Although one of the best predictors of abuse in pregnancy is previous abuse, as many as 40% of women who reported abuse in pregnancy, stated that the abuse started when they became pregnant. Abuse in pregnancy involves tactics that are unique to the childbearing year during a time when women are more physically and emotionally vulnerable. Some of the ways in which women are abused in the childbearing year include the following:

Isolation

• Preventing her from getting prenatal care
• Preventing her from accessing information regarding her pregnancy
• Locking her inside the house
• Refusing or interfering with her contact with family and friends

Male Privilege

• Demanding she care entirely for the household
• Asserting that the child will be raised according to his customs and belief systems
• Demeaning her role as a mother
• "Father knows best" mentality

Emotional Abuse

• Telling her she looks fat or making other derogatory comments about her body
• Verbally abusing her so she is unable to look after herself or her child

Using Children

• Threatening to harm her child should she decide to leave
• Trying to convince others that she is an unfit mother
• Threatening to call the Children's Aid Society

Physical Abuse

• Increasing the severity/frequency of physical assaults
• Directing abuse towards her abdomen

Minimizing, Denying and Blame

• Holding her solely responsible for the pregnancy
• Refusing to admit that he is the father of the child
• Blaming her for the child being the "wrong" sex

Sexual Abuse

• Forcing her to engage in unwanted sexual activities
• Forcing her to engage in unwanted sexual activities which could cause injuries
• Having an affair, transmitting Sexually Transmitted Infections to her, causing risk to her and the fetus

Coercion and Threats

• Threatening to leave her if she does/doesn't have the child
• Threatening to harm her if she tells any of her caregivers about the abuse

Financial abuse

• Denying access to food, clothing, money by which she could provide for herself
• Making her work despite concerns for her health

Intimidation

• Making threatening motions towards her
• Throwing things at or near her

(The above information is available as a Power and Control Wheel handout.)

While these tactics have been separated into categories, they actually overlap and work together to create an atmosphere of fear and isolation for the abused woman. Sometimes a man may stop behaving abusively in one particular way, for instance he may stop physically assaulting his partner (because he doesn't want to face jail or probation again), and he will adopt new strategies to maintain power and control in the relationship. It is important to remember that because the abusive partner knows his partner so well, the tactics he chooses to use are catered to her, to create the greatest impact on her and are deeply personal. We cannot compare tactics and place more weight on one type over another. Each form of abuse is corrosive to a woman's self-esteem, her sense of autonomy and her emotional and physical well-being.

 

There are some key considerations to understand while supporting a pregnant woman experiencing abuse:

• pregnancy can increase a woman's vulnerabilty (i.e. increased fatigue, sickness, less capacity to defend herself) yet it can also motivate her to make great changes for herself and her baby
• invasive interventions or procedures (i.e. vaginal exams, use of foreceps) may have profound impacts on a woman who is being abused
• some pregnancies maybe the result of a sexual assault committed by the partner
• women who are pregnant or who have just given birth may be financially dependant on the father of the baby
• abused pregnant women may require additional support related to pregnancy and birth ( i.e. labour support, postpartum support)

A Handbook for Health and Social Service Professionals Responding to Abuse During Pregnancy, National Clearinghouse on Family Violence (NCFV)

Impact on nutrition

There is growing recognition that among the serious impacts of woman abuse, there are tactics which "can lead to poor nutrition in children and pregnant women", according to the Women, Infants and Children (WIC) program. Women who are being abused may have limited access to nutritious foods or vitamin supplements. You may wish to ask your clients/patients whether or not they are able to meet their dietary needs according to Health Canada Guidelines for Healthy Eating, or if there are barriers with which they may need assistance — be ready to offer referrals to appropriate programs. For some women, taking care of themselves does not come easily. They may feel unworthy or undeserving when it comes to nurturing themselves with healthy food choices or, due to depression, may not be able to prepare or cook foods for themselves. It could be appropriate to provide, in a non-threatening and non-demeaning manner, some education around simple, low fuss, inexpensive snack and food choices, or a referral to a nutritionist who has an awareness and sensitivity to the impact of abuse on women's nutrition. Remember, the issue may not be that she doesn't know what to eat, so much as that she is unable to access the food she would like/need to eat.

Impact on bringing the pregnancy to term

In most cases, abuse during pregnancy is a continuation of abuse that began before the woman became pregnant. As a professional it is important to remember that the abusive partner may perpetrate the following abuse during the woman's pregnancy:

• force her to have an abortion (there is evidence to show that a woman who is abused is more likely to have a history of one or more elective abortions)
• injure her with the intent of causing her to lose the baby (evidence has shown that women who experience severe physical trauma to their abdomen may suffer adverse pregnancy outcomes including placental abruption, preterm labour and delivery, fetal death, spontaneous abortion, rupture of the uterus, spleen, diaphragm and liver, neonatal death)
• force her to continue with an unwanted pregnancy (research has shown that unwanted pregnancies that a woman is forced to endure could lead to infant attachment difficulties, depression during pregnancy, postpartum depression, parenting difficulties — children's essential needs not being met)

A Handbook for Health and Social Service Professionals Responding to Abuse During Pregnancy, NCFV

Changes in the pattern of abuse

For a small number of women who are abused, being pregnant serves to decrease or temporarily stop the abuse from occurring. Consequently, these women may attempt to stay pregnant to stop the abuse. For the majority of these women, the abuse returns after the birth of the baby.

Many women have shared with us that when they became pregnant, the abuse intensified. The abuse tactics may have changed (e.g. decreased physical abuse) but other means of maintaining power and control increased. Current research in this area is on-going. It is important to note that pregnancy is also a dangerous time for any existing children of the abused woman.

During the pregnancy, the abuser may start, continue or change the pattern of abuse (e.g. the abuse may escalate, the assaults may be directed towards her abdomen, breasts or vagina) (Professionals Responding to Abuse During Pregnancy, NCFV)

 

About Woman Abuse in the Childbearing Year: (you are on page 1) - page 2 - page 3