What is domestic violence and abuse and how common is it?

Different agencies and governments have different definitions of domestic violence and abuse (DVA). We will focus on three here before looking at the prevalence of DVA generally as well as during pregnancy.

The UK Domestic Abuse Bill, 2020 definition

The new statutory definition provides that domestic abuse occurs between two people if they are both over 16, ‘personally connected’ and the behaviour is defined as abusive.
_{(GOV.UK, 2020)}

Abusive behaviour

• Physical or sexual abuse
• Violent or threatening behaviour
• Controlling or coercive behaviour
• Economic abuse (behaviour that has a substantial adverse effect on the victim’s ability to acquire, use or maintain money or other property, or obtain goods or services)
• Psychological, emotional or other abuse

The US Centers for Disease Control and Prevention (CDC) definition

Intimate partner violence (IPV) is abuse or aggression that occurs in a romantic relationship. ‘Intimate partner’ refers to both current and former spouses and dating partners. IPV can vary in how often it happens and how severe it is. It can range from one episode of violence that could have lasting impact, to chronic and severe episodes over multiple years.
_{(CDC, 2020)}

Physical violence

Sexual violence

Stalking

Psychological aggression

The World Health Organization (WHO) definition

Self-reported experience of one or more acts of physical and/or sexual violence by a current or former partner since the age of 15 years.
_{(WHO et al., 2013)}

Physical violence

Being slapped, pushed, shoved, hit with a fist, kicked, dragged, beaten, choked, burnt, having something thrown at you, and/or being threatened and/or having a weapon (gun, knife, etc.) used on you.

Sexual violence

Being physically forced to have sexual intercourse, having sexual intercourse due to fear of what the partner may do and/or being forced to do something sexual that is humiliating or degrading.

Prevalence

Prevalence is typically based on exposure in the last 12 months and on rates of lifetime experience. The UK Office for National Statistics (2018) estimates that 2 million adults aged 16 to 59 years in England and Wales experienced DVA in the last year, equivalent to 1.3 million women (7.9% of the overall population) and 695,000 men (4.2% of the overall population). In terms of lifetime exposure (for US population), we draw on CDC data.

_{Select the image to expand it.
Adapted from the CDC, 2020}

Taking a more global perspective and integrating women’s experiences of sexual as well as domestic abuse, the WHO states that one in three women across the world is subjected to domestic violence and abuse from a partner or ex-partner or sexual violence from a non-partner (World Health Organization et al., 2013).

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_{[Adapted from WHO et al., 2013]}

Prevalence of DVA during pregnancy

The WHO women’s multi-country study reported prevalence rates for physical DVA in pregnancy of between 1% (cities in Japan) to 28% (provinces of Peru) (García-Moreno et al., 2005). In an analysis of data from 19 countries, prevalence rates ranging from 2% in Australia, Denmark, Cambodia and Philippines to 13.5% in Uganda were reported by Devries et al., 2010. Rates appear to be higher in low- and middle-income countries: Egypt (32%), India (28%), Saudi Arabia (21%) and Mexico (11%) (Campbell et al., 2004).

A meta-analysis involving 19 African studies by Shamu et al., 2011 yielded an overall prevalence of 15% for any DVA during pregnancy. While there is considerable variation in prevalence rates across studies and parts of the world, taken together, this data points to the high likelihood of professionals in maternity services, and in other settings where pregnant individuals seek healthcare, encountering women who have recent exposure to DVA. We have used a conservative estimate of 1 in 10 to communicate the numbers of pregnant women around the world exposed to DVA.

References

_{Campbell, J., Garcia-Moreno, C., & Sharps, P. (2004). Abuse during pregnancy in industrialized and developing countries. Violence Against Women, 10(7), 770-789. DOI link}

_{Centers for Disease Control and Prevention. (2020). Preventing intimate partner violence. Web link}

_{Devries, K. M., Kishor, S., Johnson, H., Stöckl, H., Bacchus, L. J., Garcia-Moreno, C., & Watts, C. (2010). Intimate partner violence during pregnancy: Analysis of prevalence data from 19 countries. Reproductive Health Matters, 18(36), 158-170. DOI link}

_{García-Moreno, C., Jansen, H. A. F. M., Ellsberg, M., Heise, L., & Watts, C. (2005). WHO multi-country study on women’s health and domestic violence against women. World Health Organization. Web link}

_{GOV.UK. (2020). Domestic Abuse Bill. Web link}

_{Office for National Statistics. (2018). Domestic abuse in England and Wales: Year ending March 2018. Web link}

_{Shamu, S., Abrahams, N., Temmerman, M., Musekiwa, A., & Zarowsky, C. (2011). A systematic review of African studies on intimate partner violence against pregnant women: Prevalence and risk factors. PLoS ONE, 6(3), Article e17591. DOI link}

_{World Health Organization, London School of Hygiene and Tropical Medicine, & South African Medical Research Council. (2013). Global and regional estimates of violence against women: Prevalence and health effects of intimate partner violence and non-partner sexual violence. World Health Organization. Web link}