The Western Australian government has announced a new program designed to combat domestic violence during pregnancy. The program aims to provide assistance to victims during their antenatal health care appointments.
Western Australia’s McGowan Government is hoping that the program to teach doctors and clinicians how to spot the signs of domestic abuse in pregnant women will reduce violence against expectant mothers and their babies.
Minister for the Prevention of Family Violence Simone McGurk said all WA women will now undergo preventative screening for domestic violence during the important time around the birth of their baby.
“This screening tool will be really crucial. This is about saving the lives of mothers and babies,” she said.
Health Minister Roger Cook said the $1.6 million program would be rolled out in metropolitan areas as well as across the Country Health Service.
He expected it to be very successful in domestic violence prevention.
One in four women will experience domestic violence during pregnancy. Pregnancy is a time when violence toward women is known to increase. For many, it is the first time that they will actually experience family violence. Women who are already in an abusive relationship may hope that pregnancy and/or having a baby will reform their partner and that they violence and/or manipulation will stop; however it is more likely to have the opposite effect, as rates of violence actually increase.
Many women who experience family violence in pregnancy are reluctant to leave because they are financially vulnerable, or they fear what their partner may do.
Health Consequences of Domestic Violence during Pregnancy
Violence during pregnancy is harmful to both the woman and her unborn baby. Research has shown that women reporting abuse during pregnancy had higher rates of intrauterine growth retardation, preterm labour and lower birth weight, as well as a higher risk of miscarriage. The baby can also be damaged by physical assault.
Family violence has significant mental health impacts for women, and is linked to antenatal depression,anxiety, and decreased attachment to the baby. It is also associated with lower rates of breastfeeding.
To Jacquelyn Campbell, a professor at the Johns Hopkins University School of Nursing in Baltimore, it isn’t. She’s been working on the issue of pregnancy and domestic abuse for more than 30 years.
Dr Campbell’s research shows men who abuse their partners during pregnancy are “particularly dangerous.”
“It’s one of the risk factors for homicide,” she says.
Even so, Dr Campbell wants us to view this information in context. “The vast majority of women who leave an abusive partner leave safely,” she says.
Reflecting on the hundreds of stories she’s heard from woman who have been abused during pregnancy, Dr Campbell says the partner was often “pathologically jealous” and against the evidence “thought the baby was somebody else’s.”
Dr Campbell goes on to explain that the variables are complex. For some women in violent relationships, she says, pregnancy is a protective factor. The violence ceases at pregnancy and resumes again after the baby is born.
For other women, it’s more of a “business as usual” scenario.
As a registered nurse, Dr Campbell is greatly concerned about the health risks this type of violence poses to the mother and baby. “We find that women who are abused during pregnancy are more likely to have a low birth weight infant,” Dr Campbell says, and “have an early delivery.”
While Dr Campbell says “we don’t know all the reasons why” babies of abused mothers are prone to having low birth weights, it “suggests some compromise of the placenta, which may be that stress response.”
Furthermore, the evidence shows intimate partner violence during pregnancy can be associated with “mental health problems and cognitive delays” in children.
And as Dr Campbell points out, the mother’s mental health can suffer too. “Abuse during pregnancy is one of the major risk factors for post-partum depression,” she says.
Experts now suggest that those involved in antenatal care – obstetricians, midwives and GPs – need to consider cultural norms and acceptability when asking women – especially migrant women – questions about domestic violence, and this must always be done in a way that keeps the woman safe. Partners should not be present when the questions are asked – and this may be done at another time in the pregnancy if necessary.
When women have continuity of midwifery care and get to know a midwife or doctor well throughout the pregnancy, it is easier for midwives to gain women’s trust and to notice when things change.
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