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Monday, 14 January, 2002, 01:35 GMT
Abuse screening 'may backfire'
Domestic violence
Pregnancy may spark domestic violence
Questioning women about domestic violence during antenatal visits could cause more harm than good if not done properly, says a report.

The study among pregnant women at Guy's and St Thomas' Hospitals in London found that not all of the women questioned had benefited from such screening.

The Department of Health recommends routine screening of women by health professionals to help uncover instances of domestic violence.

But the study's authors found that routine screening is only worthwhile with the right training and support in place.

One in three women are affected by domestic violence in their lifetime.

Previous studies into the problem have shown that during pregnancy, instances of violence caused by a partner may be as high as 16% (affecting one in six women).

Interviews

Even higher rates were found after questioning by health professionals.

The latest study, published in the British Journal of Obstetrics and Gynaecology, was conducted by Loraine Bacchus, Gill Mezey and Susan Bewley.


Being asked about domestic violence helped [some women] to think about things differently

Report authors

Their work followed a study of midwives' attitudes towards domestic violence (published in 1999), which found that 55% did not think questions about abuse should form part of the antenatal assessment.

A total of 771 women were originally screened at the initial reporting of pregnancy. This was later reduced to 32 women who were interviewed by the authors after their child's birth.

They were interviewed alone - either at home or in a doctor's surgery - and had either reported domestic violence before or during their pregnancy, or had never experienced domestic violence.

The report said: "Some women said that being asked about domestic violence helped them to think about things differently and assisted them in their seeking help and decision making."

'Painful memories'

However, for some in violent relationships, a baby's arrival had "engendered more positive feelings about the future of the relationship and a wish to 'make a go of things' for the sake of the baby".

These women felt that having a midwife raise the subject of domestic violence at this time conflicted with their own hopes for the future.

Some women also said midwives asked questions in a very "perfunctory manner".

One woman said of her midwife: "She was very carefree. It was an inadequate response ... it was all very clinical."

In some cases, the questions "triggered painful memories" if women had left violent relationships and begun re-building their lives.

Most, however, did think midwives were appropriate health professionals to ask about domestic violence in pregnancy.


Disclosing this kind of thing is very painful for the victim

Myra Johnson, Women's Aid

The report concludes more research is needed to determine whether on-site specialist domestic violence workers could help midwives in talking about similar past experiences with expectant mothers.

Myra Johnson, from Women's Aid, the charity which supports victims of domestic violence, said midwives were ideally placed to talk to women about their relationships, often forming "intimate relationships" with patients.

But she said it was crucial health professionals had the proper training and guidance and understanding of confidentiality issues.

She said: "It is fairly pointless, if you have personnel who do not possess the information and training to know what to do when someone discloses domestic violence to them.

"You cannot do half a job and if something is done in a hurry it can do harm, because disclosing this kind of thing is very painful for the victim."

She said the charity would not recommend bringing in a third party.

The charity offers health professionals guidance on preparing to talk to victims of abuse - which is available on its website.

See also:

04 Dec 01 | Sci/Tech
Online kiosks aid abused women
22 Nov 01 | England
Door opens on domestic violence
06 Aug 01 | Sci/Tech
Park bench goes online
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