Screening for domestic violence during pregnancy follow-up: evaluation of an intervention in an antenatal service

To assess the impact of a brief training for obstetricians and midwives about screening for domestic violence during pregnancy follow-up and to identify barriers to a routine enquiry. A monocentric quasi-experimental study was performed in an obstetrics department in Paris, France. We asked patients during their pregnancy follow-up to complete a survey describing their demographic characteristics. They were also asked if a health professional had screened them for domestic violence during the current pregnancy. Exclusion criteria were refusal and inability to complete the survey alone. Health professionals attended a brief training about domestic violence. The intervention provided general information about domestic violence to alert health professionals (prevalence, risk factors, consequences on women’s health, pregnancy, and children) and guidelines on screening and how to deal with women disclosing domestic violence. They also had to complete a survey about their knowledge and practice concerning domestic violence. Two months later, patients consulting for their pregnancy follow-up completed the same survey. Health professionals were not aware of the study’s aim throughout its course. The primary outcome was the rate of patients screened for domestic violence during pregnancy follow-up. The secondary outcome was the identification of barriers to a routine enquiry. Four hundred ninety-five patients completed the first survey (control group): 21 patients (4.8%) had been screened for domestic violence. Twenty-one health professionals attended the intervention. Eight (38.1%) stated that they never screened for domestic violence, and 3 (14.3%) stated that they always did. Three hundred ninety-five patients completed the second survey (experimental group): 17 patients (4.3% vs 4.8%, p = 0.53) stated that they had been screened for domestic violence. The main barriers to screening mentioned by health professionals were the presence of the partner, the lack of awareness of the need to screen, uncomfortable feelings, and the difficulty to identify victims. There was no increased screening for domestic violence during pregnancy follow-up after a brief training of obstetricians and midwives. An early training during medical studies or more extensive training for professionals could be more efficient.