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2003) Which Found That 1% Of Women Attending The A&e Depts In The Study Were ...

2003) which found that 1% of women attending the A&E Depts in the study were there as a direct result of direct physical violence and the same authors calculated the overall lifetime prevalence rate for domestic violence in this population to be in the region of 22%.This second set of figures is more nearly in keeping with the majority of other studies in the area (viz. Dearwater S R et al. 1998).

A smaller Scottish study (Wright J et al. 1997) considered an A&E dept seeing 60,000 cases per year and found 19 cases of overt (incontrovertible) domestic violence in a two month period. Another factor which may be considered to be implicit in the term domestic violence is the fact that the violence is considered to have occurred in the home. This is not universally the case. A rather older study (Fothergill N et al. 1990) found that between 15% and 20% of cases of assault occurred at sites away from the victim's home. One of the overriding factors that must be considered in any type of critical analysis of the figures is that part of the apparent disparity in both incidence and prevalence is due to the structure of the studies. There appears to be a distinct overrepresentation of victims of domestic violence in the populations that present to A&E Depts. If we compare these figures with those obtained from more community based studies such as the British Crime Survey (cited in Mirrlees-Black C 1999) we find that lifetime prevalence figures are in the region of 26% for women and 17% for men and annual prevalence figures in the same study are quoted as 5.9% and 4.9% respectively.

We have made mention of some of the demographic elements earlier. If we consider these in rather more detail, we can point to studies (Roberts G L et al. 1996) which suggest that, (again in a population of A&E Dept attenders), over 15% of men had experienced at least one episode of domestic violence in their lives and this was approximately half that of a similar group of women. Factors that were found to be independent risk factors for the risk of domestic violence include lack of education, alcohol misuse, unemployment, low income, and recreational drug use (Kyriacou D N et al. 1999).

In specific consideration of our investigation in the role of the midwife in the issue of domestic violence, we note that there was a widely reported study which suggested that being pregnant was also an independent risk factor for abuse (Gelles R J 1988). This was considered to be a landmark study in the area at the time of its publication, but we note that other reputable and carefully constructed studies have failed to replicate the original author's findings. (McGrath M E et al. 1998. Other relevant factors include comparative youth as a risk factor and there are also studies that suggest that post-partum status carries a higher risk of domestic violence than does antenatal status. (Gazmararian J A et al.

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