Doctors calling for more consistent screening for depression and intimate partner violence during pregnancy check-ups

Doctors calling for more consistent screening for depression and intimate partner violence during pregnancy check-ups
  • PublishedMay 24, 2024

Doctors are calling for more consistent screening of pregnant women for intimate partner violence and boosting funding to frontline services to respond to disclosures.

Clinicians say regular, consistent screening of pregnant women for depression and childhood trauma could help detect those who are victims of intimate partner violence.

But they are warning it must be matched with a boost to support violence support services if it is to be effective.

New research from Monash University has found a connection between perinatal depression and a higher risk of violence during and after pregnancy.

The findings build on a significant body of research pointing to this link, with doctors saying pregnancy is a unique opportunity to build trust with patients and screen for violence regularly, and new programs are broadening options for screening.

Consistent screening key

Psychiatrist Megan Galbally led the Monash study and found pregnant women experiencing intimate partner violence were significantly more likely to develop depression.

Professor Galbally said the findings underscored the importance of screening patients for depression and violence more than once.

“We certainly know that women don’t always disclose any violence when they’re screened, or certainly when they’re first screened.”

Currently, most jurisdictions do screen for both depression and safety risks but at differing rates and without standardised screening tools.

Professor Galbally said frequent visits during pregnancy mean doctors can build trust with patients and consistently check in about their safety.

“Women can be reluctant to disclose, and it really is about building that safe, environment, that trauma-informed care that can allow that disclosure at some point.”

A white woman with short chin length red hair stands outside near a yellow leaved tree, wearing a black blazer and green blouse
Megan Galbally led the Monash study and found pregnant women experiencing intimate partner violence were significantly more likely to develop depression.(Supplied)

A major 2020 study from ANROWS — called the SUSTAIN study — found domestic violence is prevalent among pregnant women using antenatal services and recommended standardised 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 behaviours by partners and other family members,” researchers said.

A separate 2020 study from the Murdoch Children’s Institute, Melbourne University and the Royal Women’s Hospital Melbourne found almost one in 10 pregnant women experienced emotional intimate partner violence.

Emotional and physical intimate partner violence was strongly associated with patients reporting mental health issues like depression and anxiety but also physical health problems too.

Promising screening tools being evaluated

Kelsey Hegarty, who led the SUSTAIN study and directs the Melbourne Royal Women’s Hospital’s Centre for Family Violence Prevention, said giving pregnant patients a range of avenues to disclose can be beneficial.

“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.

“You need to make sure that the woman is alone during this time to be able to ask the questions, and we also know that women often prefer to answer it through an online format.”

A middle aged white woman with short chin length grey hair and wearing a black top, smiling in front of a blurred background.
Kelsey Hegarty says new digital screening options could help pregnant patients disclose violence.(Supplied)

The Royal Women’s Hospital is currently trialling a digital mental health screening app from the Centre of Perinatal Excellence called iCope which Professor Hegarty said could broaden access to screening.

“People can go on and actually answer questions about psychosocial issues and family violence questions … it can be translated into 25 languages,” she said.

“This is making it accessible for any person, any woman in this country, even if they don’t speak English and it’s a great program.”

‘We can’t just ask, we have to actually respond’

Professor Hegarty said along with consistent screening there must be services ready to respond to disclosures.

“We can’t just ask, we have to actually respond and we know what women want in terms of a response.

“Women want to be listened to and inquired about their needs, validating their experience and believing them, trying to enhance their safety and it does involve trying to get a team involved … and offering ongoing support.

“Women really want choice and control over what the response post-disclosure looks like.”

Professor Galbally said support services for women who are victims of violence must be better resourced to meet need.

“They’re under-resourced, there is not enough availability even within the sort of hospital settings in terms of the social workers and others who get involved in this.

“That’s always the concern with screening, that we really want to make sure that we have that response.

“A really important part of identification is actually doing something about this.”

SOURCE: ABCNEWS

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