07.22.10: One in six are abused during pregnancy
I recently caught news segments of Mel Gibson allegedly taped spewing foul-mouthed venom at his ex-girlfriend. He’s accused of physical and emotional abuse; of bashing his girlfriend’s teeth out while she was holding their baby.
I just finished Kathryn Stockett’s debut novel, The Help, about the civil rights movement in Jackson, Mississippi told from the perspective of black maids raising white children. One of the maids, Minny, got pregnant with her sixth child because her husband didn’t usually beat her when she was pregnant.
These unrelated stories point to an epidemic we don’t talk enough about. Domestic Violence. I’ve evaluated so many patients in the labor unit because they’ve “slipped, banged their head on a counter, walked into a door or fallen down the stairs.” Some come in because the “slammed on the breaks and banged up their stomachs” with oddly-shaped bruises that don’t resemble steering wheels or seatbelts. Hardly any come in because their husband/boyfriend beat them. It’s usually a self-inflicted accident or clumsiness; something they’ve done to themselves. Some “fall down the stairs” pretty often; repeat customers who come to the emergency room for stitches and reassurance that their baby is safe. These “accidents” can jumpstart preterm contractions, cause kidney damage, head injuries, placental separation and more.
When these women arrive on our unit, they’re almost always with partners who refuse to leave her side. They’re so worried about their wife/girlfriend, you’d think they were poster-boys for compassionate, doting husbandry. Usually, the battered woman (ehem, “accident victim”) won’t say anything that might be construed as blame; that is, if she says anything at all. The guys like to do most of the talking. When we insist she answer for herself or that he leave the room so she can talk privately, these guys get kind of testy and confrontational. Some get downright in-your-face about it.
According to the March of Dimes, one in six women will be abused during pregnancy, often for the first time. For some couples, pregnancy kicks up serious emotional and marital issues, financial problems, jealousy and anger. Abuse is especially bad when it’s an unplanned pregnancy.
Since many abusers were raised by abusers, they repeat learned behavior. They act like their parents did when they felt frustrated, confused and threatened. They beat, shove and berate. Not all abuse is physical but that’s the kind that brings women to the hospital. Sucker-punches to the stomach and breasts are prime targets.
In some cases, like Minnny’s in The Help, pregnancy provides a reprieve from abuse. She’s safe from her husband when she’s pregnant. Abuse often resumes shortly after the baby is born however, especially when parents get tired, tempers get short and babies get demanding. Some women choose back-to-back pregnancies as a way of escaping abuse.
Abuse isn’t usually a one-off deal. If he hits once, he’ll most likely do it again and his behavior will follow a pattern and become more frequent and severe over time – a cycle of abuse described here by the American College of Obstetricians and Gynecologists:
• Phase 1—Tension mounts as the abusive partner increases his threats of violence, often calling the woman names or shoving her. During this phase, the abused woman may try to please the abuser or calm him down. Often, her efforts only delay the violence.
• Phase 2—The abuser becomes violent and throws objects at his partner; hits, slaps, kicks, or chokes her; rapes or sexually abuses her; or uses weapons, such as belts, knives, or guns.
• Phase 3—The abuser apologizes and expresses guilt and shame. He promises the violent behavior won’t happen again. He often buys his partner gifts. Sometimes the abuser blames the violence on the woman, saying it wouldn’t have happened if she hadn’t made him angry.
Over time, he puts less time and effort into making up, being forgiven or explaining his behavior as he learns his violence is controlling his partner.
Sometimes, the only chance a woman has to break the cycle and get help is when she’s in the hospital. That’s why hospitals have policies of asking in private whenever possible: “Are you in a safe relationship? Has anyone ever hit, kicked or hurt you? Can you access emergency help?” The answers are usually “yes, no and yes,” even when we know she didn’t fall down the stairs. We know he punched her in the stomach and knocked her teeth out.
If we can get her alone, even for a second, like when we step into the bathroom to “give her a towel,” we’ll say, “Did he do this to you?” She might whisper, “yeah, but I made him mad.” More likely, she won’t tell. She’s too scared. She’s under his thumb. And yet, unless she tells, the cycle continues. That’s the first step – tell your nurse, doctor, midwife, friend, sister or mother. Just tell us. We’ll help you.
This Fit Pregnancy blog is intended for educational purposes only. It is not intended to replace medical advice from your physician. Before initiating any exercise program, diet or treatment provided by Fit Pregnancy, you should seek medical advice from your primary caregiver.