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Safety assessment

It is imperative that you check in with the person about their current level of safety and enhance safety.
© Coventry University. CC BY-NC 4.0
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The woman or birthing person has disclosed and you have validated their experiences and difficulties.
Before the consultation comes to a close, it is imperative that you check in with the person about their current level of safety and enhance safety (LIVES).
You can begin to establish their safety through questions such as ‘Is it safe for you to go home today?’ However, as mentioned previously, there can be ambiguity around the notion of safety and people subjected to abuse may not perceive themselves as necessarily ‘unsafe’.
Running through some objective indicators will help to signal to you (and the person) if there is an imminent risk of harm. You can establish if they are unsafe by referring to specific behaviours and exposures.
  • Has the abuse been escalating? (Depending on the person’s stage of readiness for change (García-Moreno et al., 2015), it may be better to focus on specific behaviours rather than referring to the ‘abuse’)
  • Has the perpetrator been physically violent during the pregnancy?
  • Has a weapon been used against her?
  • Has she been subjected to rape or sexual assault? (Forced to do sexual things she did not want to do)
  • Has the perpetrator threatened to kill her (or the children or pets) or does she believe they could?
Endorsing any of these behaviours would be a red flag. It warrants clear and compassionate communication to help the person understand that they are at high risk of serious injury or harm. It requires making a safety plan and providing immediate and accessible options for safe accommodation – this could be a family member or friend or involve making a referral to a refuge/shelter.

References

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.
© Coventry University. CC BY-NC 4.0
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Identifying and Responding to Domestic Violence and Abuse (DVA) in Pregnancy

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