Interventions to reduce Domestic Abuse in Pregnancy:a Qualitative Systematic Review

Research output: Contribution to journalArticle

Abstract

Background. Pregnant women are at an increased risk of domestic abuse, with prevalence rates of 5% to 21% during pregnancy and 13% to 21% postnatally. There is a significant threat to the health and wellbeing of the mother and baby that may lead to potential morbidity and mortality. A total of 80% of women in abusive relationships seek help at least once and, on average, seven to eight visits are made to health professionals before disclosure of abuse. Pregnant women are routinely screened for domestic abuse as part of the routine care in the UK, but we do not know what interventions work in reducing abuse in pregnancy. Recent guidelines from NICE (2008) underline the urgent need for evaluation of domestic abuse interventions.Aim. To assess the effectiveness of interventions to reduce domestic abuse in pregnancy. Method. The Centre for Reviews and Dissemination (CRD) Systematic reviews: CRD’s guidance for undertaking reviews in health care (CRD, 2008) and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were used to structure the review. Electronic database searches were completed in Medline, EMBASE, CINAHL, Cochrane, ASSIA and PsycINFO from inception until April 2012 and data were extracted that met inclusion/exclusion criteria. All studies were critically appraised by three independent reviewers and the Cochrane ‘Risk of Bias’ methodology was used for assessment. Results. Five studies met the inclusion criteria. Counselling was found to be significant in reducing domestic abuse in two of the four studies, which used the Dutton’s 1992 empowerment model as the basis for their counselling intervention. Implications. The strength of evidence for the effectiveness of counselling is promising. Interventions based on mentoring appear to be beneficial. Further research is recommended.
LanguageEnglish
Pages137-142
JournalEvidence Based Midwifery
Volume10
Issue number4
Publication statusPublished - Dec 2012

Fingerprint

Counseling
Pregnancy
Pregnant Women
Guidelines
Health
Disclosure
Meta-Analysis
Mothers
Databases
Morbidity
Delivery of Health Care
Mortality
Research
Power (Psychology)
Mentoring

Keywords

  • Domestic abuse
  • pregnancy
  • intervention
  • prevention
  • midwives
  • systematic review
  • evidence-based midwifery

