Imagine the person you love looking down at you as you gasp for air, wondering if he will actually kill you this time.
Figures released to NZME through an Official Information Act showed 111 people in the Bay of Plenty were charged with strangulation between December 2018 and September 2019.
Of these, 106 were men and two-thirds were family members.
The Family Violence (Amendments) Act 2018 made changes to a number of Acts to improve responses to family violence in both criminal and civil law. Strangulation or suffocation became a separate criminal offence.
Strangulation is when pressure is applied on or around the neck with enough force to stop someone being able to breathe and while the brain of oxygen.
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A 2008 study in The Journal of Emergency Medicine found those strangled by a partner or ex-partner were at greater risk of being seriously injured or killed by them in the future.
There can be a loss of consciousness within 20 seconds and death within five minutes.
But 111 charges across the region did not scratch the surface, said Waiariki Women's Refuge manager Paula Coker.
Strangulation was a tactic used by abusers, and nearly every woman she worked with had been strangled at some point. A lot of the time went unreported, Coker said.
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In 2018, there were 3828 family harm investigations in Rotorua.
"If you think about the number of women in Rotorua who have died at the hands of people who were meant to love them ... it's violence and it's killing our women."
Coker said women minimised strangulation either because they feared the repercussions of reporting it. They felt it was their fault or the prolonged abuse became "normal".
"Using elbows or anything else in and around the chest area which breaks off the ability to breathe is a form of strangulation."
Some women tell her of the fear and belief their life would end in the moments of being unable to breathe, and felt guilt immediately after, Coker said.
"If I just did what he said or if I didn't react that way, it wouldn't have happened," she said victims told her, placing themselves as the perpetrators.
it took Coker and her team a lot of work to help victims realise it was not their fault, and the dangers of strangulation.
For some who could not see a way out, they wanted the strangulation to end their ongoing abuse, she said.
They would tell her: "I just wanted him to take me out, I just wanted to die, I'm sick of this shit", she said.
Coker sees the impacts of strangulation daily, and has worked with women strangled to the point of unconsciousness. She said there needed to be more education on what strangulation was and that it was a criminal offence which needed to be reported.
It was also something that could save lives.
"If there is any restriction to your ability to breathe and live life, you need to say something, you need to get out, something needs to be done before it's too late."
Family Works Rotorua manager Lynne Fairs said the law against strangulation was a step in the right direction; to help victims and perpetrators realise how deadly strangulation was.
Fairs, who is based in Hamilton, said Family Works saw a lot of families at the centre of family violence and it was "a huge problem, particularly in Rotorua".
"The change in the law is good because I think for a long time, strangulation wasn't seen as it's seen now and it happened without people really being aware of the consequences."
But it was more than criminalising it, and now more effort needed to be put into educating the public on the dangers.
"People don't consider the harm. The perpetrator, and even the women, don't actually consider it could kill them ... There should be more awareness of that."
Safety and trust became an issue for victims and their supports and networks disappeared with family violence, she said.
Children became very watchful and protective of their caregiver and there were knock-on effects in behaviour and schooling.
If a woman said she had been strangled or abused in any other way, the first steps Family Works would take would be to ensure she was safe and had medical help. They would discuss the option of reporting it.
Then, the process of rebuilding the "rock-bottom" confidence and working through the trauma to move forward could begin.
They worked closely with other organisations to help women move on from the abuse, usually after the initial crisis teams such as Women's Refuge or police.
Bay of Plenty youth, community and family harm district manager, Inspector Phil Gillbanks said allegations of methamphetamine or alcohol abuse was often the cause of the stress in the relationship.
"Drugs, alcohol and mental health do play a significant part in family harm. Often there are children involved."
There were 13,219 family investigations carried out in the Bay of Plenty last year - nearly 1000 more than the previous year and about 483 more than in 2016.
Of these investigations, 2213 cases went to court, which is the highest number of family harm prosecutions of any region in the country and an average of six a day.
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