GPs to monitor home violence

MINISTERS ARE to support a series of measures to curb domestic violence following research that reveals a shocking number of attacks on pregnant women.

Doctors and hospital staff are to be asked to help detect women suffering beatings after learning that one-third of attacks on women take place for the first time when they are pregnant. Experts believe that jealousy provoked by the prospective arrival of a baby drives men to violence.

The report, "Why mothers die", will be unveiled by the Health minister, Baroness Hayman, at a conference today. It details how six expectant women have been murdered and thousands more subjected to violent attacks during a two-year period under review.

The Government will call for far greater vigilance by medical staff to prevent injuries, and ask hospitals and GPs to include questions about domestic violence for all pregnant women.

Assaults by male partners are now recognised to cause greater harm to mother and child than medical conditions which are routinely screened for in pregnancy. Yet the warning signs are often missed.

"The confidential inquiry into maternal deaths", a regular survey conducted by a team of specialists, says questions about violence should be included when a woman's social history is being taken at her first ante-natal visit. In addition to routine questioning to spot those at risk, it says health authorities and NHS trusts must establish strategies for helping those identified.

The report, to be launched at the Royal College of Obstetricians today, examined 376 deaths from all causes associated with pregnancy between 1994 and 1996 and occurring up to a year after the birth. Of these, 268 were directly linked with pregnancy and occurred within 42 days of birth, the definition of a maternal death.

It also shows that domestic violence occurs across all social classes with one in three women estimated to suffer an assault at some time during their lives. Experts claim that violence worsens during pregnancy, and doubles the risk of miscarriage.

John Friend, a consultant obstetrician in Plymouth and a spokesman for the Royal College of Obstetricians, said: "The male partner suddenly feels threatened when the woman gets pregnant. He sees a rival in the camp ... Domestic violence is a very big problem and carries greater risks for the developing foetus and the mother than many of the conditions we routinely screen for such as pre-eclampsia."

Another survey carried out into domestic violence and pregnancy, based on a sample of 1,000 expectant women, has discovered serious problems in the process of screening abuse.

The study, by Dr Susan Bewley, director of obstetrics at Guy's and St Thomas' NHS Trust, in south London, and Dr Gill Mezey a consultant in forensic psychiatry at St George's Medical School in London, found that up to 25 per cent of pregnant women could not be questioned about domestic violence because they were accompanied at all interviews by their male partners.

Dr Bewley said: "As a society we have encouraged greater involvement of men in childcare, and it is now difficult to exclude them. As we can see this may not be a good thing in cases where we have vulnerable women and controlling men. This is a problem which cuts across social and racial classes."

The six women who died as a result of domestic violence were all murdered by their husbands or male partners and are likely to represent only a fraction of the total. From the few cases that were reported, all too obvious warning signs were present, the report says.