Domestic Violence is an issue that seems like it never faded away throughout the history. Some believe it is a phenomenon that mostly increases during eras of poverty; others perceive it as outcome of capitalism and patriarchy. These views are not wrong, but they do not apply to all cases. The most outstanding example is the fact that male partners are victims of domestic violence from female partners. That is against the belief of patriarchy being the cause.
But we are not here to explain different reasons that may lead to the fact. We are here to analyze the phenomenon, expand it to the possibility of a coexisting pregnancy and explore the Midwives’ role on recognizing and dealing with it.
* Disclaimer 1st: This article may contain sensitive data that can be triggering to some people. If you are pregnant, or have ever been a victim of violence, please proceed with caution.
** Disclaimer 2nd: This article is specifically referred to sis or trans women that are victims of domestic violence before, during and after a pregnancy (pregnant trans men can be included to this possibility). Their partner can be sis or trans, female or male, or non binary. We do recognize that are several other potentials, but they are not going to be discussed in this specific article.
© EVI KAMPERI, SOME RIGHTS RESERVED 15/06/2021
What is Domestic Violence
According to the United States Department of Justice Office on Violence Against Women, the definition of domestic violence is a pattern of abusive behavior in any relationship that is used by one partner to gain or maintain control over another intimate partner.
Many types of abuse are included in the definition of domestic violence, such as physical abuse, sexual abuse, emotional abuse, psychological abuse, threats, cyber stalking and economic abuse.
The Statistics
6% of USA kids (which equivalents to about 4,5 million) witness violence among parents or a parent and their partner.
18% of violent partners may become violent parents.
About 30% of the incidents firstly appeared during pregnancy and 40-60% of those continue during pregnancy and after. Those rates are higher than preeclampsia or gestational diabetes.
Domestic Abuse is the number 1 cause of miscarriage and stillbirth.
Domestic Violence and Pregnancy
Domestic Violence frequently starts or escalates during pregnancy. Sociologically, this can be explained due to the fact that it is a stressful period of life that creates lots of physical, hormonal and emotional changes to both parents. Their relationship starts to alter and this alteration is the possible cause of the appearance or escalation of violent incidents.
That rationale, though, cannot work as an excuse for any incident, as small or as big as it is. After all, a violent partner exposes the pregnant parent to higher rates of maternal and baby illness and death. Physical abuse of the pregnant may lead to serial stillbirths, sudden fetal death, preterm labour, low birth weight and delayed start of obstetric monitoring.
At this point, it is crucial to remind everyone that violence against pregnant people has impact on 2 victims, both the pregnant person and the baby. The fetus in those cases is considered and referred to as the Unborn Victim of Violence.
The role of the Midwife
The Midwife is the professional that can have some “alone” time with all the pregnant people. They can demand the privacy needed for taking the medical history, which can be a really helpful tool in order to recognize victims of domestic abuse and help them open up. Patients’ ways of showing or hiding their struggle can vary. Midwives have to recognize the signs of abuse. A question on domestic abuse must become a standard practice while taking the medical history. This will help pregnant people seek for help when there is a friendly and safe environment.
But what happens if the answer is “I m indeed a victim of abuse”? At some countries there are established protocols that follow this statement. In case your country does not have one you (as a Midwife) can rely on an interdisciplinary team that is going to get formed in order to help and protect the victim. This team can include psychologists, psychotherapists, social workers, shelter volunteers, pathologists, obstetricians, embryologists and every other possibly related scientist. There could be specialized Midwives that will follow up the monitoring of the pregnancy as the victim takes a distance from the abusive partner.
Conclusion
Domestic Violence can have many faces and people (especially pregnant) can show what they go through very differently. The role of the Midwife is to recognize any unusual behaviors, determine whether those can be outcomes of an abusive and violent relationship and follow all steps needed in order to help the victims.
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Reference list
Alhusen, J.L., Ray, E., Sharps, P. and Bullock, L. (2015). Intimate Partner Violence During Pregnancy: Maternal and Neonatal Outcomes. [online] Journal of Women’s Health. Available at: https://www.liebertpub.com/doi/10.1089/jwh.2014.4872?url_ver=Z39.88-2003&rfr_id=ori%3Arid%3Acrossref.org&rfr_dat=cr_pub++0pubmed&.
