The aim of this study Asian women attending routine to explore the acceptability of antenatal enquiry for domestic abuse from the perspective of women using maternity services. It also sought to understand the experiences of referral and support offered to women who had positively disclosed abuse. A multimethod approach was adopted including quantitative and qualitative elements.
The survey assessed women's views of the acceptability and impact of routine enquiry for domestic abuse. Interviews aimed, to understand the views and experiences of women who had positively disclosed abuse during their contact with maternity services.
Interviewees subject to abuse during pregnancy were happy to be questioned, even though they did not always feel able to disclose immediately. Women had a positive view of antenatal enquiry for domestic abuse in healthcare settings and support its continuation.
Women expect to be asked and that midwives can respond appropriately. Raising the issue creates a culture in which women are made aware of the impact of abuse and understand there are avenues of support even if she decides not to leave the relationship.
Women may choose not to disclose about the abuse Asian women attending routine the initial time of asking, for fear of their own safety but asking signifies that she can disclose about at a later contact. Domestic violence and abuse can include many forms of behaviour including physical, psychological, emotional and sexual, restriction of movements, isolation, deprivation and financial control.
Within the context of the United Kingdom UKthere were over one million female victims of domestic abuse in England and Wales in the last year. Domestic abuse in pregnancy continues to receive increased attention from UK and international policy makers as it can have grave consequences for both the mother Asian women attending routine the unborn baby.
Nevertheless, reported prevalence rates of violence in pregnancy range from 0. Health professionals such as general practitioners GPsmidwives, practice nurses, accident and emergency staff, and health visitors may often be the first point of contact for abused women. However, the continuing unwillingness of health professionals to openly ask a woman about domestic violence has been attributed to Asian women attending routine number of reasons including: There also remains some uncertainty whether routine enquiry for partner violence in health settings is appropriate or indeed effective.
The study also sought to understand the experiences of referral and support for women who had positively disclosed domestic abuse. A multimethod approach was adopted including both quantitative and qualitative elements. The latter provided the opportunity to understand the views and experiences of women who had positively disclosed a history of abuse during their contact with maternity services and identify the reasons why women may opt not to disclose to their care givers.
University and NHS Ethical approval was obtained. Close attention was paid to issues of safe guarding, particularly during interviews, in accordance with the Nursing and Midwifery Council NMC Code of Professional Conduct 36 about the disclosure of information about the risk of harm to children or vulnerable adults.
Safety measures were explained, and particular attention was paid to information about child Asian women attending routine and the right to withdraw. National and local support telephone numbers for Women's Aid were included with the survey.
Researchers recognized that these may be highly sensitive interviews; therefore, provision was made for additional support for any issues subsequently women wished to discuss through the participating voluntary organizations.
The women Asian women attending routine also aware that they could invite their support worker to accompany them to the interview; only one participant took up this request. Pseudonyms were used ensuring participant confidentiality. The survey assessed women's views of the acceptability and impact of routine enquiry for domestic violence on their experiences of maternity care.
The survey was developed on the basis of previous work undertaken in the field 2124262728 and piloted to ensure data collected was reliable. Amendments were made where piloted questions were considered ambiguous. Biographical data were also collected including ethnicity, age and type of housing. These were connected to the role of the midwife in asking about abuse; appropriateness of being asked and the possible benefits of disclosure.
These variables were identified from the qualitative literature and previous work conducted in the field. Biographical information was recorded, women were asked to reflect on their experiences of the maternity services after disclosure, including Asian women attending routine degree to which they felt able to respond honestly when asked directly about abuse.
Reflections were also sought on how practitioners had shared information with other agencies, and women were asked to include the degree to which the care they received was delivered collaboratively across agencies including suggestions for future service improvement.
The interviews were mostly conducted at the premises of women's support agencies. One interview was conducted in the woman's home, but at the time of the interview, the Asian women attending routine was separated from her partner.
This was still engaged with the women's support services and her named support worker was present during the interview. Women were recruited from 12 community clinics, while attending for antenatal care between September and January The clinics represented communities with diverse cultural, social and ethnic minority populations with significant numbers of women: Women were asked by their midwives, if they would like to complete a questionnaire which focused on the acceptability of enquiry for domestic abuse.
This is because involvement in interviewing could potentially put women at personal risk. Survey data were entered in SPSS version 19 and were independently checked for Asian women attending routine accuracy and data validity including coding for missing values.
Response frequencies were tabulated and response percentages were calculated both over all respondents and over sample responses allowing for missing values. All interviews were transcribed by the researchers conducting the interviews, imported to specialist software package NVivo 8 and double coded, with no substantial differences highlighted.
Informed by grounded theory and using the method of constant comparative analysis, it was possible to move back and forth between conceptual speculation Asian women attending routine within the literature, data collection and analysis and personal reflection.
