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Women’s experiences of Domestic Violence and Abuse

Getting help from doctors and other health professionals for domestic violence and abuse

Early research showed that women were using health services to address physical injuries as well as the emotional impacts of abuse. It wasn’t until the mid-1990s in the UK however, that the medical profession began to address the issue. Many women in abusive relationships make contact, at some point, with health services, either though routine check-ups, for appointments during pregnancy and child-birth, for help with stress and mood disorders or for treatment of injuries caused by physical abuse. Early research showed that women used health practitioners because the consultation was confidential, thereby allowing them to assess and judge risk, and because it might be the only place a partner would allow them to go alone.

 

The GP was the first person Alonya talked to about domestic abuse. She said she didn’t know ‘where she would be’ if she hadn’t, and her GP ‘called up exactly the right people’.

The GP was the first person Alonya talked to about domestic abuse. She said she didn’t know ‘where she would be’ if she hadn’t, and her GP ‘called up exactly the right people’.

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The police did that and then I went to GP…

Ah, ok.

… I was already on, on antidepressants…

Right.

…and I needed a higher dose. 

Right.

And I burst out, it was after the policeman, after a few days. 

Right.

And I burst out and I spoke to GP and I said, “This is what happens”, and she helped me.

Right.

She called up to the social worker… [tearful].

Right.

… which, who helped me a lot in the beginning. And she contacted [local Domestic Violence and Abuse agency].

The doctor did?

The doctor did. 

Right.

So she’s, she was, she made the referral to [local DVA agency]…

Right.

… and she made the referral to social worker. 
The research in this area has continued since 2000 and we now have a range of training opportunities available for general practice and other staff. The IRIS programme (Identification and Referral to Improve Safety)* is now in operation across the UK, providing training for general practitioners and other health professionals in how to identify victims of domestic violence and abuse combined with a referral pathway to the local domestic violence and abuse services (see also ‘Getting help from counselling & therapy for domestic violence and abuse’ and ‘What doctors need to know about domestic violence and abuse’).

*See Resources & Information page

Women we interviewed usually found it hard to talk to doctors or nurses about problems at home, unless the health professional asked them first. They were not sure about confidentiality and worried that other people, including their partner, might find out if they said anything. Women particularly feared losing custody of their children. Tanya, whose back was covered in bruises after an assault did not want to tell her doctor about the cause. She said, ‘You don’t want anyone to know what’s going on, you feel stupid, feel ridiculous’. In most cases women only talked to a doctor after the relationship had ended, for fear of reprisals from their partner if he found out. Tanya was:

‘Terrified of telling [the doctor] …terrified I’d have the kids taken off me, I was scared he’d kill me if he found out I was telling someone, but I did it because I had to’. 

Disclosure for some women happened very gradually as they were often ‘closed down’ or ‘self-doubting’ and found it difficult to talk about abuse. (See ‘What doctors need to know about domestic violence and abuse’.)

Getting to see the doctor alone

A major difficulty for women was getting a chance to talk to the doctor on their own since their partners insisted on accompanying them. Some women did not seek medical attention at all for fear of their partner’s reaction, and they convinced themselves that emergency treatment was not necessary. Abusive partners did not encourage women to seek medical treatment, such as Jessica’s husband who would not take her to hospital for a broken ankle until she had first cooked tea for the family. 

Following a miscarriage, Yasmin endured eleven days of increasingly heavy bleeding before her husband took her to hospital. After a life-saving blood transfusion while Yasmin was still weak, her partner took her home before anyone asked any questions.
 

Yasmin was shocked that the hospital would let her go in a weak condition following major blood loss.

Yasmin was shocked that the hospital would let her go in a weak condition following major blood loss.

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I mean when I went in hospital I had eight point something in blood …

Uh-huh.

… and when they done the morning blood test it was four point something.

Gosh, mm.

After all the D&C and after all … everything. I lost half of my body blood, and I was not with …

No.

… I was like faint. The nurse who came into that, and she’s checked the blood pressure and she got panicked. She rushed to call everybody.

Yes.

At that time I had 21 glucose and three bottles of blood.

Right.

But he was like, ‘Oh you can’t look after her’ and this and that, ‘I’m taking my wife home.’ And he did took me home [laughs].

He took you home?

Because he got so much concern about it, they might … because they had D&C and everything, they might ask me something and I might … 

But you didn’t, so you didn’t get a chance to talk?

When I came home and I said, ‘That’s it.’ And he make sure I’m not telling my sister and sister-in-law it was miscarriage, and just make sure … ‘You just tell them oh, I was not feeling well.’ So he took me home, and I’m shocked how hospital let me go …

Yes.

… in that condition.

Yes. Yeah.

They shouldn’t.

No.
 

When Sara became seriously ill one night her husband, after making himself a cup of tea, reluctantly rang for an ambulance. Her check-up was Sara’s first chance to see a doctor alone (read by a professional).

When Sara became seriously ill one night her husband, after making himself a cup of tea, reluctantly rang for an ambulance. Her check-up was Sara’s first chance to see a doctor alone (read by a professional).

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He said, "I can't believe this is happening again" and I was just like, sat there bewildered like "I'm not trying to, like I don't want to be like this." And he's like, "I'm fed up with it, I've had enough." 

