PROFESSIONAL ISSUES Asking pregnant women about domestic abuse By June Keeling and Linda Birch ABSTRACT The aim of the research was to explore the prevalence and nature of domestic abuse experienced by women attending an early pregnancy unit and the correlation between demographic variables such as age and employment status. Participants were given the opportunity to identify if they agreed with these questions being asked in the clinic. 26% of women had experienced severe emotional or physical intimate partner abuse, whilst 9% had experienced physical abuse within the last year. There was a significant association between the age of the woman and the prevalence of domestic abuse. The majority of women feel that it is appropriate for health professionals to ask about experiences of domestic abuse when attending an Early Pregnancy Clinic. June Keeling is domestic violence co- ordinator/researcher Linda Birch is senior lecturer/practitioner at the Practice Development and Research Unit Duchess of Westminster Wing Arrowe Park Hospital This article was accepted for publication on 10 May 2004 D omestic abuse can be defined as 'any violence between current or former partners in an intimate rela- tionship, wherever and whenever the vio- lence occurs. The violence can include physical, sexual, emotional or financial abuse' (Department of Health, 2000). For an individual to be at risk of experiencing domestic abuse, the single most important risk factor is being a woman (DH, 2000). Research has demonstrated one in four women have experienced domestic violence during their lifetime (Lovendski and Randall, 1995). Early pregnancy loss within the first twelve weeks of pregnancy may be experi- enced by about 15% of women (Huisjes, 1984). Although usually due to a plethora of natural causes, this event may have result- ed following physical abuse from their inti- mate partner. Pregnancy is a particularly high-risk life event for domestic violence with the vio- lence often initiating or escalating in preg- nancy (RCOG, 2001). Amaro et al. (1990) suggests that up to 30% of the abuse com- mences in pregnancy. Rarely does the vio- lence diminish. The effects of the abuse can result in long term psychological and physical morbidity and has a direct impact on the pregnancy. Estimates of the prevalence of domestic abuse range from 6.6% (Stewart and Cecutti, 1993) up to 42% (Webster et al., 1996). Of pregnant women who died in the UK between 1997-1999, 12% had self- reported experiencing domestic abuse within the home (RCOG, 2001). Domestic abuse in pregnancy can result in immediate or long-term complications. Studies by Webster et al. (1996) and Helton and Snodgrass, (1987) have identified higher rates of miscarriage in women who are experiencing domestic abuse. Materials and methods This study used a quantitative approach to identify the prevalence of domestic abuse experienced by women attending an Early Pregnancy Unit (EPU) and their opinion about being asked these questions. The EPU is a clinical facility within the Women's unit of a large District General Hospital within the UK. Following referral by a gen- eral practitioner, women attend with