Family Violence

Family violence may be one of America's most widespread health problems and yet one of the least reported. It is of special concern to women, since the great majority of abused adults (over 90%) are women.

Abuse is forceful, controlling behavior that coerces a woman to do what the abuser wants without regard to her rights, body, or health. A woman is defined as abused if she has had intentional, usually repeated, physical or psychological harm done to her by a man with whom she is or has been in an intimate relationship. Abuse can take any of several forms. In most violent relationships, though, mental abuse and "bullying" go along with physical force.

Abuse of women by male partners knows no socioeconomic, racial, ethnic, religious, or age barriers. Abusive episodes are very common in intimate relationships between men and women from all walks of life. And nearly half of those men who batter their female partners do so with brutal regularity-three or more times per year.

The consequences of this abuse can be serious and terrifying: about 20% of the visits made by women to emergency rooms are for injuries related to abuse. And over one-third of female murder victims are killed by their male partners.

Abuse During Pregnancy
Pregnancy can be a time of increased emotional stress for both parents, and abuse often begins or increases during pregnancy. Many pregnant women are abused by their male partners.

Abuse during pregnancy puts both the mother and the fetus at risk. At this time, the abuser is more likely to direct his blows at the woman's breasts and abdomen. Dangers to the fetus may include miscarriage, low birth weight, and direct injury from blows to the mother's abdomen. The fear of harm to her unborn baby often will motivate a woman to change an abusive relationship.

In other cases, abuse may decrease during pregnancy. In fact, some women feel safe only when they are carrying a child. They know from experience that "he never hits me when I'm pregnant." This may lead to repeated pregnancies as a way of escaping abuse.

The Cycle of Abuse
Many abused women find themselves caught up in a cycle of abuse that follows a common pattern in many relationships. Unless the woman takes some sort of action to break the cycle, the violent incidents usually become more frequent and more severe over time.

Women who have a history of family violence, sexual assault or incest, or physical abuse from a male partner are at increased risk of being in an abusive relationship.

Is your current relationship "safe"?

Disagreements and arguments, even heated ones, are often a part of a normal relationship; physical violence or other abusive behavior is not. Everyone has a right to get angry. But no one has the right to express anger violently, and to hurt you. Does your partner ever

• Frighten you with threats of violence or by throwing things when he is angry?
• Say it's your fault if he hits you?
• Promise it won't happen again, but it does? A "yes" answer indicates that you may be involved in an unhealthy relationship. Remember: no woman deserves to be abused. There are alternatives to living in a violent relationship. There are people who can help you sort things out, decide what you would like to change about your life.

If You Are a Victim of Violence: Getting Help
The first step in breaking a violent pattern in a relationship is to tell someone. Let someone know about your situation so you can contact them in case you need to leave a dangerous situation. The person you tell may be a nurse or doctor, counselor or social worker, a close friend or family member, or a clergy member.

At first, you may find it hard to talk about the abuse. But many abused women feel a great sense of relief-and some sense of safety-once they have confided their problem to someone outside the home.

Feelings of shame are common at this point. Keep in mind that no one deserves to be abused. Violent behavior is the responsibility of the one who is violent, not the victim. There are things you can do, though, to change the situation.

If you think you may be involved in a relationship that threatens your well-being or that of your children, start the communication process. Talk to your doctor or nurse. Seek out a friend or counselor. If you know you are involved in an abusive relationship, talk to someone right away, and devise an exit plan to safeguard your well-being and that of your children.

Remember, no one deserves to be abused. It may be scary at first, but you can change your life for the better. You are not alone.

Source: Patient education material from the American College of Obstetrics and Gynecology was used as a source of information to develop the content for this topic.