When Pregnancy Triggers Violence

Posted by Andrea Altomaro on
Trudy Watts in a scene from Episode 1.

Andrea Altomaro discusses how and why it can be difficult to uncover domestic abuse.

Editor’s Note: The opinions expressed in this blog post are solely those of the author.

Spoiler Alert: This post discusses events in Call the Midwife Season 6 Episode 1

For me, there are few television shows these days that evoke emotion simply by the introductory music like Call the Midwife does. The thrill of a new season, knowing that drama, laughter, and probably sorrow lie ahead all comes to the surface as soon as that music starts playing.

I was pleased to see the excitement of the sisters and midwives of Nonnatus house returning home from their South African journey, but it was easy to feel within the first few minutes that so much had changed in their absence. Having a new leader at the helm of Nonnatus House, Sister Ursula, was sure to shake things up. Although my heart ached for Sister Julienne, seemingly demoted, I tried to keep an open mind regarding Sister Ursula. After all, remember the changes that occurred when Nurse Crane came on board? She’s now a loved member of the Nonnatus House crew! Surely, I can give Sister Ursula a chance.

At first, it seemed the shake-up within the leadership at Nonnatus house was going to be the focus of the episode, but of course, that was intertwined with the sad and complex story of Trudy Watts.

When we first met the pregnant Trudy and her little boy, Mickey, not much seemed amiss. Unfortunately, though, like in so many cases of domestic abuse, it’s not always easy to see on the surface. Trudy and her son were well-dressed and seemed happy enough (although learning of Mickey’s bed-wetting clued me into some potential anxiety or stress at home).

Unfortunately, pregnancy is a time in a woman’s life where she is more likely to experience domestic violence. Per the Centers for Disease Control, more than 1 in 3 women have experienced violence (rape, physical violence, and/or stalking) by an intimate partner1. Most women who experience intimate partner violence during pregnancy have been abused by their partner before.

Today, everyone that comes to an initial pregnancy appointment, and every time someone is hospitalized, they will be asked questions to screen for domestic violence. This questioning is always done privately, when someone is alone, so they can hopefully feel more comfortable answering honestly. Truthfully though, asking one time may not be enough. Did you know that you often must ask several times before someone feels comfortable sharing their experience with you? 

Knowing that pregnancy is often a trigger for domestic violence, our nurses at the Henry Ford West Bloomfield Hospital Labor and Delivery Unit partnered with HAVEN, a nonprofit organization that works to prevent sexual assault and domestic violence as well as empower survivors. Together, they made this video to help spread awareness about domestic violence:


The intimate relationships that often form between midwives and the women we care for sometimes open us up to discovering these hard truths about someone’s home life, much like Nurse Crane discovered in this week’s episode. It brought tears to my eyes to see the gentle approach Nurse Crane took with Trudy; she could gain Trudy’s trust, but you could see that it took several attempts at offers of help before Trudy felt that she needed or could accept the help.

Nurse Crane, working with local organizations (similar to a place like HAVEN today), was able to provide Trudy with the resources needed to not only end her abusive marriage, but to help her find a safe shelter for herself and her children as they started a new life.

Andrea AltomaroAndrea Altomaro (MS, RN, CNM) has been nurse-midwife for the past three years and is currently working for the Henry Ford Health System. Before becoming a midwife, she worked as a nurse in the emergency department and also in labor and delivery.
Read More About Andrea |  Read All Posts by Andrea


If you or someone you know is in immediate danger, please always call 911.





Black, M.C., Basile, K.C., Breiding, M.J., Smith, S.G., Walters, M.L., Merrick, M.T., Chen, J., & Stevens, M.R. (2011). The National Intimate Partner and Sexual Violence Survey (NISVS): 2010 Summary Report. Atlanta, GA: National Center for Injury Prevention and Control, Centers for Disease Control and Prevention.


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