And he went down and made himself a cup of tea, he come up with his cup of tea. Then he rang the doctor and said they're sending an ambulance, they sent the ambulance, and he stayed at home with the kids because they were in bed, and I went to hospital on my own. But yeah when I came out of hospital I had to have check-ups with the doctor and he came with me for a few of them and I was really hoping and praying I could get to one without him being there and I did. And I think when the doctor said, ‘How are you?’ I just broke down in tears. 

Really, gosh. So was that the first time you'd really said anything to anybody?

Yeah I think it was actually. Because I think she gave me the number to the domestic abuse people and I spoke to them for two weeks solid, crying and everything, saying but I'm breaking up the family. 

Really. 

I had this real sense of guilt because I thought oh my goodness and they're like but you're making it better and then that was the thing and I had real peace about going.
Khalida’s husband psychologically and physically abused both her and their son but she could not confide in the doctor as her husband always went with them. The boy, aged 12, had a chronic bowel problem and had attempted suicide, but he managed to create an opportunity for disclosure.
 

Khalida reveals how her son took the initiative to disclose abuse and she talks about the repercussions she would have faced if she had tried to visit the doctor alone (read by a professional).

Khalida reveals how her son took the initiative to disclose abuse and she talks about the repercussions she would have faced if she had tried to visit the doctor alone (read by a professional).

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He was shouting at the boy all the time, and he was upset all the time. So I said, “I can’t cope with this. It’s happening, it’s like all the time now. There’s no respite.”

Yes.

It was stress, stress, stress, stress, stress. So the poor boy is suffering.

Yes.

And then I realised. Then in the morning, one morning – oh sorry, then I took him to the doctor’s. He said, “I’m not going to let you take, take him to the doctor’s. You’re going to come with me. I’m going to go to the doctor. I’m going to talk to the doctor about this disgusting devil of a child, this and that. He’s not bleeding, he’s not anything. He’s lying, he’s this, he’s not, he’s not going to kill himself, he’s not.” So anyway, we went to the doctor. And the doc – and my son 

The three of you together?

Three of us together. Obviously we couldn’t, we couldn’t say anything in front of him. But my son, being, became brave and said to the doctor, “Can I speak to you without my parents?” He said it with me included, in case my father thought, his father thought that, you know, I’m included in it or something, in what he’s going to say. So after he the doctor asked us, “OK, would you mind if you went outside for ten minutes?”

So the boy had asked in front of both of you?

Yeah hmm.

Wow.

Yeah, so he was very brave.

Yes.

So I said I said, “Of course, yes, of course.” Because I knew that he was – whatever he wanted to tell the doctor. So anyway my husband was fuming when we came home. “What did he tell the doctor? You bastard this, you bastard that.” I said, “Well I don’t know, whatever was upsetting him, I guess,” I said, “he’s probably talked to the doctor about whatever was upsetting him.” And when we came in to came in to see the doctor afterwards he said, “Well I understand what’s happening with your son. And Monday I will arrange for a therapist, a therapy for him. I will arrange for someone to do counselling for him. And I will see, you know, see what I can do on Monday. Because now it’s Friday evening and I can’t do anything right now.” So anyway, Monday morning came and at eight o’clock in the morning I phoned the doctor’s, because I wanted to see the doctor, because my son wouldn’t go to school. He didn’t want to go to school and he was bleeding again. And I said, “They need to give him some medication. The colonoscopy was inconclusive. They need to give him some medication.” So the medication so he didn’t, because he didn’t have it, I said, “I need to take him to the doctor’s to get medication, see why he is bleeding, to stop the bleeding.” But my son had already told me that the doctors, “One doctor wants to see me and you together, he doesn’t want to see dad with us.” So I decided that, yes, we are going to go on Monday. I wanted it done urgently as possible. My husband wouldn’t let me go. He said, “You’re not going to the doctor. You’re not going to see to the doctor again. You’re never going again to the doctor with him. I don’t know what you’re telling the doctor. I don’t know what’s going on.” I said, “Yes I am. My son is bleeding, my son is suicidal, I am going to take him to the doctor’s and I am going to see what the doctor is going to do about it.” He wouldn’t, he wouldn’t, he wouldn’t let me go. I had my keys in my hand and my coat on, everything, got him ready. He wouldn’t let me go. And then I phoned my eldest daughter up. I said, “Listen, dad is not letting me take [participant’s youngest son] to the doctor’s. I need to take him to the doctor’s to stop the bleeding, it won’t stop.”

What would have happened if you’d just physically gone?

He’d got the keys on him, outside keys. Because that’s what he did. Whenever he didn’t want me to leave, he would keep the keys on him. Obviously, if I tried to snatch the keys he would beat me to death or something or whatever. You know, I would be too afraid to snatch the keys from him.

Yes.
Experiences of talking to a doctor

Women’s experiences of talking about their relationship to a doctor or other health practitioner varied widely. For many it was a crucial first step in accessing specialist domestic violence and abuse services. Others, however, found their doctors to be un-helpful or lacking in the knowledge and resources to help. 

Good experiences

Many of the women had good experiences of talking to their GP, particularly if the doctor had known them for a long time or if they were able to choose a particular doctor at the practice that they felt comfortable talking to. Lolita’s doctor ‘always had an ear for [her]’ and ‘referred [her] to everyone!’ The most helpful outcome for women was being referred by their doctor to a specialist Domestic Violence and Abuse Agency.
 

Mandy, depressed and unable to sleep was offered counselling and medication by her GP who also wrote the phone no. for Women’s Aid on the prescription.

