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Experiences of violence are common for women and affect pregnancy and childbearing in a myriad number of ways. How a woman may be affected is as individual as she is and depends on the type of violence she experienced, for what duration, what type of support she received at the time and continues to receive and numerous other factors. It is important that women know that they are not alone as it is essential that caregivers, nurses, doulas, therapists, social workers, policy makers, police and others become actively involved in educating themselves on how to best support women who are victims or survivors of violence in their lives. The silence that surrounds childhood sexual assault, incest, intimate partner violence, woman abuse and systematic oppression needs to be broken in order for healing to take place. This wiki is an avenue for speaking up and out as it is a tool for those who wish to educate themselves and contribute to the growing body of information on how to optimally ensure the health and well-being for mother and child when violence and abuse are or have been present in their lives.
Not only can violence escalate during pregnancy, it can begin during a pregnancy or even in the postpartum period. Some women experience traumatic births that include interventions such as episiotomies they didn't want or felt weren't needed. Past traumatic experiences with childhood sexual abuse or rape may resurface during the childbearing year and be triggered by multiple sources. It may not be easy for the survivor to understand where her feelings are coming from, especially if she blocked out the memory of the event.
In considering these dynamics, what can be done by women and those who support her to ensure the best possible outcomes?
A woman can find a caregiver that she is comfortable with and feels respected by. This may mean speaking to a few or changing an established physician/midwife if they are not willing to be flexible and work with her. Ideally, if she found a caregiver that she was able to have a mutually respectful relationship with and she was comfortable with disclosure, she could tell them and ask them to support her in her wishes to whatever degree necessary. Some caregivers are very flexible with this and others are more rigid. Each individual woman will have to define her own comfort level. This pregnancy and birth can be a healing and empowering experience if she feels supported, is a partner in making informed decisions about her care, and is respected as knowing what is best for her.
She may enlist the support of loved ones, trusted friends or a doula to honor her birth plan and nurture her during this powerful time. A wonderful book by Penny Simkin is called The Birth Partner: Everything You Need to Know to Help a Woman Through Childbirth. This book is packed with information that will help a support person know what to expect and how to provide comfort measures in labor. Doulas can be found through local organizations or national organizations. Word of mouth is often a great way to find a doula or another woman who has experience attending women during their birth. Caregivers such as midwives and physicians, childbirth educators or prenatal yoga instructors may know of doulas in your area.
In our culture, media and belief systems, blame has been heavily shifted onto the victim. It is important that we work to deconstruct this and place blame where it belongs, on the perpetrator.perpetrator and the social belief systems that are at the core. We need to consider as well that those who make the rules and laws are those with the most power, and these statutes benefit them, not those who are powerless. This system makes it very difficult for victims to experience justice. Perpetrators of sexual assault and violence do not fit a certain profile and neither do their victims. The belief that victims "should have known better" than to be doing whatever they were doing, wearing whatever they were wearing or being wherever they were is erroneous. There is no right way to exist in order to prevent rape or sexual assault because the control is not in the victim's court. The blame is not theirs, it is the perpetrator's. It would be severely mentally disturbing and unhealthy for any individual to attempt to live in such manner as to not attract an assault because, as the statistics demonstrate, this would be impossible.
Responding to Abuse During Pregnancy from the National Clearinghouse on Family Violence. This is Canadian though it souces American journals. It is a comprehensive resource and applicable beyond the border. Canada is more progressive in addressing this issue and it could be questioned whether American statistics might be even worse than theirs given the weaker social support system in place, the deeper silence, the continuing violence, wars, occupations, the high poverty and crime rates here and on and on ...
Definitions
CAPPA - Childbirth and Postpartum Professional Association: CAPPA's mission is to offer comprehensive, evidence-based education, certification, professional membership and training to childbirth educators, lactation educators, labor doulas, antepartum doulas and postpartum doulas. CAPPA certified professionals aim to empower, connect and advocate for families in the childbearing year.
DONA - Doulas of North America: We would like every woman who wants a doula to have one. We also want doulas to be well prepared for their important role. Our mission is to provide training and certification opportunities for doulas of varied cultures, educational backgrounds, ethnic backgrounds and socio-economic levels. Also, we aim to educate health care providers, the public and third-party payers of the benefits of a doula’s presence during childbirth and postpartum.
