Australia

Calls for obstetric care workers to delve deeper into psychological abuse

Reports of domestic violence are increasing during COVID-19, with mothers and pregnant women more likely to be victims, prompting health experts to call for training to recognise signs of coercive control.Women’s health experts say compulsory training would help health practitioners provide better care.It comes after new research from the University of South Australia and the…

Reports of domestic violence are increasing during COVID-19, with mothers and pregnant women more likely to be victims, prompting health experts to call for training to recognise signs of coercive control.

Women’s health experts say compulsory training would help health practitioners provide better care.

It comes after new research from the University of South Australia and the University of Melbourne highlighted the important role obstetric health practitioners played in a woman’s decision to stay or leave an abusive relationship.

The study found doctors, midwives, nurses and social workers were in a unique position to offer empathy, support and information to women in domestically-violent relationships during pregnancy, birth and post-delivery.

UniSA researcher Fiona Buchanan said it was essential for health practitioners working in paediatrics and obstetrics to have a greater understanding of coercive control and domestic violence.

“Coercive control is a form of psychological entrapment, achieved through behaviour that victimises women through acts, words and gestures designed to isolate, frighten and demean them,” Dr Buchanan said.

“Disturbingly, women with children are three times more likely to experience domestic violence than women without children and, perhaps worse, is that the frequency and severity of domestic violence is twice as high for women during pregnancy.

“In this study, women said that they felt less isolated and distressed when others acknowledged it was happening – almost as if sharing the burden helped validate their worth and affirm their feelings.

“When concerned health practitioners empathised with their patients and provided information and support, this helped relieve some of this distress.”

In Australia, one-quarter of women have experienced emotional abuse from a current or previous partner and one is killed every nine days as a result of domestic violence.

Globally, one in three women suffer physical or sexual violence from a partner.

According to the World Health Organisation, domestic violence has increased during COVID-19.

In a report released in May, WHO said there were a number of factors that could exacerbate risks of violence for women.

This included stress, decreased access to services and disruption of social and protective networks.

“As distancing measures are put in place and people are encouraged to stay at home, the risk of intimate partner violence is likely to increase,” the report read.

“Access to vital sexual and reproductive health services, including for women subjected to violence, will likely become more limited.

“Other services, such as hotlines, crisis centres, shelters, legal aid, and protection services may also be scaled back, further reducing access to the few sources of help that women in abusive relationships might have.”

University of Melbourne co-researcher Cathy Humphreys said health professionals held a position of trust, enabling them to offer first-line support.

She said there were key behaviours that indicated psychological abuse and control.

“During pregnancy, instances of overbearing behaviours or alternatively a lack of interest in antenatal care may indicate that a partner is using coercive control tactics,” Professor Humphreys said.

“Signs of abuse could be limiting a woman’s contact with doctors; refusing to come to scans and appointments; and even making a scene when a visit is running late.

“Similarly, a lack of support or self-focus by partners is also worrisome, with some women saying that their partners blamed them for having too long a labour.

“There’s no excuse for abuse and it’s everyone’s responsibility to prevent it.”

Women’s Health Week is running from September 7 to 11.

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