Disclosure and police reporting of intimate partner violence postpartum: a pilot study

Extended postpartum intimate partner violence and its associated factors among Iranian women: Community-based cross-sectional study design

OBJECTIVE

The purpose of this study was to determine the prevalence of different types of intimate partner violence (IPV) and factors associated with it during the postpartum period.

METHODS

In this cross-sectional study, 428 women were enrolled from 10 health centers in the south of Tehran, Iran, between April 2023 and October 2023. We used a sociodemographic questionnaire, Conflict Tactics Scale (CTS2), the short form of the Connor-Davidson Resilience Scale (CD-RISC), and the Depression, Anxiety and Stress Scale (DASS-21) for data collection. Multivariate binary logistic regression was used to determine demographic and psychological predictors of IPV after childbirth.

RESULTS

Approximately two-thirds of women (n=285, 66.6%) experienced IPV within 1 year of childbirth. Psychological aggression (n= 276, 64.5%) was the most common type of IPV, whereas injury (n=96, 22.4%) was the least common. Additionally, one in three women experienced physical assault (n= 134, 31.3%), and over one-third experienced sexual coercion (n= 152, 35.5%). Predictor factors of IPV during the postpartum period were: insufficient family income (adjusted odds ratio [aOR] 4.52, 95% confidence interval [CI] 1.24-15.28), husband's smoking (aOR 3.17, 95% CI 1.70-5.92), history of IPV in pregnancy (aOR 2.44, 95% CI 1.33-4.50), number of children (aOR 3.02, 95% CI 1.79-5.10), and depression (aOR 1.2, 95% CI 1.08-1.14). On the other hand, protective factors of IPV during the postpartum period were: longer marriage duration (aOR 0.85, 95% CI 0.77-0.93) and greater resilience (aOR 0.95, 95% CI 0.90-0.99).

CONCLUSION

IPV is prevalent 1 year after childbirth. Healthcare providers should implement a thorough screening program to identify risk and protective factors related to postpartum IPV.

Prevalence of Intimate Partner Violence Among Intimate Partners During the Perinatal Period: A Narrative Literature Review

Intimate partner violence (IPV) affects individuals and families from all backgrounds, regardless of their ethnicity, socio-economic status, sexual orientation, or religion. Pregnancy and childbirth could be a time of vulnerability to violence because of changes in physical, emotional, social, and economic demands and needs. Prevalence of IPV against women during the perinatal period is increasingly researched and documented. However, evidence on IPV prevalence among intimate partners as well as on the course of IPV over the perinatal period is scarce. The purpose of this review was to provide a narrative synthesis of the existing literature regarding the prevalence estimates of IPV among intimate partners over the perinatal period. Through this review, we also gained better insight into associated factors, as well as the various forms of IPV. Of the 766 studies assessing prevalence estimates identified, 86 were included, where 80 studies focused on unidirectional IPV (i.e., perpetrated by men against women) and six studies investigated bidirectional IPV (i.e., IPV perpetrated by both partners). Most of the included studies reported lower overall prevalence rates for unidirectional IPV postpartum (range: 2-58%) compared to pregnancy (range: 1.5-66.9%). Psychological violence was found to be the most prevalent form of violence during the entire perinatal period. Studies on bidirectional IPV mostly reported women's perpetration to be almost as high as that of their partner or even higher, yet their findings need to be interpreted with caution. In addition, our results also highlighted the associated factors of IPV among partners, in which they were assimilated into a multi-level ecological model and were analyzed through an intersectional framework. Based on our findings, IPV is found to be highly prevalent during the entire perinatal period and in populations suffering from social inequalities. Further research exploring not only the occurrence, but also the motivations and the context of the bidirectionality of IPV during the perinatal period may facilitate better understanding of the detrimental consequences on partners and their families, as well as the development of effective intervention strategies. Public health prevention approaches intervening at optimal times during the perinatal period are also needed.

Prevalence of physical intimate partner violence in the first six months after childbirth in the city of Rio de Janeiro, Brazil

The aim of the study was to estimate the prevalence of physical intimate partner violence in the first six months after childbirth among women attending primary care clinics (UBS) for the infant's follow-up in Rio de Janeiro, Brazil. This is the first study on the theme using a representative sample of primary care clinics in the city of Rio de Janeiro. The study used a cross-sectional design from June to September 2007 and included 927 mothers/infants seen at 27 UBS, selected by complex sampling, geographically representative of the city. The information was collected in face-to-face interviews by a previously trained team, using a structured questionnaire. History of physical intimate partner violence from the child's birth to the date of the interview was obtained with the Brazilian version of the Revised Conflict Tactics Scales (CTS2). Thirty percent (95%CI: 26.2-33.8) of mothers reported having experienced some form of physical intimate partner violence in the postpartum and 14% (95%CI: 11.0-17.0) reported severe physical violence. The physical abuse occurred especially among black teenage mothres, in unfavorable socioeconomic situation, that did not live with the partner and that had received inadequate or no prenatal care and reported difficulties in breastfeeding and use of healthcare services. The widespread occurrence of physical intimate partner violence emphasizes the urgent need to deal with the problem. Primary healthcare services must be linked to other support networks and health professionals need to be prepared to deal with the problem.

