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Introduction

This course is intended for those working with individuals subjected to DVA, in particular, during pregnancy, childbirth, and post-natal care settings
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Pregnancy is a time of joy and change. Unfortunately, it is also a time when women experience domestic violence and abuse. Domestic violence and abuse is one of the most common forms of violence against women. It includes physical, sexual and emotional abuse, and controlling behaviours by an intimate partner or family member. One in ten women around the world is subjected to partner abuse during pregnancy and in the post-natal period. Though certain groups may be more at risk, domestic abuse and violence affects all social, gender, cultural, ethnic and age groups. Domestic violence and abuse during pregnancy is
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associated with: problem substance use, pregnancy loss, delayed access to maternity services, premature labour and birth, low birth weight, perinatal mental ill health. Are you a healthcare professional who provides care and support to women during pregnancy? Women come into contact with several professionals over the course of pregnancy and in the months after giving birth. Abuse may commence or escalate during pregnancy. These settings and professionals provide important opportunities for women to be asked about abuse, or to voice their concerns in a safe and confidential way. Appropriate training and support may allow you to recognise the signs and symptoms of abuse and offer a supportive response, which can be a lifeline to someone trapped in an abusive situation.
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We urge professionals to listen with empathy and without judgement, enquire about the persons needs and concerns, validate personal experience, and show you believe and understand the person, enhance safety and manage the person’s risk, and support referral and follow up. Employing these practices in your everyday work with pregnant women does not need to add burden to your day. In fact, learning to apply some tried and tested tools and strategies can go a long way to giving you the confidence to deal with sensitive issues in clinical care, and to helping people feel supported. Make a difference and continue on this learning journey with us today.

This course, introduced in the video above, uses a research-inspired teaching framework to translate evidence on domestic violence and abuse (DVA) into education. It is intended for health professionals working with individuals subjected to DVA, in particular, during pregnancy, childbirth and in post-natal care settings.

By the end of this course, you should be able to:

  • Recognise the signs and symptoms of domestic violence and abuse (DVA) during pregnancy and in the postpartum period
  • Understand and communicate about risk as well as appreciate the impacts of DVA in several domains such as pregnancy, childbirth, maternal health, infant health, long-term outcomes and parenting
  • Demonstrate awareness of the research evidence underpinning interventions for DVA during pregnancy, including screening for DVA and healthcare responses
  • Apply skills for screening, including knowing the questions to ask, when and how to ask them and creating the conditions for safe disclosure
  • Reflect on and improve supportive responses, referral options and follow-up
  • Identify and solve challenges and barriers to the provision of care to pregnant individuals experiencing DVA, as well as reflect on own experiences of abuse as a barrier or facilitator to the provision of best-practice care for survivors or those at risk.

Meet the team

This course was co-created by academics from Coventry University and other experts such as those with lived experience, midwives, safeguarding experts, researchers and professionals. We are particularly grateful for the contributions of Coventry Haven Women’s Aid to the development of this programme.

Dr Lorna O’Doherty

Lorna is an associate professor of violence and health research at the Centre for Intelligent Healthcare, Coventry University. She leads the national NIHR-funded Multi-disciplinary Evaluation of Sexual Assault Referral Centres for better Health (MESARCH) project, a national evaluation of sexual assault and abuse services and a groundbreaking cohort study looking at long-term health, wellbeing and cost outcomes for adult and young survivors of sexual assault, rape and abuse.

Over the past 10 years, Lorna’s research has involved designing and evaluating interventions for domestic violence and abuse in primary care and other settings, including the WEAVE trial (Australia) published in The Lancet in 2013. Lorna has also produced several Cochrane Reviews in the area, including a review of screening for domestic violence and abuse published in 2015.

Lorna is passionate about alleviating the burden of intimate partner violence and recognises a key role for healthcare professionals in achieving this.