Antonakou, A.A. and Papoutsis, D.G. (2019). Obstetric Care in Pregnancy. Broken Hill Publishers Ltd.
Antoniou, E. (2020). Women’s Experiences of Domestic Violence during Pregnancy: A Qualitative Research in Greece. International Journal of Environmental Research and Public Health, 17(19), p.7069.
Antoniou, E. and Iatrakis, G. (2019). Domestic Violence During Pregnancy in Greece. International Journal of Environmental Research and Public Health, 16(21), p.4222.
Chasweka, R. (2018). Isn’t pregnancy supposed to be a joyful time? A cross-sectional study on the types of domestic violence women experience during pregnancy in Malawi. Malawi Medical Journal, 30(3), p.191.
Daley, D., McCauley, M. and van den Broek, N. (2020). Interventions for women who report domestic violence during and after pregnancy in low- and middle-income countries: a systematic literature review. BMC Pregnancy and Childbirth, 20(1).
Findlaw (n.d.). What is the Definition of Domestic Violence? [online] Findlaw. Available at: https://www.findlaw.com/family/domestic-violence/what-is-domestic-violence.html.
Finnbogadóttir, H., Baird, K. and Thies-Lagergren, L. (2020). Birth outcomes in a Swedish population of women reporting a history of violence including domestic violence during pregnancy: a longitudinal cohort study. BMC Pregnancy and Childbirth, [online] 20(1). Available at: https://bmcpregnancychildbirth.biomedcentral.com/articles/10.1186/s12884-020-02864-5 [Accessed 16 May 2021].
Gharacheh, M., Azadi, S., Mohammadi, N., Montazeri, S. and Khalajinia, Z. (2015). Domestic Violence During Pregnancy and Women’s Health-Related Quality of Life. Global Journal of Health Science, [online] 8(2). Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4803975/ [Accessed 27 Aug. 2019].
Hamby, S.L., Finkelhor, D., Turner, H.A., Ormrod, R. and United States. Office Of Juvenile Justice And Delinquency Prevention (2011). Children’s exposure to intimate partner violence and other family violence. Washington, D.C.: U.S. Dept. Of Justice, Office Of Justice Programs, Office Of Juvenile Justice And Deliquency Prevention.
Holden, G.W. (2020). Parenting : a dynamic perspective. Thousand Oaks: Sage Publishing.
Howard, L.M., Oram, S., Galley, H., Trevillion, K. and Feder, G. (2013). Domestic Violence and Perinatal Mental Disorders: A Systematic Review and Meta-Analysis. PLoS Medicine, 10(5), p.e1001452.
Lewis, G., Drife, J.O., Botting, B.J., National Institute For Clinical Excellence (Great Britain, Scotland. Health Department and Northern Ireland. Department Of Health, Social Services, And Public Safety (2001). Why mothers die : 1997-1999 : the fifth report of the confidential enquires into maternal deaths in the United Kingdom. London: Rcog Press.
Marshall, J.E. and Raynor, M.D. (2020). Myles Textbook for Midwives. 16th ed. Edinburgh ; New York: Saunders/Elsevier.
NICE ( National Institute for Health and Clinical Excellence) (2008). Antenatal care: routine care for the healthy pregnant woman. [online] NICE ( National Institute for Health and Clinical Excellence). Available at: https://www.nice.org.uk/.
O’Reilly, R. and Peters, K. (2018). Opportunistic domestic violence screening for pregnant and post-partum women by community based health care providers. BMC Women’s Health, [online] 18(1). Available at: https://bmcwomenshealth.biomedcentral.com/articles/10.1186/s12905-018-0620-2 [Accessed 16 May 2021].
Pirincci, E., Celebi, E. and Durmus, A. (2020). Partner Violence During Pregnancy and its Affecting Factors a Province in Eastern Turkey. Nigerian Journal of Clinical Practice, [online] 23(12), p.1673. Available at: https://www.njcponline.com/article.asp?issn=1119-3077;year=2020;volume=23;issue=12;spage=1673;epage=1682;aulast=Celebi [Accessed 16 May 2021].
United States (2004). Unborn Victims of Violence Act of 2004. Washington, D.C.: U.S. G.P.O.
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