title: Recognizing the co-occurrence of domestic and child abuse: a comparison of community- and hospital-based midwives.
abstract: This study aimed to compare and contrast how midwives working in either hospital or community settings are currently responding to the co-occurrence of domestic and child abuse (CA), their perceived role and willingness to identify abuse, record keeping, reporting of suspected or definite cases of CA and training received. A survey questionnaire was sent to 861 hospital and community midwives throughout Northern Ireland which resulted in 488 midwives completing the questionnaire, leading to a 57% response rate. Comparisons were made using descriptive statistics and cross-tabulation, and the questionnaire was validated using exploratory factor analysis. Community midwives reported receiving more training on domestic and CA. Although a high percent of both hospital and community midwives acknowledged a link between domestic violence (DV) and CA, it was the community midwives who encountered more suspected and definite (P < 0.001) cases of CA. More community midwives reported to be aware of the mechanisms for reporting CA. However, an important finding is that although 12% of community midwives encountered a definite case of CA, only 2% reported the abuse, leaving a 10% gap between reporting and identifying definite cases of CA. Findings suggest that lack of education and training was a problem as only a quarter of hospital-based midwives reported to have received training on DV and 40% on CA. This was significantly less than that received by community midwives, as 57% received training on DV, and 62% on CA. The study suggests that midwives need training on how to interact with abused mothers using non-coercive, supportive and empowering mechanisms. Many women may not spontaneously disclose the issues of child or domestic abuse in their lives, but often respond honestly to a sensitively asked question. This issue is important as only 13% of the sample actually asked a woman a direct question about DV.
authors.affiliation: School of Sociology, Social Policy & Social Work, Queen's University, Belfast. a.lazenbatt@qub.ac.uk
authors.forename: Anne
authors.initials: A
authors.lastname: Lazenbatt
authors.forename: Margaret E M
authors.initials: ME
authors.lastname: Thompson-Cree
mesh_terms: D000328:Adult; D002649:Child Abuse / Q000175:diagnosis*; D002669:Child Welfare; D002675:Child, Preschool; D003153:Community Health Services; D017579:Domestic Violence; D005260:Female; D006761:Hospitals; D006801:Humans; D008297:Male; D008880:Midwifery; D009660:Northern Ireland; D024382:Professional Role; D011795:Surveys and Questionnaires