Facilitators and barriers for digital screening and a supportive intervention within antenatal care among danish pregnant women facing intimate partner violence: A qualitative study nested in the STOP study

Objective: To understand barriers and facilitators for participation in digital IPV screening and a digital supportive intervention among pregnant women.

Methods: Pregnant women attending standard antenatal care in the Region of Southern Denmark were systematically screened for IPV through a digital questionnaire. Those who screened positive were offered 3-6 video consultations with midwives and access to safety planning app. Semi-structured qualitative interviews were conducted with pregnant women who screened positive for IPV and participated in a digital supportive intervention.

Results: Twenty pregnant women were interviewed, and the following facilitators for participation were highlighted: The digital systematic screening approach was acceptable and helped acknowledge IPV exposure as women experienced it as more private and allowed for reflection time compared to risk-based, face-to-face screening. Video counselling was highly acceptable, as the digital approach eased conversations on sensitive topics and the flexibility boosted participation. Trust in the healthcare system, having a trained midwife as a counsellor, and familiarity with the digital tool enhanced participation. Barriers included concerns about disclosing IPV, technological issues, and the need for a private space for counselling. Additionally, women who had experienced digital violence were uncomfortable with the digital nature of the intervention. The safety app was perceived as being inefficient as it did not meet the needs of the women.

Conclusion: Systematic digital screening and supportive video counselling for IPV within antenatal care is well-received among pregnant women as it offers increased privacy and flexibility and facilitating discussions on sensitive topics. To enhance participation, barriers such as confidentiality concerns, technological challenges, and the need for private counselling spaces must be addressed. Incorporating digital tools into antenatal care can supplement other support services and increase the proportion of pregnant women who receive help.