“Domestic Violence Awareness Month evolved from the first Day of Unity observed in October, 1981 by the National Coalition Against Domestic Violence. October has been targeted to educate the public about the Domestic violence.” Domestic violence or intimate partner violence (IPV) is the leading cause of injury in women.  Intimate partner violence is a criminal offense.  It is defined as “actual or threatened physical or sexual violence or psychological/emotional abuse.”  Intimate partners include “current or former spouses, boyfriends, and girlfriends (including heterosexual or same-sex partners).”

Unfortunately, even with all the NFL scandal, our major TV News outlets missed an opportunity to highlight this issue during Domestic Violence Awareness Month. They opted to cover and raise money for Breast Cancer. The good news is that the overall rate of is declining but not fast enough

Each year more than 10 million men and women are victims of physical violence by an intimate partner. Intimate partner violence is seen as a criminal offense but it is also a medical problem.  Both the victim and the perpetrator would benefit from early detection and appropriate intervention.  Early detection and treatment requires a team approach involving health care providers, law enforcement agencies, mental health providers, and local agencies that assist the victims.

Acute medical conditions associated with intimate partner violence include: concussions, bruises, cuts, fractures, trauma due to rape, exposure to sexually transmitted diseases, unwanted pregnancy, injuries during pregnancy leading to complications such as miscarriage and premature births. Chronic illnesses that result from intimate partner violence include: depression, post-traumatic stress disorder, chronic pain syndrome that include headaches, gastrointestinal and pelvic complaints.  Chronic hepatitis and HIV infections may occur.

Unfortunately, I have seen it all. One patient kept returning to the office with a positive chlamydia test. Her partner was not getting treated and kept forcing her to have sex. His rationale was that if she had an STI no one else would want her.  Another patient would have repeated admissions for seizures because her husband threw away her seizure medication.  One memorable patient would always leave before being seen for her appointment to prevent her partner from knowing she left the house.  Being late would expose her to physical harm. With the help of our local agency, we were able to get her to a shelter.

Intimate partner violence affects women more often than men and has become the leading cause of injury to adolescent women.

http://www.futureswithoutviolence.org/userfiles/file/Children_and_Families/DomesticViolence.pdf

http://www.futureswithoutviolence.org/userfiles/file/Children_and_Families/Reproductive.pdf

Over the years I have witnessed that despite the physical and emotional pain, many women stay in dangerous situations for fear of retaliation from their abusers. Unfortunately when women try to leave these situations, they may be at risk for severe or life-threatening injuries.  One patient was locked in her in bedroom during the day until her partner returned from work. Another was forced to travel with her husband when he made cross country hauls in his truck for years.  Many women are faced with the cultural and financial constraints of leaving these relationships.  Many states do not offer adequate and safe shelter systems, medical and psychological care, or assistance with legal matters.  Many women get frustrated and feel abused by the system.

Each year as many as 10 million children in the United States witness intimate partner violence in their families. For children, witnessing violence can lead to long-term problems, which include alcohol and substance abuse, mental health problems and perpetrating or being a victim of intimate partner violence.  Violent partners usually abuse the children.  Abused adolescent females are more likely to drop out of school, have unwanted pregnancies and suffer physical abuse during pregnancy.

Statistics from 1998 show that only 59% of women reported intimate partner violence to the police. Despite all the information being provide, that number is now about 55%. Intimate partner violence accounts for 36% of all injury-related emergency room visits in women.  Women fail to report the cause of these injuries because of shame, prior insensitive responses from friends, family and health care providers, and a sense of hopelessness. IPV accounts for about 8.3 billion dollars/year in health care expenses.

Thankfully Congress did pass the Violence Against Women Act. The President signed the Proclamation to keep the month of October as Domestic Violence Awareness Month.