ICTC - International Center for Traditional Childbearing: ICTC is a non-profit, culturally diverse, pregnancy support, health promotion and training organization. We offer prenatal and parenting classes, doula services/training's and complete pregnancy support. As a whole, we strive to positively impact the lives of the unborn, newborn, mothers, fathers and their families; through education, breastfeeding promotion, and overall self-care. We are fully committed to the empowerment of women, increasing positive birth outcomes and decreasing infant mortality in African American Communities. Impart: We strive to follow the moral and ethical guidance of our learned Midwives and Healers of past.
Operation Special Delivery - provides trained volunteer doulas for pregnant women whose husbands or partners have been severely injured or who have lost their lives due to the current war on terror, or who will be deployed at the time that they are due to give birth.
When Survivors Give Birth by Penny Simkin workshop at Seattle Midwifery School
When Survivors Give Birth book by Penny Simkin
Helping Her Get Free by Susan Brewster
Conquest: Sexual Violence and American Indian Genocide by Andrea Smith
Color of Violence: the incite! anthology edited by INCITE! WOMEN OF COLOR AGAINST VIOLENCE
Incite! Women of Color Against Violence
Trauma and Recovery by Judith Herman
Trauma Stewardship: An everyday guide to caring for self while caring for others by Laura van Dernoot Lipsky with Connie Burk
Survivors of Childhood Sexual Abuse: Implications for Perinatal Nursing Care by Debra Hobbins 2004
Trauma and the Body by Pat Ogden, Keduni Minton, Clare Pain
National Advocates for Pregnant Women
Our Choices, Our Lives: Unapologetic Writings on Abortion edited by Krista Jacob
Culture & Clinical Care edited by Juliene G. Lipson and Suzanne L. Dibble
Washington State Domestic Violence and Pregnancy Facts
Perinatal Domestic Violence Identification Services: A Guide Toward Culturally Relevant Care in Health Clinics
Domestic Violence During Pregnancy on Babycenter.com
Domestic Violence and Pregnancy: Guidelines for Screening and Referral
Pregnancy Risk Assessment Monitoring System
Not only can violence escalate during pregnancy, it can begin during a pregnancy or even in the postpartum period. Some women experience traumatic births that include interventions such as episiotomies they didn't want or felt weren't needed. Past traumatic experiences with childhood sexual abuse or rape may resurface during the childbearing year and be triggered by multiple sources. It may not be easy for the survivor to understand where her feelings are coming from, especially if she blocked out the memory of the event.
In considering these dynamics, what can be done by women and those who support her to ensure the best possible outcomes?
A woman can find a caregiver that she is comfortable with and feels respected by. This may mean speaking to a few or changing an established physician/midwife if they are not willing to be flexible and work with her. Ideally, if she found a caregiver that she was able to have a mutually respectful relationship with and she was comfortable with disclosure, she could tell them and ask them to support her in her wishes to whatever degree necessary. Some caregivers are very flexible with this and others are more rigid. Each individual woman will have to define her own comfort level. This pregnancy and birth can be a healing and empowering experience if she feels supported, is a partner in making informed decisions about her care, and is respected as knowing what is best for her.
She may enlist the support of loved ones, trusted friends or a doula to honor her birth plan and nurture her during this powerful time. A wonderful book by Penny Simkin is called The Birth Partner: Everything You Need to Know to Help a Woman Through Childbirth. This book is packed with information that will help a support person know what to expect and how to provide comfort measures in labor. Doulas can be found through local organizations or national organizations. Word of mouth is often a great way to find a doula or another woman who has experience attending women during their birth. Caregivers such as midwives and physicians, childbirth educators or prenatal yoga instructors may know of doulas in your area.
In our culture, media and belief systems, blame has been heavily shifted onto the victim. It is important that we work to deconstruct this and place blame where it belongs, on the perpetrator.perpetrator and the social belief systems that are at the core. We need to consider as well that those who make the rules and laws are those with the most power, and these statutes benefit them, not those who are powerless. This system makes it very difficult for victims to experience justice. Perpetrators of sexual assault and violence do not fit a certain profile and neither do their victims. The belief that victims "should have known better" than to be doing whatever they were doing, wearing whatever they were wearing or being wherever they were is erroneous. There is no right way to exist in order to prevent rape or sexual assault because the control is not in the victim's court. The blame is not theirs, it is the perpetrator's. It would be severely mentally disturbing and unhealthy for any individual to attempt to live in such manner as to not attract an assault because, as the statistics demonstrate, this would be impossible.
