Gender-based and intimate-partner violence: asking, safety planning and activating the care route

What it is

WHO estimates that about 1 in 3 women worldwide have suffered physical or sexual violence from a partner or sexual violence from someone else. Violence causes injuries, chronic pain, depression, PTSD and sexual and reproductive harm, and in pregnancy it raises the risk of miscarriage, stillbirth, preterm birth and low birth weight. WHO does not recommend universal screening of all women, but it encourages health workers to raise the topic when injuries or conditions suggest violence, always in private. First-line support follows LIVES: Listen, Inquire about needs, Validate, Enhance safety and Support. In Colombia, Ley 1257 de 2008 defines violence against women (physical, sexual, psychological, economic and patrimonial) and gives victims the right to comprehensive, confidential care.

What it requires

• Signs that should make the nurse ask: unexplained or repeated injuries, delay in seeking care, chronic pain without a clear cause, repeated STIs or unwanted pregnancies, missed appointments and late prenatal care.
• An intrusive partner who answers for her or refuses to leave the room is a warning sign.
• Higher danger: violence that grows in frequency or severity, threats with weapons, attempted strangulation, threats to kill, beatings during pregnancy and violent jealousy.
• Separation is the most dangerous time; a woman who decides to leave should plan it and reach a safe place before the partner knows.
• Ley 1257 art. 8: the victim decides whether to be confronted with the aggressor and gives informed consent for forensic examinations in sexual violence.

Components

• Private setting: alone, with no one older than a small child able to overhear.
• First-line support: LIVES.
• Safety: assessment of immediate risk and a safety plan.
• Care: injuries, sexual and reproductive health, mental health.
• Route: referral to protection, justice and psychosocial services, according to the territory's route.

How it is applied (and why)

1. Find a way to see her alone (another room, a form, a test) — she cannot speak freely if the aggressor is near.
2. Ask simple, direct questions about fear, being hurt or controlled, using her own words — avoid labels like «victim» or «abused».
3. Listen without interrupting or judging and say you believe her — validation is part of the care.
4. Ask what she needs now (health, safety, information, someone to talk to) — her priorities guide the plan.
5. Assess immediate danger and ask if it is safe to go home — if not, look for a safe place or shelter with her.
6. Make a safety plan: where to go, children, transport, documents, money, a neighbour who can call — a plan helps if violence starts.
7. Care for injuries and offer sexual, reproductive and mental health care — violence affects the whole person.
8. Record what she says and the injuries, with her agreement and out of sight of others — the record may later be evidence.
9. Activate the care and protection route the territory has and offer follow-up — she should not leave without a next step.

In nursing practice

• In pregnancy, ask at prenatal visits when signs appear, and remember that late or missed prenatal care may itself be a sign.
• If she does not disclose, do not press: offer information about services and another visit; many women tell after being asked more than once.
• Do not offer couples counselling when there is partner violence.
• Keep records out of view (not on bed charts or request slips) and explain the limits of confidentiality before she tells.

Common mistakes

• Asking in front of the partner or family.
• Pressing her to leave, report or tell details she does not want to share.
• Letting her go without a safety plan or a next step.
• Writing the record where others can read it.

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Elsewhere in DurgiPedia

• Intimate-partner and gender-based violence
• Resolution 459 of 2012: the health-care protocol for sexual violence
• Mandatory reporting: public health, violence and abuse

Connections

← All of nursing

Educational content for students; it does not replace your institution's protocols, supervised clinical training or a prescriber's order. Dose-calculation examples use made-up numbers: they are educational, not a clinical order.

Sources: Violence against women (fact sheet) (World Health Organization, 2025); Clinical handbook on the health care of survivors subjected to intimate partner violence and/or sexual violence (national adaptation of the WHO clinical handbook) (WHO Regional Office for Africa; Ministry of Health and Social Services, Namibia, 2021); Nursing: Mental Health and Community Concepts, 15.5 Intimate Partner Violence (Open RN (Ernstmeyer & Christman, eds.), Chippewa Valley Technical College; LibreTexts, 2022); Ley 1257 de 2008 (violencia y discriminación contra las mujeres), con las modificaciones de la Ley 2136 de 2021 (Secretaría General del Senado de la República, Colombia, 2008).

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Representative model, for educational purposes only.