Ending violence against women

Besides causing injury, violence increases women"s long-term risk of other health problems, including chronic pain, physical disability, drug and alcohol abuse, and depression. Women with a history of physical or sexual abuse are also at increased risk for unintended pregnancy, sexually transmitted infections, and adverse pregnancy outcomes. The needs of these victims of violence often go unmet by health professionals. Violence against women and girls is often known as "gender-based" violence because it evolves in part from women"s culturally-legitimated subordinate status in society. Two of the most common forms of this violence are abuse by intimate male partners and coerced sex. Intimate partner abuse (wife-beating) is almost always accompanied by psychological abuse and in one- quarter to one-half of cases by forced sex as well. The majority of women who are so abused are abused many times. In fact, an atmosphere of terror often permeates abusive relationships. Health care providers can do much to help these victims, yet are often unaware, indifferent, or judgmental. With training and support, providers can do more to respond to the needs of abused women and girls. They can learn how to ask women about violence in ways their clients find helpful. They can give women empathy and support, provide medical treatment, offer counseling, document injuries, and refer their clients to legal assistance and support services. Family planning and other RH providers have a particular responsibility to help. Abuse has a major, though little recognized, impact on women"s reproductive and sexual well-being, and providers not only cannot do their jobs well unless they understand how violence and powerlessness affect women"s RH and decisionmaking ability, but are strategically placed to help identify victims of violence and connect them with other community support service and reassure women that violence is unacceptable and that no woman deserves to be beaten, sexually abused, or made to suffer emotionally. But health workers alone cannot transform the cultural, social, and legal environment that gives rise to and condones violence against women. Long-term commitment and strategies involving all parts of society are needed. Many governments have already passed and are enforcing laws that ensure women"s legal rights and punish abusers. In addition, community-based strategies can focus on empowering women, reaching out to men, and changing the beliefs and attitudes that permit abusive behavior. Only when women gain their place as equal members of society will violence against women no longer be an invisible norm but a shocking aberration. Includes lessons learned and a bibliography. (Editor"s abstract, modified)