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Domestic Abuse

Extracted from Mayes' Midwifery 14th Edition, Sue Macdonald, Julia Magill-Cuerden (Eds) Oxford; Baillière Tindall: 2011 Courtesy Elsevier

One in four women experience domestic abuse or violence at some point in their lives. This may be physical, sexual, emotional or psychological abuse. Thirty per cent of this abuse starts in pregnancy and existing abuse may get worse during pregnancy or after giving birth.

Domestic abuse in pregnancy increases the risk of miscarriage, infection, premature birth, and injury or death to the baby.

Women in abusive relationships are also more vulnerable to mental health problems including anxiety and postnatal depression.

When violence is suspected* the best way to confirm suspicion is by direct questioning, such as:

  • Has someone been hurting you?
  • Did somebody cause these injuries?
  • Do you ever feel frightened of your partner or other people at home?

The woman may choose to deny being abused but awareness that help is available is useful. Fostering a safe, nurturing and private environment during antenatal visits, with the midwife expressing empathy and honesty, may provide the woman with an opportunity to seek help. The midwife should understand the nature of domestic violence, be sensitive to clues that may suggest abuse and be aware of the impact of abuse on everyday life. Each maternity unit and midwifery group practice should have current details about domestic violence units and support groups for women. Recent research (Donovan, 2016) confirms that physical assaults on pregnant women can directly affect a growing fetus, increasing the risk of pre-term birth and low birth weight two-fold. *Routine enquiry about domestic violence should only be carried out if appropriate education and training has been provided.

The Practising Midwife featured articles

From public to private: the history of domestic abuse in Britain 2012; 14 (2): 20 - 21 Authors: Tania McIntosh, Cathy Ashwin

Cochrane Corner: Interventions for preventing or reducing domestic violence against pregnant women 2013; 16(6): 40 - 42 Author: Valerie Smith

Domestic violence in pregnancy: midwives and routine questioning 2016; 19(1): 26 - 29 Authors: G Stonard , E Whapples

 

Further reading/Resources

Donovan BM, Sprackler CN, Schweizer ML, et al. Intimate partner violence during pregnancy and the risk for adverse infant outcomes: a systematic review and meta-analysis. Br J Obs Gynecol 2016 DOI: 10.1111/1471-0528. 13928. Available at: http://onlinelibrary.wiley.com/doi/10.1111/1471-0528.13928/full

National Domestic Violence Helpline 0808 2000 247 Women's Aid https://www.womensaid.org.uk

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