This process illuminated three over arching themes: The primary purpose of the interviews was to ascertain the women's views and thoughts around the role of the midwife in routine antenatal enquiry. It was evident that some of the women wanted to talk to the researchers about some of the abusive behaviours they had experienced during pregnancy. The majority of the women who completed the questionnaire were white British Asian women attending routine the survey was translated into Polish and Somali, all those who responded completed in English.
Women lived in a range of circumstances, with approximately The table indicates that a large proportion of the women Women were asked to respond whether a midwife had asked about domestic abuse during their pregnancy: Response from the survey data signified that four of the respondents were experiencing domestic abuse during their current pregnancy.
Of the four women who were experiencing domestic abuse, only two had discussed the violence with the midwife. Women identified these concerns as concerns relating to miscarriage, stress, depression and harm to the baby. Nineteen of the women who gave this answer made a direct link between domestic violence and pregnancy, suggesting that domestic violence started in pregnancy, intensified or pregnancy in itself made women more vulnerable to violence.
A dominant concern about asking about violence is that women may be fearful of disclosing abuse because of the potential involvement of child protection services.
To establish the degree to which women have found enquiry acceptable, a set of statements were developed. Significantly, the key findings in the table above demonstrate that The women's support agency provides specialist domestic abuse services to women and children including a dedicated Black, Minority Ethnic, South Asian and Somali service.
Other services include safe houses, Asian women attending routine services, resettlement and crisis intervention. Seven interviews were conducted with women who all had experience of the local maternity services. All the women had accessed the maternity services at the Trust.
Women's ethnic backgrounds were as follows: White British, Black British and European. All the women had children.
One woman was still with her abusive partner. The remaining six had separated from their partner. Two of the women were pregnant at the time of the interviews.
Four of the participants were not in paid employment. The women reported a range of abusive behaviours, including emotional, controlling and physical violence. All those interviewed reported being bombarded with verbal and frightening abuse: This fear is eloquently described by Theresa:. I don't know just living in fear actually and I think I prepared Asian women attending routine sometimes as well for it to happen.
So I was ready for it to happen Theresa. Such findings support previous research in the field, which has suggested that women experiencing abuse pre pregnancy encountered an escalation in psychological and sexually abusive behaviours during pregnancy. One participant attributed the start of abusive behaviour by her partner to an unplanned pregnancy.
Amelia had not experienced Asian women attending routine form of abuse in the relationship previously; however, during the pregnancy, her partner became extremely abusive and aggressive towards her, with threats to kill her and the unborn baby if she did not agree to a termination of pregnancy.
Evidence suggests that an unwanted pregnancy by a male partner may trigger abuse in a relationship. One explanation for initiation of violence by men at this time is that a pregnancy may appear threatening to a partner who needs to keep tight control and the most reported reasons for the initiation of abuse can be an unwanted pregnancy and financial hardship.
For some of the participants, the controlling behaviour during the pregnancy by their partner was difficult to come to terms with:. He was not really physically violent Asian women attending routine pregnancy, he occasionally pushed or shoved me out the way, but he became more controlling, he would tell me what to wear, I was usually only allowed to wear jogging bottoms.
I was not allowed to dye my hair and he wanted me to stay in the house all the time, he did not like me going out to meet my family or friends Debbie. All the participants' interviewed believed that it was acceptable for midwives to ask about domestic abuse. It was also clear that the participants understood why midwives asked pregnant women about abuse.
One participant reported that she had not been asked about domestic abuse during her first two pregnancies. Debbie acknowledged she would have disclosed about the abuse in her previous pregnancies had she had been asked:. It took me a few years to realize that what I was experiencing was domestic violence, yeah how stupid was I? While women spoke assertively about the midwives role in asking, there was no guarantee this would result in a positive disclosure, however, it did appear to set a context in which women felt able to talk about abuse, if not then at a later date.
Reasons for this are complex, Asian women attending routine appeared to be associated Asian women attending routine a number of conflicting feelings; women recognized the behaviour of their partner was wrong, but hoped he would change, and in some instances, women saw themselves as part of the problem.
This resulted in anxiety about not being believed, embarrassment and fear of the consequences of disclosure. One participant reported that she was fearful of Social Services finding out about the abuse:.
I did not tell the midwife, not because I did not want too, but because of social services, I did not want her to tell social services. Most people are scared of social services, especially if they have got kids.
In a domestic relationship most people don't like social services so they will just suffer because they don't want social services involved Theresa.
Asian women attending routine felt comfortable enough to disclose about the violence in the relationship. Amelia was very positive about the help the midwife had given her through the pregnancy, acknowledging how much support the midwives had provided:. Soko Glam’s Original Step Korean Skincare Routine. While we showcase all 10 steps of the Korean Skincare Routine, we recommend you select the steps that align with your personal skin goals.
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