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FUTURE DIRECTIONS TO PREVENT

DOMESTIC ABUSE IN PREGNANCYAND LABOR

M.SIVASANKARI

LECTURER

OBG DEPARTMENT

THE OXFORD COLLEGE OF NURSING

BANGALORE-68

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INTRODUCTION

The vulnerability of pregnant women to violenceand their consequences is an alarming publichealth issue.

THE GOAL is to stop the violence before it beginsi.e through promoting healthy behaviours inrelationship(premarital,marital counselling classes)

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ADVOCACY & CAMPAIGNS ONVIOLENCE 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 crisiscentre/organization/hospitals/maternity homes.

Improve economic stability for women, educationalstatus,easily accessible social support groups.

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FUTURE SHOULD AIM AT:

School based programmes

Effective gender equality training

Women friendly procedures in counselling centres

More Evidence based research on healthconsequences of violence against pregnant women

Role of health professionals in dealing with victimsof violence(training on specific skills required to

communicate with the victims of violence)

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Incorporating domestic violence in curriculum atschool and college level.

To develop a set of guidelines for counselling avictim of domestic violence in pregnancy.

More literature & books to prevent & overcomedomestic violence during pregnancy.

Advocate uniform proceduresand educate midwivesto document MLC cases.

Research on difficulties faced by midwives/healthcare professionals in treating a pregnant women

with domestic violence.

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Allocate more fund to do research on pattern ofabuse, its impact on child, nature of interventionsuggested, whether womens expectations are metor not.

Women and children suffer from malnutritionbecause of the domestic violence in some way orthe other.

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Routine enquiry about domestic violence duringantenatal booking should be made as routine inhistory taking.

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Midwives usually do not raise the subject ofdomestic violence, and women often feel "silenced"and unable to talk about it with their midwife.

Maintain confidentiality , privacy, friendlyenvironment.

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RECOMMENDATIONSTHATCOUNTRIESCANTAKETOREDUCE

VIOLENCEAGAINSTWOMEN, BYPROMOTING:

improved national commitment and action througha 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.

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8/2/2019 sivasankari 20.1.12

12/17

TRAINING

Training is an important component. Train thehospital staff to address the pregnant who is avictim of domestic violence.

EG: Dilaasa----peer to peer training, training thetrainers.

