This protocol is intended to be a tool that helps health personnel in the field of emergencies to provide adequate care to women over 14 years of age who live in a situation of abuse, carried out by their partner or ex-partner, by understanding that it is the more frequent and at the same time invisible violence in our environments, in addition to including in this protocol, care for sexually assaulted women.
Violence against women is not sufficiently visible in the care actions provided by the Health System nor is it assumed as a serious public health problem by a significant part of its professionals.
This is influenced by our model of society, which establishes gender relations that give rise to a hierarchy between the sexes, which undervalues or discriminates against the feminine and establishes power relations between men and women, keeping women in a situation of subordination and constituting a structural violence against them.
Violence against women obeys this model, it is carried out by men, who for the most part are or have been emotional partners of these women, whom they intend to maintain in a hierarchical and unequal relationship, and in traditional gender roles that maintain that situation. Furthermore, it has been tolerated to some extent that men use violence to assert their authority. In this sense, it is also instrumental violence to maintain domination and control over women. This violence against women is not due to singular or pathological traits of a series of individuals.
It is necessary to recognize that health personnel do not escape these social gender stereotypes, therefore, the actions we take as health professionals must identify the existence of these conditions, to confront them and facilitate the change in attitudes and modes of intervention.
The different cultural and social construction for women and men, called gender construction, also entails differences in the state of health and in the health care that is demanded and that we provide. The construction of gender and gender relations give rise to differences in the health of women, which are aggravated when they find themselves in a situation of abuse and are treated without health personnel relating the symptoms to that situation.
The process of violence against women.
Violence against women, being instrumental violence, will be used in the form and intensity necessary to maintain control over the woman by the abuser.
Violence is established, naturalized and therefore made invisible, starting with behaviors that entail inequality between men and women (different attributes, roles and spaces), followed at the beginning of the relationship with situations of control (confused with expressions ). of love and protection), psychological abuse (including social isolation and environmental abuse), sexual abuse (forcing the woman to consent to unwanted sexual relations to please the abuser) and if necessary to subdue the woman, presentation of physical violence, which in its greatest severity could lead to the death of the woman.
The situation of violence experienced by women can take years before being made visible by the environment or identified and recognized by the woman herself. The cycle of violence (Leonor Walker) helps to understand the strategy that the abuser uses to keep the woman in that situation, through three phases:
Voltage buildup:
It is characterized by a gradual escalation of tension, where the man’s hostility increases without understandable and apparent reasons for the woman. Verbal violence intensifies and the first signs of physical violence may appear. They present as isolated episodes that the woman believes she can control and that they will disappear. The tension increases and accumulates.
Explosion or aggression:
Violence breaks out and physical, psychological and sexual attacks occur. It is in this phase where the woman usually denounces or asks for help.
Calm or reconciliation or honeymoon:
In this phase, the abuser states that he regrets it and asks the woman for forgiveness. He uses emotional manipulation strategies (gifts, caresses, apologies, promises) to prevent the relationship from breaking down. The woman often thinks that everything will change. As violent behaviors become more established and gain ground, the reconciliation phase tends to disappear and the violent episodes become closer in time.
These phases make it difficult for the woman to leave the relationship or distance herself emotionally from the abuser. In other situations of violence, the phases of the cycle of violence are not observed and physical abuse only occasionally appears.
Download Protocol by chapters
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Cover and index. PDF (110KB)
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1. Presentation. PDF (1604KB)
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2. Introduction. PDF (1637KB)
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3. Detection of abuse against women in Emergency Departments: Out-of-hospital and Hospital. PDF (1681KB)
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4. Action plans for mistreatment of women from Emergency Departments: Out-of-hospital and Hospital. PDF (1657KB)
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5. Action Plan for sexual assaults from Emergency Departments: Out-of-hospital and Hospital. PDF (1654KB)
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6. Ethical and legal aspects. Protection of women. Go to Court. Communication to the Prosecutor’s Office. PDF (1669KB)
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7. Action in Out-of-hospital Emergency Devices in the face of violence against women. PDF (1678KB)
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8. Action in Hospital Emergency Devices in the face of violence against women. PDF (1660KB)
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9. Annexes. PDF (2098KB)
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10. Resource Guide. PDF (1685KB)
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11. Bibliography. PDF (80KB)
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12. Glossary of Terms. PDF (85KB)
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