During November and December 2019, I was delighted to see so much activity around the international ‘16 Days of Activism’ campaign to end violence against women and girls. This years' theme was ‘Orange the world: generation equality stands against rape’, and so the colour orange flooded my social media feeds in solidarity for the cause. Further in support, the United Nation's ‘End violence against women’ (UNiTE) campaign called for global action to increase awareness, galvanise advocacy efforts and share innovative knowledge.
Consequently, I felt compelled to use this platform to do just that with regards to midwives, who along with nurses and healthcare assistants, are known to be three times more likely to experience domestic abuse than the average person in the UK, with 1 in 7 being affected (Cavell Nurses' Trust, 2016). I was further encouraged by the International Confederation of Midwives, who obligingly produced a bespoke campaign to end violence against midwives specifically.
This 16-day campaign ended on 10 December 2019 (global Human Rights Day), where I was privileged to be invited to the ‘Violence against women and girls safeguarding’ workshop hosted by NHS Improvement to share recent work done in collaboration with the Royal College of Midwives (RCM). The event brought together leaders in safeguarding across the capital to look at current research and innovative projects, and inspire better safeguarding throughout the UK. Here, Janet Fyle, Professional Policy Advisor at the RCM, and I shared findings in relation to our report on domestic abuse experienced by midwives and the availability and nature of workplace support designed for them (Pezaro et al, 2018a).
Broadly, findings from this report demonstrate that while there are some midwives and maternity support workers who report a positive experience, there are many who don't: barriers included a lack of knowledge and understanding, ideas around professionalism, mis-conceptions, practicalities and policies, distrust, shame, embarrassment, and fear. Lack of formal support also remained a strong theme throughout.
‘while there are some midwives and maternity support workers who report a positive experience, there are many who don't’
Additionally, the professional and personal lives of both midwives and maternity support workers may not be so easily separated and may be inter-reliant, impacting upon each other. Moreover, while some midwives had access to occupational and/or staff support services in the workplace, they were not cited to be particularly effective.
Furthermore, of the midwifery leaders asked, 66% reported that their Trust had a specific policy to support staff who may suffer domestic violence, yet only 25% reported that they had referred to it (Pezaro et al, 2018a). This may suggest that specific workplace policies could be lacking, unenforceable or underutilised.
Encouragingly, a significant amount of work is now being done to ensure that Trust policies and practices reflect and are informed by the findings in this report (Pezaro et al, 2018a). Our final recommendations were as follows:
Investment in the wellbeing of maternity staff is vital in order to safeguard quality, safety and value for money maternity services (Pezaro et al, 2015; The Royal College of Physicians, 2015; Pezaro et al, 2018b). Moreover, maternity staff are entitled to psychological and physical safety. In 2016, 51 355 NHS staff were likely to have experienced domestic abuse in the past 12 months (44 825 women and 6 530 men) (SafeLives, 2016).
Now is the time to implement change in relation to how we effectively support those in the midwifery profession who experience domestic violence themselves, so that both midwifery professionals and maternity services may reap the rewards. Yet there is still much work to be done if we are to eliminate all forms of violence against women and girls by 2030 in line with the UN's sustainable development goals.
The RCM report (Pezaro et al, 2018a) summarised here identifies that being a knowledgeable and skilled professional does not offer sufficient protection from manipulation and abuse, as some midwifery professionals still do not recognise the signs of being affected by domestic abuse themselves, even when trained to see it in others.
This brings about further concerns in relation to the midwife's ability to screen others effectively within their role. Consequently, in 2020 I look forward to working on further projects aimed at building positive pregnancy journeys through enhanced responses to disclosure of intimate partner violence in healthcare settings. I also intend to continue dedicating my career to securing the wellbeing of midwives for the benefit of all.