In our team, everyone is on standby: sometimes, mothers confide in people outside the medical profession such as the secretaries. Every month, we meet to review all the issues. Apart from medical care, technical procedures and knowing how to observe and notice things is very important. In 2016, the whole department received training from a midwife coordinator from the state on how to identify and assist women victims of violence. By mobilizing all professionals, expectant mothers will be more willing to enter our psych screening; at first, they do not see why it is valuable to talk, and they are sometimes ashamed of their background and can feel that they have failed...
What are the alarming signals?
Often they are silent because they want to show that everything is fine, while actually this is not the case... A woman who has given birth in several different maternity wards can be an alarming sign. Or a woman who does not have an apartment, who lives with relatives, means that she is financially vulnerable. There are also women who have addictions: in general, they bring it up quickly to see if it's dangerous for their child. Or a husband, who is too aggressive during the consultations, who does not let the mother speak, is also a flashing warning sign. The teams no longer have a fear of asking questions: we go all in in honesty. Today, the protection of the child is at the heart of the maternity ward.
After giving birth to a woman in distress, how does it go?
Normally, we keep the mother up to three days. Sometimes it is at the moment of birth that she has no more barriers, that she frees herself. We observe the mother-baby relationship to assess the situation. The child is a very good indicator of the state of the mother. If it is too quiet or too noisy, it can be significant. There is much concerning information that can be flagged and reported, and if Child Welfare thinks there is an immediate real danger for the child, it can intervene. There are also cases where the risk factor is so great that it is unthinkable to let the mother and baby leave together... so we keep them until we can find accommodations elsewhere.