Pregnancy and Domestic Violence

While for many women pregnancy is a time of great anticipation and joy, for some it can be a time of vulnerability to domestic violence. The actual incidence rates of domestic violence during pregnancy are difficult to ascertain. Studies report widely varying statistics from 0.9% to 20.1% (1). This is due to many factors, including: differences in populations sampled (eg. socioeconomic groups); definitions of abuse used; definition of pregnancy used (ie. whether it only referred to the actual gestation time or time before and after pregnancy); and where the study took place (eg. hospital emergency department or prenatal clinic). The majority of studies, however, report an incidence between 4-8% (2).

Definition of violence

Domestic violence is any form of abuse, violence or coercion by a partner or previous partner that serves to establish and maintain power and control over another person, is enacted in a context of unequal power or privilege and has the potential to cause harm to the physical and/or emotional wellbeing of that person. The behaviours which constitute (this) violence include actual or threatened physical assault, sexual assault, verbal, social, spiritual and economic abuse (3).

Who experiences violence during pregnancy?

There are a number of factors which place a woman at risk of experiencing violence during pregnancy. The most significant of these is the experience of violence prior to pregnancy. Whether the pregnancy was intended or not is also a major factor. One study found that women with an unwanted or mistimed pregnancy reported higher rates of violence compared to women with an intended pregnancy (15.3% and 12.6% compared to 5.3%) (4). It should be noted, however, that an unwanted or mistimed pregnancy (or any other factor) is never an excuse or a reason for a woman’s partner to be abusive and, most importantly, the violence is never her fault.

Other risk factors include: low socioeconomic status; low education level; race/ethnicity; low levels of social support; and youth (5). However, violence during pregnancy is not limited to women with these circumstances. Women from all walks of life are victims of domestic violence.

Relationship between pregnancy and violence

The effect pregnancy has on the incidence of violence varies from situation to situation. For women currently experiencing violence in the relationship, pregnancy may result in a decline in the violence. Alternatively, the type of violence may change with women being subjected to less physical violence but an increase in other behaviours such as verbal abuse and attempts to control the woman’s actions.

An escalation in violence, either in frequency or intensity, may also occur during pregnancy. This development can be particularly distressing if the woman believed that having a child may improve the relationship and, perhaps, even bring an end to the violence.

Other women may experience pregnancy to be the trigger that initiates their partner’s abuse or violence towards them. This can be very frightening for the woman who not only has to cope with the changes a pregnancy brings, but must also deal with the realisation she is a victim of domestic violence.

Increases in domestic violence or the initiation of domestic violence during pregnancy may occur for a variety of reasons. Sexual jealousy, for example, can be a contributing factor. If a woman’s partner frequently accused her of infidelity previously, it is likely that he may also question the paternity of the child (6). Similarly, the partner may have feelings of jealously or anger towards the unborn child. After the child is born it may subsequently become the victim of physical or psychological abuse. Concern about the financial pressure a child or further children can also result in added conflict or violence in a relationship.

The postnatal period can also be a time when women experience an escalation in violence.

Impact on health of mother and baby

Violence impacts on a pregnant women’s health and the health of her baby in a number of ways. Women who experience domestic violence are, for example, less likely to attend antenatal care or to begin attendance late in their pregnancy. Women who are in a stressful environment are also more likely to use tobacco, illicit drugs and alcohol as a coping mechanism, which can affect their health and the health of their unborn child.

Women may experience physical violence directed towards the abdomen area. There is, therefore, a higher risk of injury to the foetus and/or miscarriage. While some evidence suggests a higher risk of having a baby of low birthweight and/or premature labour, this is still inconclusive. Women who experience violence are also more likely to suffer from postnatal depression and difficulties with breastfeeding (7).

Screening

Routine screening of women during antenatal care for violence is a suggested strategy and various programs have been initiated. Screening provides women with a relatively safe opportunity to disclose their experience of violence and to be directed to appropriate support services. Screening programs that ask all women about violence have the effect of raising the awareness of the issue amongst health care practitioners and the wider community.

