Most people, including many health workers, treat hands on the throat as one violent act among others. It is not. Of everything that happens in an abusive marriage, this is the one that changes what we say to a woman and how quickly we say it.
There are two reasons. It can kill or cause lasting injury without leaving anything visible, and it is the strongest single predictor that somebody will later be killed by the same person. Neither of those is widely known, which is why this has its own page.
What it actually is
It covers hands round the throat, a forearm across the neck, a cloth, a wrapper, a belt, a cable, being pressed against a wall or a bed by the neck, and pressure from a knee or an elbow. It also covers anything that closes the mouth and nose, including a pillow or a hand.
It does not have to last long. It does not have to leave you unconscious. It does not have to be described by him, or by you, as an attempt to kill you. Very often it is described afterwards as “I was just holding her” or “I only pushed her back”, and the person saying it may even believe that.
Why there is often nothing to see
This is the part that causes the most harm, because it is the reason women are sent away from clinics and police stations with nothing done.
The neck is not like an arm. Serious pressure can interrupt the blood supply to the brain and the air supply to the lungs without breaking skin and without bruising, and where bruising does appear it often arrives a day or two later rather than on the night. A woman who goes to a clinic within an hour may have nothing to show, and be told to go home, at exactly the moment she most needs attention.
So the absence of a mark is not evidence that nothing happened. If somebody has told you that it cannot have been serious because there is nothing on your neck, that is wrong, and it is wrong medically rather than as a matter of opinion.
What can happen afterwards
Most people are fine. The problem is that the ones who are not can deteriorate hours or even days later, when the danger seems to have passed and everybody has gone to bed.
Swelling inside the throat can build slowly and narrow the airway. Damage to a blood vessel in the neck can cause a clot that travels to the brain later. Fluid can collect in the lungs after the airway has been obstructed. Brief loss of consciousness means the brain was without oxygen, and that is not a small thing even when somebody wakes up and feels ordinary.
None of that is a reason to panic and all of it is a reason to be seen.
Signs that need attention today
- Any change to your voice, hoarseness, or losing your voice.
- Pain or difficulty swallowing, or a feeling of something in your throat.
- Any difficulty breathing, noisy breathing, or coughing that started afterwards.
- Neck pain, swelling, or tenderness.
- Small red or purple spots on the face, the eyelids, in the whites of the eyes, behind the ears, or inside the mouth.
- Headache, dizziness, confusion, blurred vision, ringing in the ears, or a gap in your memory of what happened.
- Having lost control of your bladder or bowels during it. People are ashamed of this and do not mention it. It matters, because it usually means loss of consciousness.
- Weakness or numbness down one side, drooping on one side of the face, or slurred speech — that is an emergency, go now.
You can have none of these and still have been badly hurt. You can also have one of them and be fine. That is precisely why it is a decision for somebody with training rather than for you at two in the morning.
What to do
Get seen, the same day if you possibly can, even if you feel well and even if there is nothing on your neck.
Say the words plainly to whoever examines you. Not “we had a fight” but “he put his hands on my neck and I could not breathe”, and say whether you passed out, whether your vision changed, and whether you lost control of your bladder. Those three details change what a clinician looks for.
Ask them to write down what you said and what they found, including finding nothing. A note made on the day, by somebody independent, is worth a great deal later, and it costs nothing to ask for. What is time critical after an assault covers what to expect at the clinic and what to ask for.
If you can, avoid being alone for the next day or two, and tell whoever is with you what to watch for. If that is not possible, that is worth telling a clinician too.
What it means for your safety
We will be direct, because being vague about this has costs.
Where somebody has put their hands on a partner’s neck, the risk of very serious harm later is materially higher than in relationships where every other kind of violence has happened but this has not. It tends to escalate rather than settle. It is also frequently repeated once it has happened the first time, because it works: it produces immediate fear and leaves nothing to point at.
That does not mean you have to leave tonight, and it does not mean anybody is going to tell you what to do. Many women stay, for reasons that are entirely rational, and we help them either way. It does mean this belongs at the top of any plan rather than somewhere in it. A plan you can make while still living together is written for exactly that situation.