Cite this

@article{49340994c2e949efbf5a50c1d70d792d,
title = "Interventions to reduce Domestic Abuse in Pregnancy:a Qualitative Systematic Review",
abstract = "Background. Pregnant women are at an increased risk of domestic abuse, with prevalence rates of 5{\%} to 21{\%} during pregnancy and 13{\%} to 21{\%} postnatally. There is a significant threat to the health and wellbeing of the mother and baby that may lead to potential morbidity and mortality. A total of 80{\%} of women in abusive relationships seek help at least once and, on average, seven to eight visits are made to health professionals before disclosure of abuse. Pregnant women are routinely screened for domestic abuse as part of the routine care in the UK, but we do not know what interventions work in reducing abuse in pregnancy. Recent guidelines from NICE (2008) underline the urgent need for evaluation of domestic abuse interventions.Aim. To assess the effectiveness of interventions to reduce domestic abuse in pregnancy. Method. The Centre for Reviews and Dissemination (CRD) Systematic reviews: CRD’s guidance for undertaking reviews in health care (CRD, 2008) and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were used to structure the review. Electronic database searches were completed in Medline, EMBASE, CINAHL, Cochrane, ASSIA and PsycINFO from inception until April 2012 and data were extracted that met inclusion/exclusion criteria. All studies were critically appraised by three independent reviewers and the Cochrane ‘Risk of Bias’ methodology was used for assessment. Results. Five studies met the inclusion criteria. Counselling was found to be significant in reducing domestic abuse in two of the four studies, which used the Dutton’s 1992 empowerment model as the basis for their counselling intervention. Implications. The strength of evidence for the effectiveness of counselling is promising. Interventions based on mentoring appear to be beneficial. Further research is recommended.",
keywords = "Domestic abuse, pregnancy, intervention, prevention, midwives, systematic review, evidence-based midwifery",
author = "Susan Leneghan and Patricia Gillen and Marlene Sinclair",
note = "Reference text: Bailey BA. (2010) Partner violence during pregnancy: prevalence, effects, screening, and management. International Journal of Women’s Health 2: 183-97. Bent-Goodley TB. (2007) Health disparities and violence against women: why and how cultural and societal influences matter. Trauma, Violence and Abuse 8(2): 90-104. Bybee DI, Sullivan CM. (2002) The process through which an advocacy intervention resulted in positive change for battered women over time. American Journal of Community Psychology 30(1): 103-32. Campbell M, Fitzpatrick R, Haines A, Kinmonth AL, Sandercock P, Spiegelhalter D, Tyrer P. (2000) Framework for design and evaluation of complex interventions to improve health. British Medical Journal 321(7262): 694-6. Campbell J, Jones AS, Dienemann J, Kub J, Schollenberger J, O’Campo P, Gielen AC, Wynne C. (2002) Intimate partner violence and physical health consequences. Archives of Internal Medicine 162(10): 1157-63. Carroll C, Patterson M, Wood S, Booth A, Rick J, Balain S. (2007) A conceptual framework for implementation fidelity. Implementation Science 2: 40. Centre for Reviews and Dissemination. (2008) Systematic reviews: CRD’s guidance for undertaking reviews in health care. See: york.ac.uk/inst/crd/index_guidance.htm (accessed 26 October 2012). Coker AL, Smith PH, McKeown RE, King MJ. (2000) Frequency and correlates of intimate partner violence by type: physical, sexual and psychological battering. American Journal of Public Health 90(4): 553-9. Coker AL, Sanderson M, Dong B. (2004) Partner violence during pregnancy and risk of adverse pregnancy outcomes. Paediatric Perinatal Epidemiology 18(4): 260-9. Dane AV, Schneider BH. (1998) Program integrity in primary and early secondary prevention: