Domestic violence by a partner or ex-partner during pregnancy doubles the risk of pre-term birth and low birth weight, according to a study.
Researchers from the University of Iowa also found that domestic violence, which includes physical, sexual, financial, psychological or emotional abuse, slightly increased the risk of a baby being small for gestational age.
They said their meta-analysis of 50 studies, encompassing more than 5 million children from 17 countries, illustrated the importance of identifying abuse quickly and taking effective action to stop it.
The report’s lead author, Audrey Saftlas, professor in epidemiology at the University of Iowa, said: “Domestic violence by a partner or ex-partner is of particular concern during pregnancy when not one, but two lives are at risk. Although rates of domestic violence differ across the world, the detrimental effects of abuse on pregnant women are very clear and we must continue to establish effective interventions globally in order to prevent violence and to support women who report abuse.”
Domestic violence by a partner or ex-partner can directly affect the growing foetus, through physical or sexual trauma, or indirectly due to increased stress, inadequate nutrition and poor prenatal care. Abuse can also lead to alcohol or drug use – associated with adverse birth outcomes – by women.
More than one in four women in England and Wales has experienced at least one incident of domestic violence at the hands of a partner or ex-partner since the age of 16 and more than 1 million women a year suffer at least one such episode.
The study, published in BJOG: An International Journal of Obstetrics and Gynaecology, found that risks were even greater for women who experienced two or more types of domestic violence during their pregnancy.
Among such women, pre-term birth was 2.3 times more likely and low-birth weight 2.5 times more likely compared with those who did not suffer abuse during pregnancy.
Prof Lesley Regan, vice-president for strategic development for the Royal College of Obstetricians and Gynaecologists (RCOG), said: “Healthcare professionals have an important role to play in tackling the problem and are often the first and only point of contact that the isolated and vulnerable victim reaches out to. All of us working in health and social services need to be trained to recognise the signs of domestic violence and abuse and know how to act and who to refer to, to ensure the woman’s safety.”
The Royal College of Midwives (RCM) has chosen Women’s Aid, which campaigns to end domestic abuse against women and children, as its charity of the year.
The RCM’s professional policy adviser, Janet Fyle, said midwives had an essential role to play but needed to be able to spend more time with women.
“Midwives can often be the only contact the woman has with health services, and the midwife’s role is crucial in recognising signs of domestic abuse or violence and supporting or signposting women for further advice and support as appropriate,” she said.
“However, midwives need to be able to spend time with victims of domestic abuse and violence, to gain their trust, and provide them with information, and support women to report the abuse or violence. This is one of the reasons that continuity of care and carer is so important in maternity care.”
