“You’re a terrible mother. The baby would be better off without you.”
There aren’t many jobs that require someone to weave their way into a family’s life as much as a doula. We see our clients at their best and at their lowest ebb. We see them when the veil is lifted, masks are set aside and the raw authenticity of their true selves is revealed.
Most of the time, what we see is the beauty, strength and resilience at the heart of our clients. We see them struggle, flounder and recover. We see them doubt their decisions but ultimately come to own their choices. We see them discover how brave and strong unconditional love can make you. Most of the time, what we witness is bathed in the warm, oxytocin glow of familial love.
However, not all our clients will have conceived and borne a baby while held in the bosom of a supportive, mutually supportive relationship. Sometimes, as we spend more time with a couple, we increasingly leave them carrying a heavy sense of something being not quite right. Every so often we witness domestic abuse or our client discloses behaviour from their partner that causes us concern.
“If you weren’t pregnant, I wouldn’t be stuck with you.”
According to the most recent survey (up to March 2025) by the Office of National Statistics, an estimated 3.8 million people aged 16 or over experienced domestic abuse in the previous year. Women’s Aid calculates that all refuge services in England supported an estimated 10,824 women and 12,989 children in 2022-23, and that all community-based support services supported an estimated 120,518 women and 156,673 children (Women’s Aid, 2024).
“That never happened — you’re imagining things.”
According to the Domestic Abuse Commissioner, In the 12 months to March 2025, there were around 1.4 million recorded domestic abuse incidents/crimes (533,967 incidents and 816,493 crimes). Also in that period, the prosecution service received 76,393 referrals for domestic abuse-related offences; 53,919 suspects were charged and 41,070 convicted.
Among domestic-abuse crimes recorded in the year ending March 2024, approximately 72.5% of victims were female.
“I only said that because you made me.”
Domestic abuse often begins, escalates, or changes in pattern during pregnancy and the postnatal period. It can take the form of verbal abuse, physical abuse or coercive control. Many people do not know that verbal abuse and coercive control are even things they can report and are therefore more likely to put up with the abuse, blaming themselves or explaining away their partner’s behaviour, attributing it to stress, worry or poor mental health.
“You’re sleep-deprived — you don’t know what you’re talking about.”
During pregnancy existing abuse can intensify, particularly coercive control, physical violence, and monitoring behaviours. Some studies estimate that 3–9% of pregnant women experience physical abuse, and more experience coercive control, psychological, sexual, or financial abuse. Abuse is more common than several obstetric complications routinely screened for.
Pregnancy can change the dynamics of control in a relationship. This can sometimes mean that the abuser feels a loss of power over the victim’s body, attention, or autonomy. They may feel jealousy or resentment as the focus shifts to the baby. Financial pressures, dependency, or social isolation can worsen, while some abusers use pregnancy itself as a tool for control – reproductive coercion (sabotaging contraception, forcing or preventing termination).
Domestic abuse is associated with a higher risk of miscarriage, preterm birth, low birth weight, and small-for-gestational-age babies. It is also associated with increased maternal stress hormones, which affect fetal neurodevelopment. There is also an increased risk of maternal substance use, poor nutrition, and missed antenatal appointments due to control or fear and an elevated risk of maternal mental health complications, including anxiety, depression, PTSD, and birth trauma.
Coercive Control is often less visible but just as harmful. A partner may monitor the victim’s movements and any messages received. They might dictate what the pregnant person eats or wears, prevent or control antenatal care or impose economic restrictions (withholding money for example). There may be threats related to the baby ( e.g “You’ll lose the baby if you leave me”)
The postnatal period is another high-risk window, particularly the first 3–12 months.
Intense fatigue, hormonal changes and recovery needs can erode the victim’s resistance and the abuser may feel competitive for attention with the newborn. Isolation can increase as many new parents spend long periods at home without social contact. Financial strains and disrupted sleep amplify stress and abusers may escalate control when the mother is physically recovering, breastfeeding, or emotionally vulnerable.
Postpartum abuse can take many forms, including sleep deprivation as a weapon (for example, preventing naps, waking the mother deliberately), sabotaging breastfeeding or using it to shame or criticise, interfering with infant care to undermine confidence, withholding help but criticising the victim for struggling. Intensifying surveillance (phones, baby monitors, controlling outings) and using the child as leverage, including threats around custody are also common.
