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Intimate Partner Abuse In Pregnancy

WHAT YOU NEED TO KNOW:

What is intimate partner abuse in pregnancy?

Intimate partner violence, also known as domestic violence, may happen during pregnancy. The abuser uses fear to control or overpower the relationship by using intimidation, threats, or physical force. There may be a pattern of an ongoing or on and off abuse. The abuser may beg for forgiveness, promise to change, or try to make up for the wrongdoing. The abuser may also act as if the violence never happened. Intimate partner abuse is not normal or acceptable.

What are the types of intimate partner abuse?

  • Physical abuse: This includes pushing, hitting, kicking, slapping, biting, choking or pulling hair. Physical violence may also include stalking, or being held down. Your abuser may use a knife or gun on you. Physical violence may become life-threatening.
  • Emotional or psychological abuse: This may include verbal abuse such as name-calling and insults. The abuser may also not let you do what you want to do with family or friends. He may not let you spend any money.
  • Sexual abuse: This is when your partner has sex with you when you do not want it. Sexual abuse may include forcing sex when you are tired or sick. Using objects, or inviting other people to have sex when you do not agree is also sexual abuse.

What increases my risk of intimate partner abuse in pregnancy?

  • You are a young woman who is single, separated, or divorced.
  • You have low income or live in a crowded place.
  • Your pregnancy was not planned.
  • You have delayed seeing your healthcare provider since you became pregnant.
  • You have a medical condition, such as high blood pressure.
  • You use drugs and alcohol.

What are the signs and symptoms of intimate partner abuse in pregnancy?

  • Physical signs and symptoms:
    • Bruises, cuts, scratches or burns from the abuse
    • Unexpected vaginal bleeding
    • Bladder or kidney infections
    • Sexually transmitted infections, such HIV and herpes
    • High blood pressure
    • Increased alcohol and drug use
  • Emotional signs and symptoms:
    • Feelings of stress, anxiety, worry, or sadness
    • Sleeping problems
    • Thoughts of harming yourself, your fetus, or other people

How is intimate partner abuse in pregnancy diagnosed?

Your healthcare provider will ask you questions. Everything you say to your healthcare provider will be kept private. Tell your healthcare provider as much as possible, so that you can get the help that you need. Your healthcare provider must report the abuse to police. Your healthcare provider may need to examine you, and may ask if they can take pictures of your injuries. You may also need any of the following:

  • Blood and urine tests: Blood and urine tests may be done to check for problems, such as an infection.
  • Vaginal and pelvic exam: You may need to have this exam so healthcare providers can check for any injuries that may have resulted from the abuse. A sample of discharge may be collected from your genitals, and sent to a lab for tests.
  • Fetal ultrasound: This test uses sound waves to show pictures of your fetus inside your uterus. Gel is put on your abdomen, and a small wand is gently moved through the gel. As this is done, pictures of your baby can be seen on a monitor. Healthcare providers can learn the age of your baby, and see how fast he is growing. The movement, heart rate, and position of your baby can also be seen.
  • X-rays: These may be done to see if any bones have been broken or are displaced. X-rays of your chest and abdomen may also be taken.

How is intimate partner abuse in pregnancy treated?

When you are ready, you can get help. Your healthcare provider may suggest any of the following:

  • Counseling: Intimate partner violence may cause you to feel scared, depressed, or anxious. Your healthcare provider may suggest that you see a counselor to talk about how you are feeling.
  • Medicines: Healthcare providers may give you medicine to help decrease pain, anxiety, or depression. You may also need antibiotic medicine.
  • Surgery: You may need surgery to treat injuries. Surgery may return bones to their normal position if you have a broken bone. Surgery may also be needed to correct a deformity or treat other injuries.

What are the risks of intimate partner abuse?

  • Your abusive partner may grow angrier and more violent if he learns that you are seeking help. Contact your healthcare providers and support services secretly. The abuse may increase the risk that your children will get hurt. Children who see intimate partner abuse are more likely to use drugs and have behavior problems. Your child may become angry, very sad, or want to kill himself.
  • Intimate partner abuse can cause serious health problems for you and your fetus. You may get bruises, cuts, or serious infections. The abuse may cause your baby to be born before he is ready. Your newborn baby may be very small and need special care after birth. You are also at higher risk for depression after your baby is born. Without treatment, intimate partner abuse may get worse during your pregnancy. The attacks may happen more often and become more severe. Your abuser may use weapons, such as knives and guns, on you and other family members. Intimate partner abuse may become life-threatening to you and your fetus.

What can I do to protect myself?

  • Create a safety plan:
    • Prepare a bag with clothes, spare money, and important papers in case you need to leave your house quickly.
    • Hide an extra set of house and car keys.
    • Have a secret way to let your family or friends know you need urgent help.
    • Plan where you can go if you need to leave.
    • If you do not have a cell phone, ask your healthcare provider about emergency cell phones for 911 calls only.
    • When you are attacked, avoid rooms with one entrance (such as bathrooms) and stay out of the kitchen.
  • Contact the police: Call the police if you or your baby's life are at risk. The police can remove your abuser and make him stay away from you if that is what you choose.
  • Think about spending one or more nights in a shelter: A woman's shelter can give you a safe place to stay when you need it.
  • Ask for names and phone numbers: Get a list of phone numbers for people who can help you. People at these phone numbers can answer your questions, and tell you where to go to get help.
  • Ask about a domestic violence advocate: This is a trained healthcare provider who will talk to you about your choices. Contact with this healthcare provider is private. This person may also help you in an emergency to make sure that you are safe from your abuser.

Where can I find support and more information?

  • National Domestic Violence Hotline
    Phone: 1- 800 - 799-7233
    Web Address: www.ndvh.org

When should I contact my healthcare provider?

  • You have a fever.
  • You have pain when you urinate, or vaginal bleeding.
  • You have abdominal pain.
  • You have questions or concerns about your condition or care.

When should I seek immediate care or call 911?

  • You fear for your life, or the lives of your fetus or other children.
  • You or your fetus have been badly hurt, such as if you are hit in the head or stomach.
  • You feel like hurting yourself, your fetus, or someone else.
  • You have sudden trouble breathing, chest pain, or a fast heartbeat.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

© 2016 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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