The degree of suffering among pregnant women with a history of violence, help-seeking, and police reporting

OBJECTIVES

To explore the degree of self-reported suffering following violent incidents and the prevalence of police reporting as well as other help-seeking behaviour among women in early pregnancy with history of violence.

STUDY DESIGN

A cross-sectional design. 1939 pregnant women≥18years were recruited prospectively between March 2012 and September 2013 in south-west Sweden. Of those, 761 (39.5%) reported having a history of violence, and they comprised the cohort investigated in the present study. Descriptive statistics, Chi-square analysis, and T-test were used for the statistical calculations.

RESULTS

More than four of five women (80.5%) having a history of emotional abuse (n=374), more than half (52.4%) having history of physical abuse (n=561), and almost three of four (70.6%) who experienced sexual abuse (n=302) reported in the early second trimester of their pregnancy that they still suffered from their experience. Of those women who had experienced emotional, physical, and sexual abuse, 10.5%, 25.1%, and 18.0%, respectively, had never disclosed their experiences to anyone. At most, a quarter of the abused women had reported a violent incident to the police.

CONCLUSIONS

All midwives and other actors who meet women with experience of abuse need to have increased knowledge about the long-term consequences of all types of abuse. Increased routine questioning of pregnant women about history of violence would help to prevent experiences of violence from affecting pregnancy and childbirth negatively and facilitate the provision of help and support.

Women are considerably more exposed to intimate partner violence than men in Rwanda: results from a population-based, cross-sectional study

Background

Intimate partner violence (IPV) against women is an important, yet often neglected public health issue. The existence of gender norms imbalance expressed by men’s and women’s attitudes in relation to power and decision-making in intimate relationships may influence the magnitude of IPV. The aim of this study was to investigate the prevalence and potential risk factors of physical, sexual and psychological IPV in young men and women in Rwanda.

Methods

This population-based, cross-sectional study included a representative sample of men and women from the Southern Province of Rwanda. Face-to-face interviews were performed using the World Health Organization (WHO) questionnaire for violence exposure to estimate past year and earlier in life IPV occurrence. Risk factor patterns were analyzed by use of bi- and multivariate logistic regression.

Results

Women were, to a considerably higher extent, exposed to physical, sexual and psychological IPV than men. Of the women, 18.8% (n = 78) reported physical abuse in the past year, compared to 4.3% (n = 18) of men. The corresponding figures for women and men for sexual abuse were 17.4% (n = 71) and 1.5% (n = 6), respectively, and for psychological abuse, the corresponding figures were 21.4% (n = 92) and 7.3% (n = 32). Findings illustrate that violence against women was recurrent, as the highest frequency (>3 times) dominated in women for the various acts of all forms of violence. Identified risk factors for women’s exposure to physical violence were being low educated, having poor social support, being poor and having many children. For men exposed to physical violence, no statistically significant risk factor was identified.

Conclusions

In this setting, IPV exposure was more common in women than men in the Southern Province of Rwanda. Promotion of gender equality at the individual level is needed to make a positive difference in a relatively short term perspective. Men’s lower reporting of IPV confirms women’s subordinate position, but men’s denial of incidents could also explain the gender role pattern.

The Comparison of Self-differentiation and Self-concept in Divorced and Non-divorced Women Who Experience Domestic Violence

Background

A number of researches indicate that domestic violence (DV) causes abuse and vulnerability of women and children. Two components that can decrease violence and divorce are self-concept and self-differentiation.

Objectives

In this research, we compare self-differentiation and self-concept in divorced and non-divorced women that experience domestic violence.

Materials and Methods

To achieve the goal of the research, 80 divorced women with domestic violence were chosen through available sampling and equalized with 80 non divorced women with domestic violence in aspect of age and education. They respond to instrument of self-differentiation (Skowron) and self-concept (Rodgers). Data was analyzed between the two groups using independent t-test. The significant level was (P < 0.01).

Results

The findings indicated divorced women have more self-differentiation and self-concept than non-divorced women. In addition, there is a significant difference with respect to self-differentiation and self-concept in divorced and non-divorced women with domestic violence.

Conclusions

These results emphasize that self-differentiation and self-concept can be considered in premarital education (therapeutic interventions) to protective conditions against the occurrence of DV.

Women's experiences of important others in a pregnancy dominated by intimate partner violence

BACKGROUND

Being exposed to intimate partner violence (IPV) during pregnancy is a difficult and complex situation. Despite this, there are few studies describing women's own needs for help and support.

AIM

The aim of this study is to gain a deeper understanding of women's experiences of important others in relation to changing their life situation in a pregnancy dominated by IPV.

METHODS

The study has a qualitative phenomenological design. The data were collected through in-depth interviews with seven Norwegian women, who were exposed to IPV during pregnancy.

