Pregnant women are at increased risk of domestic violence in all cultural groups

April 26, 2018 by Hannah Dahlen And Virginia Schmied, The Conversation
Women having a subsequent baby are more likely to disclose domestic violence than first time mothers. Credit: Vyshnova/Shutterstock

Domestic violence occurs across all age groups and life stages. Rather than reducing during pregnancy, expecting a child is a key risk factor for domestic violence beginning or escalating.

Our research, published today in the journal BMJ Open, found that 4.3% of pregnant women due to give birth in Western Sydney disclosed when asked about it by a midwife at her first hospital visit. The study examined more than 33,000 ethnically diverse women who gave birth between 2006 and 2016, and found that these disclosures spanned all cultural groups.

Domestic in pregnancy not only causes distress and trauma for the mother and baby, it increases the risk of the baby having a (very small baby) or being born prematurely (before 37 weeks), which is linked to jaundice, anaemia and respiratory distress in infancy, and diabetes and heart disease later in life.

Abuse and trauma

Depending on the state or territory, women may receive a "psychosocial" assessment from midwives when they first book into a public hospital during pregnancy. This screens for depression, anxiety, childhood , domestic violence, support and stress.

Using these assessments, we found that 4.3% of women disclosed domestic violence overall, but rates were higher among women having a subsequent baby, compared with first-time mothers.

We're unsure if this is because violence has escalated for these women with subsequent pregnancies; if they trust health providers more to disclose the violence; or if they seek help because they're becoming more aware of the impact of domestic violence on their children.

We found a strong link between the disclosure of childhood abuse and the disclosure of domestic violence. Nearly 24% of women disclosing domestic violence had also disclosed childhood abuse.

This doesn't mean that one causes the other, but women who experience are more vulnerable to re-victimisation (being abused again). They may feel like they're not worthy and gravitate towards men who abuse them.

Women who disclosed domestic violence in our study were more likely to have a history of anxiety or depression (34%) and have thoughts of harming themselves.

This is concerning, as maternal suicide during pregnancy or following the birth appears to be rising and has now become one of the main causes of maternal death in Australia.

We also found rising rates of disclosing domestic violence and being admitted to hospital for bleeding and signs that labour may be starting early (before 37 weeks). When this happens, women are admitted to hospital to try to stop the labour, or to find the source of the bleeding. Sometimes stress can contribute to preterm birth and bleeding in pregnancy.

Ethnic backgrounds

We found that domestic violence occurred across all cultural groups, but reported rates were highest among women from New Zealand and Sudan.

Previous research has shown high rates of domestic violence among Maori women in some parts of New Zealand.

There is also evidence of high rates of domestic violence among Sudanese women prior to migration.

We found that women born in India and China reported very low rates of domestic violence. This may reflect a cultural tendency not to discuss what is considered private family business with outsiders.

It's important that health professionals know how to ask about domestic violence in a culturally appropriate way so women feel comfortable disclosing abuse and can access appropriate support.

What needs to be done?

Midwives need to consider cultural norms and acceptability when asking migrant women questions about domestic violence, and this must always be done in a way that keeps the woman safe. Partners should not be present when the questions are asked – and this may be done at another time in the pregnancy if necessary.

Where English is not the first language, interpreters should be used. But this can also present challenges if the interpreter comes from the same community and is known to the woman.

When women have continuity of midwifery care and get to know a midwife well throughout the , it is easier for midwives to gain 's trust and to notice when things change. This style of care should be rolled out more widely in Australian public hospitals.

Explore further: Domestic violence during pregnancy doubles risk of preterm birth and low birth weight

Related Stories

Domestic violence during pregnancy doubles risk of preterm birth and low birth weight

March 8, 2016
Domestic violence by a partner or ex-partner during pregnancy increases the risk of preterm birth, low birth weight and small-for-gestational-age babies, finds a study in BJOG: An International Journal of Obstetrics and Gynaecology ...

Why family violence leave should be paid

March 28, 2018
Five days unpaid family violence leave is a significant improvement over no guaranteed leave at all. But research shows that finances and domestic violence are inextricably linked.

Domestic violence and perinatal mental health

May 28, 2013
Women who have mental health disorders around the time of birth are more likely to have previously experienced domestic violence, according to a study by UK researchers published in this week's PLOS Medicine.

Domestic violence twice as likely to start for pregnant women after HIV diagnosis

July 31, 2017
A diagnosis of HIV during pregnancy makes domestic violence twice as likely to start for some women after their baby has been born, according to new research led by a Drexel University researcher.

Feeling disconnected contributes to women's depression from domestic abuse

May 22, 2015
Women in abusive relationships feel depressed not only from the violence but from the loss of their sense of belonging, a new University of Michigan study finds.

Recommended for you

Teens get more sleep with later school start time, researchers find

December 12, 2018
When Seattle Public Schools announced that it would reorganize school start times across the district for the fall of 2016, the massive undertaking took more than a year to deploy. Elementary schools started earlier, while ...

Large restaurant portions a global problem, study finds

December 12, 2018
A new multi-country study finds that large, high-calorie portion sizes in fast food and full service restaurants is not a problem unique to the United States. An international team of researchers found that 94 percent of ...

Receiving genetic information can change risk

December 11, 2018
Millions of people in the United States alone have submitted their DNA for analysis and received information that not only predicts their risk for disease but, it turns out, in some cases might also have influenced that risk, ...

Yes please to yoghurt and cheese: The new improved Mediterranean diet

December 11, 2018
Thousands of Australians can take heart as new research from the University of South Australia shows a dairy-enhanced Mediterranean diet will significantly increase health outcomes for those at risk of cardiovascular disease ...

Effect of oral alfacalcidol on clinical outcomes in patients without secondary hyperparathyroidism

December 11, 2018
Treatment with active vitamin D did not decrease cardiovascular events in kidney patients undergoing hemodialysis, according to a research group in Japan. They have reported their research results in the December 11 issue ...

Licence to Swill: James Bond's drinking over six decades

December 10, 2018
He may be licensed to kill but fictional British secret service agent James Bond has a severe alcohol use disorder, according to an analysis of his drinking behaviour published in the Medical Journal of Australia's Christmas ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.