Which of the following is a sign to suspect domestic violence in prenatal care?

• A. Missing prenatal care appointments
• B. Frequent medical visits for somatic complaints
• C. Normal, consistent prenatal care
• D. Partner attends every visit with the patient

Answer: (B)

Frequent medical visits for somatic complaints signal the possibility of domestic violence in prenatal care. When a patient reports non-specific physical symptoms like headaches, fatigue, abdominal pain, or GI upset repeatedly, without clear medical findings to explain them, it can reflect distress from ongoing abuse. This pattern often emerges because patients may underreport home violence but still seek care for relief from stress-related symptoms. Seeing this pattern should prompt a careful, confidential screen for abuse and a supportive response, rather than assuming the patient is simply noncompliant or experiencing ordinary pregnancy discomfort.

Missing prenatal appointments could be due to barriers to care or other factors, not necessarily abuse. Normal, consistent prenatal care is not a red flag. Having a partner attend every visit might be protective or could complicate disclosure, but by itself it does not identify abuse. If you notice the somatic-complaint pattern, approach with privacy, validate the patient’s experience, use sensitive screening questions, and provide resources or referrals as appropriate.