Table of Contents  
COMMENTARY
Year : 2014  |  Volume : 7  |  Issue : 4  |  Page : 480-481  

Intimate partner violence in pregnancy


Department of Obstetrics and Gynecology, Padmashree Dr. D. Y. Patil Medical College, Hospital and Research Centre, Dr. D. Y. Patil Vidyapeeth, Pune, Maharashtra, India

Date of Web Publication25-Jun-2014

Correspondence Address:
Meenal Patvekar
Department of Obstetrics and Gynecology, Padmashree Dr. D. Y. Patil Medical College, Hospital and Research Centre, Dr. D. Y. Patil Vidyapeeth, Pune, Maharashtra
India
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Source of Support: None, Conflict of Interest: None


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How to cite this article:
Patvekar M. Intimate partner violence in pregnancy. Med J DY Patil Univ 2014;7:480-1

How to cite this URL:
Patvekar M. Intimate partner violence in pregnancy. Med J DY Patil Univ [serial online] 2014 [cited 2021 Sep 29];7:480-1. Available from: https://www.mjdrdypu.org/text.asp?2014/7/4/480/135275

Pregnancy when coupled with domestic violence is a form of intimate partner violence (IPV), and such a kind of an abusive relationship between domestic partners can often result in higher maternal mortality and morbidity rates. Abuse may be a longstanding problem in a relationship that continues after a woman becomes pregnant or it may commence in pregnancy. [1] The image of dishonoring a pregnant women by choking her or kicking her in the abdomen or head and inflicting such rude injuries on her often deeply moves and offends us. But this distaste also prevents us from intervening, screening, and providing support to the patients. [2]

Throughout the world, the reported rates of abuse vary from 5.4 to 27.7%. [3],[4],[5],[6],[7],[8] The prevalence of physical violence in pregnancy in a World Health Organization (WHO) study was reported to be between 1 and 28% in 15 different countries. [9]

Victimization is often dismissed as "human nature." However, societies exist in which violence is rare and violence against women is virtually nonexistent. [10]

A number of risk factors are associated [11] with bringing violence into an intimate relationship and these are as follows:

  1. Alcoholism/substance abuse
  2. Poverty or financial difficulties
  3. Family disruption
  4. Emotional insecurity
  5. Borderline personality disorders
  6. Violence in abuser's family of origin


Conversely, it is pertinent to remember that no individual is at "low risk."

The most common physical injuries seen are to the head and neck (40%), followed by musculoskeletal injuries (28%). Pregnant women are most likely to be struck on the abdomen or have multiple sites of injury. [12] The effects of this usually result in hypertension, premature rupture of membranes, or anemia in the women.

Features of fetal morbidity such as growth restriction, preterm babies, low-birth-weight babies, and abruption resulting in fetal death due to blunt trauma on abdomen are reported to occur more frequently in abused than non-abused pregnant women. Children born to such mothers exhibit more behavioral problems in their childhood.

The WHO [13] recommends that the health sector should

  1. respond to violence against women,
  2. ensure that women are not stigmatized or blamed if they divulge abuse,
  3. give appropriate medical attention, and
  4. guarantee security and confidentiality.


There is limited evidence of effective and promising interventions for pregnant women who experience domestic violence. Behavioral interventions to identify abusive behavior in pregnancy include physical harm,counseling,and documentation of injuries.

Domestic violence during pregnancy is a complex social problem and a frustrating experience for the physicians. Pregnant women should retain a privileged position in the society and domestic violence must be uprooted in order to escalate the women's reproductive health. Patient education, counselling during antenatal visits, community support, and timely legal involvement may help in dealing with this vexing issue. However, further studies need to be done so that the interventions are more effective and preventive to halt the harmful consequences of abuse in pregnant women.

 
  References Top

1.Johnson JK, Haider F, Ellis K, Henry DM, Lindow SW. The prevalence of domestic violence in pregnant women. BJOG 2003;110:272-5.  Back to cited text no. 1
    
2.Cook J, Bewley S. Acknowledging a persistent truth: Domestic violence in pregnancy. J R Soc Med 2008;101:358-63.  Back to cited text no. 2
    
3.McDonnell E, Holohan M, Reilly MO, Warde L, Collins C, Geary M. Acceptability of routine enquiry regarding domestiv violence in the antenatal clinic. Ir Med J 2006;99:123-4.  Back to cited text no. 3
    
4.Ahmed S, Koenig MA, Stephenson R, Effects of domestic on perinatal and early childhood mortality: Evidence from north India. Am J Public Health 2006;96:1423-8.  Back to cited text no. 4
    
5.Kaye DK, Mirembe FM, Bantebya G, Johansson A, Ekstrom AM. Domestic violence during pregnancy risk of low birth weight and maternal complications: A prospective cohort study at Mulago Hospital, Uganda. Trop Med Int Health 2006;11:1576-84.  Back to cited text no. 5
    
6.Johnson JK, Haider F, Ellis K, Hay DM, Lindow SW. The prevalence of domestic violence in pregnant women. BJOG 2003;110:272-5.  Back to cited text no. 6
    
7.Kataoka Y, Yaju Y, Eto H, Horiuchi S. Domestic violence during pregnancy. Japan J Public Health 2005;52:785-95.  Back to cited text no. 7
    
8.Yanikkerem E, Karadas G, Adiguzel B, Sevil U. Domestic violence during pregnancy in turkey and responsibility of prenatal healthcare providers. Am J Perinatol 2006;23:93-103.  Back to cited text no. 8
    
9.Ellsberg M, Jamen HA, Heise L, Watts CH, Garcia-Moreno C; WHO Multi-country study on women's health and domestic violence against women study Team Intimate partner violence and women's physical and mental health in WHO multi-country study on women's health and domestic violence: An observational study. Lancet 2008;371:1165-72.  Back to cited text no. 9
    
10.Eyler AE, Cohen M. Cases studies in partner violence. Am Fam Physician 1999;60:2569-76.  Back to cited text no. 10
    
11.World Health Organization. Geneva. World Report on Violence and Health. 2002;1-44. Available at http://whqlibdoc.who.int/hq/2002/9241545615.pdf [Last accessed 13 June 14].  Back to cited text no. 11
    
12.Bhandari M. Musculoskeletal manifestations of physical abuse after intimate partner violence. J Trauma 2006;61:1473-9.  Back to cited text no. 12
    
13.World Health Organization. Intimate Partner Violence. Available at http://www.who.int/violence_injury_prevention/violence/world_report/factsheets/en/ipvfacts.pdf [Last accessed 20 September 2013].  Back to cited text no. 13
    




 

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