Definition Abuse during pregnancy is the mistreatment, battering, or abuse of a pregnant woman. The term includes physical, sexual, and emotional violence. Abuse affects women of all ages and from all social and economic backgrounds.
Physical abuse is one of the most common causes of complications during pregnancy. It is estimated that 1 pregnant woman in 4 is physically abused. This rate is even higher in pregnant teenagers.
What are the signs and symptoms of the injury? A foetus has very soft, delicate tissues and organs, especially in the head and chest area. Trauma to the pregnant woman's abdomen can cause:
maternal haemorrhage, which can result in the deaths of both mother and baby
A woman who is abused may not seek antenatal care early in her pregnancy. When antenatal care is delayed, the foetus's early development can have problems. So early antenatal care is very important. Some of the reasons for late antenatal care are fear of the abuser, low self-esteem, and the lack of a support system. The abuser may try to control the woman and keep the abuse hidden from doctors.
If the woman has any chronic illnesses, abuse can make them worse. These include high blood pressure, diabetes, and asthma. This worsening can have bad effects on the foetus.
Abuse can also increase stress and depression. Stress causes the body to release hormones that can lead to premature labour. These hormones can also decrease the blood flow through the placenta. Decreased blood flow may cause low birth weight.
Stress also makes it harder for the woman to take care of herself during her pregnancy. The result is higher rates of malnutrition and poor weight gain. Abused women have higher rates of pregnancy risks such as smoking or using smokeless tobacco, drinking alcohol, or taking drugs during pregnancy. Good nutrition and rest are very important for a healthy pregnancy.
What are the causes and risks of the injury? The women who are most at risk for abuse during pregnancy are those who have been physically abused before. They may have a history of physical abuse, sexual abuse, or family violence. More abuse is directed toward unmarried pregnant women, and those with unplanned pregnancies.
What are the treatments for the injury? Pregnant women may try to leave their abusers for the sake of the unborn child. But often money problems bring them back home. Women may not be able to properly care for themselves on their own. They may see no other option but to return home to the abuser.
If a doctor suspects that a woman is abused, she should be given the chance to talk without her partner present. Abused women are more likely to talk about the abuse to other women, or to people who offer protection and support.
The goal of treatment is to get the woman away from the abuser. If she decides to leave the abuser, she needs a means of escape. Most communities have shelters, counselling services, and other resources to help her leave the dangerous situation. The National Domestic Violence Hotline, 1-800-799-SAFE, offers information and support 24 hours a day. Local crisis shelters can provide a place to stay for women and children on a nightly basis. They provide counselling, legal and hospital advocacy, and community education.
What happens after treatment for the injury? Abuse during pregnancy may leave lasting psychological effects. Sadly, about 70% of men who abuse their female partners will also abuse their children. This supports the notion of a cycle of violence that can last for generations.
Author: Gail Hendrickson, RN, BS Reviewer: eknowhow Medical Review Panel Editor: Dr John Hearne Last Updated: 25/04/2005 Contributors Potential conflict of interest information for reviewers available on request