Are implementation effects out of control? Clinical Psychology Review 18(1): 23-45. Department of Health. (2000) Domestic abuse: A resource manual for healthcare professionals. HMSO: London. Department of Health. (2010) Call to end violence against women and children. HMSO: London. Department of Health and Social Services and Northern Ireland Office. (2005) Tackling domestic violence – a policy for Northern Ireland. Department of Health and Social Services and Northern Ireland Office: Belfast. Devries KM, Kishor S, Johnson H, Stockl H, Bacchus LJ, Garcia-Moreno C, Watts C. (2010) Intimate partner violence during pregnancy: analysis of prevalence data from 19 countries. Reproductive Health Matters 18(36): 158-70. Dobash RE, Dobash RP. (1992) Women, violence and social change. Routledge: London. Dutton M. (1992) Empowering and healing the battered woman. Springer: New York. El Kady D, Gilbert WM, Xing G, Smith LH. (2005) Maternal and neonatal outcomes of assaults during pregnancy. Obstetrics & Gynecology 105(2): 357-63. Garcia-Moreno C, Jansen HAFM, Ellsberg M, Heise L, Watts CH. (2006) Prevalence of intimate partner violence: findings from the WHO multi-country study on women’s health and domestic violence. Lancet 368(9543): 1260-9. Gottlieb AS. (2008) Intimate partner violence: a clinical review of screening and intervention. Women’s Health 4(5): 529-39. Harris V, Loise R, Spencer H, Cox H. (2002) Domestic abuse screening pilot in primary care 2000-2002: final report. Support and Survival: Wakefield. Higgins JPT, Green S. (Eds.). (2011) Cochrane handbook for systematic reviews of interventions version 5.1.0 (updated March 2011). The Cochrane Collaboration. See: cochrane-handbook.org (accessed 26 October 2012). Jackson N, Waters E. (2005) Criteria for the systematic review of health promotion and public health interventions. Health Promotion International 20(4): 367-74. Jahanfar S, Janssen PA, Howard L. (2011) Interventions for preventing or reducing domestic violence against pregnant women. Cochrane Database Syst Rev 11: CD009414. Kataoka Y, Yaju Y, Eto H, Matsumoto N, Horiuchi S. (2004) Screening of domestic violence against women in the perinatal setting: a systematic review. Japan Journal of Nursing Science 1(2): 77-86. Kiely M, El-Mohandes AAE, El-Khorazaty MN, Gantz MG. (2010) An integrated intervention to reduce intimate partner violence in pregnancy: a randomised trial. Obstetrics & Gynaecology 115(2): 273-83. Lagan B, Sinclair M, Kernohan WG. (2006) Pregnant women’s use of the internet: a review of published and unpublished evidence. Evidence Based Midwifery 4(1): 17-23. Lewis G. (2011) Saving mothers’ lives: reviewing maternal deaths to make motherhood safer, 2006-2008. The eighth report of the Confidential Enquiries into Maternal Deaths in the United Kingdom. CEMACH: London. Liberati A, Altman DG, Tetzalff J, Mulrow C, Gotzsche PC, Ioannidis JPA, Clarke M, Devereaux PJ, Kleijnen J, Moher D. (2009) The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate healthcare interventions: explanation and elaboration. PLoS Med 6(7): e1000100. Lumley J, Chamberlain C, Dowswell T, Oliver S, Oakley L, Watson L. (2009) Interventions for promoting smoking cessation during pregnancy. Cochrane Database Syst Rev 3: CD001055. McFarlane J, Soeken K, Wiist W. (2000) An evaluation of interventions to decrease intimate partner violence to pregnant women. Journal of Public Health Nursing 17(6): 443-51. McWilliams M, McKiernan J. (1993) Bringing it out into the open. HMSO: Belfast. NICE. (2008) Antenatal care: routine care for the healthy pregnant woman. NICE: London. O’Campo P, Kub J, Woods A, Garza M, Snow Jones A, Gielen AC, Dienemann J, Campbell J. (2006) Depression, PTSD, and comorbidity related to intimate partner violence in civilian and military women. Brief Treatment and Crisis Intervention 6(2): 99-110. O’Campo P, Ahmad F, Cyriac A. (2008) Role of healthcare professionals