Perhaps nothing motivates a woman to leave an abusive situation more than knowing that her child might be in danger. And the risks for a battered mother-to-be and her baby are substantial. The range of injuries inflicted on fetuses includes skull and femur fractures, early separation of the placenta, and death; the mother's uterus may be lacerated as well. Battered women who are undernourished -- a significant number are so depressed or anxious that they fail to gain enough weight during pregnancy -- are more likely to have a low birth weight baby (under 5 1/2 pounds). This is especially worrisome because these babies are 22 times more likely to die before their first birthday. A malnourished mother-to-be increases her odds of becoming anemic, of having a difficult recovery from childbirth, and of suffering from vaginal and urinary tract infections, bleeding and spotting, and miscarriage. Her chances of preterm delivery go up, too, in turn increasing the odds that her baby will have breathing and feeding difficulties. Bonnie Dattel, M.D., a professor of obstetrics and gynecology at Eastern Virginia Medical School in Norfolk, says research indicates that the risks to children may go well beyond infancy to include developmental and learning problems at school.
To make matters even worse, many women turn to cigarettes, alcohol, or drugs to numb depression, anxiety, and suicidal feelings. "They use the substances to cope with the violence," says McFarlane. And because battered pregnant women are twice as likely to delay prenatal care until the third trimester, they place themselves and their babies in even greater danger. They may be too depressed to take care of themselves properly, or afraid a doctor or nurse will ask about their injuries. Some batterers even stop partners from getting care. Dr. Chambliss's patients have confided to her that husbands or boyfriends had taken away car keys or bus fare to prevent them from seeing a doctor.
Expecting the Worst ahead