Addressing domestic violence through maternity services: policy and practice

Area of Science:

• Public Health
• Healthcare Policy
• Women's Health

Background:

• Domestic violence is a significant public health issue affecting women during pregnancy.
• Identifying and supporting women experiencing domestic violence within maternity services is crucial for their well-being and that of their children.

Purpose of the Study:

• To explore current policies and practices in UK maternity units for identifying, assessing, and supporting women experiencing domestic violence.
• To understand the extent of implementation of domestic violence protocols in National Health Service (NHS) Trusts.

Main Methods:

• A postal survey was conducted between June and October 1999.
• The survey targeted Heads of Midwifery or designated domestic violence leads in all NHS Trusts in England and Wales providing maternity services.
• Key outcome measures included the use of written policies, agreed practices for identification and referral, information availability, routine questioning, and partner-unaccompanied appointments.

Main Results:

• 87% of NHS Trusts participated.
• Only 12% of maternity units had written policies for identifying domestic violence; 30% had agreed practices.
• Less than half routinely offered partner-unaccompanied appointments, and just over half displayed domestic violence information.
• Audit of domestic violence practices was rare, with only three units reporting such activity.

Conclusions:

• There is considerable variability in domestic violence policies and practices across maternity units in England and Wales.
• There is a clear need for standardized guidelines on identification and referral.
• Essential improvements include mandatory training, regular audits, and better integration of domestic violence policies with child protection protocols.