Chapter 1: Give every child the best start in life

Whilst pregnancy can be a time of great happiness and joy, it can also be a time when domestic abuse can get worse or even start for the first time. For this reason, all women get asked about domestic abuse during their pregnancy by their midwives and other health professionals.

It's estimated that almost one in three women who suffer abuse, experience abuse for the first time whilst they are pregnant.
(Grier G and Geraghty S (2015). Intimate partner violence and pregnancy: How midwives can listen to silenced women. British Journal of Midwifery. 23(6).) This makes domestic abuse the most common health problem for women during pregnancy. Domestic abuse is a pattern of assault and coercive behaviour, and can be emotional, physical, psychological, financial and/or sexual.

Local figures highlight the fact that pregnancy is a risk factor for domestic abuse. 1 in 56 women aged 15-49 reported domestic abuse last year in Gateshead (2021).

Approximately 1 in 5 women who are referred to the Domestic Abuse Team (aged 15 - 49) are pregnant or have recently given birth. (Gateshead Council. (2022) Local Data (unpublished). ONS. (2022) Population and household estimates, England and Wales: Census 2021, Sex by single year of age. ONS. (2022) Conceptions in England and Wales: 2020)

Domestic abuse brings many risks for both the pregnant woman and their unborn baby, including infection, premature birth, miscarriage, injury or death. Domestic abuse can also affect a woman's mental health and wellbeing as well as aggravate existing health problems or chronic pain conditions.

One of the side effects of domestic violence is stress and anxiety, which can affect the way babies grow and develop, resulting in long term negative outcomes for babies. Women who are being abused may also worry about how competent they will be as a mother and their ability to love and protect their baby. 

It's important to disclose if domestic abuse is taking place, and everyone should be assured that it will be treated in a totally confidential manner. We must all remember that domestic abuse is not the fault of the victim/survivor and we must ensure that people are supported and encouraged to report their experience to someone, whether that's a health professional, the police or a charity.

Here in Gateshead, women are asked about whether they are experiencing domestic abuse as part of a routine inquiry model within the pregnancy pathway. During each appointment, women are asked how they are, how things are at home, how their partner is, if they feel safe at home.

Maternity staff have been trained in this approach and receive regular clinical supervision with the safeguarding lead midwife where they are able to reflect on their practice.