Mandy, depressed and unable to sleep was offered counselling and medication by her GP who also wrote the phone no. for Women’s Aid on the prescription.

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I think I realised that I had serious problem in the sort of September/October last year. I thought I was depressed, I wasn’t sleeping. I was having a hard time at work as well. I went to see my GP and she prescribed me antidepressants and signed me off for two weeks. She also put me forward for counselling because I said I, I felt like I was depressed and I was really struggling at work, it was having a negative impact on me. And I think it was the counsellor that first sort of flipped the switch in my head, and I thought, “Oh my God, she’s actually right”, and suddenly everything made sense. It wasn’t me that was depressed, it was him, and because of it he was making me miserable. As soon as I actually ended it, I felt free. 

So when, when did you go to see your GP, in the…

It was, it was in the October, because I was…

…Right. 

…still signed off for two weeks, last week of October, first week of November. 

So after it all?

Well, while I was, yeah, I think, I was on my first week when he attacked me. 

So, did you, what did you tell your GP? Did you discuss it like, what had been going on in your relationship with him or…?

Yeah…I can’t even remember, I know I wasn’t sleeping. I didn’t think I was coming out of there with antidepressants, I thought I was coming out sleeping pills. I hadn’t slept properly for weeks. I was irritable. I was tearful. I was stressing, and I mentioned I was under-performing at work, and I probably said that I was snapping at him…

Did you say how he’d been to you?

I must have done, because on the prescription she gave me the phone number for Women’s Aid.

Right.

I can’t rem-, I honestly can’t remember, as I say … 

…She wrote it on there.

She wrote it on there, and told me what she’d done and I remember taking, taking these antidepressants and, everything just went a little bit soft-focus. I remember, they gave me an incredibly dry mouth, no amount of water could, could help with that and, I didn’t stay on them long. I think I maybe did three weeks…

Yeah.

…and I just felt so rubbish on them. It, but it took weeks for the dry mouth to go away. 
Jane felt that health professionals ‘are a lot more clued up about domestic abuse now’ and the joint working of doctors, police, her children’s school and social services made it possible for her to leave her husband of 20 years.
 

Jane could not stop crying with relief when she was finally able to say what was going on.

Jane could not stop crying with relief when she was finally able to say what was going on.

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Because you’ve always got that voice in your head, you’ve always got that feeling that you know you’ve done nothing wrong, which is partly why the mental torture is so bad, is because you know that you haven’t done anything wrong but he’s making you believe, he’s trying to make you believe that you did something wrong. So the minute you’ve left that relationship it all seems to lift. It’s like a big weight that’s just been lifted off your shoulders. But, you know, I had tremendous support from my doctor. There was only one doctor that I wanted to see, and she saw me during her lunch hour because she had to measure my injuries just in case it went to court, if I pressed charges, and different things like that. And she’d just make sure that I had the right medical support as well so.

And the contact with that GP over the lunch break, what day did that happen?

That happened, I think, on the, on a Friday.

Friday.

Happened on the Friday.

Was that the day after…

Yeah.

…he beat you up?

Yeah, it was the day after.

And was that the first time you’d been to a GP and talked about what had happened?

Yes, the very first time. And again, I couldn’t stop crying because it was such a relief, such a relief to, to actually finally say what was going on. Because you, you kid yourself that everything’s OK. You know, you sweep it under the carpet and you, you make excuses. And every time you do that a little bit of you gets lost.

Yeah.

So then when you finally do lift that carpet up and sweep up all the rubbish, it just comes out so much and it’s just a, a great relief to, to finally get that off your shoulders and to, to, to realise that, you know, it wasn’t you, you haven’t done anything wrong. It was the relationship, you know, and you’ve called time on it and that’s the correct thing to do.

And how did you get that appointment with the GP? Was that through Social Services?

It was through Social Services.

Right OK.

Yeah, they just literally rung up my GP surgery and said, “Look, you know, [Name of participant] has suffered some severe trauma and injuries from domestic violence attack. Would you be willing to see her?” And, yeah, straight away, no problem.

Yeah.

Got in straight away.

Was it a she?

Yeah.

And how did she react? What did she offer?

She just said, “Things make sense now.” Because, you know, they could never quite understand as to why I suffered so badly from the, the pain I was suffering and how I was getting through so, so many tablets and everything suddenly sort of like started to make sense. But like the impact of that health-wise is I still now have to take a pill sometimes when I feel stressed.

Right.

It’s something that doesn’t go away. It’s now a lot, lot, lot better than what it was, because I was doing that all the time. But I still get that moment, I suppose it’s like a smoker having to give up cigarettes or an alcoholic having to give up alcohol, you still get those moments when you feel that you need that, that crutch, just to get you through the day.

Yeah, yeah. And were there times in the consultations when you were at the GP’s and talking about the pain you were experiencing that you thought perhaps it was something that you could disclose to them?

You’re worried that, as a result of that disclosure, that something is going to happen that you’re not going to be able to control. You’re worried that you’re going to say something and that they’re not going to do anything or, you know, nothing’s going to happen, or it’s going to get looked into and then everything’s OK, everything’s fine and just, you know, close the door again and leave you to pick up the pieces. 
 

Irina’s GP was ‘really really helpful’ in providing a letter for her to apply for Legal Aid

Irina’s GP was ‘really really helpful’ in providing a letter for her to apply for Legal Aid

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And just thinking, you saw met with, met with the worker from [Women’s support service] in your GP practice, have you ever kind of discussed your situation with your GP or a health visitor or any, any health professional?

