On November 21, just ahead of the national 16 Days of Activism for No Violence Against Women and Children campaign, the government declared gender-based violence (GBV) a national disaster. This followed weeks of campaigning by anti-GBV organisations, which built toward powerfully dignified protests across the country.
National disaster status allows for the government to direct towards urgent interventions. We call for dedicated allocation to high-risk groups such as pregnant women and girls and mothers of young children and for investment in mental healthcare for the many women and girls who are surviving violence.
When Thabisa* told her partner she was pregnant, everything changed. The insults became routine. The controlling behaviour escalated. Then came the blows. After the baby arrived, he walked out, blaming her for “bringing it on herself”.
Left alone, exhausted and overwhelmed, Thabisa cried through the day, lay awake at night, missed clinic visits, stopped answering her mother’s calls and began to believe she was “the problem”.
Her story is painfully common.
Women and girls in SA experience some of the highest rates of GBV in the world.
Violence often increases during pregnancy and after childbirth, a time when households are under emotional and financial stress and roles and responsibilities change.
Intimate partner violence (IPV) refers to abuse by a partner or husband, while domestic violence (DV) includes abuse by other household members, such as relatives or in-laws.
During pregnancy, the link between violence and mental health runs in both directions.
Research by the Perinatal Mental Health Project (PMHP) at the University of Cape Town shows that women exposed to IPV and DV are at high risk of developing depression, anxiety or post-traumatic stress.
Symptoms such as constant worry, hopelessness, low self-esteem and withdrawal from supportive relationships increase women’s isolation.
Women already struggling with poor mental health are more vulnerable to abuse. Fear, exhaustion and self-blame make it harder to seek help.
Stigma makes this worse. Community stigma leads to disbelief or rejection when women speak out about the abuse. Internal stigma traps women in silence when they come to believe that mental illness makes them “weak” or “crazy”. Many endure worsening violence rather than risk further shame or rejection.
Abusers may believe that a woman’s distress is laziness or “being difficult”, using these false assumptions to justify further harm. Mental health problems can make it difficult for women to work or study. This means they earn less money and may have to depend on others.
Violence during pregnancy can cause serious harm to mothers and babies. SA continues to record one of the world’s highest rates of intimate partner femicide, the killing of women by their partners.
The South African Child Gauge shows that violence against mothers often coexists with violence against children. Homes where pregnant women are abused are more likely to expose children to neglect or violence.
Boys who witness their mothers being beaten are more likely to use violence later in life. Girls who grow up in violent homes are more likely to experience abuse as adults or to use violent discipline on their children. In this way, violence continues from one generation to the next.
Violence against women may be widespread in SA, but it is not normal. Breaking the cycle requires collective action.
Government departments, especially health and social development, must expand investment in evidence-based programmes that address violence and maternal mental health, tackling not only the consequences but also the root causes.
Healthcare and social service providers are crucial allies. They often see women repeatedly during pregnancy and after birth, offering opportunities to listen, ask about safety and provide support using the World Health Organisation’s LIVES approach (listen, inquire, validate, enhance safety and support). The new national integrated maternal and perinatal care guidelines give providers practical steps for referring women to shelters, police services and mental health support.
Communities and families have a vital role. We must break the silence that isolates women, believe survivors and offer practical support: a place to stay, childcare or financial help.
In Thabisa’s case, a clinic nurse recognised her distress and referred her to an on-site counsellor. Through counselling, she was able to speak openly for the first time, to see that she was not to blame and to rebuild her confidence. With support, she made a safety plan in case her ex-partner returned, reconnected with her family and began to imagine a future for herself and her child.
Violence and mental health are intertwined, but compassion, awareness and collective responsibility can break the cycle.
* While the name and some details have been changed, this story reflects the real experiences of women supported by the maternal support service of the PMHP.
Honikman is an associate professor and director of the PMHP Centre for Public Mental Health, University of Cape Town.
Dalya Levin is PMHP intern
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