in preventing and intervening on IPV: In: Keeling J, Mason T. Domestic violence: a multi-professional approach for healthcare practitioners. Open University Press: Maidenhead. O’Reilly R, Beale B, Gillies D. (2010) Screening and intervention for domestic violence during pregnancy care: a systematic review. Trauma, Violence and Abuse 11(4): 190-201. Parker B, McFarlane J, Soeken K. (1994) Abuse during pregnancy: effects on maternal complications and birthweight in adults and teenage women. Obstetrics & Gynecology 84(3): 323-8. Parker B, McFarlane J, Soeken K, Silva C, Reel S. (1999) Testing an intervention to prevent further abuse to pregnant women. Research Nursing Health 22(1): 59-66. Power TJ, Blom-Hoffman J, Clarke AT, Riley-Tillman TC, Kellerher C, Manz P. (2005) Reconceptualizing intervention integrity: a partnership-based framework for linking research with practice. Psychology in the Schools 42(5): 495-507. Ramsay J, Rivas C, Feder G. (2005) Interventions to reduce violence and promote the physical and psychosocial wellbeing of women who experience partner abuse: a systematic review. See: dh.gov.uk/assetRoot/04/12/74/26/04127426.pdf (accessed 26 October 2012). Ramsay R, Carter Y, Davidson L, Dunne D, Eldridge S, Feder G, Hegarty K, Rivas C, Taft A, Warburton A. (2009) Advocacy interventions to reduce or eliminate violence and promote the physical and psychosocial wellbeing of women who experience intimate partner abuse. Cochrane Database Syst Rev 3: CD005043. Renker PR, Tonkin P. (2006) Women’s views of prenatal violence screening: acceptability and confidentiality issues. Obstetrics & Gynaecology 107(2 Pt 1): 348-54. Sarkar NN. (2008) The impact of intimate partner violence on women’s reproductive health and pregnancy outcome. Journal of Obstetrics and Gynaecology 28(3): 266-71. Shadigan EM, Bauer ST. (2004) Screening for partner violence during pregnancy. International Journal of Gynaecology and Obstetrics 84(3): 273-80. Steckler A, Linnan L. (2002) Process evaluation for public health interventions and research. Jossey-Bass: San Francisco. Steen M, Downe S, Graham-Kevan N. (2010) Development of antenatal education to raise awareness of the risks of relationship conflict. Evidence Based Midwifery 8(2): 53-7. Steen-Greaves M, Downe S, Graham-Kevan N. (2009) Men and women’s perceptions and experiences of attending an abusive behaviour management programme. Evidence Based Midwifery 7(4): 128-35. Taft A, Small R, Hegarty KL, Lumley J, Watson LF, Gold L. (2009) MOSAIC (MOtherS’ Advocates In the Community): protocol and sample description of a cluster randomized trial of mentor mother support to reduce intimate partner violence among pregnant or recent mothers. BMC Public Health 9: 159. Taft A, Small R, Hegarty K, Watson L, Gold L, Lumley A. (2011) MOtherS’ Advocates In the Community (MOSAIC) – non-professional mentor support to reduce intimate partner violence and depression in mothers: a cluster randomised trial in primary care. BMC Public Health 11: 178. Tiwari A, Leung WC, Leung TW, Humphreys J, Parker B, Ho PC. (2005) A randomised controlled trial of empowerment training for Chinese abused pregnant women in Hong Kong. British Journal of Obstetrics and Gynaecology 112(9): 1249-56. Wathen CN, Macmillan HL. (2003) Interventions for violence against women: scientific review. JAMA 289(5): 589-600. WHO. (2001) WHOTERM: A quick reference compendium of selected key terms used in The World Health Report 2000. See: who.int/health-systems-performance/docs/whr_2000_glossary.doc (accessed 26 October 2012). WHO. (2010) Preventing intimate partner and sexual violence against women: taking action and generating evidence. WHO: Geneva.",
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language = "English",
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journal = "Evidence Based Midwifery",
issn = "1479-4489",
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}

