Understanding Intimate Partner Violence

Intimate partner violence (IPV) affects hundreds of thousands of women. But the true number may be much higher because many women may not report it. Partner violence often starts or gets worse during and after pregnancy. This may be from the stress of pregnancy and a new baby. IPV can result in pregnancy complications, poor postpartum care, and poor health of the baby.

You may feel alone if you are experiencing intimate partner violence during or after your pregnancy but know that you’re not. It’s far more common than you think. And there’s help and hope. Talk with your healthcare provider if you are not safe.

Types of intimate partner violence

Most people think of IPV as just physical abuse. While it does often include physical abuse, IPV can be emotional and sexual abuse. These other forms of abuse are sometimes harder to see. This is especially true for emotional abuse, because it can distort your own viewpoint.

  • Physical abuse includes using physical force to hurt or disable a partner. It can include throwing objects, pushing, kicking, biting, slapping, strangling, hitting, or beating.
  • Emotional abuse includes making threats and controlling money or other resources. It’s anything that erodes a person’s sense of self-worth. It may look like name-calling, blaming, and stalking. It can also include isolation from friends, family, and even access to healthcare.
  • Sexual violence includes rape, unwanted kissing, and forced touching. It also includes reproductive coercion. This is holding power and control over the woman’s reproductive health. It may look like efforts to sabotage contraception, having unsafe sex to purposefully expose the woman to sexually transmitted infections. It may also include forced abortion or injuries to cause a miscarriage.

Are you at risk for IPV?

IPV affects all genders, races, ethnicities, and social and economic statuses. But some people are at greater risk for being a victim or an abuser. Certain factors can increase the risk for IPV.

Individual factors

  • Having low self-esteem, being emotional dependent, insecure, and jealous

  • Having low income or being unemployed, having recent job loss or job instability

  • Being younger

  • Using alcohol or drugs

  • Being depressed, angry, having PTSD, or being hostile towards women

  • Having a history of abusing others, being abused, or witnessing abuse

  • Having poor problem-solving skills

  • Having poor impulse control

  • Being a Native Indian, Alaska Native, or African-American woman

Relationship factors

  • Marital or relationship conflict, frequent fighting

  • Having a jealous or possessive partner

  • Having control issues

  • Being under economic stress

  • Having poor social support

  • Having income inequality

It often helps to ask yourself these questions from the March of Dimes to know if you are in an abusive relationship:

  • Does my partner always put me down and make me feel bad about myself?

  • Has my partner caused harm or pain to my body?

  • Does my partner threaten me, the baby, my other children, or himself?

  • Does my partner blame me for his actions? Does he tell me it's my own fault he hit me?

  • Is my partner becoming more violent as time goes on?

  • Has my partner promised never to hurt me again, but still does?

If you answered "yes" to any of these questions, you may be in an unhealthy relationship.

If you recognize yourself or your partner in any of these descriptors, talk with your healthcare provider to get help. If you are in danger, they can help you develop a safety plan.

Health effects

IPV during or after pregnancy can cause physical and emotional health effects, pregnancy complications, poor outcomes, and injury and harm to the baby after birth.

During pregnancy

  • Physical injuries, such as bruises, cuts, or broken bones

  • Vaginal bleeding or pelvic pain

  • Early labor and delivery

  • Tearing of the placenta (placental abruption)

  • Maternal death

Infant health

  • Low infant birth weight

  • Infant who needs care from a newborn intensive care unit

  • Broken bones

  • Death of newborn

After birth

After birth, the mother may:

  • Have pain and other long-term health conditions

  • Develop postpartum depression (2 to 3 times greater risk)

  • Have high-risk sexual behaviors

  • Use harmful substances

  • Have unhealthy diet and lifestyle, such as eating disorders

Abuse is never OK. One in 6 abused women are first abused during pregnancy, when it’s dangerous to both you and your developing baby. Recognizing that you are in an abusive relationship is the first step to help. See your healthcare provider or someone else you trust who can help you develop a safety plan.

What to expect from your healthcare provider

It can be hard to bring up partner violence with your healthcare provider. But it’s an important first step in getting help. Rest assured, your conversation is confidential. They are a nonjudgmental health professional. They likely have other patients with similar problems and recognize the difficulty of the situation. Your provider may ask you questions, such as:

  • Do you feel safe in your relationship?

  • Do you have a safe place to go in an emergency?

  • Do conflicts ever turn into physical fights?

Answer honestly and completely. There will be no pressure to disclose the abuse or to press charges. They won’t ask about the abuse in front of a partner, friends, or family. The goal is to help you access help when you are ready.

Call 911

If you feel your safety is in jeopardy now, call 911 or the police.

For more help

If the person who hurt you is your partner or spouse and your situation can become dangerous again, it's vital to make a safety plan. There are resources and organizations that can help you.