FROM: Ian Kemp, Sure Start midwife
SUBJECT: Reporting domestic violence
EMAIL:
babydeliveryman@blueyonder.co.uk
Dear editor
Community midwives are expected to ascertain from pregnant women in their care, generally at the booking visit, whether domestic violence (DV) is/has affected them. I have been advised that if a woman states that DV is an issue, or even if I have reasonable suspicion of it, then I should complete a MARAC risk assessment and share this information, in the name of safeguarding children, whether with the woman’s consent or not. This appears reasonable enough in the case of a multiparous woman. However, is it legal to do this, if the woman has no children as yet? As far as I am aware, the unborn child has no legal rights. As such, if a primiparous woman informs me that DV in some form has occurred, but she does not want me to share any information with anyone else, should I not respect her wishes?
Response from the RCM's Ethics Advisory Committee:
The Ethics Advisory Committee has now discussed the letter from Ian Kemp re: reporting domestic abuse in a primiparous woman. Whilst acknowledging that the fetus does not have any legal rights at the time of disclosure by the woman that she is experiencing domestic abuse/violence, it is recognised that as soon as the baby is born then any child protection issues must be addressed. It is also recognised that whilst the unborn child does not have any legal rights, midwives have a duty of care towards the fetus – why else do we provide antenatal care if not to ensure the wellbeing of both mother and baby? With or without disclosure by the woman, if a midwife suspects there is harm or potential harm to a child then this needs to be raised – the best person to discuss this with is likely to be the Supervisor of Midwives. Discussion of the issue with other relevant health care professionals provides an opportunity to prepare a care plan for the period after the birth to provide care and support for both mother and baby. It is recognised that for some women the disclosure of domestic abuse/violence may be a precursor to seeking assistance. It may be helpful to know that there is a all-Wales care pathway for the management of domestic abuse/violence in pregnancy which might provide some practical advise for dealing with this type of situation.