Interventions to reduce Domestic Abuse in Pregnancy:a Qualitative Systematic Review. / Leneghan, Susan; Gillen, Patricia; Sinclair, Marlene.

In: Evidence Based Midwifery, Vol. 10, No. 4, 12.2012, p. 137-142.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Interventions to reduce Domestic Abuse in Pregnancy:a Qualitative Systematic Review

AU - Leneghan, Susan

AU - Gillen, Patricia

AU - Sinclair, Marlene

N1 - Reference text: Bailey BA. (2010) Partner violence during pregnancy: prevalence, effects, screening, and management. International Journal of Women’s Health 2: 183-97. Bent-Goodley TB. (2007) Health disparities and violence against women: why and how cultural and societal influences matter. Trauma, Violence and Abuse 8(2): 90-104. Bybee DI, Sullivan CM. (2002) The process through which an advocacy intervention resulted in positive change for battered women over time. American Journal of Community Psychology 30(1): 103-32. Campbell M, Fitzpatrick R, Haines A, Kinmonth AL, Sandercock P, Spiegelhalter D, Tyrer P. (2000) Framework for design and evaluation of complex interventions to improve health. British Medical Journal 321(7262): 694-6. Campbell J, Jones AS, Dienemann J, Kub J, Schollenberger J, O’Campo P, Gielen AC, Wynne C. (2002) Intimate partner violence and physical health consequences. Archives of Internal Medicine 162(10): 1157-63. Carroll C, Patterson M, Wood S, Booth A, Rick J, Balain S. (2007) A conceptual framework for implementation fidelity. Implementation Science 2: 40. Centre for Reviews and Dissemination. (2008) Systematic reviews: CRD’s guidance for undertaking reviews in health care. See: york.ac.uk/inst/crd/index_guidance.htm (accessed 26 October 2012). Coker AL, Smith PH, McKeown RE, King MJ. (2000) Frequency and correlates of intimate partner violence by type: physical, sexual and psychological battering. American Journal of Public Health 90(4): 553-9. Coker AL, Sanderson M, Dong B. (2004) Partner violence during pregnancy and risk of adverse pregnancy outcomes. Paediatric Perinatal Epidemiology 18(4): 260-9. Dane AV, Schneider BH. (1998) Program integrity in primary and early secondary prevention: Are implementation effects out of control? Clinical Psychology Review 18(1): 23-45. Department of Health. (2000) Domestic abuse: A resource manual for healthcare professionals. HMSO: London. Department of Health. (2010) Call to end violence against women and children. HMSO: London. Department of Health and Social Services and Northern Ireland Office. (2005) Tackling domestic violence – a policy for Northern Ireland. Department of Health and Social Services and Northern Ireland Office: Belfast. Devries KM, Kishor S, Johnson H, Stockl H, Bacchus LJ, Garcia-Moreno C, Watts C. (2010) Intimate partner violence during pregnancy: analysis of prevalence data from 19 countries. Reproductive Health Matters 18(36): 158-70. Dobash RE, Dobash RP. (1992) Women, violence and social change. Routledge: London. Dutton M. (1992) Empowering and healing the battered woman. Springer: New York. El Kady D, Gilbert WM, Xing G, Smith LH. (2005) Maternal and neonatal outcomes of assaults during pregnancy. Obstetrics & Gynecology 105(2): 357-63. Garcia-Moreno C, Jansen HAFM, Ellsberg M, Heise L, Watts CH. (2006) Prevalence of intimate partner violence: findings from the WHO multi-country study on women’s health and domestic violence. Lancet 368(9543): 1260-9. Gottlieb AS. (2008) Intimate partner violence: a clinical review of screening and intervention. Women’s Health 4(5): 529-39. Harris V, Loise R, Spencer H, Cox H. (2002) Domestic abuse screening pilot in primary care 2000-2002: final report. Support and Survival: Wakefield. Higgins JPT, Green S. (Eds.). (2011) Cochrane handbook for systematic reviews of interventions version 5.1.0 (updated March 2011). The Cochrane Collaboration. See: cochrane-handbook.org (accessed 26 October 2012). Jackson N, Waters E. (2005) Criteria for the systematic review of health promotion and public health interventions. Health Promotion International 20(4): 367-74. Jahanfar S, Janssen PA, Howard L. (2011) Interventions for preventing or reducing domestic violence against pregnant women. Cochrane Database Syst Rev 11: CD009414. Kataoka Y, Yaju Y, Eto H, Matsumoto N, Horiuchi S. (2004) Screening of domestic violence against women in the perinatal setting: a systematic review. Japan Journal of Nursing Science 1(2): 77-86. Kiely M, El-Mohandes AAE, El-Khorazaty MN, Gantz MG. (2010) An integrated intervention to reduce intimate partner violence in pregnancy: a randomised trial. Obstetrics & Gynaecology 115(2): 273-83. Lagan B, Sinclair M, Kernohan WG. (2006) Pregnant women’s use of the internet: a review of published and unpublished evidence. Evidence Based Midwifery 4(1): 17-23. Lewis G. (2011) Saving mothers’ lives: reviewing maternal deaths to make motherhood safer, 2006-2008. The