There are, however, drawbacks to routine screening including the tendency for women who experience violence to attend antenatal care late in their pregnancy, or not at all. Women may also be reluctant to disclose information about violence if they hope the relationship might improve or if they fear the abuser will find out. Similarly, even though women report violence in the screening process it does not necessarily mean they will take up offers for assistance.

For screening to be effective, health care practitioners require adequate training in screening for violence and need to feel confident in their ability to screen. In addition, if women do disclose and/or ask for assistance there needs to be adequate services for referral. Ideally, these services would be suitable for pregnant women or women who have recently given birth.

What a woman can do if she is experiencing violence

As is the case with all domestic violence, women need to know that they, and their children, have the right to feel safe. Whether a woman decides to leave or stay in a violent relationship, there is assistance available.

If a woman fears for her or her children’s safety or life she should ring the police on 000. As well as providing immediate emergency help, the police can assist women in taking out a protection order.

Women can also contact dvconnect womensline on 1800 811 811. This is a 24 hour service that provides confidential support, telephone counselling, information advocacy, statewide refuge referral and referral to community based domestic and family violence services.

Developing a safety plan is also an important strategy. A safety plan can be used when a woman is ready to leave the violent relationship or when she needs to leave in a hurry due to safety concerns. It includes where a woman can go and who they can call. A woman might also consider keeping clothing, medications, important papers, spare keys and money at another location (eg. a friend’s place).

What friends and family can do if their friend/loved one is experiencing violence

The best assistance a friend or family member of a victim of domestic violence can provide is support. Listening to and believing the woman without passing judgment is important as other responses may further damage her feelings of self-worth and self-confidence. Friends and family can remind the woman that the violence is not her fault and she has not done anything to deserve it. They can also encourage her to contact appropriate services and assist in developing a safety plan (see section above).

Perpetrators of violence can contact dvconnect men’s line on 1800 600 636. It provides counselling and information for men, particularly those seeking assistance for their own use of violence.

References

1. Gazmararian JA et al. Prevalence of violence against pregnant women JAMA 1996; 275:24:1915-1920
2. Gazmararian JA et al. Prevalence of violence against pregnant women Ibid
3. SA Domestic Violence Unit, 1997. Qtd in Chung D et al. Home Safe Home: The Link Between Domestic and Family Violence and Homelessness University of South Australia , Pirie Publications, 2000
4. Gazmararian, JA et al. The relationship between pregnancy intendedness and physical violence in mothers of newborns: The PRAMS Working Group Obstet Gynecol 1995; 85:6:1031-8
5. Jasinski J L. Pregnancy and domestic violence: A review of literature Trauma Violence and Abuse 2004; 5:1:47-64
6. Burch R L and Gallop G. Pregnancy as a stimulus for domestic violence J Fam Violence 2004; 19:4:243-247
7. Jasinski J L Ibid

Further help and information from Women's Health Queensland Wide

Health Information Line:
Our free statewide line is staffed by women's health nurses and midwives. They provide women with up to date information, support and referral to health practitioners and services. Women can contact the Health Information Line by phone or email via the 'Ask a Health Question' page on the website. All phone calls and emails are confidential.
(07) 3839 9988 or 1800 017 676 (toll free outside Brisbane)

Library:
Our free lending library offers a select range of books on major women's health topics. Topic-based booklists are availableon our website, or can be posted out; books can be requested by phone or email and are posted to borrowers.
Contact on administration : (07) 3839 9962

Website:
All our factsheets and booklets are available on our website. The website also features articles on women's health from our newsletter, student factsheets, upcoming events, library services and 'Ask a Health Question' page. A list of reputable links is also available where women can search for further information on health topics.
www.womhealth.org.au

Further information and assistance

dvconnect womensline 1800 811 811
24 hours/7 days a week

dvconnectmensline 1800 600 636
Monday-Friday

Safe Women Queensland
www.safewomen.qld.gov.au

This article was written by Kirsten Braun and reviewed by the Editorial Committee for Health Journey, Vol 2 2006

Please note that this article is an archive. While every effort was made to ensure the information was accurate at the time of publication, the article has not been updated since this time. 

Last Modified: June 15, 2006