'I know the shame is not mine' - Training launched for maternity staff in hospitals to support pregnant domestic abuse victims

Women's Aid has launched an independent evaluation report by the Centre for Effective Services, of its three-and-a-half-year pilot maternity project.

The national domestic violence organisation is pioneering this project today in an effort to raise awareness and increase understanding of coercive control among maternity staff so that they are better equipped to help create a safer space for disclosures from pregnant patients who are victims of domestic abuse.

Speaking on this project, Laura*, a victim of domestic abuse who was supported by the Women’s Aid maternity outreach explained: “I had never spoken to anyone about what was going on, but I knew it wasn’t right. My outreach and medical social workers supported me throughout my pregnancy, which was a really hard time, emotionally and physically.

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"They helped me understand that it wasn’t my fault, and I had options. The outreach worker supported me to apply for a domestic violence order and accompanied me to court. She helped me to get a solicitor. I got the order, but my husband kept breaching it, we were still living in fear.

Laura continued: "She encouraged me to call the Gardaí and even came to the station with me to make a statement. Despite everything, I had a healthy baby boy and although, I am still dealing with the ongoing abuse from my husband, I feel stronger, and I know the shame is not mine.”

The project is a pioneering collaboration between Women’s Aid, the Rotunda, the National Maternity Hospital, the Coombe Hospital and Cork University Maternity Hospital.

The pilot maternity project has developed and delivered specialist training to nearly 350 maternity care staff. In parallel, regular specially designed hospital-based awareness campaigns have increased visibility of the issue and built understanding of the signs of domestic abuse during pregnancy.  

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A dedicated one to one support service in the three Dublin maternity hospitals also provided same day support upon referral to 379 victims of domestic abuse. As part of the independent evaluation of the project, a survey with pregnant women subjected to domestic violence found that most said that fear, shame and concern about having children taken away, stopped them from asking maternity staff for help.

Most women were also in favour of regular screening for domestic abuse during a woman’s journey throughout pregnancy. The independent evaluators found that the model of co-designed training and awareness addressing domestic abuse needs funding to be replicated and expanded across maternity settings and potentially other areas of the health service. 

The evaluation also provided important analysis and recommendations for participating hospitals to support improvements in data collection and tracking of enquiries about abuse, as well as disclosures and referrals of abuse survivors-victims internally.  

Sarah Benson, CEO of Women’s Aid said: “The impacts of domestic abuse during the perinatal period can be devastating. Perinatal abuse and in particular targeted assaults aimed at the abdomen increase the risk of maternal and foetal morbidity and mortality. Essentially, both mother and baby are victims of domestic abuse during pregnancy.”

Ms Benson continued: “This unique project emerged from years of Women's Aid work with maternity hospital staff and with survivors of domestic abuse. The maternity project provided a unique three-pronged approach of training, awareness raising and outreach support.

"We know that pregnancy can be a time when women are thinking more about the future, presenting an opportunity for intervention and support. Regular, ongoing healthcare appointments in pregnancy not only offer multiple opportunities for disclosure and space to build trusting relationships, but also provide a situation where women can access services without arousing suspicion from an abusive partner.”

Dr. Jennifer Hanratty, Centre for Effective Services evaluator, says: “Our independent evaluation has found that the project has had a positive effect on awareness of domestic violence and abuse for both staff and women using services. This pilot project demonstrated great potential for improving maternity services response to domestic violence and abuse.

"The evaluation also uncovered major challenges for maternity services in the recording and monitoring of Domestic Violence and Abuse screening and referrals offered to women. These issues need to be addressed at both local and national level to enable the project to have impact at scale.”

Fiona Hanrahan, Director of Midwifery, The Rotunda Hospital: 

"Going forward The Rotunda want to continue empowering our staff and our patients to recognise the signs of abuse, so women can receive appropriate supports within the hospital and through Women’s Aid.”

Laura Harrington, Head Medical Social Worker, The National Maternity Hospital says;

“Our partnership with Women's Aid over the last three and a half years has enhanced the service that we offer women attending The National Maternity Hospital during their pregnancy.

"We look forward to continuing to work together to support women and their babies who are exposed to domestic violence and abuse.”

Kate Burke, Acting Principal Medical Social Worker, The Coombe Hospital says: 

“As a hospital dedicated to women and infants, our priority at the Coombe Hospital is to offer an environment in which pregnant women feel safe and comfortable to disclose abuse.

"As Medical Social Workers, we have been working with pregnant women to provide the emotional and practical support that they need to ensure their safety and wellbeing, for many years. However, the number of affected women is growing, and more resources are required to meet this need.

"We value this partnership with Women’s Aid and the progress we have made, a lot has been done but there is much more to do”

Maria Leahy, Manager of Social Work Services Cork University Maternity Hospital within Ireland South Women & Infants Directorate says: “Ireland South Women & Infants Directorate are committed to listening, supporting and believing any woman who may be experiencing domestic violence.

"We have been proud to collaborate with Women’s Aid on the Maternity Project as we continue to raise awareness of our staff and respond to the needs of pregnant women experiencing domestic violence both locally and nationally."

Women’s Aid 24hr National Freephone Helpline 1800 341 900 www.womensaid.ie 

National Male Adviceline 1800 816 588 Male Advice Line - Men's Development Network