eighth report of the Confidential Enquiries into Maternal Deaths in the United Kingdom. CEMACH: London. Liberati A, Altman DG, Tetzalff J, Mulrow C, Gotzsche PC, Ioannidis JPA, Clarke M, Devereaux PJ, Kleijnen J, Moher D. (2009) The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate healthcare interventions: explanation and elaboration. PLoS Med 6(7): e1000100. Lumley J, Chamberlain C, Dowswell T, Oliver S, Oakley L, Watson L. (2009) Interventions for promoting smoking cessation during pregnancy. Cochrane Database Syst Rev 3: CD001055. McFarlane J, Soeken K, Wiist W. (2000) An evaluation of interventions to decrease intimate partner violence to pregnant women. Journal of Public Health Nursing 17(6): 443-51. McWilliams M, McKiernan J. (1993) Bringing it out into the open. HMSO: Belfast. NICE. (2008) Antenatal care: routine care for the healthy pregnant woman. NICE: London. O’Campo P, Kub J, Woods A, Garza M, Snow Jones A, Gielen AC, Dienemann J, Campbell J. (2006) Depression, PTSD, and comorbidity related to intimate partner violence in civilian and military women. Brief Treatment and Crisis Intervention 6(2): 99-110. O’Campo P, Ahmad F, Cyriac A. (2008) Role of healthcare professionals in preventing and intervening on IPV: In: Keeling J, Mason T. Domestic violence: a multi-professional approach for healthcare practitioners. Open University Press: Maidenhead. O’Reilly R, Beale B, Gillies D. (2010) Screening and intervention for domestic violence during pregnancy care: a systematic review. Trauma, Violence and Abuse 11(4): 190-201. Parker B, McFarlane J, Soeken K. (1994) Abuse during pregnancy: effects on maternal complications and birthweight in adults and teenage women. Obstetrics & Gynecology 84(3): 323-8. Parker B, McFarlane J, Soeken K, Silva C, Reel S. (1999) Testing an intervention to prevent further abuse to pregnant women. Research Nursing Health 22(1): 59-66. Power TJ, Blom-Hoffman J, Clarke AT, Riley-Tillman TC, Kellerher C, Manz P. (2005) Reconceptualizing intervention integrity: a partnership-based framework for linking research with practice. Psychology in the Schools 42(5): 495-507. Ramsay J, Rivas C, Feder G. (2005) Interventions to reduce violence and promote the physical and psychosocial wellbeing of women who experience partner abuse: a systematic review. See: dh.gov.uk/assetRoot/04/12/74/26/04127426.pdf (accessed 26 October 2012). Ramsay R, Carter Y, Davidson L, Dunne D, Eldridge S, Feder G, Hegarty K, Rivas C, Taft A, Warburton A. (2009) Advocacy interventions to reduce or eliminate violence and promote the physical and psychosocial wellbeing of women who experience intimate partner abuse. Cochrane Database Syst Rev 3: CD005043. Renker PR, Tonkin P. (2006) Women’s views of prenatal violence screening: acceptability and confidentiality issues. Obstetrics & Gynaecology 107(2 Pt 1): 348-54. Sarkar NN. (2008) The impact of intimate partner violence on women’s reproductive health and pregnancy outcome. Journal of Obstetrics and Gynaecology 28(3): 266-71. Shadigan EM, Bauer ST. (2004) Screening for partner violence during pregnancy. International Journal of Gynaecology and Obstetrics 84(3): 273-80. Steckler A, Linnan L. (2002) Process evaluation for public health interventions and research. Jossey-Bass: San Francisco. Steen M, Downe S, Graham-Kevan N. (2010) Development of antenatal education to raise awareness of the risks of relationship conflict. Evidence Based Midwifery 8(2): 53-7. Steen-Greaves M, Downe S, Graham-Kevan N. (2009) Men and women’s perceptions and experiences of attending an abusive behaviour management programme. Evidence Based Midwifery 7(4): 128-35. Taft A, Small R, Hegarty KL, Lumley J, Watson LF, Gold L. (2009) MOSAIC (MOtherS’ Advocates In the Community): protocol and sample description of a cluster randomized trial of mentor mother support to reduce intimate partner violence among pregnant or recent mothers. BMC Public Health 9: 159. Taft A, Small R, Hegarty K, Watson L, Gold L, Lumley A. (2011) MOtherS’ Advocates In the Community (MOSAIC) – non-professional mentor support to reduce intimate partner violence and depression in mothers: a cluster randomised trial in primary care. BMC Public Health 11: 178. Tiwari A, Leung WC, Leung TW, Humphreys J, Parker B, Ho PC. (2005) A randomised controlled trial of empowerment training for Chinese abused pregnant women in Hong Kong. British Journal of Obstetrics and Gynaecology 112(9): 1249-56. Wathen CN, Macmillan HL. (2003) Interventions for violence against women: scientific review. JAMA 289(5): 589-600. WHO. (2001) WHOTERM: A quick reference compendium of selected key terms used in The World Health Report 2000. See: who.int/health-systems-performance/docs/whr_2000_glossary.doc (accessed 26 October 2012). WHO. (2010) Preventing intimate partner and sexual violence against women: taking action and generating evidence. WHO: Geneva.

