Monday, November 23, 1998 Published at 13:24 GMT
Zero tolerance urged for domestic violence
Almost a third of domestic violence cases begin when the woman is pregnant
The government has promised "zero tolerance" for men who batter their partners as a report reveals that 30% of cases start when the woman is pregnant.
Health minister Baroness Hayman told a conference organised by the Royal College of Obstetricians and Gynaecologists: "This is a serious issue and I for one intend to demonstrate zero tolerance of violence towards women."
She was speaking following the publication of the government-commissioned Report of the Confidential Enquiries into Maternal Deaths which showed that between 1994 and 1996 six women died just before or after childbirth because of domestic violence.
The government believes the figure may be an underestimate because it is difficult to get accurate figures.
The report urges health workers looking after pregnant women to be more alert to the problem and more sensitive in the way they handle it.
The report recommends that health workers should routinely ask about violence when they take a social history of the woman.
It also proposes that an interpreter who is not related to the patient be provided for all women whose first language is not English.
The government says it is pulling together a package of advice for health workers on how to help women.
Baroness Hayman said: "The enquiry's findings underline the reasons behind the government's commitment to a cross-departmental strategy to tackle domestic violence.
"Effective partnerships involving statutory bodies, health professionals and voluntary agencies will help to change attitudes and help prevent violence against women."
Jalna Hanmer, director of the research centre on violence, abuse and gender relations at Leeds Metropolitan University, said there had been no detailed research into why men attacked their pregnant partners.
In some cases, she said they appeared to deliberately want the woman to abort her child.
She said the reasons seemed to vary from man to man, but it was likely that many men attacked pregnant women because they were at their most vulnerable.
"We know that domestic violence increases with marriage, when a woman has children and when she is pregnant.
"This is because the woman is in a more vulnerable position in relation to the man. Basically, they do it because they can get away with it," she said.
She welcomed the government initiative, saying domestic violence in childbirth was a much greater problem than many other medical complications.
She had been trying to get funding to research good practice on domestic violence in primary care.
She said resources had been scarce until now because the medical profession had been reluctant to see domestic violence as a health issue.
She particularly welcomed the recommendation that pregnant women should be routinely questioned about whether they have been abused.
"Women will not be deely upset to answer no, but they will be incredibly grateful to answer yes and even if they answer no and they have been abused, they will not feel so isolated because it will seem the problem is so common," she said.
The report, which covers the 1994-1996 period, looks at women who have died during pregnancy or within 42 days of giving birth.
For the first time it includes deaths from domestic violence, car accidents, psychiatric illness and substance abuse.
All 268 deaths recorded are directly linked to or aggravated by pregnancy.
Most were due to medical complications, such as hypertension and blood clots and some were caused by missed diagnoses.
Suicide accounted for a "significant proportion" of deaths and the report called for more support for women suffering post- and ante-natal depression.
It added that many women were unaware of the need to use seat belts when they are in cars.
The belts should be worn above or below the bump.
Baroness Hayman said the findings showed that many of the women who died had felt inhibited about seeking help, particularly the socially excluded, the very young and those from ethnic minority groups.
"Services need to be responsive to the needs of vulnerable women," she said.
The British Medical Association recently issued a report on domestic violence which recommended doctors have special training to deal with domestic violence cases.
It estimated that a quarter of all women have been abused in the home and that over a third do not seek medical help.
A recent survey found that half of all maternity hospitals had failed to implement Royal College of Midwives guidelines on helping pregnant women who have been abused.
Three quarters of the hospitals said they gave no training to staff on how to identify women at risk.
The survey is part of the first nationwide report on violence against pregnant women.