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Domestic violence.

Extracts from this document...

Introduction

9699964 Introduction One in four women are victims of domestic violence, at some point in their life with violence escalating during pregnancy. This clearly makes the subject a health care issue for all health care professionals including midwives and the women in their care (DOH 2000). However, the subject can be undervalued, particularly with reference to antenatal screening, and the support of women thereafter as some midwives believe that this subject is not their business (Bewley & Gibb 2001). Midwives may question whether it is considered to be part of their role to intervene, or whether their role is simply to continue to support women through the medical and physical processes of childbirth. This negative attitude may be directly resultant of a dichotomy between theory and practice. This may occur as a result of lack of education within this area and supports the value of evidence based practice. The purpose of this in depth study is to examine the position of midwives in screening for domestic violence and supporting sufferers of domestic violence. Where midwives are now and what they need to know and do in order to move forward will also be considered. Firstly the author considers it appropriate to include a historical background relating to the subject of domestic violence. A problem statement will also be included. Current research relating to the subject of domestic violence will be included in a literature review, and will be critically appraised, in an 9699564 attempt to update both the existing knowledge of the author and of the reader. A critical analysis of the topic of domestic violence in pregnancy will be included in the form of chapters, followed by a conclusion including recommendations for change in practice. Current practice within the author's workplace will be evaluated and examined, in an attempt to improve quality of care and practice for the future. The study will also incorporate the English National Board (ENB) ...read more.

Middle

Animal research suggests that fighting can lead to both increases and decreases in testosterone levels depending on whether the animal wins or looses respectively (Rose, Bernstein & Gordon 1975). In one study college wrestlers who won their matches showed greater levels of circulating testosterone than losers (Elias 1981). However, the same results were found in the case of winners and losers of tennis matches - a game that 9699564 involves activity, competition, but not violence (Mazur & Lamb 1980). Hunt & Martin (2001) dispute the theory that raised testosterone levels are linked to violence stating that this would not account for the higher levels of aggressive behavior in pre-pubescent boys at ages prior to testosterone reaching significant amounts. Researchers as a potential cause for violence towards women have also considered genetic theories. Research into the genetic origins of violent behavior includes studies of the heritability of violent traits and the effect of genetic anomalies (Greene et al 1994). Walters (1992) performed a meta-analysis of 38 family, twin and adoption studies to examine the connection between genetics and criminal behavior. He reported that the studies published after 1975 were better designed than earlier studies and provided less support for a gene-crime relationship. He considered that there was only a weak gene-crime correlation. Mednick, Gabrielli & Hutchings (1984) found that adopted children of criminal biological parents were likely to engage in criminal behavior. However, this apparent genetic link was true only for criminal activity and not specifically for violent crimes. Researchers have considered as Neurochemicals or transmitters such as Serotonin, Norepinephrine, Dopamine and Monoamine Oxidase (MAO) as potential causes of violence towards women. Suggesting that Serotonin plays an inhibitory role while Norepinephrine and Dopamine each play a facilitating role (Raine 1993). Lower levels of serotonin metabolite were associated with a lifetime history of aggressive behavior and suicide attempts in one study, Brown et al (1982) Linnoila et al (1983) ...read more.

Conclusion

there appears to be no definite conclusive reason for violence against women. For this reason, the author recommends that midwives do not focus simply on the causes as they do not, legitimize the act of violence, or change the outcome. Midwives should seek to make education, excellence in practice and support of women their main priority. The role of the specialist midwife for domestic violence has been instrumental in the author's own workplace in helping midwives evolve within the subject. Midwives within the Trust are gradually becoming more receptive to the needs of domestic violence sufferers and also more responsive to provision of education within this area with an increase in the uptake of workshops provided for staff. Clearly this is not a subject that midwives can embark upon lightly or in isolation, and for this reason, the author recommends that midwives acknowledge their limitations and seek supervisory support if necessary. The author suggests that amalgamation of trust policy within the area would be of benefit to women. If all trusts within the area liased and worked together in the formation of a North West Trust policy for domestic violence, all practitioners would then be sharing the same vision. This would 9699564 surely provide consistency for women and midwives therefore improving care. The author believes that the way forward is by using a multi-agency approach, avoiding practice in isolation. This approach would include mandatory education for both student midwives and midwives, which would be flexible. Domestic violence protocols and the appointment of specialist midwives would also be essential. Clearly defined support systems for staff is also a necessity. The word midwife means "with woman", Some midwives may believe, despite educational and supervisory support, that their role is simply to support women through the physiological processes of childbirth. Midwives who do not acknowledge that their role is also to support women through the psychological processes, need to question their reasons for entering the profession of midwifery and question the reasons for their own beliefs. ...read more.

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