BACKGROUND:
Domestic abuse (DA) is a global public health emergency. In the UK, a disclosure of domestic abuse during the perinatal period is likely to trigger a referral to children's social care, to safeguarding the infant and by extension the mother. Despite clear guidance and evidence, maternity services in the UK are inconsistent in asking about domestic abuse, signposting to relevant support services and identifying those at risk of DA.

OBJECTIVES:
To explore maternal morbidity, mortality and and experiences of women who disclose domestic abuse during the perinatal period

METHODS:
A mixed methods study was co-designed with lived experience input. Findings from narrative interviews, maternal mortality surveillance data, a confidential enquiry into maternal deaths of women known to children's social care, and a prospective cohort study of linked healthcare records were triangulated to explore domestic abuse during the perinatal period

RESULTS:
Domestic abuse is the most prevalent risk factor among women who die during the perinatal period with children's social care involvement (65%, 205/420). However, the confidential enquiry found that routine DA inquiry is not embedded and professional curiosity to explore women's social circumstances is often missing. Triangulated findings from the enquiry and narrative interviews showed systemic and individual barriers prevent disclosures during pregnancy and the postnatal period, leading to missed opportunities for signposting and support.

CONCLUSIONS:
Maternity services have a critical role to play to identify those women and birthing people subjected to DA. Routine inquiry about DA and staff competencies to understand the full breadth of DA is crucial to improve screening and signposting of those at such a vulnerable time for mother and baby.

KEY MESSAGE:
- Prevalence of perinatal domestic abuse is consistently high across the various arms of the study - A routine domestic abuse inquiry can be life-saving - Midwives have a critical role to play in identifying, supporting, and signpost those at risk Poster session 1 (Group A)