O&G · Professional practice — family and domestic violence, advocacy and safety
Family and domestic violence
Also known as FDV · Intimate partner violence · IPV · Domestic violence · Family violence · Coercive control · Reproductive coercion · Domestic abuse
Exam-exhaustive FRANZCOG fellowship reference on family and domestic violence (FDV) in women's healthcare — RANZCOG routine enquiry, the WHO LIVES first-line response, validated screening tools (HARK, HITS, Abuse Assessment Screen), the Campbell Danger Assessment, safety planning, trauma-informed care, the perinatal period as a high-risk window, mandatory reporting by jurisdiction, reproductive coercion, and the documentation standard. RANZCOG-primary, globally tagged to MRCOG and ABOG.
Practise this topic
On this page
Study tools
Your progress
Saved on this device.
Target exams
Red flags
- Disclosure with a partner who will not leave the room — you cannot screen, you cannot safety-plan; the doorway is the first intervention
- Non-fatal strangulation is a red flag for future femicide — document it, escalate risk, never minimise it as 'choking'
- Pregnancy and the postpartum year, recent separation, and partner access to firearms are the highest-risk windows for lethal violence
- Discharge summaries and posted letters are read by perpetrators — flag the record confidential or you re-disclose the abuse
- A child in the household is a separate mandatory-reporting obligation; the unborn and the siblings are not optional addenda
- Leaving is the most dangerous time — the safety plan and the timing of separation determine the outcome, not the clinician's directive
She is 24, sixteen weeks pregnant, here for her booking visit, and her partner answers every question the midwife puts to her. The bruise on her inner upper arm is the shape of a thumbprint. The single most dangerous thing you can do is nothing — and the single most useful thing you can do is get her alone for three minutes and ask the question. FDV is not a fringe social issue in maternity care; it is core obstetric morbidity, and RANZCOG makes the response mandatory training for every trainee and fellow.[14][2]
Definition and classification
FDV is defined by pattern and by power, not by a single blow. The RANZCOG term "family and domestic violence" deliberately folds together partner-perpetrated and family-perpetrated abuse.[14]
- Intimate partner violence (IPV) is the subset perpetrated by a current or former partner — the form most commonly seen and most lethal in the perinatal period.[1]
- Family violence broadens to abuse by any family member, the framing preferred in Aotearoa New Zealand and for abuse perpetrated by in-laws, carers or extended kin.[14]
- Coercive control is the contemporary lens: a cumulative pattern of assault, threats, humiliation and intimidation that strips a woman of autonomy and liberty. It is the engine, not merely a feature.[9]
Classify FDV by the type of harm so your documentation is complete: [13][9]
- Physical — hitting, slapping, kicking, choking and attempted strangulation, weapon use, burning.
- Sexual — forced or coerced sexual activity, marital rape, reproductive coercion.
- Psychological and emotional — intimidation, threats, isolation, degradation, gaslighting, surveillance.
- Financial — controlling money, withholding funds, sabotaging employment.
- Technology-facilitated — GPS tracking, monitoring devices and social media, image-based abuse, coercive messaging.[9]
References15ShowHide
- [1]Devries KM, Mak JY, García-Moreno C, et al. Global health. The global prevalence of intimate partner violence against women Science, 2013.PMID 23788730
- [2]Curry SJ, Krist AH, Owens DK, et al. Screening for Intimate Partner Violence, Elder Abuse, and Abuse of Vulnerable Adults: US Preventive Services Task Force Final Recommendation Statement JAMA, 2018.PMID 30357305
- [3]Sherin KM, Sinacore JM, Li XQ, et al. HITS: a short domestic violence screening tool for use in a family practice setting Fam Med, 1998.PMID 9669164
- [4]Sohal H, Eldridge S, Feder G The sensitivity and specificity of four questions (HARK) to identify intimate partner violence: a diagnostic accuracy study in general practice BMC Fam Pract, 2007.PMID 17727730
- [5]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
- [6]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
- [7]Horon IL, Cheng D Enhanced surveillance for pregnancy-associated mortality--Maryland, 1993-1998 JAMA, 2001.PMID 11255421
- [8]Cheng D, Horon IL Intimate-partner homicide among pregnant and postpartum women Obstet Gynecol, 2010.PMID 20502288
- [9]American College of Obstetricians and Gynecologists Committee on Health Care for Underserved Women ACOG Committee Opinion No. 554: reproductive and sexual coercion Obstet Gynecol, 2013.PMID 23344307
- [10]American College of Obstetricians and Gynecologists Committee on Health Care for Underserved Women ACOG Committee Opinion No. 518: Intimate partner violence Obstet Gynecol, 2012.PMID 22270317
- [11]Hill A, Pallitto C, McCleary-Sills J, Garcia-Moreno C A systematic review and meta-analysis of intimate partner violence during pregnancy and selected birth outcomes Int J Gynaecol Obstet, 2016.PMID 27039053
- [12]Stöckl H, Devries K, Rotstein A, et al. The global prevalence of intimate partner homicide: a systematic review Lancet, 2013.PMID 23791474
- [13]World Health Organization Responding to intimate partner violence and sexual violence against women: WHO clinical and policy guidelines World Health Organization, 2013.Source
- [14]Royal Australian and New Zealand College of Obstetricians and Gynaecologists Family and Domestic Violence eLearning Module and Clinical Guideline RANZCOG, 2024.Source
- [15]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