Non-fatal strangulation is what domestic violence advocates fear the most right now.

Content warning: This story includes descriptions of domestic violence that may be distressing to some readers.

*Margaret vividly remembers the times she was strangled by her ex-husband during their marriage.

Most times it was fleeting. Other times she feared he wouldn't let go of her neck.

"It was all about control and power for him, in doing what he did," she tells Mamamia.

"It happened about a dozen times during the marriage, and each time he did it, it terrified me. Eventually I managed to leave safely, and I'm in a good place now. But the impact the choking had is quite emotionally taxing. But it's also had a physical affect too, my doctors say. My windpipe isn't the same as it used to be."

Conversations about non-fatal strangulation are at an all-time high right now, with domestic violence advocates noting just how dangerous it can be for a person's health. There's the emotional and psychological distress of course, but it can also have long-term impacts on the body. And there's the potential for a delayed response in consequences too.

The pressure applied to the neck and lack of oxygen as a result can impact the brain severely, with a risk of brain damage that can occur weeks or even months later.

Watch women and violence: the hidden numbers. Post continues below.

The NSW Government this week introduced amendments to the Crimes (High Risk Offenders) Act, aiming to include serious strangulation offences in the definitions of 'serious violence offence' and 'serious sex offence'. 

This will put non-fatal strangulation in a similar category to other crimes like murder, manslaughter, intentionally inflicting grievous bodily harm and recklessly inflicting grievous bodily harm.

It's a move that has been recommended by experts and advocates for some time now, the NSW Domestic Violence Death Review Team also noting their concern.

The statistics speak for themselves.

Research shows a correlation between strangulation and domestic homicide, given that over a quarter of intimate partner homicides involve the abuser having strangled the victim during a prior attack.

In fact, non-fatal strangulation in a domestic relationship is a strong indicator of future risk for serious harm and death of the victim. The risk of death after experiencing a non-fatal strangulation incident increases by 700 per cent. 

They're sobering facts, but realities not enough people know about. 

Non-fatal strangulation certainly isn't just an issue in Australia. It's worldwide. 

In the UK, The Institute for Addressing Strangulation was established in October 2022, following the introduction of new legislation on strangulation and suffocation as a stand-alone offence in England. 

Beforehand, strangulation and suffocation tended either to be not charged at all or charged as a generic offence such as common assault, or sometimes actual bodily harm. What the Institute does is train professionals on best practice in supporting victims/survivors of strangulation through a forensic and medical lens, as well as leading research and advocacy on the subject. 

As IFAS' Dr Gemma McKenzie says: "Behind every homicide statistic is a person who had friends, family, thoughts, feelings, dreams and hopes."

Queensland Centre of Domestic and Family Violence Research published a report recently, where they spoke to hundreds of women impacted by non-fatal strangulation.

One of the women, Debbie, estimated she had been strangled more than 100 times over a five-year period in her former relationship. 

A woman called Ellen said: "He was very aware of what he was doing. He knew that he had created the fear. He knew exactly where to push, you know, against my neck, which would create that choking sensation. He knew exactly how long to choke for. It was very premeditated."

The findings of the report were that many victim-survivors had a lack of awareness about the serious nature of non-fatal strangulation, particularly if the strangulation was temporary and didn't leave noticeable physical injuries. 

Reflecting on the proposed law changes in NSW, the state's Attorney General Michael Daley says that reducing domestic violence is a top priority.

"It is crucial that our legislation capture the kind of violent offending that may escalate to homicide. This Bill leaves no doubt as to the gravity of serious strangulation offences and sends a strong message to offenders who continue to pose an unacceptable risk of committing a serious offence at the end of their prison sentence."

Last month in Victoria it was announced that non-fatal strangulation would also become a stand-alone offence.

Speaking to Mamamia, Professor and Chair of Respect Victoria Kate Fitz-Gibbon says it's crucial for all states and territories to improve the responses to  and the prevention of non-fatal strangulation.

"Initiatives that support earlier intervention and prevention are critical. There is a need to ensure any legislation is coupled with education of the community, hospitals and health services and police, and effective information sharing between agencies to track high risk individuals," she notes.

As well as policy intervention, it's also crucial that community understanding on the issue increases too. 

"Non-fatal strangulation is a serious risk indicator that an individual is at high risk of escalated abuse and femicide. The impacts of non-fatal strangulation can be significant and long lasting, including acquired brain injuries. As with all forms of intimate partner violence, this violence is preventable."

*Margaret's name has been changed for privacy reasons. Her identity is known to Mamamia. 

If this has raised any issues for you, or if you just feel like you need to speak to someone, please call 1800 RESPECT (1800 737 732) – the national sexual assault, domestic and family violence counselling service. 

Mamamia is a charity partner of RizeUp Australia, a Queensland-based organisation that helps women and families move on after the devastation of domestic violence. If you would like to support their mission to deliver life-changing and practical support to these families when they need it most, you can donate here.

Feature Image: Getty.