Yeah, three years ago I, because he hit me …

Yeah.

… just, this part of the head and, he just, I went to check my eyesight and everything I reported. And also I went to see her because I need, I needed letter from GP to apply for Legal Aid.

Right.

And she was really helpful. She was really, really helpful. 

What sort of support, so what was her reaction to your disclosure? How was she supportive? Or not supportive?

You know how she looked at me, I’m not the first, first woman coming to her asking for this letter. But it, it’s, of course it’s confidential information. If I, if we, if she could tell me all those stories, probably she would. And it’s just understanding …

Yeah.

… the situation. And she gave me letter straight away.
Sara went to her GP for a check-up following pneumonia, for once without her husband. She ‘broke down’ and talked about her home life, and the GP gave her the telephone number of the domestic abuse help-line. She said her GP was ‘amazing ... exactly the right doctor at the right time ... a female ....she just listened, let me cry ...gave advice, was very proactive... she said I could ring her any time’

Un-helpful experiences 

Some women experienced an un-helpful response from their doctor or had low expectations of their ability to help. Several women, like Stephanie didn’t go to the doctor as they knew they would be given anti-depressants and put in a long queue for counselling.
 

Initially Kate felt that talking to her GP and a counsellor about abuse made the situation worse as she had to go home and face her husband’s frightening explosions of anger.

Initially Kate felt that talking to her GP and a counsellor about abuse made the situation worse as she had to go home and face her husband’s frightening explosions of anger.

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Did the GP give you any support before you left the surgery, in terms of what you may return to at home?

No I believe she said that, you know, “If you felt in any danger to call the police.” I think she said that. But, no, the reality of it was I just had to go home and, and deal with whatever the fallout was going to be, and I had to do it by myself. And I think that’s quite dangerous. I mean both the [marriage guidance] chap and the GP inadvertently made the situation much more dangerous for me and the children, because what was happening was making him so angry and out of control. That I feel actually quite fortunate that there wasn’t more violence as a result.

How do you think they could have managed the situation differently?

I don’t know how the situation should or could be handled. But I think there needs to be a recognition that if you’re going to tell a person that they are abusive or report them to Social Services or report them to the police and that you’re likely to trigger an angry attack, then you have to bear in mind that there might well be reprisals for the partner. 
Women who went to their GP with exhaustion, sleeplessness, low mood or anxiety often found that the doctor focused on testing for physical illness or simply prescribed anti-depressants. Julia felt that GPs are not trained to ‘go below the surface’. Short appointments were also a problem. As Melanie said, if she started opening up she ‘would be there forever’. Some women found it difficult to talk to a male doctor, or an unknown doctor if they had moved home. Others were mistrustful of confidentiality if they talked to a doctor who also treated their partner. 

Several women said that talking to their GP about problems at home was not helpful when no further support was offered. Ana’s doctor was ‘quite nice and understanding’ but ‘nothing happened’ afterwards. Kanya talked to her GP and a counsellor but still felt alone in having to ‘deal with the situation’.

Lindsay was anally raped and damaged internally on her wedding night but her GP and the hospital doctors refused to accept that a woman can be raped by her husband. On another occasion, covered in bruises, Lindsay went to her GP for help with depression and her doctor commented that ‘all marriages go through a rough patch’. She contrasted them with her current GP who specialises in sexual abuse and is ‘absolutely brilliant’.
 

Lindsay described her contact with doctors who did not acknowledge domestic abuse after she was raped by her husband.

Lindsay described her contact with doctors who did not acknowledge domestic abuse after she was raped by her husband.

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Back in 2001 when he first raped me, the police, doctors, appalling, no support, no nothing.

Did you go to them and tell them what was

Yeah.

happening?

I went to me doctor. Got married on Friday, raped me Friday night, went to the doctor’s Monday. The doctor just said, “Everybody goes - it’s a new marriage, everyone goes through a rough patch.” Anyhow, I ended up bleeding from the back passage, had to ring an ambulance. Police escorted me to the hospital and on the way down there the policeman [sighs] he just said to me, “How can you have been raped by, it’s the partner’s, this is the partner’s journey,” or something like that. “How can you be raped by your husband? He’s just had it a little bit too rough.” Until the nurse the nurse’s report came back, the internal came back and there was damage done to, on the inside. Wasn’t offered no support then by the police. No victim support.

What about the hospital when you, just checking it’s coming through here.

No, nothing, like no counselling, no, absolutely no nothing.

So they just sent you away from the hospital?

Yeah.

They just sent you away with a?

Just give me some antibiotics in case I had an infection through the ripping of me back passage.
Tanya lived in a small tight-knit community where her partner’s family, his alcohol addiction counsellor and the teachers at her children’s school all knew he was abusive but no-one would talk about it or offer her support.
 

When Tanya told her GP how scared she was of her husband, her GP responded: ‘Oh, that’s Irish daddies for you’.

When Tanya told her GP how scared she was of her husband, her GP responded: ‘Oh, that’s Irish daddies for you’.

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Yeah, my daughter was playing a sport the next day and we, I told the lady that I knew was the child protection officer of the sport team.

Right OK.

