Why don't midwives ask about domestic abuse?

Routine screening for domestic abuse in pregnancy is recommended and midwives are in an ideal position for this role. However due to an apparent reluctance to enquire about domestic abuse it often remains a hidden problem with detrimental consequences for women and their unborn children. The aim of this systematic review was to identify the most commonly reported factors that prevent healthcare professionals from routinely screening women for domestic abuse. Six electronic databases were searched for all articles published in the English language up to January 2006. Data, including all the reported reasons for not screening for domestic abuse, were extracted from all the studies which met the inclusion criteria. A simple 'vote-counting' analysis was performed with graphical representation and calculation of weighted means. Thirteen papers met the inclusion criteria. The perceived barriers to screening appeared similar across a range of specialities and clinical settings. The most commonly cited factors were: lack of time, lack of training, and inadequate resources. Domestic abuse remains a serious public health issue and is frequently exacerbated by pregnancy. Our results suggest that raising awareness of the issue should help midwives understand the need to prioritise screening and find the time required to do so. Encouragingly it also suggests that improving basic education and increasing access to simple resources, such as leaflets giving details of where to get support, may provide practitioners with the confidence required to ask women about domestic abuse. [ABSTRACT FROM AUTHOR]