What characteristics would lead a provider to suspect domestic violence, child abuse, or elder abuse is taking place within a family

VIOLENCE AGAINST WOMEN The American College of Nurse-Midwives (ACNM) affirms:

• Certified Nurse-Midwives (CNMs®) and Certified Midwives (CMs®), as advocates for and providers of primary women's health care, have a critical role to play in mitigating the effects of violence in women's lives.

• CNMs and CMs are educated to understand the dynamics of violence against women and

the impact of violence on the lives of women and their children.

• Appropriate assessment, intervention and referral for violence against women should be an integral part of all health care services provided to women and techniques for this process should be included in all health professional education programs.

• Development of health care policies that promote universal screening for the possibility

of past or current violence is essential as a first step in addressing health care risks of violence against women.

Background Violence against women is an enormous public health problem which adversely affects the physical, emotional and mental health of millions of women and their children. Violence against women is experienced by girls and women of all ages and occurs among all sectors of society. It occurs among all racial and ethnic groups; all religions; all economic and educational levels; and in heterosexual and same sex couple relationships. Abuse may be verbal, physical, emotional, sexual, and/or economic. The sequela of abuse includes a broad range of somatic, physical, emotional and behavioral problems that directly and indirectly impact the health of pregnant and non-pregnant women, their fetuses, their children and their families. ACNM supports a policy of "zero tolerance" for violence against women. In recognition that many women disclose violence in their lives to their health care providers, it is essential that there be the development of health care policies that promote universal screening for the possibility of past or current violence. In addition, ACNM recognizes violence against women as a community problem requiring a multi-disciplinary, community-based response. * Midwifery as used throughout this document refers to the education and practice of certified nurse-midwives (CNMs) and certified midwives (CMs) who have been certified by the American College of Nurse-Midwives (ACNM) or the American Midwifery Certification Board, Inc. (AMCB), formerly the American College of Nurse Midwives Certification Council, Inc. (ACC). Origin: Violence Against Women (Ad Hoc Committee) Current Source: Division of Standards and Practices, Clinical Standards and Documents Section Approved by the ACNM BOD: November 1995 Revised: August, 1997; 2003; Revised and reapproved, September 2013