During Domestic Violence Awareness Month in October, The American College of Obstetricians and Gynecologists (ACOG) calls attention to the 2 million women in the US who are physically or sexually assaulted by an intimate partner each year. Domestic, or intimate partner, violence is an ongoing public health problem that accounts for 22% of all violent crimes against women.
As experts in women’s health, ob-gyns know that any woman can be the victim of abuse, no matter her age, sexual orientation, or socioeconomic, racial, ethnic, or religious background. The effects of intimate partner violence are devastating to women, their families, and society.
Women may be subjected to numerous forms of abuse, including threatened or actual physical, sexual, psychological, financial, or emotional trauma doled out by the abuser—usually a spouse, partner, or relative—in a deliberate, repetitive, and unpredictable manner. Many women live in fear of retaliation from their abuser or police involvement, or are too embarrassed to speak out or try to break free from the abuse.
Because ob-gyns see most of their patients on a routine basis, they have many opportunities to identify victims of intimate partner violence. While some women need treatment for physical injuries to the genitalia or the reproductive system, the majority of abused women exhibit more subtle symptoms. Vague ailments, such as headache or chronic pelvic pain, excessive distress during routine gynecologic examinations, recurrent STDs due to partner infidelity, and unintended pregnancy from forced sex can all be signs of abuse. Women may also experience posttraumatic stress disorder or battered woman syndrome, which can lead to depression, anxiety disorders, substance abuse, physical problems, and suicide.
The prevalence of domestic violence is alarming, and because there is no “typical” profile of an abused woman, ACOG recommends that all women be screened for intimate partner violence. Ob-gyns may conduct these screenings for non-pregnant women during preconception care, family planning, and routine ob-gyn visits. Several inquiries may be necessary to uncover domestic violence during pregnancy, a time when abuse often accelerates. Therefore, ACOG recommends pregnant women be screened at the first prenatal visit, at least once per trimester, and again at the postpartum follow-up.
If ob-gyns discover abuse in their patients, they can acknowledge the abuse, assess the immediate safety of patients and their children, help establish a safety plan, and go over the options that women may have. Ob-gyns can also offer women educational materials, information on local resources, referrals to counselors and other organizations, and further support at subsequent office visits.
Intimate partner violence can be a life or death matter. Women do not have to stay in a dangerous situation and continue to be victimized. ACOG encourages women to talk to their ob-gyns and take steps to get help.