|Year : 2014 | Volume
| 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 Publication||25-Jun-2014|
Department of Obstetrics and Gynecology, Padmashree Dr. D. Y. Patil Medical College, Hospital and Research Centre, Dr. D. Y. Patil Vidyapeeth, Pune, Maharashtra
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Patvekar M. Intimate partner violence in pregnancy. Med J DY Patil Univ 2014;7:480-1
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.  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. 
Throughout the world, the reported rates of abuse vary from 5.4 to 27.7%. ,,,,, 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. 
Victimization is often dismissed as "human nature." However, societies exist in which violence is rare and violence against women is virtually nonexistent. 
A number of risk factors are associated  with bringing violence into an intimate relationship and these are as follows:
- Alcoholism/substance abuse
- Poverty or financial difficulties
- Family disruption
- Emotional insecurity
- Borderline personality disorders
- 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.  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  recommends that the health sector should
- respond to violence against women,
- ensure that women are not stigmatized or blamed if they divulge abuse,
- give appropriate medical attention, and
- 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.
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