Prevalence of domestic violence when midwives routinely enquire in pregnancy

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Abstract
Objective  To assess the prevalence of domestic violence in pregnancy when midwives are trained to enquire about it routinely.Design  A cross sectional study during a period after midwives had been trained to routinely enquire about it and a retrospective case note survey at an earlier period.Setting  The maternity services of Guy's and St Thomas' NHS Hospital Trust in South London.Sample  Women aged 16 and over booking for maternity care between 14th September 1998 and 21st January 1999.Methods  Midwives were required to routinely enquire about domestic violence at booking, 34 weeks of gestation and postpartum (within 10 days) using a series of structured questions.Main outcome measures  The lifetime and annual rates of domestic violence. The prevalence of domestic violence in pregnancy.Results  The prevalence of domestic violence in pregnancy was 1.8% at booking, 5.8% at 34 weeks of gestation and 5.0% at 10 days postpartum. Eight hundred and ninety‐two women were asked about domestic violence on at least one occasion, of whom 22 (2.5%) reported domestic violence in pregnancy. Two hundred and sixty‐five maternity notes were reviewed for the retrospective case note survey and one (0.37%) case of domestic violence in pregnancy was identified. Routine questioning increased the rate of detection of domestic violence by 2.1% (95% CI = 0.1–3.4%; P= 0.03). The lifetime prevalence of domestic violence was 13%, and 6.4% in the previous 12 months.Conclusions  Routine enquiry for domestic violence can increase the rate of detection in maternity settings, thereby providing an opportunity for women to access help early.

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