In conversation with health visitors and women, discussing domestic abuse. A reflexive analysis.

Introduction: Domestic abuse is a pervasive form of violence affecting one in four women in the UK, with health visitors playing a key role in supporting mothers and safeguarding children. This study explores the perspectives of health visitors and mothers, examining the nature of professional support and its impact within universal health visiting services.

Study aim: to seek opportunities to progress and improve health visiting practice when supporting families experiencing domestic abuse. This is formed through the achievement of three key objectives.

1. Exploring the wider implications and perspectives of domestic abuse,
2. Exploring the broader perceptions of health visiting support,
3. Exploring the perceptions of achievable/wanted outcomes.

Methodology: A qualitative, feminist-informed approach was used, with semi-structured interviews conducted with 15 practicing health visitors and 13 mothers who had experienced domestic abuse. Data were analysed using reflexive thematic analysis, ensuring an authentic representation of lived experiences.

Findings: Three themes emerged: Discerning Curiosity – Health visitors and mothers navigated uncertainty, balancing professional inquiry with evolving understandings of abuse. Love and Justice – Relational care and trust were central to supportive health visitor–mother interactions. Moments and Opportunities – The timing of interventions influenced disclosure and access to support.

Discussion: The synthesis of the data presents intersecting considerations that result in relational practice through epistemic notions, taking a momentary approach, and finally enhancing empathy.

The study reinforces the use of reflexivity in health visiting and research and enhances the role it plays within professional competency. The study identifies how epistemic injustice affects health visitors, particularly in domestic abuse, and shows how mother’s experiences are often dismissed. The study emphasises the need for health visitors to unlearn biases within a safe and nurturing environment of practice. Furthermore, the issue of responsibilisation is considered, adding an additional layer placed on health visitors as well as the deep moral and emotional weight felt.