The discussion on sexual abuse reminded me of the other "taboo" we tend to
avoid - Domestic Violence

Due to the fact that we get to see moms chests and breasts, we also may see
the bruising related to domestic violence.  This is one of the hardest
problems to deal with for me as a professional.   I do ask where they came,
and accept her answer, however unlikely (fell down the steps).  

However, I am learning to be a little more forward, a lot more open, and
always carry with me the small card created by the local domestic violence
program, that she can hide in her shoe.  We may see her at a time when she
is not ready to leave.  But if we let her know we are NOT afraid if she
answers in the affirmative (studies show that health care professionals
don't ask, because they don't know what to say next...), sometimes she'll
get help - not from me necessarily, but from someone. 

We just had a mom of twins who did reach out - first visit, she was very
quiet - dad was in the back room and we didn't know it.  Second visit, she
opened up, but was not ready.  She had subsequent visits from the Public
Health Nurse.  Now she's ready.

So I recommend that each one of you have in your bag the list of resources
the mom can use - in a very small card that she can easily hide.

Jeanette Panchula, BSW, RN, IBCLC
Vacaville, CA

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