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Red flags and gut feelings: midwives’ perceptions of screening for domestic and family violence

Domestic and family violence is significant problem affecting women in all countries. Defined as physical, sexual, or psychological harm at the hands of a current or former partner, domestic and family violence is the most common reason for hospital admission of women aged 15 – 54 years in Australia. Violence can begin for the first time in pregnancy or if already occurring, the frequency and intensity of violence can escalate. Midwives play an important role in helping women to recognise that they are experiencing domestic and family violence and linking women to appropriate support services to reduce the risk of serious harm.

A team of Transforming Maternity Care Collaborative researchers, led by Associate Professor Kathleen Baird, have recently published new research in this area (Baird, et al., 2020). Their research set out to explore midwives’ experiences in relation to screening for domestic and family violence.

Ten midwives, all with experience of working with women experiencing violence during pregnancy were interviewed. Key findings from the research were:
• Midwives valued ongoing training about working with women experiencing domestic and family violence,
• Midwives felt uncertain or unprepared to deal with domestic and family violence even after training and recognised that developing hands on experience is important,
• Midwives were reluctant to screen if they were not confident about what to do when a woman discloses a history of violence,
• Midwives described recognising “red flags” or having a “gut feeling” that something wasn’t right for some women who did not disclose a history of violence on routine questioning, and
• Having strong interpersonal relationships with women removed barriers to disclosure.

The authors concluded that “the best way to determine if the woman requires support is simply to ask her. However, it is important that this work with women is carried out in a supportive environment by a knowledgeable and trained midwife.”

References
Baird, K., Brandjerporn, G., Gillespie, K., Callander, E.J., & Creedy, DK. (2020). Red flags and gut feelings – midwives’ perceptions of domestic and family violence screening and detection in a maternity department. Women & Birth, in press.