Protecting Pregnant Women: Prevention and Screening of Gender-Based Violence in Maternal-Infant Services

Violence during pregnancy is a pervasive and clinically significant issue, with serious implications for the psycho-physical well-being of both mothers and fetuses. It is associated with an elevated risk of miscarriage, preterm birth, low birth weight, and both fetal and neonatal mortality. The changes that occur during pregnancy can intensify existing power imbalances and expose instances of abuse. In this context, the healthcare system assumes a pivotal role. Prenatal visits offer a continuity of care and a secure environment in which women feel heard. The establishment of trusting relationships with gynaecologists and midwives can facilitate the disclosure of violent experiences. A Cochrane review has demonstrated that healthcare screening is an effective method for identifying instances of domestic violence. However, it is still rarely employed in many countries. To assess the feasibility of identifying instances of intimate partner violence (IPV) during pregnancy, the SVSeD (Service for Sexual and Domestic Violence, a public anti-violence centre situated within a university hospital) collaborated with the Family Counselling Centre of the Policlinico Hospital of Milan to develop a brief questionnaire to be administered during the first, second and third trimesters of pregnancy. The questionnaire investigates vulnerability factors and indicators of violence, incorporating the Abuse Assessment Screen (AAS) tool. The questionnaire was completed in a confidential setting, without the presence of the partner, with the objective of identifying instances of abuse and promptly activating a support network. In the initial three-month period of the project, 191 women completed the questionnaire, indicating that 18 women (9.4%; 95% CI: 5.8-14.7%) were identified as victims of violence. Preliminary findings of this study confirm that IPV during pregnancy is not infrequent, and that the implementation of screening can facilitate the identification of such situations.