09/17/2014 02:06 pm ET Updated Nov 17, 2014

Shades of Blue

Sarah Small via Getty Images

All the recent media coverage of domestic violence made me realize what an opportunity we have as healthcare providers to help so many women who come to us, women who are already in such a vulnerable condition. There is one patient I will never forget. When I walked into the room, she was already in the triage bed, her eyes glued to the ceiling. At first glance, I didn't understand why she was lying in front of me. Her hair was disheveled, and she looked like she had just gotten out of bed, but she wasn't breathing through contractions or doubled over in pain. She was so still and silent. She just lay there, crying silently, tears falling effortlessly from her face. Obviously in distress, I asked her if she was contracting or bleeding, and she shook her head no. I asked her if she was in labor, and again, she only shook her head. She flinched when I went to raise her shirt to place the external monitors on her. As I lifted her shirt, I could see her belly covered in bruises. I remember having to shut my eyes for a moment. This was the first time I would have to care for someone who suffered from domestic violence. There was not a single mark on her face, but her arms and belly were covered with anger, visible in every shade of blue and black. I distinctly remember holding my breath as I placed the external monitors gently on her stomach. But it was no use. Her baby's heartbeat had been silenced by blows delivered with so much force and fury, even her arms shielding her stomach could not protect her baby. And at that moment, my questions of what was wrong were answered without the patient ever having to say a word. I knew then that the patient already knew her baby was dead. She was almost nine months pregnant.

You don't graduate from nursing school prepared to deal with these kinds of situations. That wasn't on any exam I ever had to take, or in any lesson ever given. As a nurse, you aren't given any kind of advanced warning that this is about to walk through the door. We can't get angry and yell, asking who could have done something like this. Obstetrical nurses are part mother, part sister, part lawyer and part best friend disguised in scrubs with a pink badge. A part of me wanted to sit in the bed next to that patient and hug her until she could finally let go and allow herself to cry with sound that could give depth to her grief. I wanted to get hysterical. I was so angry that anyone could hurt someone so vulnerable. But I knew I had to stay focused, because that's what we do as nurses when we have to take care of anyone who presents us with something gut-wrenching and tragic. Every single one of our actions is driven by what's best for the patient in front of us.

If you have ever had to take care of someone who came to you blatantly bruised and every shade of blue, or if you have ever cared for someone who guarded their abuse and stayed silent, you know how devastating domestic violence can be. We have to constantly be on the look-out for women who may need our help. Some of these women may come right out and ask for assistance, but many more women will stay quiet out of embarrassment, fear or lack of resources. Make your patients feel as if they can trust you, because every woman we take care of should know we're always on their side. What would you do if this were your patient tomorrow? Would you know who to tell and would you know what to do?

And to any woman out there... If you have ever been in any situation where you felt unsafe, I hope you were the woman who reached out and asked for help. If you were ever the woman who was too afraid to say a word, you have to know that you can trust your healthcare providers. Our only job is to take care of you, in whatever sense is right for you. Do not be afraid to reach out or to speak up, because your life and the lives of your children are affected by your environment. Women who are pregnant are more vulnerable, exposing them to greater threats of violence and abuse. This effects you and your unborn baby. Physical abuse can cause injury to your uterus, causing disability or death to your baby. You're more likely to go into premature labor, suffer a miscarriage or stillbirth and your baby is more likely to suffer from emotional and physical disabilities. I don't want any woman to secretly be every shade of blue. I don't want any woman to suffer from the silence of a baby's unbeating heartbeat. Find a way to ask for help. And if I know anything, I know this: women are so much stronger than they even realize. You are stronger than you know.
Effects of Domestic Violence During Pregnancy

Violence as a Public Health Problem

The National Domestic Violence Hotline

Until my next delivery ♥