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Domestic Violence for MRCOG

ImbibeMe / ImbibeMedMRCOG Part 2Module 2 – Antenatal Care / Domestic Violence for MRCOG.

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Background

Percentage of women that present as victims of domestic violence in pregnancy –  30%.

Percentage of women that report having some form of domestic violence per year  – 7.1%.

Majority (85%) victims of domestic violence will see 5 professionals before they receive effective support.

Percentage of cases of domestic violence that start or escalate in pregnancy30%.

Domestic violence accounts for what percentage of foetal mortality among affected pregnancies – 1.6% (16 per 1000).

Percentage of men which reported having experienced at least one form of domestic violence during their lifetime according to 2012/13 Crime Survey for England and Wales –  16.3%.

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Strategies

It is recommended that staff in contact with women during the antenatal and postnatal period ask about domestic violence as a routine part of care and safeguarding of vulnerable adults and children is often a component of NHS trust mandatory training. 

Selective screening in :-

  • if suspicion arises,
  • if their husband constantly fails to accompany for the antenatal appointments,
  • those women who got pregnant for more than two times in the last four years
  • those women who have undergone more than two abortions.
  • those women who report with bleeding and pregnancy.

Also selective screening for domestic violence in high risk patient populations such as those attending gynaecology and HIV outpatient clinics.

Other innovative approaches include the placement of posters behind toilet doors in routine antenatal clinics telling women to place a blue sticker on their urine sample bottle if they wish to talk to a midwife about domestic abuse without their partner being present.  The midwife then ensures that he or she sees the patient alone at some point during the consultation.

Impact

The Department of Health estimates that women experience 35 episodes of domestic violence before seeking help.

Women who experience domestic violence in pregnancy have an increased risk of adverse pregnancy outcomes such as depression, preterm delivery, low birth weight, spontaneous miscarriage, intrauterine death and perinatal maternal and infant death.

The incidence of pre – eclampsia and gestational diabetes in pregnancy is around 2 – 5% whereas the incidence of domestic violence during pregnancy is 4 – 12%.

Recommendation

It is recommended that training on domestic violence be provided to all professionals who care for at risk patient groups.  The level of training recommended corresponds to the role of the healthcare practitioner; for example, healthcare assistants are required to obtain ‘level 1’ training whereas safeguarding leads require ‘level 4’ training.

Also, simulation for training about domestic violence be provided in the UG, PG and CPD courses in domestic violence management.

The most important feature of simulation is the provision of educational feedback also known as debriefing.

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Revise Numbers and Percentages in this article.

Percentage of women that present as victims of domestic violence in pregnancy –  30%.

Percentage of women that report having some form of domestic violence per year  – 7.1%.

Majority (85%) victims of domestic violence will see 5 professionals before they receive effective support.

Percentage of cases of domestic violence that start or escalate in pregnancy30%.

Domestic violence accounts for what percentage of foetal mortality among affected pregnancies – 1.6% (16 per 1000).

Percentage of men which reported having experienced at least one form of domestic violence during their lifetime according to 2012/13 Crime Survey for England and Wales –  16.3%.

The Department of Health estimates that women experience 35 episodes of domestic violence before seeking help.

The incidence of domestic violence during pregnancy is 4 – 12%.

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