Responding to Abuse During Pregnancy from the National Clearinghouse on Family Violence. This is Canadian though it souces American journals. It is a comprehensive resource and applicable beyond the border. Canada is more progressive in addressing this issue and it could be questioned whether American statistics might be even worse than theirs given the weaker social support system in place, the deeper silence, the continuing violence, wars, occupations, the high poverty and crime rates here and on and on ...
Definitions
- Woman Abuse: any act of gender-based violence that results in, or is likely to result in, physical, sexual or psychological harm, or suffering to women, including threats of such acts, coercion or arbitrary deprivation of liberty, whether occurring in public or private life. Woman abuse can be physical: punching, kicking, choking, stabbing, mutilation, disabling, murder; sexual: rape, any unwanted touching or act of a sexual nature, forced prostitution; verbal/psychological: threats to harm the children, destruction of favourite clothes or photographs, repeated insults meant to demean and erode self-esteem, forced isolation from friends and relatives, threats of further violence or deportation if the woman attemts to leave; stalking: persistent and unwanted attention, following and spying, monitoring of mail or conversations; financial: taking away a womans wages or other income, limiting or forbidding access tot he family income, and other forms of control and abuse of power.
- Childhood Sexual Abuse: "A child (anyone under 16 years) is sexually abused when another person, hwo is sexually more mature, involves the child in any activity which the other person expects to lead to their sexual arousal. This might involve intercourse, touching, exposure of the genital organs, showing pornographic material, or talking about sexual things in an erotic way." Child sexual abuse is the sexual use of a child by someone with more power. The vast majority of child sexual abuse happens in situations where the child trusts or is dependent upon the offender.
- Rape: Forced or coerced penetration or contact between the mouth, genitals or anus with any object, no matter how slight
- Consent: Someone who is drunk, drugged, incapacitated or under the age of consent cannot legally give consent
Statistics
- Somewhere in the U.S. a woman is raped every two minutes
- 66% of rape victims know their assailant
- 93% of sexual assault victims under the age of18 know the perpetrator
- of these, 34.2% were family members and 58.7% acquaintances - Only seven percent of the perpetrators were strangers to the victim
- While about 80% of all victims are white, minorities are somewhat more likely to be attacked:
- In 2002, seven out of every eight rape victims were female
- Homicides of women while they are pregnant is a leading cause (in some studies, homicide is the leading cause) of death during pregnancy
- 20% of women who die from pregnancy-associated deaths are murdered
- 30% of all homicides of women are committed by intimate partners - usually after they have separated - making leaving dangerous
- More than 8% of pregnant women report physical violence in pregnancy by intimate partners or family members
- 30% of lesbians report having experienced sexual assault or rape by another woman
- Females accounted for 39% of the hospital emergency department visits for violence-related injuries in 1994 but were 84% of the persons treated for injuries inflicted by intimates.
Important facts about domestic violence and woman abuse:
Jodi Hinds has an easy to reference Woman Abuse in the Childbearing Year Power and Control Wheel on her A Safe Passage website. The American College of Obstetricians and Gynecologists have a domestic violence brochure with a lot of facts in it here.Impacts on Mothers:
Pregnancy carries with it many biological, psychological and social stresses for most women. Her whole life may be changing. The added stress of being abused has numerous ramifications for her and her child's lifelong well-being. Just as nutrition in pregnancy impacts a child for a lifetime, maternal stress can impact a child's physiological, psychological and physical development.-
Women of Color
- Women of color experience the greatest amount of all forms of violence from that in an intimate partner relationship to that perpetrated through systematic oppression that pervades our institutions and society. Experiencing racism at a constant level has now formally been attributed to preterm births and low birth weight babies. Because of economic oppression, women of color are most likely to live in communities and work at jobs that maximize exposure of environmental toxins in their lives. This type of environmental racism is a further contributor to what may cause the maternal and infant well-being disparities experienced by such communities. Women of color experience regular violence perpetrated by the criminal justice system. The long history of rape, murder and torture of women of color through the colonizers conquest and later slavery are evident today. The continued trafficking of women is one of the more obvious forms that continue today. Of the more subtle forms include the reproductive health policies that target these women for sterilization without their consent and other atrocities that have been experienced in the not so distant past. Even if these practices are being curbed (they usually are not public until after the fact and even then, they are not widely spread), women of color are still targeted for forms of birth control with the greatest risks attached such as Depo, Norplant and Quinicrine that have sterilizing effects of their own. All of these forms of violence significantly impact a woman's childbearing experience. Since the origins of violence have a long history that today's dominant belief systems are rooted in, no matter how subtly, these beliefs are often held by many of the individuals who come into contact in a "helping" capacity during the childbearing year. The parallels of the violations experienced against these woman are not acknowledged because they are systematic, normalized, minimized and otherwise, under the surface. This fact, that the perpetrators are often the ones who make the rules and deny blame for their consequences, applies to the other specific categories of mothers below.
