The work of a maternity IDVA: where pregnancy and abuse intersect

Written by Eve Copeman 

My role working as an Independent Domestic Violence Advocate (IDVA) in the Midwifery Domestic Abuse Support Service (MiDASS) allows me to offer holistic, trauma-informed support to women experiencing domestic abuse during pregnancy and the postpartum period.  

It is a well-known fact in the VAWG sector that much of domestic abuse starts in pregnancy. Studies suggest that 20-30% of women will experience physical violence during pregnancy, while 20% will experience sexual violence. For women who are experiencing abuse before conception, it is likely that this behaviour will escalate during pregnancy. Domestic abuse can have a profound impact on mothers and babies and is associated with risks including low birth weight, premature birth, miscarriage, developmental delays and difficulties with bonding and attachment. Pregnancy can also make leaving an abusive situation more complicated. It is often a time of heightened vulnerability, emotional strain, and economic dependence, all of which can create additional barriers to seeking safety and support. 

My work as an IDVA in the MiDASS team allows me to offer support to these women who are navigating some of the most complex circumstances, and no two days are ever the same. I spend most of the week at a busy maternity hospital, working alongside midwives who specialise in safeguarding. Being based at the hospital allows me to meet women at short notice, often after they have attended a scan or a routine antenatal appointment and disclosed concerns to a midwife. I can meet with them then and there, discuss their situation and explore what support we might be able to offer.  

The experiences of the women I speak to vary greatly, and the support I offer must reflect this. Often, I meet women in crisis. They might have fled an abusive relationship, and I need to help them to access safe accommodation or a women’s refuge that same day. For others, leaving is not something that they feel ready to consider. In these cases, I might inform them of their rights and options and offer one-to-one sessions to raise their awareness of abuse and its impacts both on them and their unborn baby, supporting them to make an informed and empowered decision about what they want to do next.  

I support women around a range of issues, from immigration to housing, to navigating the criminal justice system and applying for protective orders. Much of my time is spent liaising and collaborating with other agencies and advocating for survivors in multi-agency environments.  

A common thread throughout this role is maintaining a survivor-centred approach. Domestic abuse is inherently disempowering for survivors, stripping them of their power and sense of control. A key part of my role is to help restore their autonomy, providing women with choices, never rushing or pressuring them to make decisions and working at a pace that feels right for them.  

Alongside my casework, I provide training to midwives on how to recognise domestic abuse amongst their patients, respond in a trauma-informed way and refer on for the appropriate support. Around 80% of women experiencing abuse will seek help from health services, making it vital that health professionals feel confident in receiving these disclosures and know how to respond. Our team delivers regular training, to both new and experienced midwives, alongside bespoke sessions and small group workshops for midwives across differing specialities. Through this, I am able to raise awareness of VAWG while influencing meaningful shifts in organisational attitudes and responses, all which shapes the experiences of survivors when seeking help. 

There are certainly days that feel demoralising and times when I leave work questioning the impact that I’m making. It can feel like you’re tirelessly advocating and trying to bring attention to an issue that is so often side-lined. 

Despite challenging times, there are amazing moments that stay with you. When a woman moves to safety and tells you that they can finally breathe again. The ‘you might not remember me but…’ texts months down the line sharing positive news. Getting sent a picture of a newborn baby who will grow up in a place of safety.  

It’s in those moments that the hard work feels worth it, and I’m reminded of why this role matters.