Domestic violence, as well as other forms of violence against women, has received increased attention from many sectors of society in the past two decades. Estimates that one fourth to one half of all women in the United States are victims of some type of violence are startling. There exists today a broad-based recognition of and response to the impact of violence on the workplace, the health care community, and the woman survivor and her children. Public health, corporate, and government initiatives are actively seeking solutions to address this most destructive dynamic. The education of health care providers to assess women appropriately for the potential of abuse--including proper intervention, documentation, and referral--has become an essential component of health care. As a recipient of a 3-year federal grant to educate students and practicing nursemidwives in the United States about the issue of domestic violence, the Special Projects Section of the American College of Nurse-Midwives (ACNM) has joined the ranks of concemed provider organizations. The primary goal of the project is to promote and enhance universal screening of all women who present for midwifery care. The role of the certified nurse-midwife and other women's health care providers and the role of ACNM in responding to the issue of domestic violence, including future goals and expectations, are discussed. Domestic violence (DV) is a public health problem with multiple and varied impacts on the family, workplace, and medical communities, as well as on society at large. National surveys estimate that at least 2 million women each year are battered by an intimate partner (male 90-95% of the time), and crime data from the Federal Bureau of Investigation records about 1,500 murders of women by male intimate partners each year (1). Domestic violence is an issue of power and control, with ever-increasing isolation playing a large part in both aiding the perpetrator in continuing the abuse and prohibiting the survivor from speaking out. This isolation may leave many women without access to the usual resources of family and friends or too ashamed to speak of the abuse to those individuals.
Medical care, often in the form of obstetric or gynecologic care, will still be sought in most instances; this