Online Program

Midwives' identification of and response to domestic violence during pregnancy in the UK: An analysis of midwives' accounts including barriers encountered

Monday, November 4, 2013

Nicole Person-Rennell, BA, MphilPH, Mitchell Student Center, Mayo Clinic College of Medicine, Rochester, MN
This study explores midwives' accounts of identification and response to domestic violence, including discussing barriers and methods of overcoming obstacles in working with women who are experiencing domestic violence. A qualitative design was used to conduct interviews and focus groups with 19 midwives. Thematic analysis was then utilized. Midwives reported challenges in negotiating policy and practice around domestic violence. They discussed working through identification by calling upon duty to screen routinely, employing midwife intuition, and engaging in communication as part of the midwife-patient relationship. Routine screening, seen as a solution to value judgements because of the understood universal nature of abuse, was undermined by a variety of factors without a routine or consistent solution. In responding to domestic abuse, they described navigating the tension between policy and practice by utilizing strategies such as collaboration with others and acknowledging limitations on their roles as midwives. In understanding issues in cross-cultural interaction, midwives' accounts included talk around communication complexity, emphasizing the additional challenges when patients have no recourse to public funds. Midwives expressed challenges in negotiating the complexities of encounters with women and working within a policy framework. These were described as being met with a variety of solutions, including engineering private time with the patient, utilizing resources and knowledge, navigating the midwife-patient relationship, and emphasizing their role as midwives. Additional solutions were recommended, including implementation of policy for routine private consultation, strengthening resource availability, revisiting the named midwife structure, engaging in a best practices session, and further research in solution evaluation.

Learning Areas:

Clinical medicine applied in public health
Diversity and culture
Other professions or practice related to public health
Provision of health care to the public

Learning Objectives:
Describe methods used by midwives to identify and respond to domestic violence Describe midwives' barriers to identifying and responding to domestic violence Asses methods used by midwives to overcome barriers in identifying and responding to domestic violence Identify policy and institutional changes to assist midwives in identifying and responding to domestic violence

Keyword(s): Domestic Violence, Midwifery

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have experience leading and performing domestic violence research in the UK, South Africa, and the USA, focusing on government and institutional actions and policies. I have professional and scientific interest in care of pregnant women and interventions to reduce domestic violence.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.