Disclosure of family violence in pregnancy — communication and safety station

Communication and safety station on a family and domestic violence disclosure in pregnancy. Exercises the WHO LIVES first-line response, lethality risk assessment with non-fatal strangulation, woman-led safety planning, the documentation and confidential-flag standard, the referral to specialist advocacy, and the separate mandatory child-protection obligation. The eight published RANZCOG oral domains apply.

Prompt

A 28-year-old woman at 24 weeks' gestation is seen in the antenatal clinic. Her partner has accompanied her to every visit and answers questions on her behalf. Today you arrange to speak to her alone for part of the consultation. Once alone, she discloses that her partner hits her, controls her finances and phone, and two weeks ago 'held her down by the throat'. She has a four-year-old child at home. She is frightened and tearful. The assessor plays the patient. You have twelve minutes.

Station brief

Format. Communication and safety station, approximately 12 minutes. You are the obstetric registrar. The assessor plays the patient. A social worker is available by phone. The assessor will run the clock, observe the conversation, and feed prompts as the woman responds. ^[1]

Candidate instruction. Respond to the woman's disclosure. Demonstrate the first-line response, assess her risk of lethal violence, help her build a safety plan, explain your documentation and referral, and address the welfare of her child. Speak to her directly — the communication is the assessment. ^[1]

References5Show

[1]World Health Organization Responding to intimate partner violence and sexual violence against women: WHO clinical and policy guidelines World Health Organization, 2013.Source
[2]Campbell JC, Webster DW, Glass N The danger assessment: validation of a lethality risk assessment instrument for intimate partner femicide J Interpers Violence, 2009.PMID 18667689
[3]Glass N, Laughon K, Campbell J, et al. Non-fatal strangulation is an important risk factor for homicide of women J Emerg Med, 2008.PMID 17961956
[4]Rivas C, Ramsay J, Sadowski L, et al. Advocacy interventions to reduce or eliminate violence and promote the physical and psychosocial well-being of women who experience intimate partner abuse Cochrane Database Syst Rev, 2015.PMID 26632986
[5]Royal Australian and New Zealand College of Obstetricians and Gynaecologists Family and Domestic Violence eLearning Module and Clinical Guideline RANZCOG, 2024.Source

Disclosure of family violence in pregnancy — communication and safety station

Station brief

References5Show

[1]World Health Organization Responding to intimate partner violence and sexual violence against women: WHO clinical and policy guidelines World Health Organization, 2013.Source
[2]Campbell JC, Webster DW, Glass N The danger assessment: validation of a lethality risk assessment instrument for intimate partner femicide J Interpers Violence, 2009.PMID 18667689
[3]Glass N, Laughon K, Campbell J, et al. Non-fatal strangulation is an important risk factor for homicide of women J Emerg Med, 2008.PMID 17961956
[4]Rivas C, Ramsay J, Sadowski L, et al. Advocacy interventions to reduce or eliminate violence and promote the physical and psychosocial well-being of women who experience intimate partner abuse Cochrane Database Syst Rev, 2015.PMID 26632986
[5]Royal Australian and New Zealand College of Obstetricians and Gynaecologists Family and Domestic Violence eLearning Module and Clinical Guideline RANZCOG, 2024.Source