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Screening for domestic violence during pregnancy follow-up: evaluation of an intervention in an antenatal service

Archives of Women's Mental Health volume 24, pages 293–301 (2021)Cite this article

Abstract

To assess the impact of a brief training for obstetricians and midwives about screening for domestic violence during pregnancy follow-up and to identify barriers to a routine enquiry. A monocentric quasi-experimental study was performed in an obstetrics department in Paris, France. We asked patients during their pregnancy follow-up to complete a survey describing their demographic characteristics. They were also asked if a health professional had screened them for domestic violence during the current pregnancy. Exclusion criteria were refusal and inability to complete the survey alone. Health professionals attended a brief training about domestic violence. The intervention provided general information about domestic violence to alert health professionals (prevalence, risk factors, consequences on women’s health, pregnancy, and children) and guidelines on screening and how to deal with women disclosing domestic violence. They also had to complete a survey about their knowledge and practice concerning domestic violence. Two months later, patients consulting for their pregnancy follow-up completed the same survey. Health professionals were not aware of the study’s aim throughout its course. The primary outcome was the rate of patients screened for domestic violence during pregnancy follow-up. The secondary outcome was the identification of barriers to a routine enquiry. Four hundred ninety-five patients completed the first survey (control group): 21 patients (4.8%) had been screened for domestic violence. Twenty-one health professionals attended the intervention. Eight (38.1%) stated that they never screened for domestic violence, and 3 (14.3%) stated that they always did. Three hundred ninety-five patients completed the second survey (experimental group): 17 patients (4.3% vs 4.8%, p = 0.53) stated that they had been screened for domestic violence. The main barriers to screening mentioned by health professionals were the presence of the partner, the lack of awareness of the need to screen, uncomfortable feelings, and the difficulty to identify victims. There was no increased screening for domestic violence during pregnancy follow-up after a brief training of obstetricians and midwives. An early training during medical studies or more extensive training for professionals could be more efficient.

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References

  • Alaggia R, Regehr C, Rishchynski G (2009) Intimate partner violence and immigration laws in Canada: how far have we come? Int J Law Psychiatry 32(6):335–341

    Article  PubMed  Google Scholar 

  • Alhusen JL, Bullock L, Sharps P, Schminkey D, Comstock E, Campbell J (2014) Intimate partner violence during pregnancy and adverse neonatal outcomes in low-income women. J Women's Health 23(11):920–926

    Article  Google Scholar 

  • Amaro H, Fried LE, Cabral H, Zuckerman B (1990) Violence during pregnancy and substance use. Am J Public Health 80(5):575–579

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • American College of Obstetricians and Gynecologists (2012) Intimate Partner Violence. Committee opinion. Obstet Gynecol 119(518):412–417

    Google Scholar 

  • Bacchus LJ, Bewley S, Torres Vitolas C, Aston G, Jordan P, Murray SF (2010) Evaluation of a domestic violence intervention in the maternity and sexual health services of a UK hospital. Reprod Health Matter 18(36):147–157

    Article  Google Scholar 

  • Baird KM, Salmon D, White P (2013) A five-year follow-up study of the Bristol pregnancy domestic violence programme to promote routine enquiry. Midwifery 29:1003–1010

    Article  PubMed  Google Scholar 

  • Baird KM, Saito AS, Eustace J, Creedy DK (2018) Effectiveness of training to promote routine enquiry for domestic violence by midwives and nurses: a pre-post evaluation study. Women Birth 31:285–291

    Article  PubMed  Google Scholar 

  • Beynon CE, Gutmanis IA, Tutty LM, Wathen CN, MacMillan HL (2012) Why physicians and nurses ask (or don’t) about partner violence: a qualitative analysis. BMC Public Health http://bmcpublichealth.biomedcentral.com/articles/10.1186/1471-2458-12-473 Accessed 6 August

  • Borges Jelinic A (2019) I loved him and he scared me: migrant women, partner visas and domestic violence. Emot Space Soc 32:1–8

    Article  Google Scholar 

  • Boufettal H, Majdi F, Belhouss A, Mahdaoui S, Noun M, Hermas S, Samouh N (2012) Violence conjugale chez les femmes enceintes. Rev Médecine Légale 3(2):72–78

    Article  Google Scholar 

  • Brownridge DA, Taillieu TL, Tyler KA, Tiwari A, Chan KL, Santos SC (2011) Pregnancy and intimate partner violence: risk factors, severity, and health effects. Violence Against Women 17(7):858–881

    Article  PubMed  Google Scholar 

  • Cherniak D, Grant L, Mason R, Moore B, Pellizarri R (2005) Déclaration de consensus sur la violence exercée par le partenaire intime. J Obstet Gynaecol Can 27(4):389–418

    Article  Google Scholar 

  • Cillart L, Parayre I, Pereira B, Desmartin C, Leymarie MC (2017) État de lieux des pratiques du dépistage des violences conjugales en Auvergne. Rev Sage-Femme 16(5):296–302