So I told her. It took me ages. It took, it, it, I don’t know how long it took. I was stood outside her car window, outside her car, trying to tell her. And it, it took me at least ten minutes to say, “I’ve got something that I need to tell you.” yeah, so I did. And I was sat [voice falters] in the car with her and I told her everything, how he’d been that night, and that it wasn’t really an isolated incident. And she said I needed to speak, tell my GP.

Right. Was she the first person you disclosed to what had been happening in your relationship or had there been other people?

No, she was the first - no, I’d told - his mum knew, his sister knew.

Yeah OK.

His addiction counsellor knew.

So you said about the keys, yeah.

I tried telling the GP before, but the GP was, had been my husband’s father’s GP. We were living where all his family had grown up and were still there from.

Years and years.

Yeah, so really I didn’t stand a chance. So I told her and she said, “Oh, that’s Irish daddies for you.” I said, I said, because we were scared about my youngest son, my husband had been very emotionally cruel one morning and then we’d ended up at the GP for a toe, a sore toe, some damage. I mean my husband hadn’t done it. I’m not making sense. 

Yeah, but that’s XXXX.

We were there because of a foot injury to my son, yeah. And I’d said about being scared of my husband and that he’d upset us and he’d upset the kids sometimes. Because one thing he’d do with the kids was he’d grab hold of them, lick their faces, which would just upset them. Obviously, whenever he was doing stuff like this, I was trying to get him to stop. And, you know, made, you know, like, “Alright, bedtime kids.” Just always trying to keep things as peaceful and OK.
Experiences with other health professionals 

Some health professionals suspected domestic abuse and tried to talk to the women concerned who were not always able to respond. Victoria’s midwife asked her directly if there was ‘abuse going on at home’ but Victoria, in floods of tears was not yet ready to admit the real cause of her unhappiness to herself. Ana’s breastfeeding counsellor observed her partner’s behaviour and shared her concerns with Ana.
 

Ana was ‘petrified’ of her husband’s anger and made excuses for his behavior (played by an actor).

Ana was ‘petrified’ of her husband’s anger and made excuses for his behavior (played by an actor).

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And then I remember one incident, yeah, it was just a couple of months after I gave [gasps], oh in the hospital, oh God, yeah. When … so it’s coming to me, yeah.

When you were giving birth?

When I was giving birth, he was actually really good before and then during the, during labour, and then after, it was really weird. I was, they come to visit me, his mum come and his sister and he was there and the baby was next to me, and the way he was speaking to me was you know, it was just, he was basically being rude to me so much that one of the breastfeeding advisors pulled me to the side and she said, “Oh sorry, can I just talk to you about breastfeeding equipment?”

Yes.

And I said, “Okay. Okay, whatever.” so, and she said, she said to me, “You know this man is abusing you, he’s abusive, you know you can get help and you can ring the helpline.”

Really?

Yeah, so she recognised and she’s seen the look he would give me and the tone he was giving him, she recognised it straightaway.

Really?

And I, obviously, at that point, I was petrify.., you know, I was like, “No, no, no. He’s just…” Oh, just making excuses. “Oh no, he’s tired or oh no he’s stressed.”

Well what things was he saying to you that made her …

I can’t remember but he was giving me the looks and he was just like, everything I was doing, if I packed the bag, he would get angry over absolutely everything. He would just look at me and I’d get scared. It was the look.
Yasmin had few opportunities to be alone and her health visitor did not pick up on the hints she gave about her controlling abusive partner. Yasmin later found out that her midwife and health visitor had written their concerns about her welfare in her medical notes but no action was taken.
Whilst being assessed in a psychiatric unit, Min was denied access to her seven-week old baby who she was breastfeeding.
 

Min was not allowed to feed her baby and she was left overnight without access to a breast pump to relieve the painful swelling (played by an actor).

Min was not allowed to feed her baby and she was left overnight without access to a breast pump to relieve the painful swelling (played by an actor).

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So they took me to the hospital, the mental health unit. This was like 7.00 pm or something so of course all the psychiatrists were off duty. And [blows nose] they put me in this room with a little window. They told me not to close the window. And they put a chair outside and there was a person sitting outside the whole night. Nobody talked to me. I didn’t know what the hell was going on. I had no idea what was going on. My breasts were going to explode and so I said, “I need a breast pump. Please will you get me a breast pump.” The nurse in the maternity wing actually said, “You won’t be needing one of those for much longer.” Then I got angry. So I phoned up again and demanded to speak to somebody and demanded a breast pump. So one got sent up by a really, really nice nurse, completely different to the other one [sniffs]. The next morning I got up and I made sure, as soon as it got to nine o’clock, I made sure I was dressed, I was ready. And I got out of the room. I told the psychiatric, psychiatric nurse or the body guard or whoever was there outside my room, I said, “I need to make a formal complaint about this. This isn’t right. Please take me to someone.” So they took me to an office. And I said, “I want to make a complaint about this. I’m being falsely imprisoned. This isn’t right.” Within two, within two hours I had a mental health lawyer, I had a family lawyer, I’d been visited by Social Services. 
Women’s fears and anxieties about talking to health professionals

Fear of losing their children 

Many women were afraid to talk to a doctor about their abusive relationship for fear that the doctor would contact social services and they might lose their children. This view was reinforced by Min’s GP who knew about her abusive relationship and advised her to ‘put up with it because it’s better than having your children removed’.
 

Min described her GP as ‘absolutely lovely and totally clueless’. She told Min not to ‘rock the boat’ by talking about abuse (played by an actor).