Dr Sally Pezaro

Dr Sally Pezaro is a registered midwife with experience working as a midwife clinically in the UK, the Gambia and Ethiopia. She is an editorial board member of the British Journal of Midwifery, the Midwives Information & Resource Service (MIDIRS) Midwifery Digest and Evidence-based Midwifery, the International Journal of Childbirth, and the CPQ Women and Child Health Journal. She is also a member of the Mary Seacole Awards steering group funded by Health Education England, and a panellist on the Nursing and Midwifery Council’s Fitness to Practise Committee. She is also ‘The Academic Midwife’ on Facebook.

Reflecting on her own experiences, Sally has developed a passion for supporting the psychological wellbeing of health care professionals and has worked with the Royal College of Midwives in producing their report and recommendations on workplace support for midwives experiencing domestic abuse.

Dr Pezaro has been honoured with a first prize award from the Royal Society of Medicine in ‘Leading and inspiring excellence in maternity care’ and was also first runner-up for the British Journal of Midwifery’s ‘Midwife of the Year’ 2019. The overriding vision for Sally’s ongoing research is to secure a psychologically safe professional journey for midwives and excellence in maternity care.

You can follow Sally on Twitter at @SallyPezaro.

Dr Elizabeth Bailey

Liz began working as a clinical midwife after qualifying in 2004 and became interested in data and improvement through supporting audit and project work, both in hospital and community midwifery settings.

Liz’s first midwifery project alongside clinical practice was based in the community and looked at complex social factors and aimed to provide individualised and community-linked support to women with several issues in pregnancy. From this, Liz moved into clinical research roles recruiting into clinical trials for preterm labour.

During this time, Liz became interested in the physiology of contractions and preterm birth and was successful in securing a PhD Fellowship. The study of this topic evolved from a motivation to support the women experiencing preterm labour, and the emotional burden that comes with preterm birth, a condition which is not declining, and which is subject to ongoing health inequalities. Following her PhD studies, Liz moved into a Midwife Research Fellow posts at Imperial College Healthcare Trust, then University Hospitals Coventry and Warwickshire/Coventry University and continues to explore a wide range of pregnancy-related research.

You can follow Liz on Twitter at @Liz8ailey.

Samantha Nightingale

Sam Nightingale has worked as a nurse and midwife for over 30 years and has a breadth of clinical experience and a special interest in the care of vulnerable women in pregnancy.

Sam set up and ran the Coventry (UK) pathway for teenage pregnancy in a seconded public health role. She was also awarded the NIHR/HEE funded Masters by Research (MRes) programme, and the Wellbeing of Women funded Entry Level Research Scholarship for Midwives.

Sam’s area of research interest has been around the care of vulnerable women and safeguarding. For example, she has undertaken research related to human trafficking and pregnancy, maternal mental health and improving women’s preparation for induction of labour, as well as this current work which aims to better equip midwives regarding their responses to domestic violence and abuse.

You can follow Sam on Twitter @mwsamnight.

Co-creation team

Name Role
Helen Janiszewski Midwife and PhD student, Coventry University
Gemma Halliwell Researcher, University of Bristol
Sahar Shahid PhD student, Coventry University
Jaime Richards Development and funding officer, Coventry Haven Women’s Aid
Vicki Birks Independent domestic violence advisor, Victim Support
Suzanne Pollitt Senior lecturer in Emergency Care, Coventry University
Helen Oliver Midwife, Warwick Hospital
Becky Rendina Independent domestic violence advisor, Victim Support
Sahana Kongadi Venkatesh Student MSc Healthcare, Coventry University
Lisa Pratley Professional lead for safeguarding, University Hospital Coventry & Warwickshire
Gail Westerman Doctoral researcher, Coventry University and former midwife
Alex Musto Researcher and social work practitioner, Coventry University

Contributing to discussions

Where you choose to contribute in the open areas, we ask that you keep in mind that someone else participating in the course may have experienced or witnessed domestic violence and abuse.

Throughout the course, we are mindful about our use of language, that we respect the views of others, that we exercise compassion towards others and ourselves. Where feminine pronouns are used, they are not intended to exclude those who identify with other genders or no gender at all.

If you have any concerns about your experiences throughout the course, you are welcome to contact the course director Dr Sally Pezaro via email (sally.pezaro@coventry.ac.uk).

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Identifying and Responding to Domestic Violence and Abuse (DVA) in Pregnancy

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