Guidance on Domestic Abuse Questioning

We will now further examine what is involved in the inquiry aspects of the LIVES approach (WHO, 2014).

Fundamentally, the framing and use of direct questions can be an effective approach to DVA screening (Bailey, 2010; Shadigian & Bauer, 2004).

More specifically, examples of behaviours should be provided to pregnant women so as to describe acts of DVA (including physical, psychological, and sexual DVA), rather than only asking whether the individual has, or is currently, experiencing domestic violence and abuse; the latter can be open to interpretation (McMahon & Armstrong, 2012).

Different healthcare settings and documentation may already provide a screening question to prompt healthcare professionals and to guide them on how to enquire about DVA.

It is helpful to open the conversation with a general question or statement (‘How are things at home?’ or ‘Many women are affected by problems in their relationships/with their husbands’) and followed up with more specific questions.

You could ask about safety: ‘Do you currently feel safe in your own home?’ It might be worth elaborating on that, to add something such as, ‘Do you and the baby feel safe within the home, and with those you live with?’

Someone might not automatically consider themselves ‘unsafe’ in the context of their relationship or at risk from their partner. This is particularly the case in the early stages of recognising the abuse (García-Moreno et. al., 2015). Thus, more direct questioning, similar to the approaches set out below, can be helpful to support the person to communicate about their circumstances and evaluate their safety and their partner’s behaviours.

Examples of Direct Questions

• Does your husband/wife/partner ever insult you or put you down?
• Do you ever feel pressured by your partner to do things you don’t want to?
• Do you feel afraid of your husband/wife/partner?
• Has your husband/wife/partner pressured you to do sexual things you do not want to do?
• Does your husband/wife/partner try to control you? For example, control who you socialise with, your contact with family and friends, your choices related to work and career, your access to money, phone and so on?
• Does your husband/wife/partner physically hurt you (for example, pushing, slapping, hitting, kicking, punching)?
• Does your husband/wife/partner threaten to hurt you, your unborn baby or your other children?
• Has your husband/wife/partner hurt, insulted, threatened or screamed at you?

References

_{Bailey, B. A. (2010). Partner violence during pregnancy: Prevalence, effects, screening, and management. International Journal of Women’s Health, 2, 183-197. DOI link}

_{García-Moreno, C., Hegarty, K., d’Oliveira, A. F. L., Koziol-McLain, J., Colombini, M., & Feder, G. (2015). The health-systems response to violence against women. The Lancet, 385(9977), 1567-1579. DOI link.}

_{McMahon, S., & Armstrong, D. Y. (2012). Intimate partner violence during pregnancy: Best practices for social workers. Health & Social Work, 37(1), 9-17. DOI link}

_{Shadigian, E. M., & Bauer, S. T. (2004). Screening for partner violence during pregnancy. International Journal of Gynecology & Obstetrics, 84(3), 273-280. DOI link}

_{World Health Organization. (2014). Health care for women subjected to intimate partner violence or sexual violence: A clinical handbook. Web link}