News

Margo Kennedy remembers encouraging the young woman at the support group for abused women, celebrating her plans for a nursery and choice of a baby name.

But at home, the woman - in her 20s and pregnant for the first time - attracted only scorn from her partner. She wasted money on baby clothes, he said. She probably cheated - this wasn't his child. Her belly was fat; he'd have to look elsewhere for sex.

"She was under incredible stress during her pregnancy," said Ms. Kennedy, a social worker who can't forget the woman whose daughter would be born prematurely and die soon after.

The woman's story, like the stabbing death of a pregnant Toronto woman on Monday, highlights a problem that doctors, counsellors and advocates have flagged for years: Pregnancy is one of the most dangerous times for women in abusive relationships.

In a Health Canada study, 21 per cent of abused women reported violence during pregnancy, and of those women, 40 per cent said the violence began while they were pregnant.

Homicide is a leading cause of trauma death to pregnant women in the United States.

While comparable statistics are not available in Canada, recognition of the problem led gynecologists and obstetricians to issue a new set of clinical guidelines on how to look for signs of abuse in patients in 2005.

The most horrific cases in which spouses are accused of abusing and killing their wives usually make the headlines. Earlier this week, 25-year-old Aysun Sesen died in Toronto after suffering multiple stab wounds to her abdomen, police say. Efforts to save her unborn child failed, and Ms. Sesen's husband, an unemployed carpenter, has been charged with second-degree murder.

Other highly publicized cases include Laci Peterson, whose body was found in San Francisco Bay; Liana White, whose body was dumped in a ditch near Edmonton; and Manjit Panghali, the Surrey, B.C., schoolteacher whose charred body was found next to a highway last year.

All of the women were pregnant when they were killed and their husbands later charged in connection with their deaths. Two were convicted; Ms. Panghali's husband is awaiting trial.

Experts have several theories on why partners abuse pregnant women.

"Control is a major dynamic in domestic violence cases," says Dr. William Lucas, a regional supervising coroner and chair of Ontario's Domestic Violence Death Review Committee, which analyzes many of the provinces estimated 29 to 40 deaths related to domestic violence each year. "Pregnancy is one of those situations where the female ... has a lot of control over what's happening with her body. Psychologically, some males perceive that as a threat to their dominance."

Abusers may also resent the attention showered on their partner, said Irene Gabinet, who counsels pregnant women and new mothers who are in abusive relationships at the Women's Health Centre at St. Joseph's Hospital in Toronto.

"People are attracted to pregnant women like magnets to steel," she said. "An abusive man does not want her to be getting that attention. That's part of the abusive dynamic."

Many of the women contact Ms. Gabinet during their third trimester. Often, they wait that long because they believe that their abusive partners will relent during their pregnancy.

Sometimes, they are right. But most often the abuse continues, or gets worse, says Ms. Gabinet, who has been counselling women in abusive relationships for 13 years.

"Women are asking me: Do you think this is going to change after I have this baby? Help me understand what's going on here. Why isn't he changing? Why is he abusing me while I'm pregnant?"

Increasingly, medical professionals are taking on the issue of domestic violence, because deaths can be prevented - if intervention comes early enough.

Since pregnant women need medical attention, doctors are in a unique position to help women who might hesitate to disclose their abuse out of shame, fear, or embarrassment.

"What's become more of a priority in recent years is working with health-care providers so they have a better understanding of the signs and symptoms," said Marsha Sfeir executive director at Springtide, a Toronto-based charity that runs programs aimed at preventing domestic violence.

Two years ago, the Society of Obstetricians and Gynaecologists of Canada created new guidelines for doctors to help them know what signs to look for and how to help.

Women abused during pregnancy are more likely to be depressed, suicidal and experience pregnancy complications and poor outcomes, according to the guidelines.