domestic violence disclosure

[studentmidwifecb]

Dear All
As you can see I am a first time poster, so please be gentle with me! I am a third year student midwife and am writing my dissertation on domestic violence. I am keen to discover mums views on how we ask you about this (if at all) and would be really grateful if you would spend a couple of minutes completing my survey about this. Its only got 6 questions, so won't take too long. Please click on the link below to complete.
www.surveymonkey.com/s/QMBPYTH
Thanks so much!
CB

I'm more than happy to help, but can u make the link clickable? I'm on iPad and can't copy and paste.

Just out of interest tho....(have a background in dealing with DV) how do u as a midwife feel about asking the question?

Hiya, sorry I dont know how to make the link clickable! If any one knows how, please could they tell me?
I personally have no difficulty asking the question, I ask in a way that neednt cause any offence or create a danger to the woman, but a lot of the research shows that many midwives do find it hard to ask.

Click here to take survey

www.surveymonkey.com/s/QMBPYTH

Here OP. Hopefully that worked.

Ooh thank you very much!

I feel so frustrated that any woman feels offended (and I know some do). I'm happy to be asked and just very grateful that I can, honestly, say "No".

I honestly think it is a question that needs to be revisited later in the pregnancy (I was asked at the booking in appointment right at the start of the pregnancy), and once again just before the mum is discharged by the midwife after home visits.

Off topic slightly, sorry. Is this question commonly asked by midwives? I've had 3 dc and have never been asked.

I've done the survey

Since a lot of domestic violence either starts or gets worse during pregnancy and after childbirth, it only makes sense to check back at least once (some time in the third trimester) and again after the birth.

When I went to my first scan I used the ladies toilets and on the inside of the cubicle door was a big poster about DV and it said, "If you are suffering from DV in your relationship but cannot talk to us today as you are accompanied by your partner then please remove a green sticker from the attached bag (which was stapled to the poster) and put it at the top of your maternity notes. The midwife will look for this during your appointment and if she sees a sticker she will call you later in the day to arrange a time to see you individually."

I always thought this to be a great idea as I imagine in a lot of DV instances the male wouldn't allow the woman to be on her own with a professional in order to purposefully stop her from telling anyone about what was going on in the home. My DH comes to all my appointments with me so this sticker system would really be the only way of me conveying to the professionals that there might be a problem.

Thank you all so much for your replies! In answer to some of the points, yes we are supposed to ask everyone, and we do try using ideas such as the stickers you mention, which can be effective. Keep those responses coming ladies!

Writer - that's a very good idea. The Health Visitor asks here, when she asks a load of questions. I would be very surprised if anyone ever said they were a victim in these circumstances. Personally, I think it needs to be put across in terms of " if you have anything you want or need to talk about, then I am available and everything is confidential. We can provide help and support from other agencies, with your consent, if appropriate" or something along those lines. Having survived DV, I know I wouldn't have told the HV.

Also it needs to be about emotional abuse - so many times on here you read 'but he doesn't hit me' and victims don't always see it as abuse. So maybe it should say if you fear your partner, or are unhappy in your relationship, take a sticker to talk in confidence etc

To add to qwerty's post, I think it's generally referred to as "domestic abuse" in recognition that there can be a much wider spectrum of abusive behaviours.

It's worth remembering that one in four relationships experience domestic abuse (regardless of sexuality and gender of perpetrator/victim) so it's much more common than one would think.

Thank you all so much for replying, it's really helpful to have your views. I qualify this summer and this is an area I really hope to be able to make a difference to. Thanks again to you all :-)

I was asked by my midwife "is he good to you" when referring to my husband.
No abuse in my case but I think a more direct question such as "has there ever been any violence in your relationship or are you ever afraid of your partner" might have been better.

Thank you for these stories. It's been a great response so far. Everything I've heard had been helpful.

Many people in abusive relationships don't think the relationship is abusive. I agree it's tricky to get right. I was never asked when I was in my abusive relationship. I am now on the maternity forum in my area and did a presentation on dv and the importance of midwives/maternity services providers. Unfortunately people are not keen to make it a priority in my area and they reflect the RCM research - are afraid to ask and not sure how to deal with it. I think there needs to be good support for individual staff from their managers and asking in the right way isn't enough. Staff need training and support to feel confident in dealing with disclosures.

I think that before a MW asks any questions, she should give a bit of an explanation first - along the lines of 'Pregnancy can be a difficult time for couples, even a much wanted pregnancy and often behaviours such as controlling, manipulating and violence increase. Have you found that your relationship has changed since you became pregnant?' and then followed up by (for clarity) 'Has xx ever behaved in a way that you felt was abusive?'

I suggest this because my MW asked me simply did I feel safe at home, no explanation of what she meant and as we were in the middle of some building work, I honestly thought she was asking whether I thought the new ceiling was safe!

I think the stickers idea is fantastic.

Also perhaps MW should explain before asking the question that disclosing DV won't necessarily mean that she will be immediately on the phone to Social Services.

I think if I was in an abusive relationship, the fear of what I might trigger as a result of disclosure would be a big barrier.

it's the fear of what happens next that stops you from saying anything. I was in a very violent relationship whilst preg with DS, all I wanted was for some kind of fairy godmother to turn up and take me and my unborn baby away to somewhere safe. I was scared that If I I did mention anything my DS would be taken away at birth and I would be killed my ExP for saying anything.

I think DV victims need to know upfront what the midwife can do and how quickly and discreetly they can act. Are they able to get you to a refuge etc? The sticker in the notes section strikes me as a good idea. The informal drop in clinic sounds good too as DP would make sure he attended all the appointments written in my notes. I was desperate to tell someone but I needed to know they had the power to act, and help me not judge me.

I'm really pleased that so many people like the idea of a drop in. It's such a hard thing for women to talk about, and knowing your appointment is only 15 mins doesn't make that easier for anyone. I wish we could give you longer! My recommendations will definitely include the drop in, which of course could be used for discussing any concerns a woman may have.

I think the only thing you would need to take into account with the Drop
In Session is how you are going to keep it discreet and confidential. Would you be holding it at the GP Surgery or Hospital? I just wonder if women would find it hard to go to a Session if they knew that other women (I.e the receptionist or other women in the waiting room) knew why they were there. Would the session be advertised for women suffering from DV or just as a general advice clinic?

Done

In response to a number of points on the survey about the drop in session: the idea would be that it would be there for anything, so no-one's partner need know why they are there. It would be for women to come and discuss anything - so it could be anything from swollen ankles to much more serious problems. It would not be a group session, definitely private, but I guess there would be a wait if a number of women all turned up at the same time.