- Women of color experience the greatest amount of all forms of violence from that in an intimate partner relationship to that perpetrated through systematic oppression that pervades our institutions and society. Experiencing racism at a constant level has now formally been attributed to preterm births and low birth weight babies. Because of economic oppression, women of color are most likely to live in communities and work at jobs that maximize exposure of environmental toxins in their lives. This type of environmental racism is a further contributor to what may cause the maternal and infant well-being disparities experienced by such communities. Women of color experience regular violence perpetrated by the criminal justice system. The long history of rape, murder and torture of women of color through the colonizers conquest and later slavery are evident today. The continued trafficking of women is one of the more obvious forms that continue today. Of the more subtle forms include the reproductive health policies that target these women for sterilization without their consent and other atrocities that have been experienced in the not so distant past. Even if these practices are being curbed (they usually are not public until after the fact and even then, they are not widely spread), women of color are still targeted for forms of birth control with the greatest risks attached such as Depo, Norplant and Quinicrine that have sterilizing effects of their own. All of these forms of violence significantly impact a woman's childbearing experience. Since the origins of violence have a long history that today's dominant belief systems are rooted in, no matter how subtly, these beliefs are often held by many of the individuals who come into contact in a "helping" capacity during the childbearing year. The parallels of the violations experienced against these woman are not acknowledged because they are systematic, normalized, minimized and otherwise, under the surface. This fact, that the perpetrators are often the ones who make the rules and deny blame for their consequences, applies to the other specific categories of mothers below.
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Bi, Lesbian, Trans and Queer Gender
- Women are often discounted as abusers and this can make it difficult for individuals abused by women to get the services that they need. Someone who is abused by a woman, trans or queer gendered partner may be seen as less of a priority than women who are battered by men.
- Women are often discounted as abusers and this can make it difficult for individuals abused by women to get the services that they need. Someone who is abused by a woman, trans or queer gendered partner may be seen as less of a priority than women who are battered by men.
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Women Living with Disabilities
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Homeless Women
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Adolescents
- Adolescents face special challenges in a culture that labels them as naive. They have much of their autonomy taken from them in the system. They are also the age group experiencing the highest rate of sexual victimization. Lawmakers and adults seem to have a belief that they can protect adolescents by keeping vital information from them about their sexuality and reproductive health versus arming them with accurate and accessible information and services related to their sexuality. The ultimate outcome is a devalued youth whose health and lives are endangered by policies that strip them of respect, dignity and a capacity for independent decision making. The Facts on Teenagers and Intimate Partner Violence
- Adolescents face special challenges in a culture that labels them as naive. They have much of their autonomy taken from them in the system. They are also the age group experiencing the highest rate of sexual victimization. Lawmakers and adults seem to have a belief that they can protect adolescents by keeping vital information from them about their sexuality and reproductive health versus arming them with accurate and accessible information and services related to their sexuality. The ultimate outcome is a devalued youth whose health and lives are endangered by policies that strip them of respect, dignity and a capacity for independent decision making. The Facts on Teenagers and Intimate Partner Violence
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Undocumented Immigrant Women
- Immigrant women are often in a vulnerable position as they can be exploited by those who bring them into this country, partners, employers, landlords and others who exercise power over them. If a language barrier exists, they are even more vulnerable. Many undocumented immigrant women are not aware of special protections afforded them when they are crime victims or witnesses of crime and they report these crimes. Even with these safeguards in place, the current political climate may not always ensure that they are protected under the laws and may face deportation as the legal system is cryptic with many law enforcement and ICE (immigration and customs enforcement) officers don't usually take the time to inform undocumented immigrants and detainees of their rights. It is common for those of them who are abused to suffer in silence under threats by their abuser of reporting them. The Facts on Immigrant Women and Domestic Violence
