If you are pregnant and being abused, you may wonder what impact this is having on your unborn child. It is a good question but one that is difficult to answer fully because we just don't know for sure what other impacts abuse may have beyond those related to direct injuries and the mother's stress, nutrition and substance use.

Physical injury

If you are being directly physically abused there are potentially life-threatening injuries that could be inflicted on yourself and your baby. Sometimes abusive partners directly assault the pregnant woman's abdomen in an attempt to cause injury or death to the baby.

Direct physical abuse to the pregnant abdomen can potentially have any of the following impacts on the fetus:

• spontaneous abortion
• fetal death
• placental abruption
• preterm labour and delivery
• gestational age less than 37 weeks
• fetal injuries, such as skull fractures, intracranial hemorrhage and bone fractures

(Petersen et al., 1997)

The effects of stress

The stress you are under may also have serious health consequences for you, such as raised blood pressure, sleep deprivation and decreased immunity to infection, all of which can affect your baby. High levels of stress may also decrease blood flow to your baby and could cause you to go into labour early.

Substance abuse

Sometimes the stress from the abuse is so great that women struggle with substance use during their pregnancies and find they are unable to reduce or eliminate these substances even when they know that they can harm their babies. You may have a partner who sabotages your efforts to stay clean during the pregnancy and encourages relapse by bringing drugs, alcohol or nicotine around you or by forcing you to use.

We understand how much shame and fear you may feel if you are using substances in your pregnancy and are not sure how your baby may be impacted. It is likely that your baby will show signs of being exposed to these substances at birth and throughout life (e.g. Fetal Alcohol Syndrome) and it may be in your best interest to seek out, before the birth of your baby, the support of a substance use counselor who specializes in working with pregnant women who are using.

To find out about the health impacts of specific substances you may have used or are currently using, visit www.motherisk.org, which has evidence-based information about the safety or risk of drugs, chemicals and disease during pregnancy and lactation.

Impact on nutrition and fetal development

Eating nutritious food in sufficient quantities and in the right balance, is important for the health of both mother and baby. As a woman who is being abused, however, you run the risk of not getting proper nutrition if the abuse has any of the following manifestations or impacts:

• if your abusive partner limits your access to healthy foods and/or vitamin supplements, or to the money needed to buy them
• if taking care of yourself does not come easily because the abuse has had an impact on your self-esteem and you feel unworthy or undeserving
• if you are suffering from depression as a result of the abuse and it is affecting your ability to prepare or cook foods for yourself
• if, as a result of the abuse, you suffer from anorexia, bulimia or other eating disorders

Poor nutrition is a risk factor for low birth weight, which in turn is the determining factor in about two-thirds of all deaths among newborns. Low weight babies who survive are at a greater risk than normal weight babies for developing serious and lifelong disabilities.

If you are having difficulty meeting your unborn baby's nutritional needs, please let someone know of your need for assistance.

It can be very distressing for women to acknowledge that the abuse they experience impacts their children. You may try very hard to protect your children from being exposed to the abuse you suffer, but children are affected even if they are never present during the abuse:

• Children can sense tension. When they don't know what the cause is, they can feel all the more nervous and insecure, and/or worry that it must be something about themselves that is making you tense.
• Your ability to focus on caring for yourself and your children is probably compromised when you are struggling with the day to day reality of an abusive partner's behaviour, and this takes away from you being able to be fully present in your child's life. It is difficult to parent when you are worried about your physical and emotional safety.
• Your child's belongings may be destroyed during an argument and you may find yourself needing to explain or make excuses to your child about what happened.
• Your child may hear you crying or sharing your story with another adult and may internalize what is happening to you as their fault. Children in homes where there is abuse going on may grow up believing that there is something wrong with them, that they are the cause of the abuse. The abusive partner may even tell your child(ren) that they are to blame, or say things like "look at mommy, she cries over every little thing." This is very confusing for children who try to reconcile their feelings of both love and fear of the abusive parent, and they may even act out towards you in their frustration. Remember that you are not to blame for the abuse against you and, while there are steps you can take to remove your children from the abusive environment, your partner is the one choosing to create that environment and expose your child(ren) to the abuse against you.
• You may be using coping skills that are harmful to yourself and your children but find yourself not aware or unable to manage the stress in any other way. There are people who care about you and can help you learn new tools. Becoming a good parent is a process that is learned over time and you should not feel ashamed if you feel that you could learn more tools to raise your children.

There are steps you can take to assist your child in coping with abuse in the home; however, we know that the best thing for a child's emotional and physical health is for their mother to be safe. Making the choice to leave an abusive relationship is often the most difficult step, but it is the most important step you can take to reducing the impacts of violence on your child's life.

You may be afraid to tell someone that you are being abused because if you do, they may need to call your local Child Protection Agency. You may have concerns about your safety once you have told and a call does need to be made. You may be worried that your partner will retaliate. Please speak with the professional working with you about these concerns or contact a local helpline/shelter for support and safety planning. It can be difficult to remember that professionals are trying to assist you in getting and keeping you and your children safe.

If a report of abuse in the home needs to be made to a Children's Aid Society (CAS) / Child Protection Agency (CPA) please consider making the call yourself. The call itself will be anxiety-provoking and scary but the message that you will be sending to the CAS/CPA will be that you are seeking support to ensure your child's safety. A child protection agency's intent is to work in the best interest of your child, protecting your child from further abuse and harm, and advocating for your child if necessary.

Being exposed to abuse in their home is devastating to children and they will continue to be impacted for as long as they remain in the situation. You may be reassured, however, to know the following about children who are no longer living in an abusive environment:

• most "psychological problems" in children diminish once the violence stops
• research shows that most children who lived with violence in the past are functioning normally from a psychological point of view
• living with violence as a child is not a "life sentence" for a bad future
• children are resilient and can thrive
• not all children need professional treatment to overcome the effects of violence: there is a lot a mother can do to help her children

From Helping Children Thrive - Supporting Woman Abuse Survivors as Mothers by Linda Baker and Alison Cunningham (2004). London Family Court Clinic

You will find valuable information and tools available to print out for assisting yourself and your child by scrolling down to the Handouts for Women section on this page: www.lfcc.on.ca/mothers.html.

Shelternet has a section Just For Kids to help them understand that they are not alone and not to blame for the abuse against you: www.shelternet.ca/en/children-youth/.

Woman abuse in the childbearing year: page 1 - page 2 - (you are on page 3) - page 4