Achieving continuous improvement in routine questioning about domestic violence with an embedded advocacy service

Domestic violence (DV) is a common but underreported cause of morbidity in pregnant women. A retrospective review of maternity notes of 103 women who delivered October-November 2007, followed by prospective review of records after feedback intervention of 168 pregnant women who had nuchal a scan in February 2008 was undertaken. The aim was to determine: (1) the proportion of women who were asked abuse questions at any time during pregnancy and postnatally; (2) the prevalence of disclosed domestic violence; (3) the sociodemographic predictors of a pregnant woman being asked about DV; (4) if feedback is associated with improved routine questioning. Routine enquiry about DV in pregnancy significantly increased from 53% in 2007 to 66% in 2008 (p < 0.05). Current DV was disclosed by 3.6% of women in both surveys. Domestic violence is common in pregnancy. After implementation of training and an embedded DV advocacy service, routine enquiry demonstrated significant increase over time.