Each year approximately two million women in the US are physically or sexually assaulted by an intimate partner. Intimate partner violence, or domestic violence, accounts for 22 percent of all violent crimes against women and affects women from all social, racial, ethnic, and economic backgrounds.Domestic violence is deliberate, repetitive, ongoing, and unpredictable. Abused women may experience physical violence such as being pushed, kicked, bitten, slapped, hit, beaten, or being threatened or attacked with any type of weapon. They may be a victim of sexual violence, such as rape and other nonconsensual sexual assault, and their partners may sabotage the use of birth control or refuse to follow safer sex practices.

Women may also be psychologically or emotionally abused through name calling; humiliation; blaming; threats; social isolation from family, friends, and work; and deprivation of food, money, transportation, medications, and access to health care. The abuse often escalates when a woman becomes pregnant.

Intimate partner violence can cause a number of physical ailments in women, such as chronic and unexplained pelvic pain, sexual dysfunction, trauma to the genitalia and breasts from sexual assaults, and STDs from partner infidelity. The stress of living in an abusive relationship can also trigger posttraumatic stress disorder or battered woman syndrome, which can lead to depression, anxiety disorders, substance abuse, physical problems, and suicide.

Domestic violence usually involves other members of the household, especially children. More than half of men who abuse their female partners also abuse their children. Children of abusive backgrounds are much more likely to become abusers or be abused themselves in adulthood.

If you are being abused, tell someone you trust-a counselor, close friend, or family member-that you are in a violent relationship. It may be hard to talk about at first, but he or she can assist you in escaping a dangerous situation. Addition-ally, your doctor can recommend services and other resources that can help.

Make a plan that can be used to get yourself and your children to safety quickly. Pack a suitcase with a change of clothes and an extra set of keys, and store it with a friend or neighbor. Keep prescription medications, identification, extra cash, your checkbook, and other special items handy so you can take them with you on short notice. If you are hurt, call your doctor or go to the emergency room, and get a police report and a copy of your medical record so you can file charges if you wish.

Your life can be better. No woman has to live with abuse.

For more information, the Patient Education Pamphlet "Domestic Violence" is available in English and Spanish at www.acog.org/publications/pati ent_education.

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