We are aware that violence disproportionately affects our transgender and gender non-conforming clients, especially those of color. We are committed to continuing to learn, gathering resources, and supporting you. Be aware that all of the resources listed and more are at your disposal. Additional information to be posted soon. (07/01/21)
It is a terrible fact that violence against women is epidemic in the United States. Studies show that between 40-50% of women will be raped in their lives. Between 16-32% of women report having been sexually abused before the age of 18. As many as 50% of women report they have been a victim of physical violence in their marriage or other primary relationship. These are not easy issues to discuss, but they are important ones for the safety and well-being of our clients. We will see you alone for a visit once during your pregnancy to screen for any abuse.
Our midwives would like to emphasize that violence against women is always wrong. No one deserves to be hurt or sexually abused. The Midwife Center is a safe place to talk about what has happened or is happening to you. The midwives will not give any information about abuse to police or to your family without your written permission. (The one exception is that as health care providers in Pennsylvania, we are required to report any evidence of child abuse to the authorities.)
Any person in our care who tells us they are being or have been abused will be believed, and we will work with them to form a plan for their health and safety. As part of your prenatal care at The Midwife Center, the midwives will ask you periodically throughout your pregnancy if you feel safe at home.
Physical Abuse
Often, physical abuse begins or worsens during pregnancy, perhaps because of the added stress. Some women will want to leave their partners who become abusive. We can help these women by referring them to shelters and counseling organizations that can help them find shelter or file orders with the court to prevent their partners from abusing them.
We can also assist women to form plans for their safety and the safety of their children. Many women do not want to leave their abusers at the present time. The midwives can help them by examining any injuries that happen to the woman and documenting them in her chart. These records can be used as evidence if the woman wants to go to the police in the future.
We can also refer women to counselors skilled at helping women who are abused. It is also helpful for us when planning her care to know if a woman is in danger at home, just as it is helpful to know that she smokes or has a history of high blood pressure.
Sexual Abuse
Some women who have been sexually abused in the past find that pregnancy can cause them special problems. These women may have difficulty trusting their midwife, may become very tense during physical exams, and may have flashbacks to their abuse or separate their minds from their bodies during exams or the birth.
If women tell the midwives about their history, we can work together to minimize these effects. We can provide referrals to skilled counselors. And we can search for alternatives whenever possible. A woman who may remember being abused if she lies on her back to give birth may feel safe and powerful on her hands and knees! The midwives are experienced at working with survivors of sexual abuse, but can only help if a woman tells us about her history.
Rape
If a woman is raped she can contact the midwives and be seen any time, day or night. The midwives can provide emergency contraception to prevent pregnancy, and can test and treat the woman for sexually-transmitted infections.
If a woman wishes to press charges against the person who assaulted her, we will refer her to a sexual-assault nurse examiner, a nurse specially trained to collect physical evidence which can be used in legal cases. We can also help the woman find a counselor who is experienced at working with women who have been raped.
Some Questions to Consider and How to Seek Help
• Has your partner, ex-partner or family member ever hit, slapped, kicked or physically hurt you?
• Has this person ever threatened to hurt you or someone you love (including pets)?
• Has your partner ever tried to restrict your freedom from doing things important to you (like working, going to school or seeing friends/family)?
• Are you afraid of your partner or family members?
• Do you feel you are in danger?
If you answered yes to any of these questions, you are at risk. In conclusion, The Midwife Center is a safe place to talk about any history of violence a client has. At the same time, we realize not all clients will be comfortable discussing these issues with us.
If you cannot talk to us, we recommend the following resources:
Women’s Center and Shelter of Greater Pittsburgh - (24 hour hotline) 412.687.8005 or toll free at 1.877.338.8255
Pittsburgh Action Against Rape - (24 hour hotline) 1.866.363.7273
No one ever deserves to be raped or abused.