Domestic violence and pregnancy
Encyclopedia
Pregnancy
when coupled with domestic violence
is a form of intimate partner violence (IPV) where health
risks may be amplified. Abuse during pregnancy, whether physical, verbal or emotional, produces many adverse physical
and psychological effects for both the mother and fetus. Domestic violence during pregnancy is categorized as abusive behavior towards a pregnant woman, where the pattern of abuse can often change in terms of severity and frequency of violence. Abuse may be a long-standing problem in a relationship that continues after a woman becomes pregnant or it may commence in pregnancy. Although female-to-male partner violence occurs in these settings, the overwhelming form of domestic violence is perpetrated by men against women.
, or reproductive coercion. Studies on the birth control sabotage performed by males against female partners have indicated a strong correlation between domestic violence and birth control sabotage. Pregnancy can also lead to a hiatus of domestic violence when the abuser does not want to harm the unborn child. The risk of domestic violence for pregnant women is greatest immediately after childbirth
.
s, and threats and violence are examples of prevention of an individual's attempt to avoid pregnancy. Pregnancy-promoting behavior of abusive male partners is one method of domestic violence and is associated with unwanted pregnancy, particularly in adolescents. Reproductive coercion itself is a form of domestic violence because it results from unwanted sexual activity and hinders a woman’s ability to control her body. Forced pregnancy can also be a form of financial abuse when a woman becomes trapped in a relationship because the pregnancy has led to economic dependence for new mothers.
Unintended pregnancies
are 2 to 3 times more likely to be associated with abuse than intended pregnancies. Research among adolescent populations shows females who experience IPV use condoms at low rates and are fearful of negotiating the use of condoms. In a study of sexually experienced women 15-19 in Uganda, surveys found that fourteen percent of women’s first sexual intercourse
had been coerced. Of those fourteen percent, the women were far more likely to be having unprotected sex without the use of modern contraceptives and to have had unintended pregnancies within the last six months compared to women who had not been sexually coerced. In Egypt, over 80% of rural women believe that beatings are sometimes justified and one of the most common reasons given as a just cause for beatings is refusing a man sex. This affects the ability of women to protect themselves from unwanted sexual contact and the consequences of sexual intercourse, such as pregnancy and sexually transmitted infections.
A study conducted by the Center for Impact Research on young mothers classified birth control sabotage into two categories: verbal and behavioral. Verbal sabotage is verbal or emotional pressure not to use birth control, or pressure to become pregnant. Behavioral sabotage is the use of force to prevent the use of birth control, or to have unprotected sexual intercourse.
.
In one study conduct by Campbell et. al, women were asked to speculate on why they thought they were abused during their pregnancies. The answers were categorized into four categories:
, late prenatal care
, stillbirth
, preterm birth, fetal injury (including bruising, broken and fractured bones, and stab wounds and low birth weight. Violence during pregnancy also leads to additional risks for the mother such as increased mental health problems
, suicide attempts, worsening of chronic illness, injury, substance abuse
, anxiety, stress, chronic pain, and gynecological problems. Women battered during pregnancy were more frequently and severely beaten throughout the course of their relationship compared to women who were not abused during pregnancy. IPV also accounts for a large portion of maternal mortality. Homicide
is the second leading cause of injury related deaths in pregnant and post-partum women in the United States and a study conducted in hospital in India found that 16% of all deaths during pregnancy were a result of partner violence. Studies have also found a correlation between domestic violence and increased use of abortion
. Pregnant abused women are less likely to report abuse or leave their abuser because of added financial and housing security concerns
In general, the rate of physical violence during pregnancy decreases as household income increases. Women whose total household income was less than $16,000 were much more likely to experience physical or sexual violence during pregnancy than women with a total household income over $16,000.
