Because of the stigma involved , women and health care providers may hestitade to initiate discussion

about abuse. However, the majority of battered women say nthey would have liked to talk about the
issue with a health care professional if they were asked (King and Ryan, 1996). Because abuse develops
slowly, starting with minor psychological abuse and building to more severe physical incidents, if often
goes unrecognized by victim and health care providers alike until a severe episode occurs.

The quality of health care that a battered woman receives often determines whether she follows
through with referrals to legal, social service, and health care agencies. Inemergency departments, at
least 15% of adult female clients have been physically or sexually abused by a partner or ex-partner
(Dearwater et al,1998). Care in the emergency departemen is often fragmented and necessarily oriented
toward life-and-death situations. Therefore women may not adequately assessed and often receivelittle
or no specific emotional support or intervention. A cycle persists in which women seek care and receive
either no interventions or ineffective interventions.