\u2018It is a difficult topic\u2019 \u2013 a qualitative study of midwives\xb4 experiences with routine antenatal enquiry for intimate partner violence

L Henriksen,M Lukasse,K.K Thorsteinsen,L.M Garnweidner-Holme

doi:10.1186/s12884-017-1352-2

Abstract

BackgroundIntimate partner violence (IPV) during pregnancy may jeopardize maternal and fetal health (IJFWM 49:159-164, 2004; IJGO 133:269-276, 2016). In recognition of the significant public health impact of IPV, the Norwegian Directorate of Health issued new guidelines in 2014, which recommend that health professionals routinely ask all women in antenatal care about their exposure to violence. The objective of this study was to gain an in-depth understanding of midwives’ experiences with routine enquiry for intimate partner violence during the antenatal period.MethodsThe study had a qualitative design. Individual semi-structured interviews with eight midwives providing antenatal care at eight Mother and Child Health Centres (MCHC) in Norway were conducted. Graneheim and Lundmans method of content analysis inspired the analysis.ResultsThree main themes emerged: Midwives do ask about violence; It can be a challenge; and Factors that make it easier to ask. All midwives enquired, but not on a regular basis, about violence. The midwives’ personal interest in the topic was an important factor that made it easier for them to ask about violence. Lack of time, fear of not knowing how to deal with a positive answer and lack of organizational support were barriers to asking pregnant women about their experiences of violence.ConclusionMidwives were aware of the guidelines and made some efforts to implement them. However, further education and organisational support is needed to enable midwives to routinely ask all pregnant women about IVP.

Highlights

Intimate partner violence (IPV) during pregnancy may jeopardize maternal and fetal health (IJFWM 49: 159-164, 2004; IJGO 133:269-276, 2016)
In recognition of the significant public health impact of IPV, the Norwegian Directorate of Health recommended in new guidelines in 2014 in which health professionals should ask women attending antenatal care about exposure to violence with a few exceptions [14]
Previous studies suggest that screening or routine enquiry about violence can contribute to a higher rate of violence disclosure and that antenatal care is a recommended setting [15]

Summary

Introduction

Intimate partner violence (IPV) during pregnancy may jeopardize maternal and fetal health (IJFWM 49: 159-164, 2004; IJGO 133:269-276, 2016). In recognition of the significant public health impact of IPV, the Norwegian Directorate of Health issued new guidelines in 2014, which recommend that health professionals routinely ask all women in antenatal care about their exposure to violence. In recognition of the significant public health impact of IPV, the Norwegian Directorate of Health recommended in new guidelines in 2014 in which health professionals should ask women attending antenatal care about exposure to violence with a few exceptions [14]. Previous studies suggest that screening or routine enquiry about violence can contribute to a higher rate of violence disclosure and that antenatal care is a recommended setting [15] This period is recognised as an ideal ‘window of opportunity’ to address IPV because pregnancy is a time when women are in regular contact with health care providers [16]. Women may be motivated for change [17]

Objectives

Methods

Discussion

Conclusion