Intimate partner violence during pregnancy

Beyond the physical trauma and sexual abuse, the mental health consequences are substantial and could contribute both directly and indirectly, to many negative maternal health outcomes including anxiety, panic attacks, and depression, affecting both mother and baby

Intimate partner violence (IPV) – also commonly referred to as domestic violence – is endemic in Sri Lanka with one in four (24.9%) women have experienced physical and/or sexual violence since age 15 by a partner or non-partner in Sri Lanka. IPV is the most common form of violence, impacting millions of women worldwide. COVID-19 lockdown and travel restrictions have disrupted women’s access to life-saving sexual and reproductive health services and have further exacerbated the prevalence of gender-based violence (GBV). The pandemic has also hampered authorities’ ability to respond to GBV, at a time when women and girls need these services the most - affecting the health and well-being of mothers and newborns.  

Physical, sexual, or psychological harm by a spouse or partner is a major factor in maternal and reproductive health that could even lead to maternal mortality. For example, women suffering from intimate partner violence are less likely to use or even have a say in using contraception, which could likely lead to unplanned pregnancies. Beyond the physical trauma and sexual abuse, the mental health consequences are substantial and could contribute both directly and indirectly, to many negative maternal health outcomes including anxiety, panic attacks, and depression, affecting both mother and baby.  

UNFPA, together with the Sri Lanka College of Obstetricians and Gynaecologists recently hosted a collaborative panel discussion on Intimate Partner Violence (IPV) as a well-recognized determinant of the health of individuals, particularly in pregnancy. IPV continues to be perpetrated during pregnancy and sometimes starts for the first time in pregnancy.   

Literature abounds with evidence of negative consequences such as abortion, preterm labour, intrauterine death, abruption, growth restriction, and an association with suicide and homicide during pregnancy. The objective of this session was to capacitate the participants of the congress, Obstetricians, and postgraduates from Sri Lanka and SAFOG countries on identifying and addressing Intimate Partner Violence in the Obstetric Practice”.  
We should be trained to look at the root causes: Dr. Shantha Kumari, President FOGSI, Consultant Obstetrician and Gynaecologist

“We are trained to focus on symptoms, but we should be trained to look at the root causes that often include the most shameful and most pervasive Violence Against Women (VAW). Look beyond the symptoms and be an empathetic person who understands women’s health. No girl or boy should grow up thinking it is ok for violence and we need to engage men in order to break this cycle”.   
We are still in the Stone Age in relation to our understanding of IPV: Dr. Sarada Hemapriya, Consultant Obstetrician and Gynaecologist

“Often ignored is the indifference of the partner after delivery. In this instance, if there are post-partum medical complications, the mother’s health is threatened because the partner will ignore the issues and refuse to take her for medical care and assistance. Though we as medical professionals use iPads these days, we are still in the Stone Age in relation to our understanding and repercussions of IPV”.  
Midwives can play a bigger role: Dr. Nethanjalie Mapitigama, Programme Manager, Gender and Health Unit FHB, Ministry of Health

“In this current context, the midwives are key to detecting and bringing attention to situations of IPV as they are in close contact with the pregnant person over a period of time. Also, in a situation where funding needs prioritization, this service can easily identify IPV situations and take appropriate measures”.   
Pregnancy is a time that provides a unique opportunity to identify women in abusive relationships: UNFPA Representative Kunle Adeniyi 

“As the United Nations’ sexual and reproductive health agency and the agency leading on GBV prevention, the session provided a unique platform to discuss the inter linkages between Intimate Partner Violence, maternal health, and the harmful impact it has on the health of women 
and girls. Pregnancy, including during pre-pregnancy and postpartum, is a time that brings women into the healthcare system, provides a unique opportunity to identify women in abusive relationships through a process of screening and discussions, and allows health professionals to provide emotional and other necessary 
supportive measures”