Partner violence in a relationship increases the chances of unintended pregnancy. A Canadian study that outlined causes of physical abuse identified “social instability” (e.g. low age, unmarried, lower level of education, and unemployment) as a trigger for violence and used unplanned pregnancies as an example. This suggests that partner violence can lead to increased unintended pregnancies which, in turn, increases physical abuse. Younger women are statistically more susceptible to reproductive coercion and this may be to due to less experience in relationships and, for minors, less access to doctor’s appointments and emergency contraception. Adolescents are especially at risk and teenage pregnancy
is correlated with increased rates of domestic violence. Young women with older boyfriends are more likely to experience domestic violence. Women who experience physical violence from their husbands are less likely to use contraception and more likely to have an unwanted pregnancy.
Incidence rates are higher for teenagers. The incidence rate for low-income, teen mothers is as high as 38%.
Pregnancy
Pregnancy refers to the fertilization and development of one or more offspring, known as a fetus or embryo, in a woman's uterus. In a pregnancy, there can be multiple gestations, as in the case of twins or triplets...
when coupled with domestic violence
Domestic violence
Domestic violence, also known as domestic abuse, spousal abuse, battering, family violence, and intimate partner violence , is broadly defined as a pattern of abusive behaviors by one or both partners in an intimate relationship such as marriage, dating, family, or cohabitation...
is a form of intimate partner violence (IPV) where health
Health
Health is the level of functional or metabolic efficiency of a living being. In humans, it is the general condition of a person's mind, body and spirit, usually meaning to be free from illness, injury or pain...
risks may be amplified. Abuse during pregnancy, whether physical, verbal or emotional, produces many adverse physical
Physical
Physical may refer to:*Body, the physical structure of an organism**Human body, the physical structure of a human*Physical abuse, abuse involving contact intended to cause feelings of intimidation, injury, or other physical suffering or bodily harm...
and psychological effects for both the mother and fetus. Domestic violence during pregnancy is categorized as abusive behavior towards a pregnant woman, where the pattern of abuse can often change in terms of severity and frequency of violence. Abuse may be a long-standing problem in a relationship that continues after a woman becomes pregnant or it may commence in pregnancy. Although female-to-male partner violence occurs in these settings, the overwhelming form of domestic violence is perpetrated by men against women.
Triggers
Domestic abuse can be triggered by pregnancy for a number of reasons. Pregnancy itself can be used a form of coercion and the phenomenon of preventing one’s reproductive choice is referred to as birth control sabotageBirth control sabotage
Birth control sabotage, or reproductive coercion, refers to efforts to manipulate another person's use of birth control or to undermine efforts to prevent an unwanted pregnancy. Examples include replacing birth control pills with fakes, puncturing condoms and diaphragms, or threats and violence to...
, or reproductive coercion. Studies on the birth control sabotage performed by males against female partners have indicated a strong correlation between domestic violence and birth control sabotage. Pregnancy can also lead to a hiatus of domestic violence when the abuser does not want to harm the unborn child. The risk of domestic violence for pregnant women is greatest immediately after childbirth
Childbirth
Childbirth is the culmination of a human pregnancy or gestation period with the birth of one or more newborn infants from a woman's uterus...
.
Birth control sabotage
Birth control sabotage, or reproductive coercion, is a form of coercion where someone manipulates another person's use of birth control - weakening efforts to prevent an unwanted pregnancy. Replacing birth control pills with fakes, puncturing condomCondom
A condom is a barrier device most commonly used during sexual intercourse to reduce the probability of pregnancy and spreading sexually transmitted diseases . It is put on a man's erect penis and physically blocks ejaculated semen from entering the body of a sexual partner...
s, and threats and violence are examples of prevention of an individual's attempt to avoid pregnancy. Pregnancy-promoting behavior of abusive male partners is one method of domestic violence and is associated with unwanted pregnancy, particularly in adolescents. Reproductive coercion itself is a form of domestic violence because it results from unwanted sexual activity and hinders a woman’s ability to control her body. Forced pregnancy can also be a form of financial abuse when a woman becomes trapped in a relationship because the pregnancy has led to economic dependence for new mothers.
