Most pregnant women subjected to domestic violence said that fear, shame and concern about having children taken away stopped them from asking maternity staff for help, new report finds.

A pioneering partnership between Women’s Aid and four leading maternity hospitals has increased practical support to pregnant victims of domestic abuse, improved understanding of coercive control among maternity staff, and created disclosure friendly environments in maternity hospitals and units across the country.
The three-and-a-half-year pilot maternity project developed and delivered specialist training to nearly 350 maternity care staff and regular hospital-based awareness campaigns around the country.
A dedicated one to one support service in the three Dublin maternity hospitals was established and provided ‘same day’ support upon referral to 379 victims of domestic abuse.
As part of the independent evaluation of the project, a survey with pregnant women subjected to domestic violence found that most said that fear, shame and concern about having children taken away, stopped them from asking maternity staff for help. Most women were also in favour of regular screening for domestic abuse during a woman’s journey throughout pregnancy.
This pilot project demonstrated great potential for improving maternity services response to domestic violence and abuse. Evaluation of the early impacts of the project indicate that it has had a positive effect on awareness of domestic violence for both staff and women accessing maternity care, increased staff preparedness and confidence to ask and respond to disclosures and improved the speed and type of support provided to women referred to Women’s Aid for urgent assistance.

Thursday, 7^th November 2024: Today, Women’s Aid, a national domestic violence organisation launches an independent evaluation report, by the Centre for Effective Services, of its three-and-a-half-year pilot maternity project. This project is a pioneering collaboration between Women’s Aid, The Rotunda, The National Maternity Hospital, The Coombe Hospital and Cork University Maternity Hospital that has increased practical support to pregnant victims-survivors of domestic abuse, increased understanding of coercive control among maternity staff, and created safe, disclosure friendly environments in maternity hospitals and units across the country. The pilot maternity project developed and delivered specialist training to nearly 350 maternity care staff. In parallel, regular specially designed hospital-based awareness campaigns increased visibility of the issue and built understanding of the signs of domestic abuse during pregnancy.

A dedicated one to one support service in the three Dublin maternity hospitals also provided ‘same day’ support upon referral to 379 victims of domestic abuse. As part of the independent evaluation of the project, a survey with pregnant women subjected to domestic violence found that most said that fear, shame and concern about having children taken away, stopped them from asking maternity staff for help. Most women were also in favour of regular screening for domestic abuse during a woman’s journey throughout pregnancy. The independent evaluators found that the model of co-designed training and awareness addressing domestic abuse needs funding to be replicated and expanded across maternity settings and potentially other areas of the health service.

The evaluation also provided important analysis and recommendations for participating hospitals to support improvements in data collection and tracking of enquiries about abuse, as well as disclosures and referrals of abuse survivors-victims internally.

Sarah Benson, CEO of Women’s Aid says:

“Pregnant women who are subjected to domestic violence and abuse face a range of barriers to help-seeking and disclosure, during a vulnerable and high-risk period. What should be a joyful time in a woman’s life can be marred by serious physical assaults and persistent abusive behaviours, that negatively impact her physical and mental health. The impacts of domestic abuse during the perinatal period can be devastating. Perinatal abuse and in particular targeted assaults aimed at the abdomen increase the risk of maternal and foetal morbidity and mortality. Essentially, both mother and baby are victims of domestic abuse during pregnancy.”

Ms Benson continues:

“This unique project emerged from years of Women’s Aid work with maternity hospital staff and with survivors of domestic abuse. The maternity project provided a unique three-pronged approach of training, awareness raising and outreach support. We know that pregnancy can be a time when women are thinking more about the future, presenting an opportunity for intervention and support. Regular, ongoing healthcare appointments in pregnancy not only offer multiple opportunities for disclosure and space to build trusting relationships, but also provide a situation where women can access services without arousing suspicion from an abusive partner.”

Laura*, a victim of domestic abuse who was supported by the Women’s Aid maternity outreach says:

“I had never spoken to anyone about what was going on, but I knew it wasn’t right. My outreach and medical social workers supported me throughout my pregnancy, which was a really hard time, emotionally and physically. They helped me understand that it wasn’t my fault, and I had options. The outreach worker supported me to apply for a domestic violence order and accompanied me to court. She helped me to get a solicitor. I got the order, but my husband kept breaching it, we were still living in fear. She encouraged me to call the Gardai and even came to the station with me to make a statement. Despite everything, I had a healthy baby boy and although, I am still dealing with the ongoing abuse from my husband, I feel stronger, and I know the shame is not mine.”