Min described her GP as ‘absolutely lovely and totally clueless’. She told Min not to ‘rock the boat’ by talking about abuse (played by an actor).

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In terms of other professionals, have you ever been able to talk to say a GP about what’s been going on and had any help from them at all?

My GP is absolutely lovely, absolutely lovely and totally and completely clueless. Totally clueless.

Really?

Yeah.

At what stage did you ever try and talk about the abuse?

The whole time.

So you were able to talk, you felt able to talk about it?

Hmm, she said, “Don’t say anything. Don’t rock the boat. You don’t want Social” – because she knew about my history, she said, “You don’t want Social Services involved because they might take your children away,” that was her view. She put me on antidepressants. She put me on Beta Blockers for anxiety. She arranged for counselling. But she told me I had post-traumatic stress disorder and arranged for CBT, but of course it was not appropriate. She did what she could, but she had a complete lack of understanding of coercive control.

Right.

And her view was definitely, “Put up with it, because it’s better than having your children removed,” which, as somebody in that situation, was very much my belief system, if you like. But I think a professional should have steered me in a different direction, to be honest with you.
 

Anna felt that health professionals and police did not know how to provide support for domestic abuse, and she never lost the fear of losing her children.

Anna felt that health professionals and police did not know how to provide support for domestic abuse, and she never lost the fear of losing her children.

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You have a fear when you’re a mum that they are professionals who could take your child, who are the most precious things to you in the world. I’m not going to risk that. And there’s a, a load of mums out there that feel exactly the same. So, no. And I’ve also had to learn the hard way by being open and honest about the past, the domestic abuse side that it can be a preventive tool for getting your other children recognising that they’ve got conditions, getting that recognised because it’s easy to blame the domestic abuse. So where people paediatricians and CAMHS are all happy to jump on, oh it’s domestic abuse, not one of them have done a session with my children on domestic abuse. No-one’s talked to my children. But it is easy to be blamed. 

So are they knew, are they still involved in, with your son, the CAMHS?

No, CAMHS aren’t involved anymore. No. He’s been through that process and yeah, no. Not with them now.

So they’re not…

But the whole time we were, we were with them for about a year and they didn’t approach that subject once.

So your feeling is actually how professionals aren’t the right people because of perhaps the fear that it, it is ….

It is that fear of …

… a child being taken away. 

… you need to eliminate that fear, yeah.

I think the police could have done more earlier. They never told me about refuges.

They, they didn’t say …

They didn’t ….

… they were, they came out to you …

They didn’t tell me there was routes out. I only got, I had a leaflet when I went to the solicitor for the injunction he gave me a load of handouts and one of those was refuge and that’s how I got to know that they even existed. There wasn’t the Internet at that point, like there was now either, so police didn’t, they made me fearful that they’d take the children.

Yeah.

Which made me not feel that I couldn’t approach them again.

Yeah.

So, yes, it’s blame, that you know, you could say there are children here but explain …

Yeah. 

… it could have an effect, on, you know, …

Yeah, so perhaps they could have had an additional role to play though in the time you were seeing …

Yeah. They could have even said there were ways out, he wouldn’t know where I was…

Yeah.

… to be told that might have been a relief, finding out that years earlier. But, yeah, no, they didn’t say anything. In, in fact they brought him back home but, yeah, no, there was nothing. 

No support offered?

No.

For you.

No.
Kate described the shocking reprisals following her disclosure of domestic abuse. Her health visitor was ‘a crucial form of support’ helping her accept that her relationship with her husband was abusive but when her GP found out about the abuse she reported it, against Kate’s wishes, to social services.
 

Kate’s partner blamed her for giving him the label of ‘an abuser’ which she might as well ‘tattoo on his forehead’.

Kate’s partner blamed her for giving him the label of ‘an abuser’ which she might as well ‘tattoo on his forehead’.

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He was angry at what I had done to him, “Look what you’ve done to me now. You’ve given me this label. Now I’m going to be labelled an abuser. I might as well tattoo it on my forehead. This is all your fault. Why would you want to do this? Why are you doing this to me? Why are you doing this to us?” It was, it was like it was nothing to do with his behaviour and his choices. The whole thing was, you know, because I’d told to somebody, that I was doing this. He raged for over the whole weekend. It was a dreadful weekend. I was very frightened. I didn’t sleep. The children were on edge. He was just livid. And by the Monday I hadn’t had any sleep and I was stressed and I was shaking and I was scared. And I went to the GP and said, “Please could you give me something to help me sleep? Because I can’t calm down enough to sleep.” And so she asked me why. And I thought, “Well I’ve already told [marriage guidance] so I will tell her and, you know, maybe there will be some support.” But what I didn’t anticipate was that, once I told her it, she did what probably should have been done all along, which was say, “I’m sorry, I’m going to have to report this situation to Social Services.” And having gone through what had just happened with [marriage guidance], I argued with the doctor for about 45 minutes saying, “Please don’t do this. You’ll make the situation worse. I don’t know how to handle it. I’ll have to go home and tell him.” I was just terrified. She compromised only so far as to say she would report it using, report it anonymously, and would only give our names if they said they felt it warranted it and it was serious enough. So I agreed to that. And I went home and I had to tell him that now Social Services were going to be involved with the family. And he just went ballistic. And again it was, “Why have you done this to me? What do you think you’re doing? Who do you think you are? How dare you do this to me? How dare you do this to us?” And it didn’t make any difference me saying, “Look, I argued with the doctor. I said it wouldn’t be helpful.” I said that, you know, “You were, you were wanting to fix things.” He couldn’t hear any of that. It was just, “You’ve done this terrible thing. How could you?” And again, no recognition that actually if you don’t want to get reported to Social Services, probably better not to behave the way you do. 
Fear of a ‘mental health’ diagnosis

Many women were fearful of talking about how they felt to a doctor in case they received a mental health diagnosis that their partner could use against them in child custody proceedings. Tanya and Min both endured mental health assessments. Jacqui became severely depressed and self-harmed. The doctor prescribed anti-depressants, giving Jacqui’s partner an opportunity to reinforce his suggestions that she was going mad.
 

