fatigue- chemotherapy
fibrosis of the tissue in the anterior chest wall- radiation
____first time mom
____more than on baby at home
____length of pregnancy- 280 days, 38-42 wks, 10 lunar months
____due date, full term if 2 wks before or after
____number of live births
____number of pregnancies regardless of outcome
