This document discusses domestic violence during pregnancy and its effects. It notes that 1 in 5 mothers experience abuse during pregnancy. Domestic violence can harm the physical and mental health of the mother and increase risks for low birth weight, preterm birth, and perinatal mortality in the baby. Factors like young age, poverty, and unwanted pregnancy can increase the risks of domestic violence during pregnancy. The document also discusses the importance of preconception care and antenatal care in improving maternal and child health outcomes.

1. Dr. Shobha dhananjaya
Professor, Dept. of OBG
JJMMC, Davanagere

2. Introduction
 Though pregnancy is joyous time in anticipation, 1 in 5
mothers experience abuse during pregnancy
 Shows the harsh reality of domestic abuse
 Multiple ways in which violence is actively occurring in
the world through physical, mental, emotional, sexual,
psychological, spiritual, verbal abuse and neglect.
violence has many faces

3.  Domestic abuse has a pattern of abusive behavior in
any relationship that is used by one partner to gain
or maintain power and control over another intimate
partner.
 It maybe any behavior that intimidate, manipulate,
humiliate, isolate, frighten, terrorize, coerce,
threaten, blame, hurt, injure or wound someone.
Contd…

4. Domestic Violence During
pregnancy
 Young age
 Poverty
 Unmarried status
 Alcohol & smoking by pregnant mothers
 Unwanted pregnancy adverse outcomes

5.  It maybe because of jealousy and anger towards the
unborn child.
 Mother affected by physical and sexual harassment
maybe having depression, stress, anxiety, pregnancy
complications are infinitely more.
 Increase drugs usage for premature labor or birth
experiences serious trauma physically and
emotionally.

6.  Homicidal deaths- 17%
 Accidental deaths- 11%
This affects the baby into low birth weight, preterm
births resulting in perinatal mortality
 Much hope for the pregnant women in places of
domestic violence as long as everyone supports &
seeking out the success of the mother and the child.

7. Preconception & Antenatal
care

8. Definition
Preconception care is the provision of biomedical,
behavior & social health intervention to women and
couple before conception occurs.

9. Benefits of preconception
care
 Reduces unintended pregnancies
 Prevents birth defects
 Prevents low birth weight and prematurity
 Prevents poor pregnancy outcomes and recurrence
 Promote healthy behaviors and reduce risk taking
behaviors
 Prepare and reinforces parents for parenting
 Promote family planning

10. Aims of ANC
 Improving their health status and changing behavior of
an individual and environment factor that contribute to
poor maternal and child health in both short and long
term.
 Opportunities to prevent and control diseases that occurs
at multiple stages of life, strong public health programs
from infancy to childhood and adolescence to adulthood.

11. Contd…
 It brings health benefit to adolescents, women and men,
irrespective of their plan to become parents.
 To secure optimal health and nutrition in both parents, not
only improves the changes of conception but also
reduces the possibility of parental death and congenital
anomalies in the fetuses.

12. Contd…
 To ensure that the woman and her partner are in optimal state
of physical and emotional health at the onset of pregnancy.
 To promote the prenatal health which include developing
positive attitude of pregnancy, womanhood and childbearing.
 To benefit woman being treated for a condition such as sickle
cell anemia, hypertension, cardiac diseases, diabetes, may
cause high risk pregnancy.

13. Purpose
 Establish lifestyle behaviors to maintain optimum
health
 Identify and treat risks (medical conditions,
substance abuse)
 Conceive a pregnancy without necessary risk factors
 Prepare people psychologically for pregnancy and
responsibilities to become parenthood

14. Why preconception care?
Preconception care has a positive effect on range of
health outcomes such as:
 Reduce maternal and perinatal mortality
 Prevent unintended pregnancies
 Prevent complication during pregnancy and delivery
 Prevent still birth, preterm birth and lowbirth weight

15. Contd…
 Prevent birth defect
 Prevent neonatal infection
 Prevent underweight and growth restriction
 Prevent vertical transmission of HIV/STIs
 Lower the risk of childhood cancers

16. Components
Nutrition Condition Infertility &
Subfertility
HIV
Genetic Condition Vaccine
preventable
disease
Mental
Health

17. Tobacco Use Interpersonal
violence
Environmental
health
Sexually Transmitted
Infection (STI)
Too Early, Unwanted &
rapid successive
pregnancies

