Around 20,000 disclosures of domestic abuse are estimated to be made to maternity services in England every year, according to new analysis by The For Baby’s Sake Trust. This data, which is not routinely collated and published at a national level, highlights the vital role healthcare professionals play in identifying abuse during pregnancy.
Domestic abuse during pregnancy and early childhood can shape a baby’s developing stress response and may later affect emotional regulation, learning, confidence, and relationships. However, these outcomes are not inevitable. Identifying abuse and connecting parents and babies with the right support can help change the course of a child’s life, making maternity care a critical opportunity for early intervention.
To better understand the scale of domestic abuse disclosures during the perinatal period, the charity submitted Freedom of Information (FOI) requests to all 118 NHS Trusts in England providing maternity services. A total of 74 Trusts provided usable data based on a multi-year average.
Across these responding Trusts, an average of 3.3% of maternity bookings involved a disclosure of current or non-recent domestic abuse, predominantly to midwives. Applying this proportion to national NHS maternity booking activity yields an estimate of 20,000 annual disclosures.
The Trust believes this figure is the tip of the iceberg, as many parents may not feel safe or confident making a disclosure during routine enquiry or at any other point in their maternity journey. The charity also uncovered discrepancies in how disclosures are recorded across NHS Trusts, prompting calls for the Government to standardise data collection and publish annual reports to inform a robust response.
The For Baby’s Sake Trust is calling for
- Consistent implementation of routine enquiry. Routine enquiry about domestic abuse should be consistently implemented across maternity services, with every parent given safe, appropriate opportunities to disclose abuse and receive help for themselves and their baby during pregnancy and the postnatal period.
- A nationally standardised recording approach. Domestic abuse disclosures should be recorded using a nationally standardised approach that includes who the disclosure is made to, alongside consistent separation of current and non-recent domestic abuse disclosures to support action and analysis. The Trust would also like to see this data collated and published annually to inform the local and national response to domestic abuse.
- Mandatory specialist domestic abuse training. Mandatory specialist domestic abuse training, which stands alone from existing safeguarding training, should be provided to all midwives, neonatal staff, and maternity professionals. The training should increase understanding of the impact of domestic abuse during pregnancy and the first 1,001 days, include practical support and resources, and support a trauma-informed approach to asking parents about domestic abuse and responding to parents who disclose abuse and harm.
- Greater recognition of babies as victims. Greater understanding of, and response to, babies, including unborn babies, as victims of domestic abuse in their own right within healthcare systems.
- Funding for whole-family interventions. Funding for trauma-informed, whole-family interventions to break the cycle of domestic abuse and address its impact on babies, such as For Baby’s Sake, available in every local area.
These recommendations build on wider national work to improve maternity safety, including the Trust’s contributions to the National Maternity and Neonatal Taskforce, its responses to the Independent Investigation into Maternity and Neonatal Services in England, and its work through the Government’s Steps to Safety programme.
Dame Nicole Jacobs, Domestic Abuse Commissioner for England and Wales, said: “For people subject to domestic abuse, pregnancy can be an extremely frightening time, with abuse often escalating alongside fears for their own life and their child’s.”
“We know survivors are more likely to disclose to healthcare workers than to any other professional, but too often opportunities are missed or victims don’t get the vital support they need at a time when they’re most vulnerable.”
“That’s why midwives, GPs, and every other professional involved in someone’s pregnancy must have the training, confidence, and support to be able to recognise domestic abuse and then respond appropriately. We owe it to survivors and their babies to make sure no appointment is a missed opportunity to tackle and prevent domestic abuse.”
Dr Panos Vythoulkas, Lead Perinatal Clinical Psychologist at North London NHS Foundation Trust, emphasised the mental and physical consequences of domestic abuse: “Domestic abuse during pregnancy can have significant psychological and physical consequences. It is associated with poorer maternal mental health and adverse obstetric outcomes, including preterm birth and low birth weight.”
“For babies, the impact may begin before birth and continue after delivery, particularly where trauma affects a parent’s sense of safety, emotional availability, and confidence in responding to their baby. Difficulties can emerge around feeding, sleep, soothing, closeness, and the early parent-infant relationship. These effects can also reach siblings and wider family relationships and, for some families, contribute to patterns of trauma and relational difficulty across generations.”
“Midwives and other maternity staff are often the professionals who first hear these disclosures. They need clear safeguarding pathways, timely access to specialist domestic abuse and perinatal mental health expertise, and appropriate support themselves.”
“A compassionate and coordinated response at the point of disclosure can therefore matter greatly for the pregnant woman, her unborn baby, and the wider family system.”
The Rt Hon Dame Andrea Leadsom DBE, Founder and Executive Chair of the 1001 Critical Days Foundation, said: “These findings are a stark reminder that domestic abuse during pregnancy does not only affect the parent experiencing it. It affects the baby too.”
“We know that the experiences a baby has during pregnancy can shape their early development. That makes pregnancy an incredibly important opportunity to identify domestic abuse and offer families the right support as early as possible.”
Gill Walton, Chief Executive of The Royal College of Midwives, added: “These findings lay bare something midwives already know from their day-to-day practice: a booking appointment or a routine check can be the moment a woman finally feels safe enough to speak.”
“Midwives are often the only professional a pregnant woman sees regularly and alone, which makes them uniquely placed to spot the signs of domestic abuse and respond with care.”
“But recognising a disclosure is only the first step. Staff need proper, specialist training to know how to respond, and services need the time and resources to follow through with support, so that no disclosure is ever a missed opportunity to protect a parent and their baby.”
“We welcome this research and The For Baby’s Sake Trust’s call for standardised data collection and investment in this area.”
Lauren Seager-Smith, CEO of The For Baby’s Sake Trust, concluded: “A visit to the midwife is currently one of the only times you are likely to be routinely asked if you feel safe at home. Pregnancy offers one of the greatest opportunities we have to intervene early to protect babies and children from the harm of domestic abuse, and to connect families with timely intervention and support.”
“Our findings show that maternity professionals are recording tens of thousands of disclosures every year, but to break cycles of domestic abuse and give every baby the best start in life, we need to ensure standardisation of data collection, specialist training on the impact of domestic abuse in pregnancy and on babies, and funding for interventions for the parents and babies impacted.”
“We know domestic abuse can have devastating consequences for parents and babies alike, contributing to poor maternal outcomes and increasing the risk of harm before a baby is even born. Every disclosure represents a vital opportunity to protect a parent and their baby, now and into the future.”