- Immigrant women are often in a vulnerable position as they can be exploited by those who bring them into this country, partners, employers, landlords and others who exercise power over them. If a language barrier exists, they are even more vulnerable. Many undocumented immigrant women are not aware of special protections afforded them when they are crime victims or witnesses of crime and they report these crimes. Even with these safeguards in place, the current political climate may not always ensure that they are protected under the laws and may face deportation as the legal system is cryptic with many law enforcement and ICE (immigration and customs enforcement) officers don't usually take the time to inform undocumented immigrants and detainees of their rights. It is common for those of them who are abused to suffer in silence under threats by their abuser of reporting them. The Facts on Immigrant Women and Domestic Violence
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Incarcerated Women
- It is well documented that women who were sexually victimized in childhood are twice as likely to be revictimized in adulthood. A large number of incarcerated women have experienced multiple forms of lifetime violence. Physical and sexual violence within correctional facilities is widespread and poorly addressed despite the growing awareness around the issue. Women of childbearing age are the fastest growing population in the system. This is a result of drug policies and again, racism. Two-thirds of women of color with similar drug charges as white women are in prison while their counterparts enjoy being surveilled via probation. These women face ultra-dehumanizing conditions when they give birth in prisons, often alone with a male prison guard with a gun watching them. They, like other women who experience a greater degree of systematic oppression, are often treated like guinea pigs for students and others.
- It is well documented that women who were sexually victimized in childhood are twice as likely to be revictimized in adulthood. A large number of incarcerated women have experienced multiple forms of lifetime violence. Physical and sexual violence within correctional facilities is widespread and poorly addressed despite the growing awareness around the issue. Women of childbearing age are the fastest growing population in the system. This is a result of drug policies and again, racism. Two-thirds of women of color with similar drug charges as white women are in prison while their counterparts enjoy being surveilled via probation. These women face ultra-dehumanizing conditions when they give birth in prisons, often alone with a male prison guard with a gun watching them. They, like other women who experience a greater degree of systematic oppression, are often treated like guinea pigs for students and others.
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Military Women
Impacts on Embryo/Fetus
Fetuses have a memory of their time in the womb. In our recent past, many believed that memory and cognitive development didn't really begin until birth but researchers are disproving this as they show that behavioral patterns are well established before this time.Impacts on Child
Impacts on Society
Women who experience abuse are 3 times more likely to take time off from their everyday activites. The estimates of the costs of healthcare range from $ 4-6 billion. Beyond the monetary costs, their is a psycological and social dis-ease when violence prevails in women and children's lives to the extent that it does. The silence and violence not only harms the victims and survivors, but also the perpetrators as they are unable to experience healthy and meaningful relationships with the women and children in their lives. By every segment of society acknowledging that they are perpetrators, victims, survivors and witnesses of violence in some form, the cycle can begin to be dismantled. We can ask the question of ourselves, "What is community? What do we want in our communities? What changes do we need to implement in order to make this a reality?"Help! Resources for Safety
In Washington State:- Washington State Domestic Violence Hotline: V/TTY: 1 (800) 562-6025 (24 hours/day)
WAVAW Network - Washington Violence Against Women Network - Connecting community through technology to enhance domestic violence and sexual assault services: through connecting the general public to resources & local programs while connecting local programs to each other, to resources. Includes support resources for financial assistance, housing, parenting and therapy.
