Study objective-To describe the responses of women in León, Nicaragua to partner abuse and identify contextual factors associated with the use of certain coping mechanisms and the likelihood of permanent separation. Design-Cross sectional populationbased survey. Setting-León, Nicaragua. Participants-188 women 15-49 years of age who had experienced physical partner abuse, out of 488 women interviewed. Main results-66% of women defended themselves eVectively from abuse either physically or verbally. Forty one per cent of women had left home temporarily because of violence and 20% had sought help outside the home. Women experiencing severe abuse were more likely to leave or seek help, whereas women with less severe abuse were more able to defend themselves eVectively. Seventy per cent of women eventually left abusive relationships. Help seeking and temporary separations increased the likelihood of a permanent separation, whereas women who defended themselves and were able to stop the violence, at least temporarily, were more likely to remain in abusive relationships. Conclusions-Women in Nicaragua use a variety of methods in order to overcome physical partner abuse. Temporary leaving and help seeking are critical steps in the process of leaving a violent relationship. However, many women indicated that they did not receive support for their situation. More interventions are needed to help women recognise and deal with violence, as well as strengthening the community support networks available to abused women. (J Epidemiol Community Health 2001;55:547-555) The physical abuse of women by intimate partners is a global problem with serious consequences for the health and well being of women and children. International studies indicate that worldwide, between 20%-50% of women experience wife assault, and approximately 3%-25% of women are assaulted by partners during pregnancy.1-3 Physical abuse is often accompanied by sexual coercion, and nearly always occurs within the context of extreme jealousy and marital control. [4][5][6][7][8] According to Dobash and colleagues, partner abuse is "often persistent and severe, occurs in the context of continuous intimidation and coercion and is inextricably linked to attempts to dominate and control women."9 The documented consequences of physical, emotional and sexual violence on women's health include chronic pain, injury, depression and suicide, and increased risk of reproductive health problems and adverse pregnancy outcomes.