Thursday, July 29, 2010

"He just gets pushy"

Say what!!! This was the response of 24yo AD Army E-3 L.Z. G1P0 NOB at 11wks gestation when asked (behind closed doors after her initial intake and her "boyfriend/father of baby" departed the room for the "girly part of the exam" )about her boyfriend's behavior towards her during the interview.
We can all appreciate the depth and breadth of inquiry during an initial OB visit...which, should be answered as best as possible by the WOMAN....well, during the interview with this particular visit, L.Z. for some reason, allowed her boyfriend/father of baby of 6 months to answer most of the questions because, as he put it, " [she] was taking too long to answer the simple questions."
He was so blatantly verbally aggressive in the exam room, that I feared how he might behave towards her when not in public or if there was actually a "real" dispute between the them. So when he volunteered his excuse from the room to allow her physical exam to be conducted, I brought it down...tactfully and professionally as possible my concerns about her safety, the safety of her unborn baby as the pregnancy ensues and the overall safety and welfare of her and the baby after delivery. Though she became teary eyed, she insisted that he had never been physically, emotionally, sexually, or otherwise abused by him nor felt threatened for her life or safety. She simply stated, "He just gets pushy." I expressed to her, again, my concerns for her during the pregnancy and discussed the recency of their relationship and pregnancy state and potential for the verbal aggression to escalate to physical violence. I provided her with multiple numbers for support and counseling that we hand wrote on a sticky pad so as not to raise alarm to her boyfriend if he saw pamphlets or handouts specifically addressing the concerns. We thoroughly documented the encounter and instructed her to schedule a visit, ALONE, within the next week and if she didn't mind, to keep the provided informed if she was seeking counseling or assistance she sought so as to ensure her optimal safety throughout the pregnancy. We did not contact her command as there was no evidence of physical abuse on exam and she vehemently denied being abused. Her boyfriend was not AD and thus this would otherwise be purely domestic requiring involvement of local law enforcement if things escalated. Moral of the story, never be afraid to ask, never be afraid to offer, never ignore your gut instinct that something is wrong. She expressed sincere gratitude for recognizing his behavior as she admitted feeling "stressed" by it...ding, ding, ding!!! and that she would follow through with scheduling her follow-up.

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