PY - 2012/12

Y1 - 2012/12

N2 - Background. Pregnant women are at an increased risk of domestic abuse, with prevalence rates of 5% to 21% during pregnancy and 13% to 21% postnatally. There is a significant threat to the health and wellbeing of the mother and baby that may lead to potential morbidity and mortality. A total of 80% of women in abusive relationships seek help at least once and, on average, seven to eight visits are made to health professionals before disclosure of abuse. Pregnant women are routinely screened for domestic abuse as part of the routine care in the UK, but we do not know what interventions work in reducing abuse in pregnancy. Recent guidelines from NICE (2008) underline the urgent need for evaluation of domestic abuse interventions.Aim. To assess the effectiveness of interventions to reduce domestic abuse in pregnancy. Method. The Centre for Reviews and Dissemination (CRD) Systematic reviews: CRD’s guidance for undertaking reviews in health care (CRD, 2008) and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were used to structure the review. Electronic database searches were completed in Medline, EMBASE, CINAHL, Cochrane, ASSIA and PsycINFO from inception until April 2012 and data were extracted that met inclusion/exclusion criteria. All studies were critically appraised by three independent reviewers and the Cochrane ‘Risk of Bias’ methodology was used for assessment. Results. Five studies met the inclusion criteria. Counselling was found to be significant in reducing domestic abuse in two of the four studies, which used the Dutton’s 1992 empowerment model as the basis for their counselling intervention. Implications. The strength of evidence for the effectiveness of counselling is promising. Interventions based on mentoring appear to be beneficial. Further research is recommended.

AB - Background. Pregnant women are at an increased risk of domestic abuse, with prevalence rates of 5% to 21% during pregnancy and 13% to 21% postnatally. There is a significant threat to the health and wellbeing of the mother and baby that may lead to potential morbidity and mortality. A total of 80% of women in abusive relationships seek help at least once and, on average, seven to eight visits are made to health professionals before disclosure of abuse. Pregnant women are routinely screened for domestic abuse as part of the routine care in the UK, but we do not know what interventions work in reducing abuse in pregnancy. Recent guidelines from NICE (2008) underline the urgent need for evaluation of domestic abuse interventions.Aim. To assess the effectiveness of interventions to reduce domestic abuse in pregnancy. Method. The Centre for Reviews and Dissemination (CRD) Systematic reviews: CRD’s guidance for undertaking reviews in health care (CRD, 2008) and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were used to structure the review. Electronic database searches were completed in Medline, EMBASE, CINAHL, Cochrane, ASSIA and PsycINFO from inception until April 2012 and data were extracted that met inclusion/exclusion criteria. All studies were critically appraised by three independent reviewers and the Cochrane ‘Risk of Bias’ methodology was used for assessment. Results. Five studies met the inclusion criteria. Counselling was found to be significant in reducing domestic abuse in two of the four studies, which used the Dutton’s 1992 empowerment model as the basis for their counselling intervention. Implications. The strength of evidence for the effectiveness of counselling is promising. Interventions based on mentoring appear to be beneficial. Further research is recommended.

KW - Domestic abuse

KW - pregnancy

KW - intervention

KW - prevention

KW - midwives

KW - systematic review

KW - evidence-based midwifery

M3 - Article

VL - 10

SP - 137

EP - 142

JO - Evidence Based Midwifery

T2 - Evidence Based Midwifery

JF - Evidence Based Midwifery

SN - 1479-4489

IS - 4

ER -