Domestic Violence and Pregnancy
Today's blog will be a bit different. I wanted to highlight some research I did regarding pregnant women and domestic violence. My sources are at the bottom of the page and you can cut and paste the links into your browser on your phone, tablet or computer. Domestic violence not only affects these women physically, emotionally and mentally, it affects their babies too! Get out for yourself! Get out for your child! Please share this with anyone who needs to read it!
Pregnancy is supposed to be a celebration of motherhood, a time to celebrate a new, little life and the addition of a new family member. However, for many women, this is simply not the case. Their pregnancy is not a time of celebration. Their pregnancy is a time of increased stress, violence and a day to day struggle to live through another day. Decorating a nursery or buying baby clothes are not on their priority list. Their pregnancy is a time of emotional turmoil and uncertainty about the future, not only for themselves but their unborn child and infant as well.
Domestic violence effects pregnant women and their children in this country everyday! I also want to highlight what pregnant women, healthcare providers and you can do to help these women be safe and stay safe. National Statistics
First, I’ll start with some statistics. This will give us all a good idea of how prevalent the problem is in the US.
Researchers suggest that every year in the US, over 300,000 pregnant women experience intimate partner violence or domestic violence. Intimate partner violence (IPV) is described as physical, sexual or emotional abusive acts as well as controlling behaviors. Not only does this effect those 300,000 women, it affects 300,000 unborn children as well. Abusers are not only harming women, they are harming children.
What increases the risk of violence during pregnancy? In one US study in the early 2000s, women with mistimed or unwanted pregnancies experienced an increase in violence by 15% compared to their pregnant counterparts who had intended pregnancy (only 5%). According to the March of Dimes, partners may become abusive during pregnancy if 1) the pregnancy is unplanned, 2) they are stressed about financially supporting a first baby or another baby they did not want, and 3) jealous that their partner’s attention may shift from them to the new baby. This is in no way the fault of the pregnant woman and women who experience mistimed or unwanted pregnancies should not have to be in fear for their lives nor the lives of their babies. The Effects of Domestic Violence on Pregnant Women
Domestic violence affects a pregnant women in many negative and dangerous ways. Pregnant women are more likely to be victims of homicide or suicide where there is domestic violence occurring in the home. One study of police and medical examiner records in the early 2000s in 11 US cities showed that pregnancy significantly increased a women’s risk for homicide in domestic violence situations. Men that abuse their partners during pregnancy were also more likely to become homicidal.
Pregnant women living with domestic violence experience negative behavioral, reproductive, physical and mental health effects as well. These women are more likely to abuse alcohol and drugs or smoke during pregnancy. Many of these women did not abuse drugs or alcohol nor smoke before pregnancy. They resort to these behaviors to cope with the stress of abuse in the face increased violence. These women may also be forced to delay prenatal care (45% more likely) against their will because their partner will not let them seek care. These women can experience miscarriage (from hitting the abdomen), forced abortion, sexually transmitted diseases, and HIV. Physical damage can include other bodily injury and impairment caused by beating, insufficient pregnancy weight gain, depression, Post-traumatic stress (PTS) and difficulties with or lack of attachment to their newborn. Preterm labor is also not uncommon for these women as a result of stress or injuries.
Many of these women want healthy babies and pregnancies. This can be very difficult when you are in survival mode from day to day.
The Effects of Domestic Violence on the Unborn Child and Infant
The unborn child and infant are at risk as well in domestic violence situations. Unborn children can be miscarried or aborted against the mother’s will in extremely violent situations. Newborns can be low birth weight babies (less than 5.5 lbs.), be born preterm (less than 37 weeks at birth) and/or be small for gestational age (infants born later than 37 weeks but underweight signifying pregnancy difficulties). Long term consequences for premature and low birthweight babies include: cognitive disabilities (decreased IQ, other brain impairment or delayed mental development), mobility disabilities like cerebral palsy, academic difficulties, delays in learning language, and a significant increase in attention, behavioral and psychological problems. Children can be affected long after the abuse has stopped or even if they are never harmed by the abuser themselves after birth.
I have a wonderful friend who has a mobility disability because of cerebral palsy. She is very independent and happy today yet she is a living example of what I am writing about in this blog. She was born to a mother who was physical abused in some way during her entire pregnancy. I love my friend dearly. Both she and I have often wondered what her life could have been like had her mother not been abused.
What Can Doctors and Nurses Do To Help These Women When They See Them?
The single most important thing a nurse or doctor can do to help these women is to stay alert for the signs of domestic abuse whether they come to your ER or to the obstetricians office. Some of these signs include: unexplained bruising, injuries that don’t match the story and how the woman behaves around her partner. The second most important thing doctors and nurses can do is to screen women at their first prenatal visit and afterwards for domestic violence. Lastly, doctors, nurses and healthcare social workers must become more aware of both shelter and advocacy programs in their community and encourage patients to use those services. One such advocacy program is Break the Silence Against Domestic Violence (BTS). You can find them on their Facebook page at Break the Silence Against Domestic Violence or their Twitter handle @BTSADV. For doctors, nurses and social workers who are interested in screening questions for their clients in the ER or obstetricians office, see the Woman Abuse Screening Tool (WAST) or the HITS Scale: Hurts, Insults, Threatens, Screams.
If you know any doctors or nurses who could benefit from this information, I encourage you to discuss it with them. If you are a doctor or nurse yourself, I encourage you to be sure you are screening the women and girls you see. You could save not one life, but two! What Pregnant Women Can Do to Help Themselves
Ladies, if you are pregnant, you can best protect yourself by first asking for help from trusted friends and family, your trusted agents. Develop a safety plan with your trusted agents to leave the situation you are in at home. This plan should include a safe place to go, extra cash, a suitcase (not kept at your home) with valuables, documents, clothing and food for you and your baby, and an exit strategy.3 Ladies, with planning and the support of your trusted agents, you and your baby can have a safe and peaceful place to live, thrive and begin a new life.
What Can You Do?
Pay attention. If you even think a pregnant friend, colleague or even a stranger is being hurt, just intervene! These woman are in plain sight desperate for someone to reach out to them. Just reach out to her. Be the trusted friend and confidant that she needs, her trusted agent. Help her with her exit strategy and/or with collecting materials to help her safely leave. After she leaves the domestic violence situation, continue to support and love her, she will need your unconditional love and non-judgmental attitude more than anything else.
My Sources (you can cut and paste these links):