This document discusses different types of abuse against women including physical, psychological, social, and the impact on health. Physical abuse involves using physical force that causes harm. Psychological abuse diminishes identity, dignity and self-worth through actions like humiliation and isolation. Social abuse cuts women off from support systems. Abuse has serious short and long term health consequences including injuries, mental health issues, and increased risks for sexual and reproductive health problems. Prevention requires a multi-sectoral approach including empowering women, ensuring services, reducing poverty, and transforming social norms. The health sector plays an important role in advocacy, screening and treatment, and promoting healthy relationships.

1. PHYSICAL, PSYCHOLOGICALAND SOCIAL
ABUSE OF WOMEN AND THEIR CONTROL
PREPARED BY:
ROSHANI BHATTARAI
M.SC NURSING 1ST YEAR
BATCH OF 2023

2. Objectives:
At the end of the session, we will be able to describe about physical,
psychological and social abuse of women and measures to control
them.

3. Physical Abuse:
• Physical abuse basically involves a person using physical force
against us, which causes, or could cause, us harm.
The United Nations defines violence against women as "any act of
gender-based violence that results in, or is likely to result in, physical,
sexual, or mental harm or suffering to women, including threats of
such acts, coercion or arbitrary deprivation of liberty, whether
occurring in public or in private life."

4. • Intimate partner violence refers to behaviour by an intimate partner or
ex-partner that causes physical, sexual or psychological harm, including
physical aggression, sexual coercion, psychological abuse and controlling
behaviours. Intimate partner abuse occurs at a higher rate during pregnancy
than other times (Shoffner, 2008).
• Sexual violence is "any sexual act, attempt to obtain a sexual act, or other
act directed against a person’s sexuality using coercion, by any person
regardless of their relationship to the victim, in any setting. It includes rape,
defined as the physically forced or otherwise coerced penetration of the
vulva or anus with a penis, other body part or object, attempted rape,
unwanted sexual touching and other non-contact forms".

5. • Gender-based violence (GBV) is a global public health emergency that
has plagued girls and women throughout history. Defined as harmful acts
directed at an individual based on their gender.
• GBV is a constant threat for girls and women around the world regardless
of their age, race, or socioeconomic status. And they are at risk
everywhere and anywhere at work, at school, and at home.
Estimates published by WHO indicate that globally about 1 in 3 (30%) of
women worldwide have been subjected to either physical and/or sexual
intimate partner violence or non-partner sexual violence in their lifetime.

6.  Most of this violence is intimate partner violence. Worldwide, almost one
third (27%) of women aged 15-49 years who have been in a relationship
report that they have been subjected to some form of physical and/or
sexual violence by their intimate partner.
 In 2020, the UN Office on Drugs and Crime found that, on average, a girl
or woman is killed by someone in her own family every 11 minutes.

7. • At least 155 countries have passed laws on domestic violence, and 140
have legislation on sexual harassment in the workplace (World Bank
2020)
Types of physical abuse:
• Physical abuse can involve any of the following violent acts:
 scratching or biting
 pushing or shoving
 slapping
 kicking
 choking or strangling

8. Types Of Physical Abuse (Contd…)
 throwing things
 force feeding or denying us food
 using weapons or objects that could hurt us
 physically restraining us (such as pinning you against a wall, floor, bed,
etc.)
 reckless driving
 other acts that hurt or threaten us

9. Psychological/Emotional Abuse:
• Psychological/ Emotional abuse is another form of domestic violence.
• Emotional abuse can happen to anyone at any time in their lives.
• Women, children, teens and adults all experience emotional abuse.
• Emotional abuse can have devastating consequences on relationships and
all those involved.

10. • Emotional abuse is defined as: "any act including confinement, isolation,
verbal assault, humiliation, intimidation, infantilization, or any other
treatment which may diminish the sense of identity, dignity, and self-
worth

11. Following are various example of emotional abuse:-
a. Accusation/ aspersion on her character or conduct
b. Insult for not bringing dowry
c. Insult for not having a male child
d. Insult for not having any child
e. Preventing the wife from taking up a job

12. Social Abuse:
• Social abuse is behaviour that aims to cut us off from our family, friends,
or community.
• It can also involve a person or people trying to damage our relationships
with others.
• People who are socially abusive may also attempt to make us look bad or
ruin our reputation.
• Social abuse can include things done in the home, in public, over the
phone, or on the internet and social media.

13. Social abuse might include:
 Stopping us from seeing friends, family, or other people
 Not allowing us outside our home, room, or accommodation facility
 Not allowing us to participate in social and community activities
 Needing to know everywhere we have been or are going
 Needing to know everyone we have seen or are planning to see
 Checking or interfering with our mail, phone, email or social media

14. Contd…
 Sharing private photos or videos of us online without our permission
 Using social media or the internet to spread lies or damaging information
about us
 Telling lies about us to friends and family or trying to turn others against
us

15. Contd…
 Deliberately doing things to make us miss, or be late for, events,
appointments or meetings
 Deliberately doing things to make us look bad or embarrass us in front of
others
• Restricting access to our car, other forms of transport, wheelchair, or
mobility aids

16. Risk factors for both intimate partner and sexual violence include:
 lower levels of education
 a history of exposure to child maltreatment
 witnessing family violence
 antisocial personality disorder
 harmful use of alcohol
 harmful masculine behaviours, including having multiple partners or
attitudes that condone violence

17. Contd…
 community norms that privilege or ascribe higher status to men and
lower status to women;
 low levels of women’s access to paid employment; and
 low level of gender equality

18. Factors specifically associated with intimate partner violence include:
 past history of exposure to violence;
 marital discord and dissatisfaction;
 difficulties in communicating between partners; and
 male controlling behaviours towards their partners.