FINDINGS

Being pregnant and exposed to violence in relation to important others means confronting present life, life history and future life. The essence implies striving for control in an uncontrolled situation, where other people might be experienced as both a rescuer and a risk. This is further described in four constitutions: the child needs protection; my mother is always present for me; an exhausted run for help; and a reduced, but important social network.

CONCLUSIONS AND IMPLICATIONS FOR PRACTICE

For women exposed to violence, pregnancy can offer an opportunity for change. Midwives play a unique role in relation to care and continuity in this phase of life, as they can support pregnant women, help to identify their needs, possibilities for action and advise them about appropriate services. Midwives can encourage and support women to find people whom they can trust and who can offer assistance. It is vital that midwives ask about the women's relationship to the baby and their social networks, especially the relationship with their mothers. Ethical considerations:  During the whole study process, guidelines for research on violence against women were followed, to respect the integrity, security and confidentiality of the participants. The study is ethically approved.

Screening of women for intimate partner violence: a pilot intervention at an outpatient department in Tanzania

Intimate partner violence (IPV) is a public health problem in Tanzania with limited health care interventions.

OBJECTIVES

To study the feasibility of using an abuse screening tool for women attending an outpatient department, and describe how health care workers perceived its benefits and challenges.

METHODS

Prior to screening, 39 health care workers attended training on gender-based violence and the suggested screening procedures. Seven health care workers were arranged to implement screening in 3 weeks, during March-April 2010. For screening evaluation, health care workers were observed for their interaction with clients. Thereafter, focus group discussions (FGDs) were conducted with 21 health care workers among those who had participated in the training and screening. Five health care workers wrote narratives. Women's responses to screening questions were analyzed with descriptive statistics, whereas qualitative content analysis guided analysis of qualitative data.

RESULTS

Of the 102 women screened, 78% had experienced emotional, physical, or sexual violence. Among them, 62% had experienced IPV, while 22% were subjected to violence by a relative, and 9.2% by a work mate. Two-thirds (64%) had been abused more than once; 14% several times. Almost one-quarter (23%) had experienced sexual violence. Six of the health care workers interacted well with clients but three had difficulties to follow counseling guidelines. FGDs and narratives generated three categories Just asking feels good implied a blessing of the tool; what next? indicated ethical dilemmas; and fear of becoming a 'women hospital' only indicated a concern that abused men would be neglected.

CONCLUSIONS

Screening for IPV is feasible. Overall, the health care workers perceived the tool to be advantageous. Training on gender-based violence and adjustment of the tool to suit local structures are important. Further studies are needed to explore the implications of including abuse against men and children in future screening.

Violence against women: a study of the reports to police in the city of Itapevi, São Paulo, Brazil

BACKGROUND

violence against women is a serious problem caused by the social construction of feminineness and masculineness that results in the domination of women by men. Public policies on gender have recently been developed in order to confront the problem. But what exactly are the problems faced by women?

PURPOSES

to survey and analyse cases of violence against women reported to the police, as recorded at the Police Stations for Women's Defence (PSWDs), and to reconstruct the procedures that women must go through in order to denounce their aggressors.

METHODOLOGY

this quantitative, exploratory and descriptive study was undertaken during 2006-2007 in the city of Itapevi, São Paulo metropolitan region, Brazil. As there is no PSWD data were collected from police reports from PSWDs of neighbouring cities.

FINDINGS

malicious physical injury (49%) and threats (42%) were the most commonly reported types of violence. The victims were aged between 20 and 49 years (93%). Almost all of the aggressors (97%) were men and most had an intimate relationship with their victim. The use of alcoholic beverages was linked to approximately 25% of the cases.

CONCLUSION

women who are victims of domestic violence in Itapevi report that going through PSWDs of neighbouring cities is a difficult, isolated, long and expensive process that often, provides no institutional protection.

IMPLICATIONS FOR PRACTICE

there is an urgent requirement for judicial-assistance and support close to home in order to provide a quality service and follow-up for these women and their aggressors; to provide training for the professionals called to attend them at police stations; and for a caring attitude from health-care professionals.

Factors associated with disclosure of intimate partner violence among women in Lagos, Nigeria

BACKGROUND

Though the prevalence of Intimate Partner Violence (IPV) remains high in less developed countries, data suggest that these figures may represent an underestimation considering that many women are unwilling to disclose abuse. This paper aims to determine women's willingness to report abuse, factors determining willingness to disclose IPV, and to whom such disclosure is made.

METHODS

A total of 911 women visiting reproductive health facility responded to the questionnaire, and the collected data was analyzed using multivariate analysis.

RESULTS

About 54% (n=443) of the participating women reported that would not disclose IPV. Among those willing to disclose abuse, 68% (n=221) would opt to disclose to close relatives in contrast to 32% (n=103) who would disclose to some form of institutions (i.e. religious leaders, law enforcement officers). Ethnicity, woman's own use of alcohol and autonomy in decision making such as having a say on household purchases, money use and visitation, independently predicted willingness to disclose IPV.

CONCLUSIONS

The role of family is still important in the Nigeria context and the implications for research and intervention are discussed.