If it has happened more than once, or if it has happened alongside threats to kill, strangling during sex without agreement, or violence during pregnancy, the picture is more serious again. Please talk to somebody. Talk to us if there is nobody else.
Reporting it
Under Nigerian law this is a criminal offence, and the fact that you are married to him makes no difference to that. The VAPP Act covers physical injury in broad terms and does not require a visible wound.
If you report it, the medical note matters more here than in almost any other kind of case, because there may be nothing for anybody to photograph. Get seen first where you can, then report. What actually happens at the station is set out separately, including what to do if you are told to go home and settle it.
You are not obliged to report anything in order to be treated, and no clinician should make treatment conditional on it.
If you are not going to do anything about it today
That is a common position and it is not a failure. Read the list of signs above once more and keep it somewhere you can find it. Tell one person you trust what happened, so that somebody other than you knows. If it happens again, get seen.
And know the thing that is easiest to lose sight of when it is your own life: this is not an argument that went too far. It is a specific act with a specific medical meaning, and everybody who works in this field treats it as the loudest signal we get.
Questions people ask
There is no mark on my neck. Does that mean it was not serious?
No. Serious pressure on the neck frequently leaves nothing visible, and bruising that does appear often arrives a day or two later. The absence of a mark tells you nothing about how dangerous it was.
It happened last night and I feel fine. Do I still need to be seen?
Yes, if you can. The problems that matter can develop hours or days afterwards, which is exactly when nobody is watching for them.
What should I say to the doctor or nurse?
That he put his hands or something else on your neck and you could not breathe. Say whether you lost consciousness, whether your vision changed, and whether you lost control of your bladder. Ask them to write down what you said and what they found.
He says he was only holding me back. Is that different?
Not medically. Pressure on the neck does the same thing regardless of what it was meant to be, and how it is described afterwards does not change what happened to the blood supply to your brain.
Do I have to report it to the police to get treatment?
No. Treatment is not conditional on reporting, and no clinician should tell you otherwise.
If you need help now
If you are in immediate danger, call 112. To talk to HealBridge, call or send a message to +2348025170267, or use the form on our contact page. Every page on this site has a Quick Exit button at the top right, and pressing the letter E three times does the same thing.
Before you rely on anything on this page
We publish these articles so that you can understand a subject and work out what to ask for. They are written carefully and in good faith. They are still general information about how things usually work, and not advice about your situation, which we do not know.
- This is not legal advice.
- We are not a law firm. Criminal law in Nigeria is largely a state matter, the VAPP Act applies in a state only if that state adopted it, and statutory, customary and Islamic marriages are governed by different law and different courts. Two people with the same facts can have genuinely different options. Get advice from a lawyer who practises where you live — and if cost is the obstacle, ask us, because arranging that is part of what we do.
- This is not medical advice.
- Nothing here is a diagnosis and nothing here replaces being examined. Do not delay seeing a doctor, nurse or pharmacist because of something you read here, and do not start, stop or change any treatment on the strength of it. If something is time critical, go and be seen.
- This is not counselling, and it is not financial advice.
- Articles about trauma, sleep, money, debt, renting or starting a business describe what commonly helps. They are not therapy and they are not a recommendation about your own money. Speak to a counsellor, a qualified adviser or your own bank about your circumstances.
- It may be out of date, or wrong for where you are.
- Law changes, services close, numbers stop answering and practice varies by state. We correct what we find, and we cannot promise that every page is current on the day you read it. Where we do not have something confirmed, we say so rather than fill the gap.
- Reading this does not make us your lawyer or your doctor.
- No professional relationship is created by reading an article, and we cannot accept liability for decisions taken on the strength of one. What we can do is help you reach somebody who is qualified to advise you, which is what the legal and health parts of our work exist for.
- We cannot promise an outcome, and we cannot make anybody safe.
- A protection order is a piece of paper backed by an enforcement system that is inconsistent. A plan works until the day it does not. Anybody in this field promising safety is selling something, and the promise itself is dangerous because it stops people planning.
Do not let this notice stop you acting. If you are in immediate danger, call 112. If something is medically urgent, go to a hospital — you do not need a police report to be treated. And if you do not know where to start, that is a normal way to begin: use the contact page and we will take it from there.
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