Why don't midwives ask about domestic abuse?

Lisa Buck · Sally Collins

21 citations0/0 files storedBritish Journal of Midwifery

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Intimate Partner and Family Violence Maternal and Perinatal Health Interventions Elder Abuse and Neglect

Abstract

Routine screening for domestic abuse in pregnancy is recommended and midwives are in an ideal position for this role. However due to an apparent reluctance to enquire about domestic abuse it often remains a hidden problem with detrimental consequences for women and their unborn children. The aim of this systematic review was to identify the most commonly reported factors that prevent healthcare professionals from routinely screening women for domestic abuse. Six electronic databases were searched for all articles published in the English language up to January 2006. Data, including all the reported reasons for not screening for domestic abuse, were extracted from all the studies which met the inclusion criteria. A simple ‘vote-counting’ analysis was performed with graphical representation and calculation of weighted means. Thirteen papers met the inclusion criteria. The perceived barriers to screening appeared similar across a range of specialities and clinical settings. The most commonly cited factors were: lack of time, lack of training, and inadequate resources. Domestic abuse remains a serious public health issue and is frequently exacerbated by pregnancy. Our results suggest that raising awareness of the issue should help midwives understand the need to prioritise screening and find the time required to do so. Encouragingly it also suggests that improving basic education and increasing access to simple resources, such as leaflets giving details of where to get support, may provide practitioners with the confidence required to ask women about domestic abuse.

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References

1992Primary care physicians' response to domestic violence. Opening Pandora's box 1999Screening and Intervention for Intimate Partner Abuse 1996Abuse During Pregnancy: Associations with Maternal Health And Infant Birth Weight 2002Barriers to screening for domestic violence 1992Abuse of pregnant women and adverse birth outcome. Current knowledge and implications for practice 1994Perinatal morbidity associated with violence experienced by pregnant women 1995Methods of and attitudes toward screening obstetrics and gynecology patients for domestic violence 1993Physical and Emotional Abuse In Pregnancy

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2012Domestic violence screening in maternal and child health nursing practice: A scoping review 2019Advancing methodologies to increase end-user engagement with complex interventions: The case of co-designing the Australian elder abuse screening instrument (AuSI)2013Domestic abuse as a transgressive practice: understanding nurses' responses through the lens of abjection 2018Abused women’s perceptions of professionals’ responses: valued support, or collusion with perpetrator?

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