Background:
Rates of domestic violence (DV) can be considered to be of epidemic proportion and affect millions of people in ways which are physical, social, psychological, financial, and spiritual. Women of reproductive age are the ones most likely to be victimized and pregnant woman also represent a group vulnerable to such violence and abuse. Mental health conditions such as depression, anxiety, and posttraumatic stress disorder are significantly higher in women who have been victims of DV. This talk seeks to outline ways in which preconception care information should be tailored to women who are contending with a host of issues related to DV (e.g., lack of independence, challenges to consistency of birth control use, financial constraints, etc.) so that they can be more likely to follow through with the advice being given to them about their reproductive health.

Objectives:
Participants who attend this session should feel compelled afterwards to screen routinely for domestic violence and should walk away with new interview and intervention skills for working with victims and survivors of DV.

Methods:
A sample DV screening tool currently being administered throughout primary care in a large California HMO will be discussed. Audience members will be asked to consider ways in which they can better identify DV and alter their health advice for women contending with DV.

Results:
Medical providers to become more skilled at recognizing domestic violence and its significant impact on patient ability to follow through with preconception care advice.

Conclusion and implications for practice:
Provision of comprehensive preconception care cannot be considered complete unless the dynamic and challenging lives of women are strategically analyzed. Better recognition of DV in patients' lives and the ways in which being a victim of abuse can serve as a barrier to medical decision-making and adherence to medical advice will very much impact preconception care that is to be relevant and of practical use.