Implement Stringent laws

http://www.google.co.uk/imgres?imgurl=http://www.kurdishaspect.com/DomesticViolence.jpg&imgrefurl=http://www.kurdishaspect.com/doc072411RM.html&usg=___oELXe8YyT9a0Ni-AW7YPQJZlGM=&h=282&w=425&sz=55&hl=en&start=13&zoom=1&tbnid=fe_8hitAOnKRWM:&tbnh=84&tbnw=126&ei=jeYYT8DBEsmJrAe8kP3NDQ&prev=/search?q=images+of+domestic+violence+on+women&hl=en&gbv=2&tbm=isch&itbs=1http://www.google.co.uk/imgres?imgurl=http://www.kurdishaspect.com/DomesticViolence.jpg&imgrefurl=http://www.kurdishaspect.com/doc072411RM.html&usg=___oELXe8YyT9a0Ni-AW7YPQJZlGM=&h=282&w=425&sz=55&hl=en&start=13&zoom=1&tbnid=fe_8hitAOnKRWM:&tbnh=84&tbnw=126&ei=jeYYT8DBEsmJrAe8kP3NDQ&prev=/search?q=images+of+domestic+violence+on+women&hl=en&gbv=2&tbm=isch&itbs=1http://www.google.co.uk/imgres?imgurl=http://www.kurdishaspect.com/DomesticViolence.jpg&imgrefurl=http://www.kurdishaspect.com/doc072411RM.html&usg=___oELXe8YyT9a0Ni-AW7YPQJZlGM=&h=282&w=425&sz=55&hl=en&start=13&zoom=1&tbnid=fe_8hitAOnKRWM:&tbnh=84&tbnw=126&ei=jeYYT8DBEsmJrAe8kP3NDQ&prev=/search?q=images+of+domestic+violence+on+women&hl=en&gbv=2&tbm=isch&itbs=1http://www.google.co.uk/imgres?imgurl=http://www.kurdishaspect.com/DomesticViolence.jpg&imgrefurl=http://www.kurdishaspect.com/doc072411RM.html&usg=___oELXe8YyT9a0Ni-AW7YPQJZlGM=&h=282&w=425&sz=55&hl=en&start=13&zoom=1&tbnid=fe_8hitAOnKRWM:&tbnh=84&tbnw=126&ei=jeYYT8DBEsmJrAe8kP3NDQ&prev=/search?q=images+of+domestic+violence+on+women&hl=en&gbv=2&tbm=isch&itbs=1http://www.google.co.uk/imgres?imgurl=http://www.kurdishaspect.com/DomesticViolence.jpg&imgrefurl=http://www.kurdishaspect.com/doc072411RM.html&usg=___oELXe8YyT9a0Ni-AW7YPQJZlGM=&h=282&w=425&sz=55&hl=en&start=13&zoom=1&tbnid=fe_8hitAOnKRWM:&tbnh=84&tbnw=126&ei=jeYYT8DBEsmJrAe8kP3NDQ&prev=/search?q=images+of+domestic+violence+on+women&hl=en&gbv=2&tbm=isch&itbs=1http://www.google.co.uk/imgres?imgurl=http://www.kurdishaspect.com/DomesticViolence.jpg&imgrefurl=http://www.kurdishaspect.com/doc072411RM.html&usg=___oELXe8YyT9a0Ni-AW7YPQJZlGM=&h=282&w=425&sz=55&hl=en&start=13&zoom=1&tbnid=fe_8hitAOnKRWM:&tbnh=84&tbnw=126&ei=jeYYT8DBEsmJrAe8kP3NDQ&prev=/search?q=images+of+domestic+violence+on+women&hl=en&gbv=2&tbm=isch&itbs=1http://www.google.co.uk/imgres?imgurl=http://www.kurdishaspect.com/DomesticViolence.jpg&imgrefurl=http://www.kurdishaspect.com/doc072411RM.html&usg=___oELXe8YyT9a0Ni-AW7YPQJZlGM=&h=282&w=425&sz=55&hl=en&start=13&zoom=1&tbnid=fe_8hitAOnKRWM:&tbnh=84&tbnw=126&ei=jeYYT8DBEsmJrAe8kP3NDQ&prev=/search?q=images+of+domestic+violence+on+women&hl=en&gbv=2&tbm=isch&itbs=1http://www.google.co.uk/imgres?imgurl=http://www.kurdishaspect.com/DomesticViolence.jpg&imgrefurl=http://www.kurdishaspect.com/doc072411RM.html&usg=___oELXe8YyT9a0Ni-AW7YPQJZlGM=&h=282&w=425&sz=55&hl=en&start=13&zoom=1&tbnid=fe_8hitAOnKRWM:&tbnh=84&tbnw=126&ei=jeYYT8DBEsmJrAe8kP3NDQ&prev=/search?q=images+of+domestic+violence+on+women&hl=en&gbv=2&tbm=isch&itbs=1http://www.google.co.uk/imgres?imgurl=http://www.kurdishaspect.com/DomesticViolence.jpg&imgrefurl=http://www.kurdishaspect.com/doc072411RM.html&usg=___oELXe8YyT9a0Ni-AW7YPQJZlGM=&h=282&w=425&sz=55&hl=en&start=13&zoom=1&tbnid=fe_8hitAOnKRWM:&tbnh=84&tbnw=126&ei=jeYYT8DBEsmJrAe8kP3NDQ&prev=/search?q=images+of+domestic+violence+on+women&hl=en&gbv=2&tbm=isch&itbs=1http://www.google.co.uk/imgres?imgurl=http://www.kurdishaspect.com/DomesticViolence.jpg&imgrefurl=http://www.kurdishaspect.com/doc072411RM.html&usg=___oELXe8YyT9a0Ni-AW7YPQJZlGM=&h=282&w=425&sz=55&hl=en&start=13&zoom=1&tbnid=fe_8hitAOnKRWM:&tbnh=84&tbnw=126&ei=jeYYT8DBEsmJrAe8kP3NDQ&prev=/search?q=images+of+domestic+violence+on+women&hl=en&gbv=2&tbm=isch&itbs=1http://www.google.co.in/imgres?imgurl=http://www.k4health.org/pr/l11/pg17.jpg&imgrefurl=http://www.k4health.org/pr/l11/l11chap4_4.shtml&usg=__9lQlqwBthkFOEr8Qjr3TSyJglgU=&h=268&w=325&sz=43&hl=en&start=7&zoom=1&tbnid=1wT_xHny4qWylM:&tbnh=97&tbnw=118&ei=M-kYT4XJA8PNrQfXrfznDQ&prev=/search?q=pregnant+women+and+domestic+violence&hl=en&gbv=2&tbm=isch&itbs=1http://www.google.co.uk/imgres?imgurl=http://4freedomofthought.files.wordpress.com/2009/12/domestic-violence-hurts-everyone.png?w=700&imgrefurl=http://4freedomofthought.wordpress.com/&usg=__C_Qn97VsTni_NtHRV0I1oQhAPgU=&h=286&w=280&sz=95&hl=en&start=22&zoom=1&tbnid=qesmNNKr-Jmk7M:&tbnh=115&tbnw=113&ei=IOkYT-NmxaysB-X7yOcN&prev=/search?q=images+of+domestic+violence+on+women&start=21&hl=en&sa=N&gbv=2&tbm=isch&itbs=1

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Midwives and Health care workers at gross routelevel are the primary resource person available forthe antenatal mothers.

