Domestic abuse disclosure in perinatal healthcare settings - A qualitative study into the experiences of mothers who had their baby removed at birth.

BackgroundIn the UK, numbers of newborn babies entering state care through child protection processes have significantly increased in the last decade. Their mothers often have experienced cumulative and intersecting disadvantages, including childhood abuse and domestic abuse (DA). DA will often be a key factor in child protection decision-making, with a persistent narrative of mothers 'failing to protect' their children. Given the profound consequences of DA disclosures and the failure-to-protect discourse that might impact care proceeding outcomes for these mothers, it is important to explore the factors influencing DA disclosure and the complexities that this population faces.ObjectivesTo explore the experiences of DA disclosure in perinatal healthcare settings among mothers who had a baby removed at birth; To understand barriers and facilitators that impact DA disclosure in this context.DesignThe MUMS@RISC study was a mixed-methods doctoral research study. This manuscript focuses on the qualitative part of the study, with women who had a baby removed at birth due child protection processes.MethodsA secondary analysis of narrative interview data from the MUMS@RISC study, using Braun and Clarke's Reflexive Thematic Analysis. Robust lived experience involvement and trauma-informed approaches were adopted throughout the entire study design.ResultsInterview data from 7 women were included. Three themes were generated, each with sub-themes: 1) Previous adversity leading to current vulnerability; 2) '"It's not that easy" - Navigating, disclosing and leaving an abusive relationship'; and 3) Finding a way out.ConclusionLifelong adversity leading to vulnerability and fear, coupled with system-level barriers, each led to inadequate support and care, impacting DA disclosure among women who have their baby removed at birth and appropriate professional response. Professional understanding about these interconnecting levels of barriers to DA disclosure and the role of coercive control in DA and sensitive routine enquiry about DA is crucial to facilitate opportunities for disclosure.