Intimate Partner Violence
Frequently Asked Questions: Women's Health
Intimate partner violence is a pattern of threatening or controlling behavior. Abuse means that someone who is in an intimate relationship with a woman has harmed her on purpose, often more than once. This harm can be physical, sexual, or emotional.
Intimate partner violence also is known as domestic violence or domestic abuse. Abuse between couples often isn’t reported. Most abuse victims are women.
Abuse can be actual or threatened. In most violent relationships, mental abuse and bullying go along with physical force. Abuse can take any of several forms:
- Battering and physical assault—Physically hurting a woman with pushing, hitting, slapping, kicking, choking, or beating. This also includes throwing things and attacking with a weapon.
- Sexual assault—Making someone do sexual acts when she does not want to, including kissing, touching, or vaginal, oral, or anal intercourse.
- Psychologic abuse — Calling names, threatening to harm a partner or her children, attacking pets, smashing valued objects, humiliating someone through social networks, or trying to dominate or control a woman’s life. This also includes forcing someone to do things that are degrading or humiliating.
There are many ways an abuser may try to control a woman’s life. These may include
- taking away her money, food, or clothing
- interfering with her sleep or transportation
- keeping her from being in touch with her family and friends (isolating her)
- monitoring her cell phone and social media
- trying to control her reproductive choices by refusing to practice safe sex, exposing her to a sexually transmitted infection (STI), sabotaging or preventing the use of birth control, or forcing her to get an abortion
If a woman is disabled or has a medical condition, the abuser may control her access to medication, assistive devices, or personal needs like getting out of bed, eating, and going to the bathroom.
Women in abusive relationships are at risk of repeated physical and emotional injury. Physical abuse may cause injuries to the head, face, breasts, belly, genitals, or reproductive system. Some women develop chronic (long-lasting) problems, such as
- problems with sleep and appetite
- pelvic pain
- urinary frequency or urgency
- irritable bowel syndrome (IBS)
- vaginal infections
- posttraumatic stress disorder (PTSD)
Many pregnant women are abused by their partners. Abuse may start or get worse during pregnancy. Abuse during pregnancy can pose a risk to both the woman and her fetus. The dangers of physical violence during pregnancy may include
- pelvic fracture
- placental abruption
- fetal injury
- preterm delivery
- low birth weight
In some cases, there may be less abuse during pregnancy. But in these cases, abuse may start again soon after the baby is born. This may lead to repeated pregnancies as a way of escaping abuse.
In many families in which the woman is abused, her children also are abused. Children who see family violence or who are abused themselves can be deeply upset. They may feel fear, helplessness, and anger. Children in abusive homes may have problems that do not seem related to family violence:
- They may have physical or emotional problems, such as chronic headaches, stomach problems, trouble sleeping, nightmares, or bed-wetting.
- Often, they have difficulty in school. Sometimes, they withdraw from their studies and their friends. Other times, they lash out in anger and get into fights.
Children may grow up thinking that physical violence is a way of dealing with problems. They also are more likely to get into an abusive relationship when they grow up, either as an abuser or as a victim of abuse.
Disagreements and arguments, even heated ones, are part of a normal relationship. Physical violence or other abusive behavior is not. Everyone has a right to get angry. But no one has the right to express anger violently or to hurt you. Ask yourself these questions:
- Does your partner ever frighten you with threats of violence or by throwing things when they are angry?
- Does your partner ever say it is your fault if they hit you?
- Does your partner ever promise it will not happen again, but it does?
- Does your partner ever put you down in public or keep you from contacting family or friends?
- Does your partner ever force you to have sex when you do not want to??
If you answered “yes” to any of these questions, you may be involved in an abusive relationship. If so, you are not alone and you have choices. Remember, you haven't done anything wrong. No one deserves to be abused.
Many abused women find themselves caught up in a cycle of abuse that follows a common pattern. Unless the woman takes some sort of action to break the cycle, the violence usually becomes more frequent and more severe over time:
- Phase 1—Tension mounts as the abusive partner increases their threats of violence, often calling the woman names or shoving her.
- Phase 2—The abuser becomes physically violent. This may include throwing objects, hitting, slapping, kicking, choking, rape or sexual abuse, or using weapons.
