Time to tackle Domestic Abuse: Why Domestic Abuse matters to Health Visitors

31st October 2025

October is Domestic Violence Awareness Month (DVAM) – Dr Tanya Dennis, Domestic Abuse Lead at Central and Northwest London NHS Foundation Trust and iHV Expert Adviser, shares a voices blog about the vital role of health visitors in supporting domestic abuse victims and safeguarding babies, children, and families.

Dr Tanya Dennis PhD, MSc, BSc, Dip N, RGN, RHV, FETC, FiHV

Domestic Abuse (DA) is a pattern of coercive and controlling behaviour including a wide range of physical, sexual, economic, and psychological maltreatment used by one person in an intimate relationship against another to gain power and control.

Domestic abuse is not just a private issue – it is a public health emergency. It affects millions of adults and children across the UK, and health visitors are on the frontline, often the first professionals to spot the signs of abuse and offer support. With unique access to families during pregnancy and early childhood, health visitors (HVs) play a vital role in supporting victims and safeguarding children.

The Reality behind Closed Doors

Domestic abuse affects every corner of society. In the year ending March 2025¹, 3.8 million adults in England and Wales experienced domestic abuse:

2.3 million women and 1.5 million men experienced domestic abuse.
108 domestic homicides in England and Wales, with eighty-three of these victims being women and twenty-five being men.
Ninety-eight suspected suicides following domestic abuse.
Over 105,000 children lived in homes with elevated risk.
78% percent of these children were directly harmed by the perpetrator.

Under the Domestic Abuse Act 2021, children are recognised as victims—not just witnesses.

Health Visitors: Trusted, Trained, and Essential

Health visitors are in a unique position. They visit families at home, build trust, and often become the first safe person who a victim can talk and confide in.

Their role includes:

Routine enquiry and sensitive questioning.
Ongoing risk assessment for adults, children, and unborn babies.
Prioritising the safety of the children within the family.
Safety planning and emotional support.
Providing information and signposting to supportive services.
Referrals to specialist services.
Work in a Trauma-Informed way, collaboratively, safely, and effectively with families, considering the needs of victims, their child (ren), and perpetrators.
Risk assessment and risk management of the perpetrators of domestic abuse.
Documentation, confidentiality, and information sharing.
Safeguarding babies and children by assessing risk.

Health Visitors: The Frontline of Support

Health visitors are Specialist Community Public Health Nurses who have advanced knowledge and expertise, and can balance risk and resilience factors whilst supporting babies, children, and families across physical health, mental health, social, and safeguarding pathways. Health visitors can:

Spot the signs of abuse, including coercive control.
Ask the right questions — gently and sensitively.
Create safe spaces for disclosure.
Assess needs and identify areas for support to both the adult and children often on a multi-agency basis.
Support and empower victims with practical advice.
Refer to specialist services, including Multi Agency Risk Assessment Conference (MARAC).
Document and report concern to Social Care when pregnant victim children are involved.

The Hidden Harm: Babies and Children

Domestic abuse does not just hurt adults — it leaves deep scars on children, even before they are born.

Abuse often begins or worsens during pregnancy, increasing the risk of premature birth, poor health outcomes, and neglect.
The first 1001 days of life are critical. Exposure to violence during this time can lead to emotional distress, poor maternal bonding, disrupted mother-child relationship and mothering capacity, and the quality of care.
Research in Practice shows long-term effects include anxiety, depression, behavioural problems, and difficulty forming healthy relationships.
Domestic Abuse can also alter a child’s perception and understanding of relationships, trust, and safety, potentially putting them at risk of developing unhealthy emotional bond and dependency in adulthood.

Building Trust, Breaking Cycles

Health visitors do not just tick boxes — they build relationships. That is why their role is so powerful:

Victims often do not realise they are being abused. HVs help them name it.
Support is non-judgmental and holistic, making it easier to accept.
Because HVs have universal contact, their help feels less stigmatising.
They can follow families over time, offering ongoing support and spotting changes.
Their ongoing presence allows for long-term support.

Practical Tips for Health Visitors

Be patient — victims may not be ready to talk – keep the door open.
Ensure victims are seen alone or with an interpreter.
Tailor safety plans to what feels achievable and safe.
Offer flexible options for contact and support.
Work within their limits — respect their pace and choices.
Advocate and collaborate with other services and build partnerships within local domestic abuse integrated care pathways.
Stay informed, training is essential to respond confidently,

Final Thoughts

Domestic abuse is complex, painful, and often hidden. But health visitors have the tools, the training, and the trust to be effective. Domestic abuse is detrimental to babies’ and children’s welfare – a central issue in child protection and it forms a significant part of the health visiting role. Health visitors are skilled and well placed to offer early support to parents who may be at risk of, or experiencing, abuse and assess the risk to children, babies (including unborn infants). Health visitors have the tools, the training, and the trust to be effective.

📢 A Call to Action

Domestic abuse is rising in complexity and prevalence. Urgent investment in health visiting services is needed to ensure timely, effective support to victims and their children. With the right tools and training, health visitors can help break the cycle of violence — for women, babies, children, and society. Let us empower health visitors to be the change-makers that our communities desperately need.