Domestic Abuse: Victims Beyond Spouses

Domestic abuse affects the child. That was the message of a presentation on the epidemiology of domestic violence and issues related to screening, prevention, intervention and teaching. "When there are children involved, domestic violence is anything but a private matter," said speaker Danielle Thomas-Taylor, MD, of the Center for Child Health Research, Rochester, NY. And physicians are likely see numerous victims of spousal abuse, Dr. Thomas-Taylor stressed, given the epidemic proportions of domestic abuse.

Dr. Thomas-Taylor emphasized the link between child abuse and domestic violence. "It is about power and control over a partner, not necessary physical blows." According to the Centers for Disease Control and Prevention and the National Institute of Justice, she said, "domestic violence is an epidemic; it affects over 3 million children."

Among the myths surrounding domestic abuse, she said, is that domestic violence is not related to physical injury when, in fact, it is the leading cause of injury among women of childbearing age. "More women are injured by their partners," she said, "than by rape, car accident, and mugging combined." Statistics that Dr. Thomas-Taylor presented from the Federal Bureau of Investigation reveal that, in 2001, there were, on average, four murders a day by partners or spouses.

These women with children, Dr. Thomas-Taylor said, are often simply expected to leave home. She reminded the audience that leaving is not as easy as it appears for women who have been not just physically abused. Domestic violence, she pointed out, "is a pattern of behaviors that involves physical, sexual, emotional and economic assault."

With more than 325,000 pregnant women beaten annually, the cycle of abuse reaches into the next generation, as spousal abuse affects birth weight and, later, a mother's ability to bond with and care for her child. And "children are not passive observers," Dr. Thomas-Taylor said. They see the bruises and hear the fighting. As they grow, they feel "powerless, confused, angry, afraid, alone and guilty."

Dr. Thomas-Taylor went on to emphasize the likelihood that, where there is spousal abuse, there is child abuse. According the US Advisory Board on Child Abuse, she said, "domestic violence may be the single major precursor to child abuse and neglect fatalities in this country."