One in six women requesting a termination has suffered domestic violence during their lifetime and 4% during the current pregnancy, a study from a London clinic has found.

This study aimed to measure the prevalence of domestic violence in a population of women seeking termination of pregnancy, using a cross-sectional survey, as part of a series of preparatory studies looking at the feasibility and design of a health service intervention.

Four clinics (two NHS and two private) were approached and one provider based in London agreed to participate. The questionnaire was a modified version of the Abuse Assessment Screen which has been validated internationally. It was truncated to fit one sheet of A4 with 11 questions – five on demographics, five on abuse and one about attitudes to support services. There was also space for free text responses.

The questionnaire was anonymous and completed in privacy.

Women accessing the clinic for termination between May 2012 and July 2012 were eligible for the study. Women were excluded if they were under 16, unable to speak or write English, or if the clinician felt it was not appropriate to offer them the questionnaire. A total of 383 questionnaires were given out and 190 returned, a response rate of 50%.

The questionnaire also included contact details of local support services for women in abusive relationships attached as a business card. Sixty six participants removed the card from the questionnaire, an uptake rate of 35%.

The mean age of respondents was 27 years (range 16 to 44) and a range of ethnicities was recorded – white British (35%), black (30%), Asian (8%), white other (13%) and other (14%). Around half (49%) of the respondents had no children. The prevalence of lifetime domestic violence was 16% and prevalence during the current pregnancy 4%.

Although there were no significant associations between domestic violence and age, ethnicity, number of children or stability of relationship; there appeared to be a higher rate of domestic violence, both lifetime and in the past year, with increasing number of terminations, but this was not statistically significant (P = 0.196).

Three quarters (133/178) of respondents were in favour of the idea of a domestic violence support service; there was no difference between those who had a previous history of domestic violence (26/35) and those who did not (107/143).

There were 64 free text comments, nine of which were from women who reported experience of domestic violence. The most common response was support for the idea of a domestic violence screening programme. Some commented that the way termination services were set up might be ideal for domestic violence intervention. Others also felt this might be a time when women might wish to seek help but three respondents disagreed, saying a specialist domestic violence setting might be more appropriate.

Although the study is limited by the relatively small sample size and low response rate and was carried out in one London clinic, it appears to be feasible and important to ask about experience of domestic violence in this cohort of women, particularly those who have had more than one termination. This question could even be asked in general practice at the time of referral when a woman presents requesting a termination.

Dr Richard Ma