So it is very essential to update their knowledge &educate them on tools of assessment, lawsregarding abused pregnant women.

Provide guidelines, a plan of action, a care plan,continous training and support.

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Easily accessible national domestic violencehotline/ toll free numbers

Exclusive website

Confidential crisis intervention Referral to local resources

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CONCLUSION

SO IT IS THE NEED OF THE HOUR TO TAKEGROUND BREAKING EFFORT TO PUTDOWNTHIS DOMESTIC ABUSE AGAINST PREGNANTWOMEN.

http://www.google.co.uk/imgres?imgurl=http://www.kurdishaspect.com/DomesticViolence.jpg&imgrefurl=http://www.kurdishaspect.com/doc072411RM.html&usg=___oELXe8YyT9a0Ni-AW7YPQJZlGM=&h=282&w=425&sz=55&hl=en&start=13&zoom=1&tbnid=fe_8hitAOnKRWM:&tbnh=84&tbnw=126&ei=jeYYT8DBEsmJrAe8kP3NDQ&prev=/search?q=images+of+domestic+violence+on+women&hl=en&gbv=2&tbm=isch&itbs=1http://www.google.co.uk/imgres?imgurl=http://www.kurdishaspect.com/DomesticViolence.jpg&imgrefurl=http://www.kurdishaspect.com/doc072411RM.html&usg=___oELXe8YyT9a0Ni-AW7YPQJZlGM=&h=282&w=425&sz=55&hl=en&start=13&zoom=1&tbnid=fe_8hitAOnKRWM:&tbnh=84&tbnw=126&ei=jeYYT8DBEsmJrAe8kP3NDQ&prev=/search?q=images+of+domestic+violence+on+women&hl=en&gbv=2&tbm=isch&itbs=1http://www.google.co.uk/imgres?imgurl=http://www.kurdishaspect.com/DomesticViolence.jpg&imgrefurl=http://www.kurdishaspect.com/doc072411RM.html&usg=___oELXe8YyT9a0Ni-AW7YPQJZlGM=&h=282&w=425&sz=55&hl=en&start=13&zoom=1&tbnid=fe_8hitAOnKRWM:&tbnh=84&tbnw=126&ei=jeYYT8DBEsmJrAe8kP3NDQ&prev=/search?q=images+of+domestic+violence+on+women&hl=en&gbv=2&tbm=isch&itbs=1http://www.google.co.uk/imgres?imgurl=http://www.kurdishaspect.com/DomesticViolence.jpg&imgrefurl=http://www.kurdishaspect.com/doc072411RM.html&usg=___oELXe8YyT9a0Ni-AW7YPQJZlGM=&h=282&w=425&sz=55&hl=en&start=13&zoom=1&tbnid=fe_8hitAOnKRWM:&tbnh=84&tbnw=126&ei=jeYYT8DBEsmJrAe8kP3NDQ&prev=/search?q=images+of+domestic+violence+on+women&hl=en&gbv=2&tbm=isch&itbs=1http://www.google.co.uk/imgres?imgurl=http://www.kurdishaspect.com/DomesticViolence.jpg&imgrefurl=http://www.kurdishaspect.com/doc072411RM.html&usg=___oELXe8YyT9a0Ni-AW7YPQJZlGM=&h=282&w=425&sz=55&hl=en&start=13&zoom=1&tbnid=fe_8hitAOnKRWM:&tbnh=84&tbnw=126&ei=jeYYT8DBEsmJrAe8kP3NDQ&prev=/search?q=images+of+domestic+violence+on+women&hl=en&gbv=2&tbm=isch&itbs=1http://www.google.co.uk/imgres?imgurl=http://www.kurdishaspect.com/DomesticViolence.jpg&imgrefurl=http://www.kurdishaspect.com/doc072411RM.html&usg=___oELXe8YyT9a0Ni-AW7YPQJZlGM=&h=282&w=425&sz=55&hl=en&start=13&zoom=1&tbnid=fe_8hitAOnKRWM:&tbnh=84&tbnw=126&ei=jeYYT8DBEsmJrAe8kP3NDQ&prev=/search?q=images+of+domestic+violence+on+women&hl=en&gbv=2&tbm=isch&itbs=1

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THANKYOU

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Routine enquiry about domestic violence in maternity settings is acceptedbywomen, provided it is conducted in a safe confidential environment(14). A pilotproject in Leeds found that 92% of women questioned were in favour of routineenquiry(15).

Midwives approve in theory of routine questioning about domestic violence, andalso broadly agree (81%) that it is their responsibility; but in practice, only about60% are happy to do it(16). Practical and personal difficulties - including lack oftime, 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 thehealth 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 violencein pregnancy: women should be offered "a supportive environment and theopportunity to disclose" and maternity service staff should be "aware of theimportance of domestic violence and competent in recognising the symptoms andpresentations" and "able to make a sensitive enquiry" and "provide basicinformation" and referral to local services.

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