Study Finds High Incidence of Sexual, Physical Abuse Among Rural Pregnant Women

BUFFALO, N.Y. -- A home in the country apparently offers no sanctuary from physical and sexual violence for rural women.

Researchers at the University at Buffalo's Rural Health Care Campus in Cuba, N.Y., found that 40 percent of 120 pregnant patients who came to their clinic for treatment said they had at some time experienced physical or sexual abuse. Moreover, only seven women had followed up and taken any legal action.

"This study indicates that violence against women occurs as often in a rural population as it does in urban areas, and little is done about it," said Geoffrey Markowski, M.D, UB clinical assistant professor of family medicine and director of the rural clinic. He conducted the study with Patricia Krebs, a fourth-year UB medical student.

Pregnant women were chosen for the study, Markowski said, because they are generally healthy, have few additional medical problems and come to the clinic regularly. The women ranged in age from 14-39 years, and all had addresses with rural zip codes.

Interviews were conducted in person, out of earshot of the physician, and were not part of the medical examination.

€ 13-15 percent of the women reported being raped, using the traditional definition -- the use of physical force to accomplish penile penetration.

€ 20-28 percent reported being raped under a broader definition that included date rape, being incapacitated due to alcohol or drugs and being threatened with physical abuse.

€ Sexual assaults on women in rural areas are more likely to lead to completed acts of rape rather than to lesser acts, such as unwanted touching or fondling.

€ 17 percent of the women who reported being raped said they had attempted suicide.

Results from interviews with the first 60 women in the study were presented at the 46th Annual Scientific Assembly of the American Academy of Family Physicians, where Krebs won first place among medical students for original student research. The study was reported in the December issue of American Family Physician.

Another 60 women have since been interviewed, Markowski said, with nearly identical results.

"I think these findings are quite startling," he said. "We tend to think of rural life as tranquil and peaceful. This is not the case for many women."

€ Alcohol abuse among rural men: Many of the incidents were alcohol related.

€ Geography: There are few public places in rural areas and homes are often far apart. Is this isolation leaving women at the mercy of perpetrators, who tend to be family members or acquaintances?

Physicians can play an important role in interrupting violence against rural women, Markowski said. One signal that abuse may have occurred is an increase in chronic complaints, such as backaches, pelvic pain and depression, he noted. Markowski asked all patients in the study about such symptoms, unrelated to their pregnancies, and found that they occurred more often among women who had been abused than those who had not.

"These complaints are often dismissed," he said. "Problems are not identified soon enough. Women who fit this profile should be asked about physical or sexual violence and treated accordingly."