    Article  Google Scholar 

  • Council of Europe (2011) Council of Europe Convention on preventing and combating violence against women and domestic violence. https://www.coe.int/fr/web/istanbul-convention/. Accessed 6 August 2019

  • Creedy DK, Baird K, Gillespie K (2019) A cross-sectional survey of pregnant women’s perceptions of routine domestic and family violence screening and responses by midwives: testing of three new tools. Women Birth, In press. https://doi.org/10.1016/j.wombi.2019.06.018

  • Daligand L (2015) Violences conjugales. Aspects psychopathologiques. Éthique Santé 12(4):250–257

    Article  Google Scholar 

  • Dunn LL, Oths KS (2004) Prenatal predictors of intimate partner abuse. J Obstet Gynecol Neonatal Nurs 33(1):54–63

    Article  PubMed  Google Scholar 

  • Foy R, Nelson F, Penney G, Mcllwaine G (2000) Antenatal detection of domestic violence. Lancet. 355(9218):1915

    Article  CAS  PubMed  Google Scholar 

  • François I, Moutel G, Plu I, Fauriel I, Hervé C (2004) Violences conjugales, quelles difficultés pour les médecins ? Presse Med 33(22):1561–1565

    Article  PubMed  Google Scholar 

  • French National Authority for Health (2019) Recommandations de bonne pratique. Repérage des femmes victimes de violences au sein du couple

  • Gazmarian JA, Ballard TJ, Saltzman LE, Marks JS (1996) Prevalence of violence against pregnant women. JAMA 275(24):1915–1920

    Article  Google Scholar 

  • Gielen AC, O’Campo PJ, Campbell JC, Schollenberger J, Woods AB, Jones AS (2000) Women’s opinions about domestic violence screening and mandatory reporting. Am J Prev Med 19(4):279–285

    Article  CAS  PubMed  Google Scholar 

  • Glass N, Dearwater S, Campbell J (2001) Intimate partner violence screening and intervention: data from eleven Pennsylvania and California community hospital emergency departments. J Emerg Nurs 27(2):141–149

    Article  CAS  PubMed  Google Scholar 

  • Hassan M, Kashanian M, Hassan M, Roohi M, Yousefi H (2014) Maternal outcomes of intimate partner violence during pregnancy: study in Iran. Public Health 128(5):410–415

    Article  CAS  PubMed  Google Scholar 

  • Hegarty K, O’Doherty L, Taft A, Chondros P, Brown S, Valpied J, Taket A, Gold L, Feder G, Gunn J (2013) Screening and counselling in the primary care setting for women who have experienced intimate partner violence (WEAVE): a cluster randomised controlled trial. Lancet 382(9888):249–258

    Article  PubMed  Google Scholar 

  • Henrion R (2005) Les violences conjugales pendant la grossesse: dépistage et orientation par les soignants. J Gynecol Obstet Biol Reprod 34(1):62–67

    Article  Google Scholar 

  • Hill A, Pallitto C, McCleary-Sills J, Garcia-Moreno C (2016) A systematic review and meta-analysis of intimate partner violence during pregnancy and selected birth outcomes. Int J Gynecol Obstet 133(3):269–276

    Article  Google Scholar 

  • Inter-ministerial Mission on Women Protection and Against Human Trafficking (2018) La lettre de l’observatoire national des violences faites aux femmes. https://stop-violences-femmes.gouv.fr/IMG/pdf/violences_au_sein_du_couple_et_violences_sexuelles_novembre_2018.pdf. Accessed 6 August 2019

  • Janssen PA, Holt VL, Sugg NK (2002) Introducing domestic violence assessment in a postpartum clinical setting. Matern Child Health J 6(3):195–203

    Article  PubMed  Google Scholar 

  • Jaspard M, Equipe Enveff (2003) Enquête nationale sur les violences envers les femmes en France. Paris: La Documentation française

  • National French College of Gyncologists and Osbtetricians (2004) Dépistage des violences faites aux femmes. http://www.cngof.asso.fr/d_livres/2004_Go_233_henrion.pdf. Accessed 6 August 2019

  • O’Doherty L, Hegarty K, Ramsay J, Davidson LL, Feder G, Taft A (2015) Screening women for intimate partner violence in healthcare settings. Cochrane 7:1–105

    Google Scholar 

  • Palladino CL, Singh V, Campbell J, Flynn H, Gold K (2012) Homicide and suicide during the perinatal period: findings from the national violent death reporting system. Obstet Gynecol 118(5):1056–1063

    Article  Google Scholar 

  • Parsons LH, Zaccaro D, Wells B, Stovall TG (1995) Methods of and attitudes toward screening obstetrics and gynecology patients for domestic violence. Am J Obstet Gynecol 173(2):381–387

    Article  CAS  PubMed  Google Scholar 

  • Rogathi JJ, Manongi R, Mushi D, Rasch V, Sigalla GN, Gammeltoft T, Meyrowitsh DW (2017) Postpartum depression among women who have experienced intimate partner violence: a prospective cohort study at Moshi, Tanzania. J Affect Disord 218:238–245

