As many as one in four women are physically or sexually abused during pregnancy. Neither partner can anticipate the mountain of debt they may accrue as a direct result of fertility treatments. Occasionally it has been reported that due to one’s dire financial straits, heavy drinking occurs along with blame towards the wife. Furthermore, without warning previously gentle husbands may start physically abusing their spouses. Although they may apologize and promise not to do it again, the drinking may continue which lowers their inhibitions and may lead them to become verbally and physically abusive.
The wife may become embarrassed and feel she can’t tell anyone about this, for fear of being harshly judged, especially if she has remained married to her abuser and stayed in their home. It can be difficult to admit that you are in a relationship where abuse has occurred. Abusive relationships may include constant monitoring by one’s partner, criticism for even minor things, accusations of unfaithfulness, and control of the ways money is spent. Additionally, the abusive partner may humiliate his wife in front of others, destroy property or things his wife may care about, and threaten to inflict harm on their already existing children (as is the case with secondary infertility) or pets. Furthermore, the violent partner may force his wife to have sex against her wishes, blame her for his outbursts, and threaten to use a weapon against her. The physical violence may include hitting, shoving, pushing, and kicking, and an abuser may also bite and beat his partner. Partner abuse can also be in the form of intimidation, constant belittling, and frequently the abuser will isolate the woman from her friends and family, and restrict her access to resources, including her car, which can cause additional isolation and dependence.
Intimate partner abuse is generally part of a pattern of abusive behavior and is rarely a onetime occurrence that resolves itself without intervention. Most abused women will experience multiple acts over time. Physical violence in an intimate relationship is almost always accompanied by psychological and sexual abuse. Intimate partner violence is experienced in both heterosexual and homosexual relationships.
Domestic violence is a violation of human rights, and is a worldwide epidemic that physically, emotionally, and financially impacts women and families. Children who are raised in homes where abuse occurred are more likely to be abused themselves or to become abusers. Domestic violence may lead to depression, high levels of stress, low self-esteem, and post traumatic stress disorder.
Unfortunately a woman’s response to abuse is often dictated by the options available to her, as may occur to women who have spent their savings on fertility treatment. Those women of limited means of economic and emotional support or who are concerned for the safety of their children are less likely to leave an abusive relationship. Emotionally dependent women or those who are unrealistically optimistic, hoping their partner will see the error of his ways and change often stay in relationships where there is domestic violence. Moreover, women who are fearful of being socially stigmatized infrequently reach out to others for assistance. Often, as a result of her years of suffering from infertility, these women already feel stigmatized, and different from those who easily conceived.
There seems to be no one factor, though, that directly leads to violence, but rather a number of factors that combine to raise the likelihood that a particular individual in a particular environment may act abusively toward a woman. Apparently, one’s social and cultural milieu combine with the abuser’s individual factors (i.e., whether he, himself, was abused or witnessed abuse), and determine the likelihood (s)he will become an abuser.
Many women who are battered during pregnancy will continue unhealthy habits due to stress, such as smoking, resorting to drug use and improper nutritional habits. These also affect the pregnancy. Immediate effects on the pregnancy can include: low birth weight; blunt trauma to the abdomen; hemorrhage (including placental separation); uterine rupture; miscarriage and/or stillbirth; preterm labor; fetal injury or death; and premature rupture of the membranes.
For those being abused, please remember that violent behavior is an abuser's choice.
Psychologists studying violent behavior have concluded that an abuser's behaviors are not about anger and rage because: 1) he does not batter other individuals, except perhaps his already existing children and 2) the violent partner waits until there are no witnesses and abuses the person he says he loves. Often the abuser will escalate his behavior from pushing and shoving to hitting in places where the bruises and marks will not show. If he were truly in a blind rage, he would not be able to direct or limit where his kicks or punches land.
If you feel you are in physical danger immediately call 911, the local police, or for anonymous and confidential help call the National Domestic Violence Hotline at 1-800-799-7233 or 1-800-787-3224 T T Y
Judith E. Horowitz, Ph.D. is a licensed psychologist in private practice in Broward County, Florida. After graduating Phi Beta Kappa from the University of Florida, she received her doctoral degree from UF, Gainesville, Florida, as well. Dr. Horowitz is a member of the American Society for Reproductive Medicine (ASRM) and is a certified Sexual Therapist and Diplomate of the American Association of Sex Educators, Counselors, and Therapists (AASECT). Judith is also a Diplomate of the American Board of Medical Psychotherapists and Psychodiagnosticians.
As an active member of the American Society for Reproductive Medicine since 1994, Dr. Horowitz was instrumental in developing and establishing the Mentoring Committee of the Mental Health Professional Group (MHPG) and served as its Chair. Judith also served on the MHPG Membership Committee, as well as the ASRM Membership Committee, and recently was appointed to the Steering Committee for Funding Development of the ASRM. Judith will act as the Chair of the e-Communications Committee of the ASRM MHPG 2009-2011.
Dr. Horowitz is a member of the American Psychological Association, the Florida Psychological Association, and the Broward County Psychological Association. Judith is also a member of the American Fertility Association (AFA), fertile Hope, and the Egg Donation and Surrogacy Professional Association (EDSPA). Dr. Horowitz is a contributing author for the Parklander Magazine and writes a monthly column. She has published numerous articles on the psychological impact of infertility and has lectured nationally. Dr. Horowitz has authored Ethical Dilemmas in Fertility Counseling, which is being published by APA Books and due to be released in 2010.
Sharon LaMothe
Infertility Answers, Inc.
http://infertilityanswers.org/
LaMothe Services, LLC
http://lamotheservices.com/
*Please note: Sharon LaMothe is not a MD, is not an attorney nor does she hold a mental health degree. All advice given is solely the experienced opinion of Ms. LaMothe. If you have any medical, legal or psychological questions or concerns, please contact your own Doctor, Attorney or Mental Health Professional.
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