Patient presents evidence of sexual abuse. Extent or type of injury is inconsistent with explanation by patient. Substantial delay exists between time of injury and presentation for treatment. Patient describes the alleged 'accident' in hesitant, embarrassed or evasive manner. Review of medical record reveals that patient has presented with repeated 'accidental' injuries.
Partner accompanies patient, insists on staying close to patient and answers all questions.
Domestic violence often begins with the first pregnancy. Patient has history of miscarriage. In the USA, domestic violence accounts for one in four suicide attempts by women. History of depression, anxiety, failure to cope, social withdrawal, with underlying sense of helplessness. The RCGP in Northern Ireland , RCGP Scotland , Wales , and Worldwide .