19. Factors specifically associated with sexual violence perpetration include:
 beliefs in family honour and sexual purity;
 ideologies of male sexual entitlement; and
• weak legal sanctions for sexual violence

20. Health consequences
• Intimate partner (physical, sexual and psychological) and sexual
violence cause serious short- and long-term physical, mental, sexual and
reproductive health problems for women.
• They also affect their children’s health and wellbeing.
• This violence leads to high social and economic costs for women, their
families and societies.
 Have fatal outcomes like homicide or suicide.
 Lead to injuries, with 42% of women who experience intimate partner
violence reporting an injury as a consequence of this violence.

21. Health (Contd…)
• Lead to unintended pregnancies, induced abortions, gynaecological
problems, and sexually transmitted infections, including HIV
• WHO's 2013 study on the health burden associated with violence
against women found that women who had been physically or sexually
abused were 1.5 times more likely to have a sexually transmitted
infection and, in some regions, HIV, compared to women who had not
experienced partner violence.
• They are also twice as likely to have an abortion.

22. Health (Contd…)
• Intimate partner violence in pregnancy also increases the likelihood of
miscarriage, stillbirth, pre-term delivery and low birth weight babies.
• The same 2013 study showed that women who experienced intimate partner
violence were 16% more likely to suffer a miscarriage and 41% more likely to
have a pre-term birth.
• These forms of violence can lead to depression, post-traumatic stress and other
anxiety disorders, sleep difficulties, eating disorders, and suicide attempts.
• The 2013 analysis found that women who have experienced intimate partner
violence were almost twice as likely to experience depression and problem
drinking.

23. Health (Contd…)
• Health effects can also include headaches, pain syndromes (back pain,
abdominal pain, chronic pelvic pain) gastrointestinal disorders, limited
mobility and poor overall health.
 Sexual violence, particularly during childhood, can lead to increased
smoking, substance use, and risky sexual behaviours. It is also
associated with perpetration of violence (for males) and being a victim
of violence (for females).

24. Impact on the health of Pregnant women
• Common injuries suffered by abused women include burns, lacerations,
bruises, and head injuries.
• Homicide abuse partner abuse is the number-one cause of death in pregnant
women.
• Abused women may have an unintended and unwanted pregnancy because
they were unable to resist sexual advances from their abusive partner.

25. Imapct (Contd..)
• A woman may come for care late in pregnancy or not at all.
• An abused woman may have difficulty following recommended
pregnancy nutrition (she must cook what her partner wants or she will be
beaten).
• She may call and cancel appointments frequently (or simply not keep
appointments) because she has an obvious black eye or a bleeding facial
laceration she does not want to reveal.

26. Impact (Contd…)
• She may be dressed inappropriately for warm weather, wearing long-
sleeved, tight-necked blouses to cover up bruises on her neck or arms.
• A woman who has experienced abuse may be anxious to listen to the
baby’s heartbeat at prenatal visits because her partner recently punched or
kicked her in the abdomen and she is worried the fetus has been hurt.

27. Impact (Contd..)
• If abdominal trauma is suspected, an ultrasound may be done because this
is the most accurate method of assessing fetal health after trauma.
• An ultrasound may reveal minimal placental infarcts from blunt
abdominal trauma. This can lead to poor placental perfusion and low birth
weight.

28. Prevention and response:
• In 2019, WHO and UN Women with endorsement from 12 other UN and
bilateral agencies published RESPECT women which stands for strategy:
R: Relationship skills strengthening;
E: Empowerment of women;
S: Services ensured;
P: Poverty reduced;
E: Enabling environments (schools, work places, public spaces) created;
C: Child and adolescent abuse prevented; and
T: Transformed attitudes, beliefs and norms

29. Role of the health sector
• While preventing and responding to violence against women requires a
multi-sectoral approach, the health sector has an important role to play.
• Advocate to make violence against women unacceptable and for such
violence to be addressed as a public health problem.
• Provide comprehensive services, sensitize and train health care providers
in responding to the needs of survivors holistically and empathetically

30. Role of Heath Sector (Contd…)
 Prevent recurrence of violence through early identification of women
and children who are experiencing violence and providing appropriate
referral and support
 Promote gender norms as part of life skills and comprehensive sexuality
education curricula taught to young people.
 Generate evidence on what works and on the magnitude of the problem
by carrying out population-based surveys, or including violence against
women in population-based demographic and health surveys, as well as
in surveillance and health information system.

32. References:
• 1. Zack GC. STAND WITH HER: 6 WOMEN-LED ORGANIZATIONS
TACKLING GENDER-BASED VIOLENCE. USA: UNITED NATIONS;
2022. Available from: https:/unfoundation.org/blog/post/stand-with-her-6-
women-led-organizations-tackling-gender-based-
violence/?gclid=CjwKCAjwjYKjBhB5EiwAiFdSfsgkei2CnR0Ul0bU28Ri995
uoTrUf2OeIZ12tsZMhshE10WTRiXgWhoCEpEQAvD_BwE
• 2.WHO. Violence against Women. USA; 2021. Available from:
https://www.who.int/news-room/fact-sheets/detail/violence-against-women

33. 3.Reach out Auatralia. What is physical abuse? Australia: 2023. Available
from: https://au.reachout.com/articles/what-is-physical-abuse
4.Shaktawat V. Psychological/Emotional abuse against women. Rajasthan,
India: Madhav University. Available from:
https://madhavuniversity.edu.in/emotional-abuse-against-women.html
5. https://www.unwomen.org/en/what-we-do/ending-violence-against-
women