Canberra midwives would be given greater responsibility to screen pregnant women for signs of domestic violence under a plan mooted by health researchers.
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Midwives should routinely ask expectant mothers a set of nationally harmonised questions about their safety and domestic violence, an Australian Institute of Health and Welfare report into screening methods and data collection has recommended.
The suggestion was welcomed by anti-domestic violence campaigners and health professionals, who said pregnant women were particularly vulnerable to intimate partner abuse and the ACT's health system needed to do more to help victims.
The report said pregnancy offered an important opportunity to screen for signs of violence and offer support, given women had frequent medical appointments.
Researchers recommended all jurisdictions adopt a standard set of questions, that would also allow for some flexibility for different groups of women, for midwives to use to ask about domestic violence.
ACT Domestic Violence Crisis Service executive director Mirjana Wilson supported routine screening and said pregnant women were particularly vulnerable to abuse and clients often reported abuse began or escalated during pregnancy.
"I think it is something that should be done directly and I don't think it's something that's currently being done across the whole system."
Ms Wilson said domestic violence hadn't previously been seen as a health problem and there was a lot more the ACT's health system could do to help victims.
"I don't know of any consistent tool that is used routinely in that situation, which is really bad."
She said any standardised screening tool needed to be appropriate or adaptable for pregnant women with disabilities, Aboriginal and Torres Strait Islanders and culturally and linguistically diverse women.
The report said that unlike other jurisdictions, the ACT currently did not have a dedicated screening tool for domestic violence that was specific to pregnancy and there wasn't a screening tool used in other health care settings.
Health Minister Simon Corbell said pregnant women who entered the ACT's public health system were offered a psycho-social assessment before and after childbirth that included questions such as "Do you feel safe at home?".
Mr Corbell said it was difficult for health professionals to screen for domestic violence-related health problems when the patient wasn't willing to report the offending to police or was reluctant to provide details of how the injuries were obtained.
"While patient rights and confidentiality always must be protected, formal reporting remains the decision of the health professional."
University of Canberra midwifery professor Deborah Davis said it was a good idea for all health professionals to ask women about domestic violence at every contact.
"If everyone's doing it as a normal part of their practice, women might be willing to eventually disclose that information."
Professor Davis said while extra training was always welcomed, midwives and other health professionals were accustomed to asking sensitive questions and dealing with complex responses.
"The critical thing is that when women do disclose, we really must make sure there are services we can put them into ... I think that's something that's lacking at the moment."
Intimate partner violence was a leading and preventable cause of death for women between 15 and 44 and was responsible for a greater disease burden than high blood pressure, smoking and obesity, the AIHW report said.
An estimated five per cent of women were abused by a partner while pregnant.
"The risk of domestic violence has been found to be higher in pregnant women and in the period following birth, posing serious health risks to both pregnant women and their babies," the report said.
Expectant mothers who experienced violence had higher risks of placental abruption, caesarean delivery, haemorrhage and infection than women without a history of assault.
They were also at greater risk of miscarriage, pre-term labour and birth and low birth weight babies.
If you or someone you know is impacted by sexual assault or family violence, call the ACT Domestic Violence 24 Hour Crisis Line on 02 6280 0900. In an emergency, call 000.
