"Studies in the United States report that physical abuse during pregnancy
is associated with delayed entry into or inadequate prenatal care" Canadian
Perinatal Surveillance System, 2004
When a woman is experiencing abuse during pregnancy there can be severe
consequences for the unborn child from either the direct physical abuse
of the woman and/or the impacts of her coping mechanisms.
When an abusive partner physically and/or sexually abuses a pregnant woman,
these assaults tend to be directed at areas related to the pregnancy or
sexual organs, such as the abdomen, breasts and genitals. The partner may
intentionally attempt to harm the fetus or threaten to do so in order to
gain and maintain power and control over the pregnant woman.
Impact of direct physical abuse to the pregnant abdomen on fetus:
- spontaneous abortion
- fetal death
- placental abruption
- preterm labour and delivery
- gestational age less than 37 weeks
- fetal injuries, such as skull fractures, intracranial hemorrhage and
bone fractures
(Petersen et al., 1997)
There are, however, other profound ways in which abuse during pregnancy
can impact a fetus.
According to Health Canada,
"There are approximately 400,000 births every year in Canada. Of
these, an estimated 10 percent of births are at risk due to poor health
and malnutrition of the mother. Poor nutrition is a risk factor for low
birth weight (less than 2500 grams). Low birth weight is the determining
factor in about two-thirds of all deaths among newborns, and those that
survive are at a greater risk of developing serious and lifelong disabilities."
If the mother is unable to care for herself because of the impact of the
abuse on her state of mind (depression), physical ability (injury) or nutrition
(being denied access to nutritious food or supplements), she may be more
likely to give birth to a low birth weight baby or go into labour prematurely.
An abused woman is also likely to use substances that are potentially harmful
to her and her baby to assist her in regulating her emotional and/or mental
health. These substances may have prolonged and permanent effects on the
unborn child and often lead to the apprehension of her child at birth by
child protection agencies. This approach often alienates the woman further
and does nothing to recognize that the overwhelming majority of pregnant
women who are substance using are survivors of abuse.
As research indicates, women who are pregnant and being abused may delay
prenatal care for a host of reasons, which puts them further at risk given
that often times if there was abuse occurring during the pregnancy, it will
likely continue and escalate once the baby is born. The later a woman gets
into prenatal care, the less time a care provider will have in working with
her before the birth of her baby. Consider how your approach to working
with women in the childbearing year either supports or discourages women
from disclosing abuse to you.
The earlier in their pregnancies we can get services to women who are
being abused, the more successful we may be at connecting them with supports
that can reduce the risk that being exposed to abuse may have on them and
their unborn babies. Actions that we take should have the best interest
of each individual woman in mind, while recognizing that caring for her
in a sensitive, respectful and non-judgmental way is the best support we
can provide for her unborn baby.
It is important to remember that a woman who is experiencing abuse in
her life is often aware that the effect on her children is harmful. However,
because of her isolation, fear, lack of resources or support she may not
be in a position to change her situation. With your support and understanding
you can provide her with an opportunity to safety plan, and with time
implement a plan for change.
Research has shown that when a woman is abused there are profound effects
on the other children present in the family. (A
Handbook for Health and Social Service Professionals Responding to Abuse
During Pregnancy, NCFV).
Children's exposure to their mother's abuse can include but is not limited
to hearing, seeing, and coping with the aftermath of the abuse in the home.
Children who witness abuse in the home are at risk of being neglected and
abused themselves (30%-40% of children who witness woman abuse are also
physically abused themselves) (A
Handbook for Health and Social Service Professionals Responding to Abuse
During Pregnancy, NCFV).
Children who witness their mother being abused are also at risk of developing
similar coping mechanisms in adult life (i.e. continuing the cycle of acting
as the abuser or being abused in an adult relationship).
Children's exposure to the abuse of their mother has been recognized as
a form of child abuse (and should always be reported to the appropriate
Children's Aid Society / Child Protection Agency).
Children who witness their mother being abused can suffer behavioural
and emotional problems that can include the following:
- post-traumatic stress disorder (including but not limited to having
nightmares, flashbacks, fear, anxiety, tension, outbursts of anger or
aggression, clingy, exhibit signs of depression);
- suffering from low self-esteem or being withdrawn (in girls we see signs
of passive or overly compliant behaviour, in boys we see signs of increased
aggression)
- suffering from physical ailments such as stomach aches, regressing to
wetting the bed, headaches
- exhibiting behavioural problems such as being overly aggressive to siblings,
friends or family, being non-compliant with adults, acting destructive,
engaging in self harming behaviour, having conflict with the law
- showing signs of anger or mixed feelings towards mother (e.g. " You
made Dad leave us"), showing signs of mixed feelings towards dad (e.g.
experience feelings of love/hate)
Children who are exposed to their mother's abuse (without intervention)
are taught serious and detrimental lessons. Among many other things, children
who witness abuse learn that power and control can be used as a means to
get what you want. They may become confused that violence is indeed wrong,
and may become more accepting of violent behaviour in and outside of their
home. As the children grow and become teenagers, they may find themselves
being involved with abusive behaviour (as the abuser or the abused). Intervention
from a supportive source is imperative in protecting children against violence
in the home.
You have a professional duty to report child abuse and/or neglect according
to your local Children's Aid Society / Child Protection Agency and there
are consequences for failing to act promptly where a duty to report is indicated.
Please discuss any concerns you have with your client directly and inform
her of your intention to call Children's Aid / Child Protection. You may
want to make the call with her present so that she is clear on what you
are reporting, or support her in making the call herself. You want to try
and engage her in the process and NEVER forget that the safety
of the woman and her children needs to guide any action that you choose
or do not choose to take.
About Woman Abuse in the Childbearing Year: page
1 - page 2 -(you are on page 3)
