Addressing violence against women and achieving the Millennium Development Goals
MDG 5: Improve maternal health
Partner violence during pregnancy is widespread and has significant consequences for maternal health. A review of research on the prevalence and consequences of abuse during pregnancy published in 2004 found that prevalence ranged from 4% to 32%, with rates being considerably higher in developing countries (23). The review found that in at least two industrialized countries with low overall maternal mortality rates, the United Kingdom of Great Britain (UK) and the United States of America (USA), partner violence was a significant cause of maternal death – in fact, in three major cities in the USA, it was the leading cause, responsible for as many as 20% of maternal deaths (23).
In addition to death, the consequences of partner violence may have both short- and long-term physical and psychological impacts (24). Whereas physical injury can be an immediate and visible consequence of violence, STIs and gynaecological problems, including for example, chronic pelvic pain are consistently associated with abuse. Mental health problems resulting from violence that would affect maternal health include depression, post-traumatic stress syndrome, feelings of helplessness, and alcohol and substance abuse (3,24). Efforts to improve maternal health should include measures to reduce partner-violence against women.
Reproductive health services, particularly antenatal clinics, are the most widely used points of contact between women and health systems in many parts of the world. Given that the prevalence of violence against pregnant women is higher than that of other conditions (e.g. pre-eclampsia) for which pregnant women are routinely screened, such services offer important opportunities for identifying possible signs of intimate-partner violence and for beginning the process of identifying, supporting and referring women who are being abused to appropriate services. Providers of reproductive health care should be trained to recognize signs of violence against women, and referral systems put in place to ensure that appropriate care, follow- up and support services are available.