Dr. Jennifer Hanratty, Centre for Effective Services evaluator, says:

“Our independent evaluation has found that the project has had a positive effect on awareness of domestic violence and abuse for both staff and women using services. This pilot project demonstrated great potential for improving maternity services response to domestic violence and abuse. The evaluation also uncovered major challenges for maternity services in the recording and monitoring of Domestic Violence and Abuse screening and referrals offered to women. These issues need to be addressed at both local and national level to enable the project to have impact at scale.”

Fiona Hanrahan, Director of Midwifery, The Rotunda Hospital:

“We are proud to partner with Women’s Aid, and our colleagues in The Coombe, NMH and CUMH, on this vitally important project. Pregnancy can be a time of joy, but also a vulnerable time for women. Going forward The Rotunda want to continue empowering our staff and our patients to recognise the signs of abuse, so women can receive appropriate supports within the hospital and through Women’s Aid”

Laura Harrington, Head Medical Social Worker, The National Maternity Hospital says;

“Our partnership with Women’s Aid over the last three and a half years has enhanced the service that we offer women attending The National Maternity Hospital during their pregnancy. We look forward to continuing to work together to support women and their babies who are exposed to domestic violence and abuse.”

Kate Burke, Acting Principal Medical Social Worker, The Coombe Hospital says:

“As a hospital dedicated to women and infants, our priority at the Coombe Hospital is to offer an environment in which pregnant women feel safe and comfortable to disclose abuse. As Medical Social Workers, we have been working with pregnant women to provide the emotional and practical support that they need to ensure their safety and wellbeing, for many years. However, the number of affected women is growing, and more resources are required to meet this need. We value this partnership with Women’s Aid and the progress we have made, a lot has been done but there is much more to do”

Maria Leahy, Manager of Social Work Services Cork University Maternity Hospital within Ireland South Women & Infants Directorate says:

“Ireland South Women & Infants Directorate are committed to listening, supporting and believing any woman who may be experiencing domestic violence. We have been proud to collaborate with Women’s Aid on the Maternity Project as we continue to raise awareness of our staff and respond to the needs of pregnant women experiencing domestic violence both locally and nationally.”

Sarah Benson, CEO of Women’s Aid, concludes:

“Women’s Aid, with the support of our donors, stepped up to address a gap in training, awareness and outreach for maternity care staff. The evaluation of the maternity project clearly indicates the success of this collaborative approach and the need for the continuation and expansion of this work. The potential is enormous to adapt the learning and content from this project to other health settings to enhance practice responses to victims-survivors of domestic abuse. To do this fully, however, funding to continue the project and build on the resources developed needs to be made available to Women’s Aid and participating hospitals by HSE or relevant state bodies.”

Ends.

Support is available:

Women’s Aid 24hr National Freephone Helpline 1800 341 900 www.womensaid.ie

National Male Adviceline 1800 816 588 Male Advice Line – Men’s Development Network

For more information contact christina.sherlock@womensaid.ie or by phone 0879192457.

Notes for Editors:

Launch details: 11am – 12.30pm, Thursday 7^th November 2024 at the Oak Room, Mansion House, Dawson Street, Dublin 2. Photocall from 10.40am.
Executive Summary available here: https://www.womensaid.ie/app/uploads/2024/11/Evaluation-of-the-Womens-Aid-Maternity-Project-Executive-Summary.pdf
Full Report available here: https://www.womensaid.ie/app/uploads/2024/11/Evaluation-of-the-Womens-Aid-Maternity-Project-Full-Report.pdf
Full case study for Laura* (name and details changed to protect identity) available here: https://www.womensaid.ie/app/uploads/2024/11/Laura-Case-Study.pdf
About Women’s Aid: Women’s Aid is a national, feminist organisation working to prevent and address the impact of domestic violence and abuse including coercive control, in Ireland since 1974.We do this by advocating, influencing, training, and campaigning for effective responses to reduce the scale and impacts of domestic abuse on women and children in Ireland and providing high quality, specialised, integrated, support services.
Centre for Effective Services, independent Evaluators of the pilot project: The Centre for Effective Services (CES) aims to improve the lives of people living in Ireland and Northern Ireland by supporting the implementation of excellent public services through evidence informed policy and practice. CES works with government departments and service providers to design, develop, implement and evaluate public policies and services. CES is a not for profit, all island organisation. For more information visit www.effectiveservices.org.