Midwives and other health professionals have a crucial role in preventing domestic violence, say experts in the light of new research highlighting the harmful impact of abuse during pregnancy.
The US study suggests domestic violence during pregnancy increases the risk of pre-term birth and low birth weight.
“All of us working in health services need to be trained to recognise the signs of domestic violence”
Researchers from the University of Iowa analysed 50 studies into the effects of domestic violence by a partner or ex-partner. In total, the studies encompassed five million women from 17 countries with 15,000 having experienced domestic violence.
The analysis found domestic violence doubled the risk of pre-term birth and low birth weight. The risk increased further for women who experienced two or more types of domestic violence during their pregnancy.
The findings – published in BJOG: An International Journal of Obstetrics and Gynaecology – also indicated a slightly increased risk of babies being small for their gestational age.
“Domestic violence by a partner or ex-partner is of particular concern during pregnancy when not one, but two lives are at risk,” said lead author Audrey Saftlas, who stressed the importance of prevention work and support services.
“The midwife’s role is crucial in recognising signs of domestic abuse or violence”
Physical assaults on pregnant women can directly affect a growing foetus, noted the study authors. Domestic abuse can also have an indirect impact on unborn babies’ welfare caused by increased maternal stress, inadequate nutrition and poor pre-natal care.
Professor Lesley Regan, vice president for strategic development at the Royal College of Obstetricians and Gynaecologists, stressed the vital role of healthcare professionals in supporting vulnerable mothers who may not know about the support available.
“Healthcare professionals have an important role to play in tackling the problem and are often the first and only point of contact that the isolated and vulnerable victim reaches out to,” she said.
“All of us working in health and social services need to be trained to recognise the signs of domestic violence and abuse and know how to act and who to refer to, to ensure the woman’s safety,” she added.
The Royal College of Midwives said midwifery staff could play a key role in identifying victims and ensuring they got help.
“Midwives can often be the only contact the woman has with health services, and the midwife’s role is crucial in recognising signs of domestic abuse or violence and supporting or signposting women for further advice and support as appropriate,” said RCM professional policy advisor Janet Fyle.
“However, they need to be able to spend time with victims of domestic abuse and violence, to gain their trust, provide them with information, and support women to report the abuse or violence,” she said. “This is one of the reasons that continuity of care and carer is so important in maternity care.
“Midwives also need time to understand the current legal framework around domestic abuse,” she added.
The RCM is working to raise awareness of the issue and has chosen domestic abuse charity Women’s Aid as its charity of the year.