How Abuse Affects Women's Health, and Where to Get Help

TL;DR: Around 1 in 3 women worldwide has experienced physical or sexual violence from a partner, or sexual violence from someone else. Abuse harms physical, sexual, reproductive and mental health, and it is not only hitting: controlling money, tracking your phone and sabotaging contraception all count. You deserve support. In the UK, the free 24-hour National Domestic Abuse Helpline is 0808 2000 247. In Kenya, call the free 1195 GBV helpline. In Lagos, the Domestic and Sexual Violence Agency lists 08000 333 333. If you are in immediate danger, call your local emergency number.

If you are reading this because something at home does not feel right, we want to start by saying this: it is not your fault, and you are not overreacting. Many women spend years asking themselves whether what is happening "counts", because it does not look like the stories they have heard. Maybe he has never hit you, but you have to account for every naira or shilling you spend. Maybe she reads your messages every night. Maybe the headaches, the stomach trouble and the sleepless nights started around the same time the relationship changed. Today is the International Day for the Elimination of Violence against Women, and this post is for anyone trying to make sense of how abuse touches health, and what help looks like.

How common is violence against women?

It is very common. The World Health Organization estimates that about 1 in 3 women worldwide (31.6%) has experienced physical or sexual violence from an intimate partner, or sexual violence from someone else, in her lifetime. That is roughly 840 million women and girls. Partner violence alone has affected about 1 in 4 (24.7%) women aged 15 and over who have been in a relationship, and WHO reports that in 2023, on average 140 women and girls were killed every day by a partner or other family member.

These numbers cut across every country, income level and faith. In Lagos, Nairobi, Accra, Johannesburg or Birmingham, there are women in your church, your office and your family group chat living with this quietly. You are far from alone.

What forms can abuse take?

Abuse is a pattern of behaviour used to control another person, and it takes many shapes. The UK Domestic Abuse Act 2021 lists physical or sexual abuse, violent or threatening behaviour, controlling or coercive behaviour, economic abuse, and psychological or emotional abuse. The NHS adds everyday examples: belittling you, cutting you off from friends and family, restricting your money and monitoring you through technology.

Two forms deserve extra attention because they are so often missed.

Economic abuse is any behaviour that seriously limits your ability to get, use or keep money or property, or to get goods and services. It can look like a partner taking your salary, refusing to let you work, running up debt in your name, or making you beg for transport money to reach the clinic. We explored this on the podcast with economist Claudia Segre in Blush and Bloom episode 14 and again in episode 24 on economic violence and health.

Tech-facilitated abuse uses phones, apps and devices to stalk, harass or control. Refuge describes how abusers may hack your phone or accounts, demand to read your private conversations, track where you go, or use gifts and devices given to your children to keep tabs on you. If a partner always seems to know where you have been or what you said to a friend, trust that instinct. Our podcast episode on online safety for women in Africa goes deeper.

There is also reproductive coercion, when a partner controls your contraception or pregnancy decisions. We cover that in its own post, reproductive coercion: when someone controls your contraception.

How does abuse affect your physical health?

Abuse affects the body far beyond visible injuries. According to WHO, violence against women is linked to headaches, chronic pain, gastrointestinal problems and limited mobility.

If you have injuries, especially to the head or neck, or if anyone has ever put pressure on your throat, please see a clinician. These can cause harm that is not obvious straight away.

What about sexual and reproductive health?

WHO links intimate partner and sexual violence with unintended pregnancy, sexually transmitted infections including HIV, miscarriage and low birth weight. When you cannot refuse sex or insist on condoms, your risk of infection rises, and an abusive partner may block you from reaching a clinic at all.

If you have had sex you did not want, or a partner has interfered with your contraception, you can still act. Emergency contraception works best the sooner you use it, and a sexual health clinic can test and treat infections confidentially. Our guide to STI symptoms, prevention and treatment explains what to look out for.

And mental health?

