8 Tips for Responding to Domestic Abuse for Maternity Healthcare Professionals

By Gene Feder OBE - Professor of Primary Health Care at the Centre for Academic Primary Care, Bristol Medical School, University of Bristol on 29 November 2021 Maternity Services RCM Midwives MSWs - Maternity Support Workers Domestic Abuse Wellbeing Of Women Safety

Pregnancy is a time of heightened vulnerability to domestic abuse, not because it is necessarily more prevalent, but because it may start or become more severe antenatally. There are generic lessons I have learned in the context of primary care about how clinicians can respond to patients experiencing abuse which may be relevant to my obstetric and midwifery colleagues.

1. Training in asking about Domestic Violence and Abuse and responding to women disclosing abuse must be integrated with safeguarding training. Otherwise, we potentially do more harm than good.
2. Ensure that in at least for one antenatal consultation you can speak to the woman on her own.
3. Ask about abuse as if you want to know the answer. If asked in a long list of screening questions, women are unlikely to disclose.
4. The immediate response to disclosure needs to be non-judgemental and supportive.
5. Don’t press for more details if the woman is reluctant to disclose them in the initial consultation. That can feel coercive.
6. There has to be a simple, direct referral route to an Independent Domestic Violence Advisor (IDVA) employed by your trust. Obstetricians and midwives cannot manage disclosure on their own.
7. Data on disclosures and referrals must be collected, reviewed by your trust and fed back to frontline clinicians and managers.
8. Your trust must have a policy on supporting clinicians and other staff who are experiencing domestic abuse.

 

Gene Feder OBE is Professor of primary health care at the Centre for Academic Primary Care, Bristol Medical School, University of Bristol. He is recognised for his work on Identification and Referral to Improve Safety (IRIS), a national domestic abuse training and referral programme for general practice and for leading research programmes on the health care response to gender-based violence nationally and globally.