Violence against women has been the focus of international attention for more than twenty years. In 1993 the World Conference on Human Rights published the Declaration on the Elimination of Violence Against Women. It established that, according to international human rights law, “states have a duty to exercise due diligence to prevent, prosecute, and punish violence against women” (WHO, 2005).

The WHO Study of 2005

Recognizing the need for research in the area of intimate partner violence, in 2005 the World Health Organization (WHO) completed a ten-country population-based survey of 24,000 women called the WHO Multi-country Study on Women’s Health and Domestic Violence Against Women. The WHO researchers asked participants a series of questions about physical and sexual violence, emotional abuse, and controlling behaviors.

Overall, the proportion of women who had ever suffered physical violence by a male partner ranged from 13% in Japan to 61% in provincial Peru. Japan had the lowest overall level of sexual violence at 6%, while Ethiopia had the highest at 59%. The majority of reports were between 10% and 50% (WHO, 2005). A review study published by WHO in 2013 found substantially similar data. It shows the global average of prevalence of intimate partner violence of ever-partnered women to be 26.4%, ranging from a low of 8.9% in some areas of East Asia to a high of 77.7% in central Sub-Saharan Africa (WHO, 2013).

It is well known that violence perpetrated against women by an intimate partner is often accompanied by emotionally abusive and controlling behavior. The National Violence Against Women survey found that women whose partners were jealous, controlling, or verbally abusive were significantly more likely to report being raped, physically assaulted, or stalked by their partners, even when other socio-demographic and relationship characteristics were controlled.

Having a verbally abusive partner was the variable most likely to predict that a woman would be victimized by an intimate partner. These findings support the theory that violence perpetrated against women by an intimate partner is often part of a systematic pattern of dominance and control (Tjaden & Thoennes, 2000). The victims are often emotionally involved and economically dependent upon the person victimizing them. In contrast, men are more likely to be victimized by someone outside their close circle of relationships (Heise & Garcia-Moreno, 2002).

Intimate Partner Violence During Pregnancy

Every year in the United States approximately 324,000 women are abused during pregnancy. Worldwide the prevalence of IPV during pregnancy in one study ranged from a low of 1% in urban Japan to 28% in Peru Province (WHO, 2005). Other studies have found even higher percentages (WHO, 2011).

More research is critical to understand the details of IPV during pregnancy but what is known so far indicates many negative effects for both mother and unborn child. Effects can be seen in negative health behaviors such as tobacco, alcohol, and drug use or delayed prenatal care. Reproductive health may be affected by many things, including poor pregnancy weight gain, low birth weight, or obstetric complications. Physical and mental effects can include injury of all kinds—up to and including death, depression, poor attachment of mother to child, and others (ACOG, 2012; WHO, 2011).

Research has demonstrated that being pregnant does not protect women from IPV, but the evidence is conflicting as to whether violence increases or decreases during pregnancy. All of the usual triggers for IPV will be in play during pregnancy but the additional stresses that surround unplanned or unwanted pregnancies appear to be an additional risk factor for violence during pregnancy (WHO, 2011).

Pregnancy (at all stages) can present opportunities for healthcare professionals to inform and advise women regarding IPV and offer choices for assistance if a woman is being abused (ACOG, 2012). These professionals need to become knowledgeable on the recognition and documentation of abuse, applicable laws in their locale, and the variety of resources available for victims of IPV.