Unintended pregnancies
Unintended pregnancy
Unintended pregnancies are those in which conception was not intended by the female sexual partner. Worldwide, 38% of pregnancies were unintended in 1999 . Unintended pregnancies are the primary cause of induced abortion, resulting in about 42 million induced abortions per year...
are 2 to 3 times more likely to be associated with abuse than intended pregnancies. Research among adolescent populations shows females who experience IPV use condoms at low rates and are fearful of negotiating the use of condoms. In a study of sexually experienced women 15-19 in Uganda, surveys found that fourteen percent of women’s first sexual intercourse
Sexual intercourse
Sexual intercourse, also known as copulation or coitus, commonly refers to the act in which a male's penis enters a female's vagina for the purposes of sexual pleasure or reproduction. The entities may be of opposite sexes, or they may be hermaphroditic, as is the case with snails...
had been coerced. Of those fourteen percent, the women were far more likely to be having unprotected sex without the use of modern contraceptives and to have had unintended pregnancies within the last six months compared to women who had not been sexually coerced. In Egypt, over 80% of rural women believe that beatings are sometimes justified and one of the most common reasons given as a just cause for beatings is refusing a man sex. This affects the ability of women to protect themselves from unwanted sexual contact and the consequences of sexual intercourse, such as pregnancy and sexually transmitted infections.
A study conducted by the Center for Impact Research on young mothers classified birth control sabotage into two categories: verbal and behavioral. Verbal sabotage is verbal or emotional pressure not to use birth control, or pressure to become pregnant. Behavioral sabotage is the use of force to prevent the use of birth control, or to have unprotected sexual intercourse.
Mechanisms
In most cases, domestic violence can be prompted by or intensified by pregnancy, but in some cases domestic violence ends during pregnancy because the abuser makes a conscious effort to not harm the fetusFetus
A fetus is a developing mammal or other viviparous vertebrate after the embryonic stage and before birth.In humans, the fetal stage of prenatal development starts at the beginning of the 11th week in gestational age, which is the 9th week after fertilization.-Etymology and spelling variations:The...
.
Decreased violence
Domestic violence does not always increase during pregnancy and can even lead to a hiatus in violence. This phenomenon can provide protection for both the woman and child. Because this can lead to decreased violence, some women use pregnancy as a means of protection against domestic abuse. Since abuse generally restarts after the pregnancy ends, women may get pregnant intentionally to prevent violence. However, since women who have been abused before getting pregnant are more likely to experience violence during pregnancy, this is not a reliable means of protection.Increased violence
Although for some women, pregnancy can be a protective period, either in terms of a hiatus of pre-existing violence, for others it is a risk period during which abuse may begin or escalate. Women with violent partners have a hard time protecting themselves from unintended pregnancy and sexual violence can directly lead to pregnancy. Studies consistently indicate that domestic violence is more common in large families. and a recent study in Nicaragua found that in 80% of families with domestic violence, the abuse was present in the first four years of marriage showing that violence may lead to an elevated number of unplanned pregnancies. However, international studies show that 25% of women are abused for the first time during pregnancy.In one study conduct by Campbell et. al, women were asked to speculate on why they thought they were abused during their pregnancies. The answers were categorized into four categories:
- JealousyJealousyJealousy is a second emotion and typically refers to the negative thoughts and feelings of insecurity, fear, and anxiety over an anticipated loss of something that the person values, particularly in reference to a human connection. Jealousy often consists of a combination of presenting emotions...
towards the unborn child - AngerAngerAnger is an automatic response to ill treatment. It is the way a person indicates he or she will not tolerate certain types of behaviour. It is a feedback mechanism in which an unpleasant stimulus is met with an unpleasant response....
towards the unborn child - Pregnancy specific violence not directed toward the child
- “Business as usual."
Effects
There are many dangerous effects that violence during pregnancy can cause for both the mother and child. A violent pregnancy is considered high risk because verbal, emotional, and physical abuse all lead to adverse health consequences for both the mother and fetus. Violence during pregnancy has been associated with miscarriageMiscarriage
Miscarriage or spontaneous abortion is the spontaneous end of a pregnancy at a stage where the embryo or fetus is incapable of surviving independently, generally defined in humans at prior to 20 weeks of gestation...