Effects on maternal mental health can vary, but include postnatal depression and anxiety, PTSD and birth trauma, bonding difficulties and increased suicide risk – suicide is the leading cause of maternal death in the UK, and domestic abuse is a major contributor.
Even if the baby is never directly touched, exposure to domestic abuse increases sleep and feeding difficulties, is associated with developmental delays, emotional dysregulation, a higher risk of behavioural problems in later childhood and impaired attachment security.
“You bruise easily — that mark isn’t from me.”
So what does this mean for doulas? It can be easy to ignore that funny feeling in your tummy, or the sense of discomfort that bristles on the back of your neck when someone enters a room. It can be difficult to broach the subject with your client, even if you’ve noticed the change in their demeanor when their partner is around. It can feel like your client’s relationship is none of your business.
However, there is a big difference between not getting involved in our client’s relationship problems and ignoring the red flags of domestic abuse. So watch out for things like frequent cancelled appointments, the partner insisting on being present at all times, hypervigilance, fearfulness or jumpiness, unexplained injuries, difficulty bonding or unusual anxiety around infant care, the partner dominating conversations or answering questions for them or financial stress despite adequate income.
So how can we help? A trauma-informed, human-rights-focused response would be to do a lot of what comes first for a doula – non-judgemental listening. Affirm your client’s autonomy and choices and gently explore safety without pressuring them to disclose anything before they feel ready.
Know your local signposting pathways, including specialist domestic abuse services, including your local IDVA, and understand how to refer if you feel your client or any children in the house are in danger. It can be useful to know how to get in touch with an IDVA (an Independent Domestic Abuse Advisor) and have the National Domestic Abuse Helpline Number to hand.
Do a safeguarding course that includes information on domestic abuse so you feel tooled up for any situation you may find yourself in.
Reassure the client that abuse is never their fault. And help them build a supportive network to regain personal agency.
Get support for yourself. Talk to a Mentor or Companion, take time to decompress and remember that you are not solely responsible for this family. There needs to be a team of specialist services around the abused person – you do not need to be the saviour, merely part of a picture of information that is built up to help service providers create a safety plan.
Finally, given the sadly enormous domestic abuse statistics in the UK, it is not uncommon for doulas to come into this work, do a safeguarding course or encounter a client who is a survivor and begin to realise that they are, in fact, living in an abusive relationship. If this is you, my wish for you is that you do not feel alone. There are other doulas who have escaped and started a new life, full of love and free of fear, many of whom are generous with their hearts, their ears and the wisdom learned from personal experience. In the DD community we have more than one Companion with a wealth of experience and knowledge in this area. Reach out to any Companion to be signposted in the right direction. There is also an IDVA within our community who can do a DASH questionnaire (Domestic Abuse, Stalking & Harassment) with you to help you assess the level of risk you are living with.
If you are a doula living within a relationship that causes you pain or fear it can mean that when you encounter clients in a similar position you may be inclined to minimise what’s happening. After all, even quite severe situations can be normalised. This can present a danger to your clients because it is not uncommon for it to be the doula who is the first to gently point out that abuse is happening. If you are unable to identify that a family you are supporting may require safeguarding, risk cannot be assessed and minimised. No one’s relationship is perfect and we all have rows and fallings out from time to time, but being able to tell the difference between normal relationship ups and downs and abusive behaviour will ultimately benefit us and the clients we support.
It is important to understand that if domestic violence or coercive control is on-going, it is highly unlikely to stop of its own accord. The trajectory almost always goes in only one direction. Leaving the situation is what removes the risk, but the time around leaving is also the riskiest, so please – if this is you or you are supporting a client to leave, make sure there is specialist support and a robust plan for exit put in place.
Some Useful Reading and Signposts
https://www.nationaldahelpline.org.uk/
https://womensaid.org.uk/information-support/
https://www.whiteribbonalliance.org.uk/safer-beginnings
https://refuge.org.uk/
https://www.citizensadvice.org.uk/family/gender-violence/domestic-violence-and-abuse-getting-help/
https://safelives.org.uk/
https://www.victimsupport.org.uk/crime-info/types-crime/domestic-abuse/
https://www.nhs.uk/live-well/getting-help-for-domestic-violence/