Jacqui described cutting her arms with razors in order to release some of the emotional pain she was feeling, and finally approaching her GP for help.

Jacqui described cutting her arms with razors in order to release some of the emotional pain she was feeling, and finally approaching her GP for help.

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We’ve touched on some of this already, but if we could just explore in a little more detail in terms of the impact of domestic abuse, when you were in that relationship how did it impact on you emotionally and psychologically?

Emotionally and psychologically I became very depressed, extremely depressed. I used to self-harm. I used to cut my arms with razors because I just had so much pain inside of me and it was the only, only thing I could do to release any of the pain. And I ended up going to see the doctor and getting antidepressants. And that was just then another rod for him to beat me with to say that I was going mad as well. So that was the ever decreasing cycle going on there.

I was just so isolated. At work I was telling people fibs about bruises. And it was afterwards I actually found out that my colleagues had suspected something, but it was always the elephant in the room.

Right.

And nobody felt they could actually ask me outright. I told lies. When he broke my ribs I told people at work that I’d been hanging curtains and I’d slipped and broken my ribs on the windowsill. So I was ashamed. I was ashamed.
 

Despite her partner using her depression as a ‘rod’ to beat her with, Jacqui eventually talked to her GP who was supportive and referred her to the local Domestic Violence and Abuse agency.

Despite her partner using her depression as a ‘rod’ to beat her with, Jacqui eventually talked to her GP who was supportive and referred her to the local Domestic Violence and Abuse agency.

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So what was the trigger for you to leave that relationship?

The trigger would have been the final time when he hurt my back. And that scared me, that really did scare me because I thought, you know, [deep breath] the next time I might not be quite as lucky in it could, it could have been much, much more serious, even more serious than it, than it was at the time, sort of thing. He could have ended up killing me just out of pure temper.

Yeah. Can you describe to me then the process of leaving?

The process of leaving then [deep breath] he eventually, this happened on a Friday night and eventually on the Sunday he took me to A&E. and even though he was there, nobody actually asked had I, did I know where to get help from. I think it’s probably changed now, I think there’s been more work done around medical staff picking up on domestic abuse.

Yeah.

But when we got home, all they could, all they could have given me was painkillers, and when my painkillers ran out and I was still in such excruciating pain with all these back spasms, I went to see my GP.

Right.

And disclosed to her. And she was the one that actually put me onto our domestic abuse organisation.

A local based organisation?

Yeah, local, yes, yes.

OK, so she referred you to them?

She referred me. Yes, yes.

OK, and how did she react then when you disclosed to her the abuse you’d experienced?

She was very supportive actually. She wasn’t at all dismissive, very supportive [pause 3secs] and very kind really, very kind. She didn’t act shocked. But she didn’t make me feel uncomfortable with disclosing to her.

And did they, the organisation, contact you then or did you have to contact them?

I had to contact them. And they were very quick to respond, very quick.

So what support did they then provide to you?

Basically when they, when I first met my community support worker, she put into practice, into place things, practical things like making sure with the police it would be a rapid response if I had to phone up. practical ideas, like always having a bag ready in case I had to flee very quickly with all my documentation and, you know, basic stuff in. She was also very good at, she wasn’t judgemental, she was very supportive, she gave me options. I had the option that I could, I could have gone into a refuge if I’d chosen to. But that’s not the way I wanted to actually do it. And she, you know, it was my decision completely. And when I did oh, she also helped me get a different banding with the council.

Right.

And she just, she just let me talk and she didn’t ever tell me what I should do or what I shouldn’t do but was just, whatever I was saying, she would support me in whatever decisions I wanted to make, she supported me. And when I finally decided to go and I managed to get a flat she was wonderful, absolutely wonderful. Because I did leave without anything and it was like jumping off a cliff, it really was. And the flat I moved to, I had absolutely nothing, and she was able to access through various charities and organisations practical things for me, like beds, carpets, cooker, fridge freezer.
 

Min was not allowed to go with her baby and she was left alone overnight and ‘sectioned’ before losing access to her children (played by an actor).

Min was not allowed to go with her baby and she was left alone overnight and ‘sectioned’ before losing access to her children (played by an actor).

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And then what happened was at about, I think, between 5.00 and 7.00 pm I heard voices outside the interview room, the room I was in. I the door opened, there was a woman there and there was a police officer. The woman looked at me, she looked me up and down and they closed the door and they talked. I didn’t hear what they were saying. And then the door opened again and the police officer said, “We’re going to take your baby to the hospital and to be examined.” And I thought, “I’m going with them.”

