Fear of having their children and unborn babies taken into care is a key reason pregnant women who are enduring domestic violence do not tell maternity hospitals about the abuse, a study published on Thursday finds.
The report, an evaluation of a pilot project between four maternity hospitals and Women’s Aid, also finds shame and a belief that hospital staff won’t be able to help further discourage pregnant women experiencing abuse asking for help.
The three-year pilot project, in the three Dublin maternity hospitals and Cork University Maternity Hospital, saw almost 350 maternity care staff receiving specialist training in recognising the signs a woman may be experiencing abuse, in sensitively asking her, and, in responding appropriately.
It also included information about supports for women experiencing domestic violence being displayed prominently throughout the hospitals and a one-to-one support service in the Dublin maternity hospitals which provided “same day” support upon referral to 379 pregnant victims of domestic abuse.
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Though such a project was committed to in the HSE’s 2016 national maternity strategy, this three-year (2021-2024) pilot, costing €536,000, was entirely funded by Women’s Aid through donations from the public and non-statutory funds.
The evaluation report, conducted by a non-profit Centre for Effective Services, surveyed 74 women who had experienced domestic violence while pregnant, conducted focus groups and interviewed key personnel involved in providing the pilot service.
It found “the majority of survey respondents indicated that they had not accessed any other specialist support services for [domestic violence] during pregnancy and the majority also indicated that they were not aware of any local support services at that time”.
In addition it found screening for domestic violence and abuse (DVA) in pregnancy was not universal in maternity hospitals, and women accessing private care were “much less likely to have seen information about DVA and much less likely to have been asked about DVA during their pregnancy”.
Survey respondents were “strongly in favour of women being asked about domestic violence and abuse [DVA] frequently at their appointments with maternity services.”
The report continued: “Women called for improved understanding of coercive control and the behaviours that constitute domestic abuse. They recommended that staff in maternity services be trained to ask questions about DVA that relate to controlling relationships, and to recognise signs of psychological abuse”.
There is no robust data on prevalence of DVA experienced by women in pregnancy or while nursing but it is known to increase during these periods in women’s lives.
“What should be a joyful time in a woman’s life can be marred by serious physical assaults and persistent abusive behaviours, that negatively impact her physical and mental health,” said Sarah Benson, chief executive of Women’s Aid.
“The impacts of domestic abuse during the perinatal period can be devastating. Perinatal abuse and in particular targeted assaults aimed at the abdomen increase the risk of maternal and foetal morbidity and mortality. Essentially, both mother and baby are victims of domestic abuse during pregnancy.”
Maternity services workers were particularly well-placed to support women, she continued. “We know that pregnancy can be a time when women are thinking more about the future, presenting an opportunity for intervention and support.
“Regular, ongoing healthcare appointments in pregnancy not only offer multiple opportunities for disclosure and space to build trusting relationships, but also provide a situation where women can access services without arousing suspicion from an abusive partner.”
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