'This is traumatic, terrifying': What you need to know about strangulation

A person who has been strangled by a partner may not be ready to leave their attacker, victim advocates say.

They may be worried about being homeless, a lack of money, or additional harm to them, their children or their pets.

Studies show that domestic violence victims may suffer abuse up to seven times before they leave this situation, said Teresa Stafford, chief executive officer of the Hope and Healing Survivor Resource Center in Akron.

“If they decide to go back, we are here for them,” Stafford said.

Stafford said one in four women has experienced violence at the hands of a partner and 60% of domestic violence victims have been strangled by a partner. She said Hope and Healing, which includes the Battered Women’s Shelter and Rape Crisis Center, provided services to 117 people who were victims of strangulation in 2023.

Ohio became the last state in the country to make strangulation a felony last January, a step that victim advocates and forensic nurses urged for many years. The law took effect in April.

What is strangulation?

Stafford described strangulation as “when a person uses their hands or an item around the neck to cut off the ability to breathe or put pressure on the throat.”

Stafford said the law mostly focuses on domestic violence situations, but sexual assault and human trafficking victims also suffer strangulation.

What are the signs of strangulation?

Stafford said strangulation victims don’t always have visible injuries.

If they do, she said, these can include petechiae, or broken blood vessels, in the eyes and a raspy voice. She said victims may have issues later, such as vomiting and headaches, and should be on the lookout for breathing problems.

Stafford said Lily Holderbaum, a forensic nurse who heads the Providing Access to Health, or PATH, program at Cleveland Clinic Akron General, and her team are doing a great job of identifying strangulation survivors.

Holderbaum said strangulation victims can have internal injuries like throat swelling and difficulty swallowing. She said they can have bruising to their ears, cheeks, head, eyelids and inside of the mouth.

Holderbaum said victims can have minimal injuries but suffer a small tear to an artery in their neck that can later cause a blood clot and put them at risk of a stroke.

Are health care professionals required to report strangulations?

Holderbaum said health care professionals are required to report strangulations to police, but it is up to victims whether they want to talk to authorities.

She said her staff collects evidence and information about what happened and keeps it on file in case the victim decides to pursue a case immediately or in the future.

Holderbaum said her staff tries to make sure victims are safe and know about the resources available to help them. She said strangulation victims often have trouble talking about the abuse they’ve suffered, which most often involves someone they know.

“The worst case I’ve seen in my life, she denied it,” Holderbaum said. “She did not want to be labeled as a victim.”

What are the long-term risks of strangulation?

Strangulation survivors can suffer from mental health issues, like post-traumatic stress disorder, said Rachel Ramirez, the director of health and disability programs for the Ohio Domestic Violence Network.

“This is traumatic, terrifying,” Ramirez said. “The memory of that can have a strong impact on their life.”

She said victims also can have depression and anxiety.

Because strangulation involves oxygen being cut off to the brain, Ramirez said victims can have damage to the parts of the brain that control functions like planning, emotions and impulse control. In severe cases, strangulation can cause traumatic brain injuries with long-term effects, she said.

How can loved ones help strangulation survivors?

Ramirez said loved ones should talk to strangulation victims, express their concern and tell them they care about them.

Ramirez said they should explain that this isn’t the victim's fault and provide them with information about strangulation and the agencies that can help. She said help shouldn’t be given as a condition of the victim taking a specific action.

“We do know the majority of survivors who are killed by their partners were in the process of leaving, or this happens after they leave the relationship,” she said.

What resources are available for strangulation and domestic violence victims?

Here are several agencies that can help:

• National Domestic Violence Hotline: 1-800-799-SAVE (7233), text “Start” to 88788 or visit thehotline.org. The website has a list of resources by city and state.

• Ohio Domestic Violence Network: odvn.org. The website has a map of programs and shelters across Ohio and information on strangulation and brain injuries at odvn.org/brain-injury/.

• Family and Community Services Inc.: https://fcsserves.org/ Links people to shelter, support, legal advocacy and other supports. 330-673-2500 or 330-296-2100

• Portage County Prosecutor's Office Witness/Victim Assistance Division: https://www.portageprosecutor.com/victim.html

Stephanie Warsmith can be reached at swarsmith@thebeaconjournal.com, 330-996-3705 and on Twitter: @swarsmithabj.

This article originally appeared on Akron Beacon Journal: Strangulation and domestic violence: How to know signs, help victims