- WCSAP - Washington Coalition of Sexual Assault Programs
- Community Sexual Assault Programs in Washington State - All of these sexual assault programs offer the following services to survivors of sexual violence, their friends and family, and others who request information whether you or someone you know is in crisis or seeking help after a sexual assault (whether recent or many years in the past): crisis intervention; legal, medical and general advocacy; information & referral; system coordination; and prevention services
- NW Network - increases communities' ability to support the self-determination and safety of bisexual, transgendered, lesbian, and gay survivors of abuse through education, organizing and advocacy. Services are free. Phone: (206) 568-7777 TTY: (206) 517-9670
- Crisis Clinic - provides crisis counseling over the phone (24 hours a day) and resources referrals at their 211 in some locations. Phone: 1(866) 4CRISIS TTY/TDD: 1(206) 461-3219
- Parent Trust for Washington Children - Provide free support and information line for families. Support group for parents, caregivers, teens and children. Classes for new dads. Pregnancy and birth education. Family Help Line: 1 (800) 932-HOPE
- National Center on Domestic and Sexual Violence - National Domestic Violence Hotline: 1 (800) 799-SAFE and National Sexual Assault Hotline: 1 (800) 656-HOPE
- NSVRC - National Sexual Violence Resource Center - Serves as the nation's principle information and resource center regarding all aspects of sexual violence. The NSVRC works to address the cause and impact of sexual violence through collaboration, prevention efforts and the distribution of resources.
Finding a Doula
ALACE - Association of Labor Assistants & Childbirth Educators: ALACE is an international nonprofit organization dedicated to supporting women's choices in childbirth. Our goal is to help women reclaim trust in their ability to safely and dependably give birth.CAPPA - Childbirth and Postpartum Professional Association: CAPPA's mission is to offer comprehensive, evidence-based education, certification, professional membership and training to childbirth educators, lactation educators, labor doulas, antepartum doulas and postpartum doulas. CAPPA certified professionals aim to empower, connect and advocate for families in the childbearing year.
DONA - Doulas of North America: We would like every woman who wants a doula to have one. We also want doulas to be well prepared for their important role. Our mission is to provide training and certification opportunities for doulas of varied cultures, educational backgrounds, ethnic backgrounds and socio-economic levels. Also, we aim to educate health care providers, the public and third-party payers of the benefits of a doula’s presence during childbirth and postpartum.
ICTC - International Center for Traditional Childbearing: ICTC is a non-profit, culturally diverse, pregnancy support, health promotion and training organization. We offer prenatal and parenting classes, doula services/training's and complete pregnancy support. As a whole, we strive to positively impact the lives of the unborn, newborn, mothers, fathers and their families; through education, breastfeeding promotion, and overall self-care. We are fully committed to the empowerment of women, increasing positive birth outcomes and decreasing infant mortality in African American Communities. Impart: We strive to follow the moral and ethical guidance of our learned Midwives and Healers of past.
Operation Special Delivery - provides trained volunteer doulas for pregnant women whose husbands or partners have been severely injured or who have lost their lives due to the current war on terror, or who will be deployed at the time that they are due to give birth.
Resources for Learning More About Supporting Survivors
A Safe Passage: Supporting Women Survivors Through the Childbearing Year workshop and training by Jodi Hinds
When Survivors Give Birth by Penny Simkin workshop at Seattle Midwifery School When Survivors Give Birth book by Penny Simkin
Helping Her Get Free by Susan Brewster
Conquest: Sexual Violence and American Indian Genocide by Andrea Smith
Color of Violence: the incite! anthology edited by INCITE! WOMEN OF COLOR AGAINST VIOLENCE
Incite! Women of Color Against Violence
Trauma and Recovery by Judith Herman
Trauma Stewardship: An everyday guide to caring for self while caring for others by Laura van Dernoot Lipsky with Connie Burk
Survivors of Childhood Sexual Abuse: Implications for Perinatal Nursing Care by Debra Hobbins 2004
Trauma and the Body by Pat Ogden, Keduni Minton, Clare Pain
National Advocates for Pregnant Women
Our Choices, Our Lives: Unapologetic Writings on Abortion edited by Krista Jacob
Culture & Clinical Care edited by Juliene G. Lipson and Suzanne L. Dibble
Washington State Domestic Violence and Pregnancy Facts
Perinatal Domestic Violence Identification Services: A Guide Toward Culturally Relevant Care in Health Clinics
Domestic Violence During Pregnancy on Babycenter.com
Domestic Violence and Pregnancy: Guidelines for Screening and Referral
Pregnancy Risk Assessment Monitoring System