Of course, I was breastfeeding, he was seven weeks old. So I stood up. They, they took the baby in the little car seat and I stood up to go with them and the policeman had his hand there and went ‘woomph’ and pushed me in the chair and said, “You’re staying here [sniffs].” And [voice falters] they took my baby [sobs]. And I went crazy. I was hysterical. I was screaming, “Where’s my baby? I need to be with my baby. I need to be with my baby [sniffs]. Why can’t I go with my baby?” I had no idea what was going on because they still hadn’t told me. All they’d told me was, “We’re taking a statement.” Then [blows nose] that woman was there, and the police. So my baby had gone. I was absolutely hysterical.

And then they sectioned me.
Missed opportunities for disclosure of abuse

Penny took a whole year to talk openly to her GP, as her depressed mood was initially mis-interpreted.
 

After failed attempts to disclose her situation to doctors at her practice, Penny finally found a sympathetic GP who referred her for specialist support.

After failed attempts to disclose her situation to doctors at her practice, Penny finally found a sympathetic GP who referred her for specialist support.

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So those years in the relationship, you ….

They were just horrible. But, I was really depressed and down and I remember going to my, I went, went to one of the GPs in my practice, because I was conscious I was drinking too much, and I was really low, I was really depressed and I went to this GP and I said, “I’m drinking too much because I’m really, really low”. And she said, “No, you’re low because you’re drinking too much”. And I thought, “I know me”. And she wasn’t listening to me and so I let that drop, and it was another year before I went to another GP in the practice who actually listened to what I was saying and I was really low then, and this is the one that I couldn’t put my finger on why I was feeling so very …

Yeah.

… low, I couldn’t get out of anything and I saw the GP and she was quite sort of puzzled and then I remember coming home from the appointment and then I phoned her back again and I said, “I think I should tell you that I’m actually being bullied in my relationship”.

Right.

And she said, “Oh, that’s the missing piece of the jigsaw, then. Now we can, now I know why you’re feeling like you do”. And it was then that she referred me. 
There were numerous other examples where signs of abuse were not investigated, like Philippa who was not asked about her severe weight loss. Anna found out that her doctor had flagged up domestic abuse concerns in her notes over many years but had never spoken about it. Linda and Jacqui both gave graphic accounts of how hospital doctors on more than one occasion did not enquire about extensive injuries, broken ribs and bruising on the body caused by physical violence, and accepted the offered excuses.
 

Linda talked about missed opportunities in hospital when she made excuses about her bruising and was afraid to talk in case her husband arrived and could over-hear.

Linda talked about missed opportunities in hospital when she made excuses about her bruising and was afraid to talk in case her husband arrived and could over-hear.

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And then on the Monday I had my physio appointment and the physio said to me, oh my gosh this is terrible you know your hips, what have you done, because I could hardly move them, my shoulder I couldn’t ‘cos of the, I told a lie I said I’d been knocked over by a little boy on a bike. 

Okay. She accepted that? 

It was a man [tearful]. He said, “This is, I can’t believe from a week ago, that it’s so bad, you know, so different the movements to how you were”. And he said “These bruises”. I said “I know I was coming down that slope at the hospital because there’s a big slope there and I said this little boy on his bike, on his scooter it was, on his scooter” and he said “oh dear me”. 

So what happened next? 

Nothing, and then I went back for my next week’s [medicine] injection and I was going to tell my consultant because I really trust her and she was in a real rush and she was really busy. 

Just when you decided. 

Yeah I decided, and she had this lovely patient with her, I can’t remember his name, and he’s having them as well and he didn’t feel well and his wife wasn’t very well and his wife had just found out she’d got cancer so I couldn’t tell her because she was really upset because his wife, so my problems weren’t as bad as his wife’s, and yeah so I didn’t’ tell her. 

When I went to the health service I was having a coil fitted and they couldn’t fit it so I had to have a general anaesthetic to have it fitted at the hospital and it was the time I was telling you about where I was covered in bruises and a week later I had to go and have this coil fitted and when I came round and there were auxiliary nurses they were called then and she came to me and she said you’ve got terrible bruises all over your back and your shoulders and your bottom and she said how did that happen and I went, I said “Oh um I think I just, oh I fell out of bed”. She said “oh okay” and that was all she said and they were so bad and what I wanted her to say was we’ll write this down in your notes, that’s what I wanted her to say was we’ll write those down in your notes that’s what I wanted her to say and then I was hoping it would be in my notes so that somebody else would ask me. Because the reason why I didn’t say anything because you know when you come out and it’s only, you’re only in for the day? 

Yeah. 

You only have those curtains, there’s so many people, you’re not in a ward, you’re not in a room and I was frightened because he was going to come and get me. 

And you didn’t want anyone. 

No I didn’t want him coming while I was saying it. 

Yes, yes of course. I think that’s a really important point that you’ve just made actually, about what it’s like and about how it was with the health professionals and the nurse and that about actually recording things in the notes, that would have been better for you if somebody. 

Perhaps if somebody has got those bruises or something you’re concerned about and you want to ask that question, perhaps when, make sure you have put them in, if you’ve got it a room where it isn’t just those curtains so you can ask them, because I would have said, if I wouldn’t have been in just on a bed with a curtain he, you know because the door was there and I was looking because the bottom curtain was open so it was only the two side ones from the other two people, women on the beds and that door so I would have been able, yes, I would have been able to see him come but. 

So at that moment in time things could have changed for you. 

It could have changed with the police officer that time and a week later if that nurse, if I wouldn’t have been in that situation where he could have come in at any time. 

Last reviewed February 2020.

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