August 2016 saw the commencement of our new domestic violence project “Screening to Safety”, funded by the Samuel and Eileen Gluyas Charitable Trust managed by Perpetual. The project centres on the intersection of domestic violence, unplanned pregnancy and abortion and is due for completion by April 2018.
The main aim of the work has been on increasing the capacity of private abortion providers to identify and respond to the needs of women experiencing domestic violence who attend for abortion care, with special focus on the issue of reproductive coercion. A parallel but more limited process has been carried out in the domestic violence and broader women’s sector.
Since the commencement of the project we have:
Resourced clinics to develop a clinic environment that is supportive of disclosure through practical support (eg posters on domestic and sexual violence in waiting areas, signage indicating patients will be seen on their own, which you can download from our resources page).
Developed domestic and family violence screening tools for abortion provision settings that incorporate screening questions about coerced pregnancy. This is further explored in the section on screening below.
Reviewed clinic and intake and admissions processes to offer advice on changes to tools and procedures. The focus of this review looked at the information routinely collected in abortion care settings and how this might inform which women were most likely to be experiencing violence, for example previous termination or miscarriage is an indicator of risk for violence.
Developed and distributed a tailored resources for guiding health care practitioners and others in their contraceptive counselling of women subjected to reproductive coercion, which you can download from our resources page.
Updated our website in-line with project learnings. Check out our updated contraception section and tips for decision making in the context of violence. The project is encouraging other abortion providers and broader sexual and reproductive health services to consider including information about discrete contraception options (can it be detected, can it be tampered with) alongside mainstream contraceptive information provision.
Developed a series of posters aimed at awareness raising, with funding from the Queensland Government and the YWCA Queensland for Women's Week 2018, which you can download from our resources page.
Provided training to clinic staff on the intersection between domestic violence and abortion, identifying and responding to the needs of women experiencing coerced pregnancy and coerced abortion. In some settings this involved nursing staff and some administration staff but not doctors. It was noted that most effective systems changes came about in clinic where doctors were actively involved in the training and discussion.
Developed three short online video training modules. With provision of medical abortion through GP providers, it was important that the project be able to reach these providers through its initiatives. These videos are made available to GP providers of medical abortion through MS Health, and publicly available through our Youtube channel:
- The intersection of domestic violence and unplanned pregnancy (6:56min);
- Reproductive coercion and forced pregnancy (8:44min);
- Reproductive coercion and forced abortion (5:47min).
Established the Screening to Safety LARC Access Fund, which enables women experiencing violence, including reproductive coercion to access suitable cost-subsidised LARC at time of TOP through our ten partnering private abortion providers. Clinics are reimbursed for associated costs by the Screening to Safety LARC Access Fund, administered by Children by Choice. Since July 2016 this fund has supported 84 women, with 13 of these women directly supported by the clinic. Women experiencing domestic violence and reproductive coercion take up the option of LARC at time of TOP when financial barriers are removed.
Collaborated with the domestic violence sector: Training on the intersection of domestic violence, reproductive coercion, unplanned pregnancy and abortion has been provided to seven different domestic violence and women’s health services, and four regional, cross agency training events have been held. Issues papers and posters have been presented at four relevant conferences. As a result of these combined initiatives, some specialist domestic violence services have now incorporated reproductive coercion screening and safety planning into their safety and risk tools, and have indicated that they will include unplanned pregnancy risk assessment and pregnancy testing as part of domestic violence refuge intake and admissions processes.
Provided education and information to a wider range of health care providers through collaboration with TRUE Relationships and Reproductive Health (formally known as Family Planning Queensland) to develop, and trial, a full day training package for health care practitioners which includes a focus on reproductive coercion, and presenting to partitioners through the Brisbane South Primary Healthcare Network.
Raised awareness of reproductive coercion at a national level through participation in roundtables on contraception and reproductive coercion, and presenting on this issue at our Children by Choice national conference in August of 2017.
We continue to appreciate Queensland’s private abortion providers and their desire to do the best for the women experiencing violence and control through compassionate care, and abortion and contraception access for Queensland’s more vulnerable women. It reaffirms for us the important role that health care practitioners can play in intervening in the sexual and reproductive health impacts of domestic and sexual violence.
We are buoyed by the capacity and willingness of Queensland’s domestic violence and women’s sector in stepping up to the challenge of responding to issues of reproductive justice through the provision of holistic responses to women’s needs in the face of constant and complex workload pressures.
For more information please contact our project officer Liz Price at Children by Choice on 07 3357 9933 (ext 3) or at lizp[at]childrenbychoice.org.au.