Healthcare professionals are advocating for more systematic screening of pregnant women for intimate partner violence (IPV) and depression, emphasizing the need to enhance funding for support services to handle disclosures effectively. Clinicians highlight that regular, consistent screening for depression and childhood trauma can help identify those at risk of IPV, but warn that this must be matched with increased support for violence prevention services to be effective.
Link Between Perinatal Depression and IPV
Recent research from Monash University underscores the connection between perinatal depression and an elevated risk of IPV during and after pregnancy. Led by Professor Megan Galbally, the study found that pregnant women experiencing IPV were significantly more likely to develop depression. These findings add to a substantial body of research indicating this link, suggesting that pregnancy offers a unique opportunity to build trust with patients and regularly screen for violence.
Importance of Consistent Screening
Professor Galbally emphasized the need for regular screening throughout pregnancy, noting that frequent visits enable healthcare providers to build trust and provide a safe environment for women to disclose IPV. “We certainly know that women don’t always disclose any violence when they’re screened, or certainly when they’re first screened,” she said. Most jurisdictions currently screen for both depression and safety risks, but the rates and methods of screening vary, and standardized tools are lacking.
A major 2020 study from ANROWS, the SUSTAIN study, highlighted the prevalence of domestic violence among pregnant women using antenatal services and recommended the adoption of standardized screening tools. “There is a clear gap in validated DV screening and audit tools for the Australian antenatal setting, which address the broad range of types of abuse women experience, including controlling behaviors by partners and other family members,” the researchers stated.
Challenges in Funding for Support Services
Despite the pressing need for consistent screening and support, funding uncertainties threaten the capacity of legal centers to take on new clients escaping violence. A separate 2020 study by the Murdoch Children’s Institute, Melbourne University, and the Royal Women’s Hospital Melbourne found that nearly one in ten pregnant women experienced emotional IPV. This form of violence was strongly associated with mental health issues such as depression and anxiety, as well as physical health problems.
Innovative Screening Tools Under Evaluation
Kelsey Hegarty, who led the SUSTAIN study and directs the Melbourne Royal Women’s Hospital’s Centre for Family Violence Prevention, emphasized the importance of offering multiple avenues for pregnant patients to disclose IPV. “We’ve got a really broad range of solid findings that this is a really important problem that is happening to women during pregnancy,” she said. Hegarty noted that ensuring women are alone during screening is crucial, and many women prefer to answer sensitive questions through online formats.
The Royal Women’s Hospital is currently trialling a digital mental health screening app called iCope, developed by the Centre of Perinatal Excellence. This app aims to broaden access to screening and provide a more comfortable format for women to disclose IPV.
Conclusion
The call for more consistent screening practices and enhanced support services is backed by robust research indicating the significant impact of IPV on pregnant women’s mental and physical health. By adopting standardized screening tools and ensuring adequate funding for support services, healthcare providers can better identify and assist those at risk, ultimately improving outcomes for mothers and their babies.
