Wednesday, August 10, 2022

Domestic Violence

This blog post is a Quick Note on Domestic Violence, one of the vital topics for MRCOG exams. The points have been taken from various resources including NICE and TOGs.

I hope this post is helpful for you. 

Please feel free to leave your feedback and suggestion for new blog posts are welcome.

Thanks



Domestic Violence
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Introduction

  • Abuse of an individual >16 yrs by a current or former partner or family member, regardless of gender or sexuality 
  • It could be   Physical   Emotional   Psychological   Financial or   Sexual

Worldwide 1 in 3 women experienced DV b/w 2000-18

UK figures

  • Incidence  1:4 lifetime risk DV
  • 2 women per wk murdered by partner/ex  
  • 30% of DV starts or escalates in pregnancy  
  • 4-9% during pregnancy ± after childbirth  

Dec 2020 Ref TOG

  • Due to the Covid-19 pandemic there was a 7% in the total number of domestic abuse-related offences 
  • Helpline calls by up to 5-fold

Impact of DV

  • Devastating for the health and well-being of women
  • Associated with risk of poor current health, chronic disease, substance abuse and also a negative impact on mental health 
  • Also an issue of child protection
  • 10% of postnatal depression attributable to DV & abuse
  • Victims are 4x more likely to have anxiety disorders and a 7-fold increased likelihood of PTSD

Adverse Effects of DV on pregnancy outcomes

  • Preterm birth, chorioamnionitis, low birth weight baby, unexplained stillbirth

Factors in pregnancy linked to increased risk of DV

  • Teenager
  • Late booker
  • Concealed Pregnancy
  • Bleeding in early pregnancy
  • Substance abuse
  • Having pre-existing mental health conditions like PND, anxiety & PTSD

Why do women hesitate to seek help?


Fear of 

    • stigma or shame
    • HCP not believing them
    • the consequences

Possible Signs  COULD BE ANYTHING

  • Vague symptoms Frequent visits
  • Missed visits Late bookers 
  • Non-compliance with t/m
  • Suicidal attempts
  • Partner attends unnecessarily

NICE recommendations for DV

  • All healthcare providers MUST ask about DV every woman
  • Mandatory training for safeguarding vulnerable adults & children
  • Screening increases the identification of DV
  • Women to be given enough time and opportunity for disclosure
  • Consultations are to be conducted in an open, supportive and non-judgmental way
  • If identified, refer to specialist services, ensure safety and arrange follow-up
  • Support groups are KEY
  • Must ensure confidentiality
  • Information should be shared among HCP for safeguarding purposes

UK Domestic Abuse Act 2021

  • Helps to provide greater support
  • DV is not just physical violence but could also be emotional, controlling, coercive and economic
  • Local authorities to provide accommodation-based support

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