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Sexual and reproductive health clinical consultations: domestic abuse
  1. Melissa Gardner1,
  2. Jayne Kavanagh2
  1. 1 Killick Street Health Centre, London, UK
  2. 2 UCL Medical School, University College London, London, UK
  1. Correspondence to Dr Melissa Gardner, Killick Street Health Centre, London N1 9RH, UK; melissa.gardner{at}

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Zeynep, a 24-year-old beautician, sees her general practice nurse about contraception. She starts the consultation by saying, “My husband wants to start having babies now, but I want to wait a bit”. The practice nurse discusses her contraceptive options and Zeynep opts to start the combined hormonal contraceptive pill.

The nurse is curious about Zeynep’s initial statement and asks about her relationship and directly about domestic abuse. Zeynep says her husband can be quite controlling and when stressed calls her names and throws things. He insists she texts him when she comes home from work, and if she doesn’t, he rings incessantly until she answers. He has banned her from going to evening work events, as he fears she will cheat on him. Recently, he became threatening and abusive about her wearing makeup, accusing her of having an affair. She is now careful about how she dresses and only wears subtle makeup. He has never physically or sexually assaulted her, and he does not have financial control over her.

The nurse responds by acknowledging the abuse and explaining about services that could help her. Zeynep is not sure whether she wants to speak to any specialist services but does agree to a follow-up appointment with her general practitioner (GP). She is concerned her partner may be able to access her notes online. The nurse retracts the consultation from online access.

Over the following months, Zeynep has several conversations with her GP about the abuse. She later agrees to speak with an Independent Domestic Violence Advocate (IDVA) at the local domestic abuse service. She decides to end the relationship and engages with counselling through the domestic abuse service. Her next relationship is healthy and …

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  • Editor's note The details of this case are fictitious. Any resemblance to actual persons, living or dead, or actual events is coincidental.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient and public involvement Patients and/or the public were involved in the design, or conduct, or reporting, or dissemination plans of this research. Refer to the Methods section for further details.

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