Imagine the immense pain and discomfort of breaking your collarbone only to be told by your partner—the person you may have once loved and trusted—that you're forbidden from going to the hospital. That’s what one survivor shared with DomesticShelters.org on our Survivors Community Page. It’s just another way an abuser will wield power and control over a victim.
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“I couldn’t sleep for two weeks,” the survivor told us.
She might actually be considered lucky if that was the only fallout. Left untreated, fractures can heal improperly, causing deformities, limited movement, momentous pain and possible life-threatening infections.
Preventing a survivor from seeking medical care is a form of physical and psychological abuse, as well as an aspect of gaslighting—the tactic by which abusers will convince survivors that their memory or perception of events can’t be trusted. An abuser might say a concerning symptom or illness is “all in your head.” They may convince them physical abuse that resulted in injury never happened—I didn’t grab you. Your arm must be hurting because of something you did.
And, of course, an abuser likely also wants to prevent a survivor from disclosing abuse, which is why if a survivor does receive any type of medical care—from a routine visit to a hospital stay—they’re often accompanied by an abuser who never leaves their side. Think a survivor can disclose it secretly when taken away for a test or X-ray? An abuser may have already threatened additional violence when they return home if the survivor gives any indication of being abused.
This can all add up to a survivor feeling confused, alone, scared and shamed into not seeking medical care at all.
Nine Months Without Prenatal Care
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Denetra McBride is the program director at New Horizons Domestic Violence Services, a Connecticut nonprofit that’s been providing, among other things, an emergency shelter and domestic violence hotline for the past four decades. She recalls a survivor who stayed at their shelter with her young child. She had escaped an abuser who refused to let her seek prenatal care for the entire nine months of her pregnancy.
“She talked about being kept in the house, restricted to just one room,” says McBride.
Luckily, her child was born healthy but this isn’t always the case. Domestic violence during pregnancy has been shown to double a mother’s risk of preterm birth—before 38 weeks—as well as an increased risk in low birth weight, resulting in the baby having more difficulty fighting off infection.
McBride notes that this particular survivor was also an immigrant, part of a population even more at risk for this type of control since abusers know they can use it as a deportation scare tactic. If the survivor was undocumented, the abuser may convince her medical personnel may report her. (Healthcare providers should protect private patient information under HIPPA laws and are not legally obligated to inquire into or report to a patient’s immigration status to authorities... though, unfortunately, some do.)
Holding Insurance Cards, Prescriptions Hostage
McBride recalls other cases of withholding medical care from survivors, like one who told shelter advocates her abusive husband first made her quit her job, then withheld his employer-provided insurance from her and their children.
“He wouldn’t let her have the insurance cards and told her she didn’t need to go to the doctor. Instead he would say, let’s just use some over-the-counter medication.”
This may be all well and good for a slight fever, but without annual exams, necessary vaccinations and access to emergency care, children can face a higher risk of disease, a missed diagnosis or early intervention for developmental delays.
“My ex-husband used to steal my medication from me little bits at a time ... so I was always running out early, and made me and everyone else think I was taking too much and was a crazy pill addict,” one survivor told DomesticShelters.org.
“My [abusive partner] smashed my birth control pills into a million pieces midcycle because he wanted me to get pregnant so he would have more control,” another wrote.
The National Coalition Against Domestic Violence found that a quarter of all women being abused by their partners also report being pressured or forced to become pregnant. Reproductive coercion is yet another way abusers can keep their victims trapped indefinitely.
Find Support, and Soon
As a grown adult, you have the right to seek medical care when needed. You don’t need the permission of a spouse or partner to do so. And if you feel like you do, or you’re scared to reach out, something is wrong.
“It’s part of isolation,” says McBride, and emphasizes, “Safety planning is definitely number one.” Reach out to a trained domestic violence advocate near you or, says McBride, if you feel more comfortable, reach out to a friend or family member. Tell them what’s going on. Tell them it may escalate (unfortunately, it usually will). “Ask them to check in if they don’t hear from you for a couple of days.”
To better understand the isolation aspect of abuse, read “From Romance to Isolation: Understanding Grooming.”
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