    Article  PubMed  Google Scholar 

  • Royal Australian College of General Practitioners (2014) Abuse and violence: working with our patients in general practice http://www.racgp.org.au/your-practice/guidelines/whitebook. Accessed 6 August 2019

  • Salmon D, Murphy S, Baird K, Price S (2006) An evaluation of the effectiveness of an educational programme promoting the introduction of routine antenatal enquiry for domestic violence. Midwifery 22:6–14

    Article  PubMed  Google Scholar 

  • Saurel-Cubizolles MJ, Lelong N (2005) Violences familiales pendant la grossesse. J Gynecol Obstet Biol Reprod 34(1):47–53

    Article  Google Scholar 

  • Smith R, Wight R, Homer CSE (2018) ‘Asking the hard questions’: improving midwifery students’ confidence with domestic violence screening in pregnancy. Nurse Educ Pract 28:27–33

    Article  PubMed  Google Scholar 

  • Spangaro J, Herring S, Koziol-Mclain J, Rutherford A, Frail M-A, Zwi AB (2016) ‘They aren’t really black fellas but they are easy to talk to’: factors which influence Australian Aboriginal women’s decision to disclose intimate partner violence during pregnancy. Midwifery 41:79–88

    Article  PubMed  Google Scholar 

  • Taft AJ, Hooker L, Humphreys C, Hegarty K, Walter R, Adams C, Agius P, Small R (2015) Maternal and child nurse screening and care for mothers experiencing domestic violence (MOVE): a cluster randomised trial. BMC Med 13(150):1–10

    Google Scholar 

  • Tison B (2015) Violences conjugales et couples indiens d’origine tamoule en France. Éthique Santé 12(4):239–243

    Article  Google Scholar 

  • Valladeres E, Peña R, Ellsberg M, Persson LÅ, Högberg U (2009) Neuroendocrine response to violence during pregnancy – impact on duration of pregnancy and fetal growth. Acta Obstet Gynecol Scand 88(7):818–823

    Article  Google Scholar 

  • Waalen J, Goodwin MM, Spitz AM, Petersen R, Saltzman LE (2000) Screening for intimate partner violence by health care providers: barriers and interventions. Am J Prev Med 19(4):230–237

    Article  CAS  PubMed  Google Scholar 

  • Webster J, Chandlera J, Battistutta D (1996) Pregnancy outcomes and health care use: effects of abuse. Am J Obstet Gynecol 174(2):760–767

    Article  CAS  PubMed  Google Scholar 

  • World Health Organization (2012) La violence exercée par un partenaire intime. https://apps.who.int/iris/bitstream/handle/10665/86232/WHO_RHR_12.36_fre.pdf;jsessionid=208B35F 03788CC7EF000F29C5F94A3EE?sequence=1. Accessed 6 August 2019

  • World Health Organization (2013) Global and regional estimates of violence against women: Prevalence and health effects of intimate partner violence and non-partner sexual violence. https://apps.who.int/iris/handle/10665/85239. Accessed 6 August 2019

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Acknowledgments

The authors would like to thank Maxence Lagalle for methodological help.

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Authors and Affiliations

  1. Department of Forensic Medicine, Service de médecine légale et médecine sociale, Hospital Jean Verdier, Avenue du 14 Juillet, 93140, Bondy, France

    Sophie Duchesne & Patrick Chariot

  2. Obstetrics Department, Service de gynécologie obstétrique, Institut Mutualiste Montsouris, 75014, Paris, France

    Anne-Claire Donnadieu & Christine Louis-Sylvestre

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  1. Sophie Duchesne
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  2. Anne-Claire Donnadieu
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  4. Christine Louis-Sylvestre
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Correspondence to Sophie Duchesne.

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Conflict of interest

The authors declare that they have no conflict of interest.

Informed consent

Patients received written information with investigator contact details. If they consented to be included, they fulfilled the survey. In case of refuse, they did not receive the questionnaires or did not give it back to the investigator.

Ethical approval

Procedures performed in this study were in accordance with the ethical standards of the institution committee, and ethical approval was given by the institutional review board CEPAR: 2018-03.

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Article 222–14 Pénal. Sect. 1: Des atteintes volontaires à l’intégrité de la personne, Loi n°2010-769 Juillet, 2010 (https://www.legifrance.gouv.fr/affichCodeArticle.do?cidTexte=LEGITEXT000006070719&idArticle=LEGIARTI000006417647&dateTexte=&categorieLien=cid Accessed 6 August 2019).

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Duchesne, S., Donnadieu, AC., Chariot, P. et al. Screening for domestic violence during pregnancy follow-up: evaluation of an intervention in an antenatal service. Arch Womens Ment Health 24, 293–301 (2021). https://doi.org/10.1007/s00737-020-01058-4

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  • DOI: https://doi.org/10.1007/s00737-020-01058-4

Keywords

  • Pregnancy
  • Domestic violence
  • Intervention
  • Screening