- Phase 3—The abuser apologizes and expresses guilt and shame. They promise that the violent behavior will not happen again. Sometimes the abuser will blame the violence on the woman.
Over time, abusers tend to put less time and effort into making up. They have learned that violence controls their partner. They will work less hard at being forgiven or at explaining away their behavior.
The first step in breaking a violent pattern in a relationship is to tell someone. If you are in an abusive relationship, talk about it with someone you trust. The person you tell may be a nurse or doctor, counselor or social worker, a close friend or family member, or a clergy member. Let someone know you are abused so you can contact them in case you need to leave a dangerous situation.
At first, you may find it hard to talk about the abuse. But many abused women feel a great sense of relief—and some sense of safety—once they have told someone outside the home.
Feelings of shame are common at this point. Keep in mind that no one deserves to be abused. Violent behavior is the fault of the one who is violent, not the victim.
Getting ready to leave an abusive relationship can be difficult, but these tips can help you make a plan:
- Contact your local shelter for domestic violence victims and find out about laws and other resources available to you. For example, some programs offer donated cell phones that your abuser can’t track.
- Keep any pictures or other evidence of physical abuse, and write down dates of when the abuse happens.
- If you are injured, go to the emergency room and report what happened to you.
- Try to set money aside or ask friends or family members to hold money for you.
Once you decide to leave, be prepared for a safe, quick escape:
- You may ask a police officer to be there while you leave.
- Make a plan for where you will go.
- Hide an extra set of car keys.
- Pack an extra set of clothes for you and your children, and a special toy or book for each child. Store them with a trusted friend or neighbor.
- Have important items handy so you can take them with you on short notice. These may include the following:
- Phone numbers of friends, relatives, and doctors
- Your driver’s license
- Medication for you or your children
- Credit cards or a list of credit cards you hold yourself or jointly
- Pay stubs, checkbooks, and information about bank accounts and other assets
- Birth certificates for you and your children
For information about resources in your area, call the 24–hour, toll–free National Domestic Violence Hotline: 800–799–SAFE (7233) and 800–787–3224 (TDD). You also can find help online at www.thehotline.org. Most areas have many local resources that can help in a crisis. These resources include
- the police department
- crisis hotlines
- rape crisis centers
- domestic violence programs
- legal aid services
- hospital emergency rooms
- shelters for women and children
Many counselors and health care professionals are specially trained to deal with domestic violence. Counseling can help with matters that will arise as you begin to make changes in your life, such as finding a job or dealing with money concerns or children’s problems.
Sometimes a woman who has been abused decides to break away from her partner for good. If this is the case and you are married to the abuser, get a lawyer who is experienced in dealing with abuse cases.
If money is a concern, check out the resources in your area—many communities have legal aid services. Ask your health care professional, counselor, or the staff of a hotline to recommend one. Call the 24–hour, toll–free National Domestic Violence Hotline: 800–799–SAFE (7233) and 800–787–3224 (TDD). You also can find help online at www.thehotline.org.
Birth Control: Devices or medications used to prevent pregnancy.
Fetus: The stage of human development beyond 8 completed weeks after fertilization.
Genitals: The sexual or reproductive organs.
Irritable Bowel Syndrome (IBS): A digestive disorder that can cause gas, diarrhea, constipation, and belly pain.
Low Birth Weight: Weighing less than 5 1/2 pounds (2,500 grams) at birth.
Placental Abruption: A condition in which the placenta has begun to separate from the uterus before the fetus is born.
Preterm: Less than 37 weeks of pregnancy.
Sexually Transmitted Infection (STI): An infection that is spread by sexual contact. Infections include chlamydia, gonorrhea, human papillomavirus (HPV), herpes, syphilis, and human immunodeficiency virus (HIV, the cause of acquired immunodeficiency syndrome [AIDS]).
Stillbirth: Birth of a dead fetus.
If you have further questions, contact your obstetrician–gynecologist.
FAQ083. Copyright January 2020 by the American College of Obstetricians and Gynecologists
This information is designed as an educational aid to patients and sets forth current information and opinions related to women’s health. It is not intended as a statement of the standard of care, nor does it comprise all proper treatments or methods of care. It is not a substitute for a treating clinician’s independent professional judgment. Read ACOG’s complete disclaimer.