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.
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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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