Research: Supporting midwives in asking women about domestic violence
What's happening in the world of midwifery research? A lead author summarises their work.
It is now widely accepted that domestic violence (DV) against women is a major public health issue. It is estimated around one in three women worldwide will have experienced either physical and/or sexual DV in their lifetime (WHO, 2017).
Engaging healthcare professionals, including midwives, in supporting women experiencing DV has proved to be a challenge. Proactive identification has been poor for a variety of reasons, such as believing that DV enquiry is not within their professional remit, fear of offending the woman, nervousness about dealing with a positive disclosure and a lack of training and education. In contrast, women experiencing DV consistently identify health professionals, including midwives, as a potential source of support. It is known that women are not offended by being asked about a history of DV when the question is asked by a caring and knowledgeable midwife. Indeed, evidence now suggests that women experiencing violence can feel let down if they are not given an opportunity to disclose their experiences.
A range of training programmes has been developed to advance midwives’ and nurses’ understanding of DV; however, very few training programmes have also included an evaluation. This particular study evaluated a one-day training programme, and measured its impact on the knowledge and preparedness of midwives and child nurses to routinely enquire about DV with women during pregnancy and the postnatal period.
Results from the study, conducted in Australia by Baird et al (2017), substantiates the fact that a robust education programme can lead to an increase in clinicians’ knowledge, confidence and awareness. However, to be successful, training and education programmes should concentrate not just on screening and detection, but on developing a supportive response for women and their children, including direct links to community specialist DV agencies and effective referral pathways. In order for routine enquiry into DV to be successful, it requires organisational commitment to ongoing support and training for staff, as well as robust policies, guidelines and referral pathways.
Regardless of whether a woman discloses or not, conducting a routine enquiry for DV can help break the silence that often surrounds it, and provides a woman with the opportunity to talk about her experience and receive information about community DV organisations that can provide advice and support.
Kathleen Baird is associate professor and midwifery and nursing education director at Gold Coast University Hospital and Griffith University, Debra Creedy is professor of perinatal mental health, Menzies Health Institute Queensland, Griffith University, and Amornrat Saito and Jennifer Eustace are lecturers at Griffith University
Baird KM, Saito AS, Eustace J, Creedy DK. (2017) Effectiveness of training to promote routine enquiry for domestic violence by midwives and nurses: a pre-post evaluation study. Women and Birth. See: doi.org/10.1016/j.wombi.2017.10.014
WHO. (2017) Violence against women: Intimate partner and sexual violence against women. See: http://www.who.int/mediacentre/factsheets/fs239/en/ (accessed 11 January 2018).