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Identifying and Responding to Domestic Violence and Abuse (DVA) in Pregnancy #16DaysOfActivism

The 16 Days of Activism against Gender-Based Violence is an annual international campaign which will kick off on the 25th of November, the International Day for the Elimination of Violence against Women, and will run until the 10th of December, Human Rights Day. #16DaysOfActivism 

During these 16 days we will be launching and inviting people (predominantly health professionals) around the globe to enrol onto our Massive Open Online Learning Course (MOOC) entitled: Identifying and Responding to Domestic Violence and Abuse (DVA) in Pregnancy


Around 1 in 12 people are exposed to domestic violence and abuse (DVA) during pregnancy. This MOOC is free to access and will offer evidence-based training to professionals around the globe looking to improve their skills in supporting those affected by domestic violence and abuse (DVA) during pregnancy. On this course, students will discover the research, guidelines and techniques for screening for DVA. Students will have the opportunity to enhance their ability to support safe disclosure in maternity settings and empower victims of DVA to explore options and seek further support.

To enrol yourself and join the course… click this link

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Until next time…Look after yourselves and each other 💚💙💜❤

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The cycle of maltreatment: How can we best support those at risk of having their baby removed at birth?

Applications for babies to be taken in to care at birth are at a national high. This results in significantly impaired life outcomes for the birthing community and their babies. So what barriers and facilitators are at play here? We have produced the following review of the literature published in @BJMidwifery to uncover therapeutic mechanisms and interventions to support those at risk of having their baby removed from them at birth.

BJM lit review

Tantawi-Basra, T., & Pezaro, S. (2020). Supporting childbearing women who are at risk of having their baby removed at birth. British Journal of Midwifery28(6), 378-387.

white bear amirugumi knitted doll

What did we find?

Barriers in supporting childbearing women who are at risk of having their baby removed at birth include:

  • Social narratives – Do these set women up to fail?
  • The paradox of help-seeking, fear and stigma – Women avoiding seeking help due to a fear of services
  • Inequalities in ethnic minority groups
  • Adverse childhood events (ACEs) and the cycle of maltreatment

Facilitators in supporting childbearing women who are at risk of having their baby removed at birth include:

  • Women’s capacity for change and self-esteem
  • Childbearing becoming a motivator for change
  • Mutual and realistic goal setting
  • The development of strong professional relationships
  • Early and sustained interventions

Uniquely, using the themes presented within this review, we have been
able to model the cycle of maltreatment which needs to be broken in Figure 1.

Cycle of Maltreatment model

As this review only yielded eight studies in total, further research could usefully inform a richer provision of research inspired teaching and training in this area.

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Until next time…Look after yourselves and each other 💚💙💜❤

 

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Midwives experience domestic abuse too…so how can they be supported in the workplace?

On Thursday October 4th 2018, The Royal College of Midwives (RCM) launched a report entitled ‘Safe Places? Workplace Support for those Experiencing Domestic Abuse’ at its Annual Conference in Manchester Central.

love shouldn't hurt-printed on back of woman

I was privileged to be asked to perform and write up the analysis for this report. The findings truly moved me. If you know my work at all, you will know that it is heavily focused upon securing the psychological wellbeing of midwives. This is because I do not believe that excellence in maternity care can be delivered to mothers and babies without the provision of effective support for midwives.

Findings here revealed that some midwives trained to recognise domestic abuse and support women, were sometimes not recognising that they themselves are victims of domestic abuse.

“I was allowed to stay overnight on my delivery suite to avoid going home to my abusive partner”

“I was made to feel I was a nuisance, constantly asking me and contacting me, pressurizing me in to coming back to work. I gave in and did but I was soon off again as I still wasn’t well, and I then left midwifery because I didn’t want to be dismissed. I didn’t receive any support that was effective for me”

“I have and was been treated very badly by my place of work, absolutely no support or care and compassion”

“I was given a specific senior midwife who I could go to for support, to discuss things at times when home was particularly bad and to deal with any sickness absence – helpful as one person knew what was going on and I could be truthful, especially about the reasons for sickness absence sometimes”

“All staff should be asked about domestic abuse or violence on a regular basis”

“Police and social services were unhelpful, and no support provided. Neither I nor my children were offered counselling or directed to appropriate services despite asking several times for help. One police officer even commented that due to my ethnicity I could handle the situation myself.”

person holding white printer paper

Based on the findings the RCM has put forward the following evidence-based recommendations. These will enable maternity service managers and NHS Trusts/Boards to support staff experiencing domestic abuse more effectively.

  • All NHS Trusts/Health Boards should develop specific policies to support who are victims of domestic abuse, aligned to existing guidance from the NHS Staff Council developed in 2017.
  • NHS Trusts/Health Boards should provide and publicise confidential domestic abuse support services for affected staff, including access to IDVAs, external counselling and legal services as appropriate.
  • NHS Trusts/Health Boards should ensure that all managers and supervisors are trained on domestic abuse issues, so that they can recognise signs of domestic abuse in their staff and confidently undertake their safeguarding obligations.
  •  NHS Trusts/Health Boards should ensure that staff at all levels are trained on domestic abuse issues and made aware of relevant workplace policies as part of their induction programme and continuous updating and are made aware of support services.

It was a pleasure to work with esteemed colleagues at the RCM to put this report together. Midwives and maternity support workers are a highly valued workforce whom we rely on to provide optimal care for mothers and babies. It is our sincere hope that this report will enable maternity service managers and NHS Trusts/Boards to support staff experiencing domestic abuse more effectively.

“Thank you to all of the midwives and maternity support workers who took part in this survey. The wellbeing of maternity staff is intrinsically linked with the safety and quality of maternity services. Your thoughts, feelings and experiences have helped us to arrive at a deeper understanding of the resources required to support those experiencing domestic abuse.”

woman carrying newborn baby

If you would like to follow the progress of work going forward..

Follow me via @SallyPezaroThe Academic MidwifeThis blog

Until next time…Look after yourselves and each other 💚💙💜❤