FUTURE DIRECTIONS TO PREVENT DOMESTIC ABUSE IN PREGNANCY AND LABOR

M.SIVASANKARI LECTURER OBG DEPARTMENT THE OXFORD COLLEGE OF NURSING BANGALORE-68

INTRODUCTION
The vulnerability of pregnant women to violence and their consequences is an alarming public health issue. THE GOAL is to stop the violence before it begins i.e through promoting healthy behaviours in relationship(premarital,marital counselling classes)

ADVOCACY & CAMPAIGNS ON VIOLENCE AGAINST WOMEN

create awareness (posters, pamphlets, brochures, IEC materials, public education through short films) Change of attitude in the society Awareness on services provided at the crisis centre/organization/hospitals/maternity homes. Improve economic stability for women, educational status,easily accessible social support groups.

FUTURE SHOULD AIM AT:

School based programmes Effective gender equality training Women friendly procedures in counselling centres More Evidence based research on health consequences of violence against pregnant women Role of health professionals in dealing with victims of violence(training on specific skills required to communicate with the victims of violence)

Incorporating domestic violence in curriculum at school and college level. To develop a set of guidelines for counselling a victim of domestic violence in pregnancy. More literature & books to prevent & overcome domestic violence during pregnancy. Advocate uniform proceduresand educate midwives to document MLC cases. Research on difficulties faced by midwives/health care professionals in treating a pregnant women with domestic violence.

Allocate more fund to do research on pattern of abuse, its impact on child, nature of intervention suggested, whether womens expectations are met or not. Women and children suffer from malnutrition because of the domestic violence in some way or the other.

Collaborative Response
Religious Leaders Advocates Police

Employers

Health Professionals

Friends

Policy Makers

Judges & Legal Professionals

Educators

Routine enquiry about domestic violence during antenatal booking should be made as routine in history taking.

Midwives usually do not raise the subject of domestic violence, and women often feel "silenced" and unable to talk about it with their midwife. Maintain confidentiality , privacy, friendly environment.

RECOMMENDATIONS THAT COUNTRIES CAN TAKE TO REDUCE

VIOLENCE AGAINST WOMEN, BY PROMOTING:

improved national commitment and action through a gender equality and human rights framework primary prevention activities greater involvement of the education sector strengthening the health sector response greater support to women living with violence sensitization of the criminal justice systems support for further research and collaboration increased donor support.

TRAINING
Training is an important component. Train the hospital staff to address the pregnant who is a victim of domestic violence. EG: Dilaasa----peer to peer training, training the trainers. Implement Stringent laws

Midwives and Health care workers at gross route level are the primary resource person available for the antenatal mothers. So it is very essential to update their knowledge & educate them on tools of assessment, laws regarding abused pregnant women. Provide guidelines, a plan of action, a care plan, continous training and support.

Easily accessible national domestic violence hotline/ toll free numbers Exclusive website Confidential crisis intervention Referral to local resources

CONCLUSION

SO IT IS THE NEED OF THE HOUR TO TAKE GROUND BREAKING EFFORT TO PUTDOWN THIS DOMESTIC ABUSE AGAINST PREGNANT WOMEN.

THANK YOU

Routine enquiry about domestic violence in maternity settings is acceptedby women, provided it is conducted in a safe confidential environment(14). A pilot project in Leeds found that 92% of women questioned were in favour of routine enquiry(15). Midwives approve in theory of routine questioning about domestic violence, and also broadly agree (81%) that it is their responsibility; but in practice, only about 60% are happy to do it(16). Practical and personal difficulties - including lack of time, staff shortages, and difficulty in obtaining sufficient privacy - were frequently cited(17). Training is essential in order to sustain routine questioning and ensure midwives are aware of how to respond to disclosure. Those midwives who - after training do question women about domestic violence find benefits for themselves also(18). Healthcare professionals have a duty to record anything that might impact on the health of their patients including domestic violence. NSF (National Standard Framework) for Children, Young people and Maternity Services(19) includes points on identification of and response to domestic violence in pregnancy: women should be offered "a supportive environment and the opportunity to disclose" and maternity service staff should be "aware of the importance of domestic violence and competent in recognising the symptoms and presentations" and "able to make a sensitive enquiry" and "provide basic information" and referral to local services.