18. Role of Midwife

19. Antenatal care

20. Definition
Antenatal care refers to care given to expected mother
from time of conception until the beginning of labor
OR
Planned examination and observation for the woman
from conception till the birth

21. Goals of Antenatal care
1. To reduce maternal mortality and morbidity rates
2. To improve the physical and mental health of women
and children
3. To prevent & identify maternal and fetal abnormality
that can affect pregnancy outcome
4. To decrease financial burden for care of mothers

22. Antenatal preparation

23. Areas addressed by
preconception care package
 Nutritional conditions
 Vaccine - preventable
diseases
 Environmental health
 Genetic conditions
 Infertility/ subfertility
 Female genital mutilation
 Too early, unwanted & rapid
successive pregnancies
 Sexually transmitted
infections
 HIV
 Interpersonal violence
 Mental health
 Psychoactive substance use
 Tobacco use

24. Health education
Hygiene Sleep Breast care Dental care

25. Sexual activity Exercise
Dressing Diet

26. Antenatal exercise
Benefits of exercise:
•Reduction in aches and pains
(eg. Backache and cramps)
•Improved posture and body
awareness
•Reduce constipation
•Reduction in minor alignment of
pregnancy
•Aids postnatal recovery
•Improve ability to cope with labour
and childbirth
•Energy level will be increased
•Helps to regain the shape more
quickly after delivery

27. Reasons for single mother
• Unmarried
• Widowed
• Separated
• Divorced

28. Surrogate mother
A woman who carries the
fetus of the infertile couple
and then relinquishes the
child to couple for rearing.
This usually done for the
couple that has difficulty
with delivering a viable
fetus.

29. Pregnant teenager married
and unmarried
Adolescents are at increased
risk for preterm labor and
delivery compared to older
women. Babies born to
adolescent mother are more
likely to be low birth weight and
are at an inceased risk of
prenatal and infant mortality.

30. On the other hand an unmarried pregnant
adolescent may be driven away by her parents and
be left with no mean of support
Signs and symptoms:
• Missing a period
• Nausea and vomiting
• Breast changes (enlargement, tenderness)
• Frequency of micturition
• Fetal movements
Prevention:
• Abstinence ( not to engage in sexual activity)
• Protected sex (condom use, birth control, IUCD
etc.)
• Counseling of teens about outcomes and risk
factors of pregnancy
• Comprehensive sex education

31. Unmarried mother
Unmarried mothers are of concern
to people in many societies, partly
because their behavior threatens
the norms of bearing children and
also BECAUSE THEY POSE A
COMPLEX PROBLEM FOR THE
MEDICAL AND SOCIAL
SERVICES. Despite this concern
and fact that many agencies
provide both social and medical
care for their needs.

32. Domestic violence
Domestic violence is serious problem on
both victim and member of his/her family
especially on children.
Physical effect of violence during
pregnancy includes;
•Insufficient weight gain by the mother
•Vaginal/cervical/UTI
•Vaginal bleeding
•Abdominal tenderness
•Hemorrhage
•Miscarriage
•Low birth weight
•Rupture uterus
•Abruptio placentae
•Death

33.  Violence against women during pregnancy have been linked with
poor physical and mental development of baby in-utero
 Psychological violence during pregnancy by an intimate partner is
strongly associated with postpartum depression
 Studies shows that 4.9% of depressive symptoms in women in
postpartum period is associated with husband’s alcoholism,
polygamy and previous depression.

34. Punishment against domestic
violence in India
Various guidelines / provisions being made for protection of
woman under different sections, such as:
 Sec 304B of Indian Penal Code – Dowry death
 Sec 313 – 316 of IPC – Female feticide
 Sec 305 – 306 of IPC – Abetment of suicide
 Sec 340, 349 of IPC – Wrongful confinement
 Sec 498A of IPC – Domestic violence

35. Prevention
•Improve educational status of the
women and girls
•Increase the opportunities for the girls
or women
•Provide sex education at the early age
to the girls at school level
•Improving their self esteem and
negotiating skills
•Reducing gender inequality
•Aware the girls and women about
their rights and power
•Encourage women to fight against
violent activities

36. Maximizing the gains for
maternal & child health
A new WHO study report shows that
preconception care has a positive impact
on maternal and child health outcome. A
report provides a foundation for
implementing a package of promoting,
preventive and curative health
interventions shown to have been
effective in improving maternal and child
health.

41. Thank
You