, late prenatal care
Prenatal care
Prenatal care refers to the medical and nursing care recommended for women before and during pregnancy. The aim of good prenatal care is to detect any potential problems early, to prevent them if possible , and to direct the woman to appropriate specialists, hospitals, etc...
, stillbirth
Stillbirth
A stillbirth occurs when a fetus has died in the uterus. The Australian definition specifies that fetal death is termed a stillbirth after 20 weeks gestation or the fetus weighs more than . Once the fetus has died the mother still has contractions and remains undelivered. The term is often used in...
, preterm birth, fetal injury (including bruising, broken and fractured bones, and stab wounds and low birth weight. Violence during pregnancy also leads to additional risks for the mother such as increased mental health problems
Psychiatric disorders of childbirth
This entry covers the complications of childbirth itself, not those of pregnancy or the postpartum period. Even with modern obstetrics and pain control, childbirth is still an ordeal for many...
, suicide attempts, worsening of chronic illness, injury, substance abuse
Substance abuse
A substance-related disorder is an umbrella term used to describe several different conditions associated with several different substances .A substance related disorder is a condition in which an individual uses or abuses a...
, anxiety, stress, chronic pain, and gynecological problems. Women battered during pregnancy were more frequently and severely beaten throughout the course of their relationship compared to women who were not abused during pregnancy. IPV also accounts for a large portion of maternal mortality. Homicide
Homicide
Homicide refers to the act of a human killing another human. Murder, for example, is a type of homicide. It can also describe a person who has committed such an act, though this use is rare in modern English...
is the second leading cause of injury related deaths in pregnant and post-partum women in the United States and a study conducted in hospital in India found that 16% of all deaths during pregnancy were a result of partner violence. Studies have also found a correlation between domestic violence and increased use of abortion
Abortion
Abortion is defined as the termination of pregnancy by the removal or expulsion from the uterus of a fetus or embryo prior to viability. An abortion can occur spontaneously, in which case it is usually called a miscarriage, or it can be purposely induced...
. Pregnant abused women are less likely to report abuse or leave their abuser because of added financial and housing security concerns
Risk factors
Certain women are more likely to be abused during pregnancy than others. Women who have been abused before getting pregnant are at higher risk of violence during pregnancy. Abuse is not restricted to a specific socio-economic or demographic group of women or to a specific period in a woman’s reproductive life.In general, the rate of physical violence during pregnancy decreases as household income increases. Women whose total household income was less than $16,000 were much more likely to experience physical or sexual violence during pregnancy than women with a total household income over $16,000.
Partner violence in a relationship increases the chances of unintended pregnancy. A Canadian study that outlined causes of physical abuse identified “social instability” (e.g. low age, unmarried, lower level of education, and unemployment) as a trigger for violence and used unplanned pregnancies as an example. This suggests that partner violence can lead to increased unintended pregnancies which, in turn, increases physical abuse. Younger women are statistically more susceptible to reproductive coercion and this may be to due to less experience in relationships and, for minors, less access to doctor’s appointments and emergency contraception. Adolescents are especially at risk and teenage pregnancy
Teenage pregnancy
Teenage pregnancy is a pregnancy of a female under the age of 20 when the pregnancy ends. It generally refers to a female who is unmarried and usually refers to an unplanned pregnancy...
is correlated with increased rates of domestic violence. Young women with older boyfriends are more likely to experience domestic violence. Women who experience physical violence from their husbands are less likely to use contraception and more likely to have an unwanted pregnancy.
Epidemiology
A study done on reporting rates of domestic violence concluded that a woman’s risk of physical and sexual violence during pregnancy is under-reported and underestimated. Each year, over 324,000 pregnant women are victims of domestic violence in the United States. A number of countries have sought to statistically analyze the amount of adult women who have experienced domestic violence during pregnancy:- UK Prevalence: 3.4%
- USA Prevalence: 3.4 – 33.7%
- Ireland prevalence: 12.5%
- Ireland Prevalence: 12.5%
- Population studies from Canada, Chile, Egypt and Nicaragua: 6-15%
Incidence rates are higher for teenagers. The incidence rate for low-income, teen mothers is as high as 38%.