WHO lists depression, post-traumatic stress disorder, anxiety, sleep problems and suicide attempts among the mental health effects of violence. Some women also start using alcohol or other substances to cope. None of this is weakness. It is a normal response to living with fear.

If you are having thoughts of ending your life, please reach out now to a crisis line, a trusted person or your nearest emergency department. Our post on anxiety and depression in women has more on getting support, and talking about mental health with your African family may help if family pressure is part of what keeps you silent.

Safety planning basics

A safety plan is a set of steps that makes you safer, whether you are staying, thinking about leaving, or have left. Women's Aid notes that abusers can become more violent and controlling around the time you leave, so it helps to plan with a trained adviser where you can. Some starting points:

• Know who you can call. Save a helpline number somewhere safe, and if you trust a neighbour, friend or relative, ask them to call the police if they hear sounds of an attack.
• Keep essentials ready. If you can do so safely, keep copies of your ID, passport, birth certificates, some cash, spare keys and any medication with someone you trust.
• Think about money. If you can, open a separate account or keep small savings somewhere your partner cannot see. Economic independence is a safety step.
• Plan your exit route. Know which rooms have a way out, and try to avoid rooms with weapons or no exit, such as the kitchen or garage, if an argument starts.
• In the UK, if you cannot speak on a 999 call, the police Silent Solution lets you press 55 when prompted on a mobile so the call is put through to police.

Staying safer online and on your phone

If someone may be checking your devices, use a phone or computer they cannot access, such as a trusted friend's phone or a library computer, to look for help. Many support websites, including the National Domestic Abuse Helpline, have a quick exit button that takes you away from the page instantly. Private or incognito browsing stops pages saving to your history on that device, though it will not hide activity from spyware.

Refuge warns that abusers often notice changes to your settings, so suddenly changing passwords or removing an app could escalate things. Talk it through with a helpline adviser before you make big changes.

Where to get help

These services were confirmed on their official sites at the time of writing:

• UK: The National Domestic Abuse Helpline, run by Refuge, is free, confidential and open 24 hours a day on 0808 2000 247, with a live chat option. The NHS also lists specialist lines including the Men's Advice Line, Galop for LGBT+ people, and Karma Nirvana for forced marriage and honour-based abuse.
• Kenya: The national gender-based violence helpline 1195 is toll free and staffed 24 hours a day by Healthcare Assistance Kenya, which works with government and UN Women.
• Nigeria (Lagos): The Lagos State Domestic and Sexual Violence Agency lists 08000 333 333 as its contact number, with an office in Alausa, Ikeja.

If you are elsewhere, your GP, a sexual health clinic, or a midwife can be a safe first conversation. Health workers are trained to listen, and you can ask to be seen alone.

How Asele fits in

Recovering your health after abuse takes time, and noticing patterns can help. Asele lets you track your cycle and log symptoms like headaches, sleep and mood, and Amara can talk through what you are feeling in Yoruba, Hausa, Igbo, Swahili, French or English. When you are ready to see a clinician, the Asele Health Brief gives you a pre-visit summary to take with you. If your phone is not private, please think about who can see it before logging anything. You can find us at Asele.

This post is education, not medical or legal advice. If you are in danger, contact emergency services or a specialist helpline.

References

1. World Health Organization. Violence against women fact sheet. who.int
2. UK Government. Domestic Abuse Act 2021, section 1. legislation.gov.uk
3. NHS. Getting help for domestic violence and abuse. nhs.uk
4. Refuge. What is tech abuse? refugetechsafety.org
5. Refuge. National Domestic Abuse Helpline. nationaldahelpline.org.uk
6. Independent Office for Police Conduct. Silent Solution. policeconduct.gov.uk
7. Healthcare Assistance Kenya. About the 1195 helpline. hakgbv1195.org
8. UN Women Africa. Kenya's national toll-free helpline 1195. africa.unwomen.org
9. Lagos State Domestic and Sexual Violence Agency. Contact. lagosdsva.org
10. Women's Aid. I want to leave my relationship safely. womensaid.org.uk