Violence against women during pregnancy: sistematized revision

The Prevalence of Violence Against Women During Pregnancy and After Delivery in Saudi Arabia: A Cross-Sectional Study

Introduction

Violence against pregnant women has become a public health issue and a violation of human rights. The World Health Organization (WHO) defines violence as any act (physical or verbal) that causes physical or psychological harm. Obstetric violence committed by healthcare providers can lead to significant health consequences harming both mother and child. During pregnancy, violence is more frequent than some obstetric complications that are routinely recorded or screened. Therefore, this study aims to assess the prevalence of violence against women during pregnancy and labor, and postpartum.

Materials and methods

In this cross-sectional study, our study population consisted of women who have experienced pregnancy and labor in the Najd region. We used both face-to-face and online questionnaires that evaluated the knowledge and practice outcomes of women who have experienced violence during labor, in addition to the behavior of healthcare providers toward these women.

Results

In our analysis of demographic data, we found a significant association between age and having experienced violence before/during birth. Most women who experienced violence were between 25 and 45 years old (p=0.002). Furthermore, the history analysis revealed a significant association between follow-up regularity and violence experiences (p=0.010). Nursing students delivered most women (71%), and they did not provide information regarding the women’s rights or procedures. Of the respondents, 39.6% did not feel comfortable and were afraid of the healthcare providers’ words, phrases, or behaviors.

Conclusion

Our study concluded that many women experience violence committed by healthcare providers before, during, and after labor without realizing it. As a result of the ignorance of their rights, violence is more prevalent among these women. As a recommendation, to expand on the rights, women organizations should dedicate more efforts and throw campaigns to raise the awareness of violence among other women.

Overcoming the problems caused by collinearity in mixed-effects logistic model: determining the contribution of various types of violence on depression in pregnant women

BACKGROUND

Collinearity is a common and problematic phenomenon in studies on public health. It leads to inflation in variance of estimator and reduces test power. This phenomenon can occur in any model. In this study, a new ridge mixed-effects logistic model (RMELM) is proposed to overcome consequences of collinearity in correlated binary responses.

METHODS

Parameters were estimated through penalized log-likelihood with combining expectation maximization (EM) algorithm, gradient ascent, and Fisher-scoring methods. A simulation study was performed to compare new model with mixed-effects logistic model(MELM). Mean square error, relative bias, empirical power, and variance of random effects were used to evaluate RMELM. Also, contribution of various types of violence, and intervention on depression among pregnant women experiencing intimate partner violence(IPV) were analyzed by new and previous models.

RESULTS

Simulation study showed that mean square errors of fixed effects were decreased for RMELM than MELM and empirical power were increased. Inflation in variance of estimators due to collinearity was clearly shown in the MELM in data on IPV and RMELM adjusted the variances.

CONCLUSIONS

According to simulation results and analyzing IPV data, this new estimator is appropriate to deal with collinearity problems in the modelling of correlated binary responses.

Does husband's alcohol consumption increase the risk of domestic violence during the pregnancy and postpartum periods in Nepalese women?

Background

Domestic violence against women during pregnancy and the postpartum period not only violates the human rights of women but also harms on the health of both mother and child. Domestic violence is entrenching in social norms, customs and structural factors against women in Nepal. The use of alcohol also exacerbates domestic violence. The objective of this study was to determine the association between domestic violence against women and husband’s drinking behavior across the periods of pregnancy and postpartum.

Methods

This study was a cross-sectional study conducted in the antenatal care and postnatal care clinics of a government hospital in Kathmandu district. Among 660 women (aged 15–49), 165 women were consecutively recruited from each trimester of pregnancy and the postpartum period. Adjusted odds ratios (AOR) were computed from a multivariate logistic regression model to determine the association between domestic violence against women and the husband’s drinking behavior.

Results

Women whose husbands drank alcohol were twice as likely to suffer from domestic violence, compared to those women whose husbands did not drink (AOR = 2.12; 95% CI: 1.4–3.2), independently of their socio-demographic status. Women suffered from domestic violence in each period of pregnancy and postpartum due to their husband’s drinking habits, but the most affected period was the second trimester of pregnancy. Among women who suffered from physical, psychological and sexual violence during the pregnancy and postpartum periods, 70.2, 67.9, and 64.2% respectively experienced violence due to their husband’s drinking habit. Other associated factors for domestic violence included the ethnic culture of Janjati ethnicity, illiteracy of the women, duration of marriage 2–5 years (compared to one year or less) and a husband who behaved in a controlling manner.

Conclusions

Having a husband who has alcohol drinking behavior is an important risk factor for domestic violence against women in the pregnancy and postpartum periods. Screening of alcohol use in husbands will not prevent domestic violence but could lead to a referral to integrated treatment for alcohol and domestic violence treatment.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-020-10021-y.

Is unintended birth associated with physical intimate partner violence? Evidence from India

A growing number of studies have tested the association between intimate partner violence (IPV) and the unintendedness of pregnancy or birth, and most have suggested that unintendedness of pregnancy is a cause of IPV. However, about nine in every ten women face violence after delivering their first baby. This study examined the effects of the intendedness of births on physical IPV using data from the National Family Health Survey (2015-16). The multivariate logistic regression model analysis found that, compared with women with no unwanted births (2.9%), physical IPV was higher among those women who had unwanted births (6.9%, p<0.001), followed by those who had mistimed births (4.4 %, p<0.001), even after adjusting for several women's individual and socioeconomic characteristics. Thus, the reduction of women with mistimed and unwanted births could reduce physical IPV in India. The study highlights the unfinished agenda of family planning in the country and argues for the need to integrate family planning and Reproductive, Maternal and Child Health Care (RMNCH) services to yield multi-sectoral outcomes, including the elimination of IPV.

Woman's perceived stress during pregnancy; stressors and pregnancy adverse outcomes

Background: Stress perceived by mothers during pregnancy is dependent on several factors and can lead to adverse pregnancy outcomes threatening mother and child physical and mental health.Objective: The purpose of the present study is measuring perceived stress of pregnant women by 14 items Cohen's perceived stress scale (PSS), detecting stressors surrounding pregnant women including male partner's role, intimate violence, socioeconomic situation, etc., as well as investigate the effect of perceived stress on pregnancy adverse outcomes.Method: Two hundred first gravid pregnant women between 18 and 35 years old at post labor ward entered our cross-sectional study. They were asked to fill out the PSS questionnaire and an information gatherer filled out the checklist for exposures and baseline characteristics.Result: Mean ± SD of participants' PSS was 25.5 ± 8.6. Mothers' PSS was significantly higher in group reported father's verbal aggression against mother (N = 71, 38%) (23.7 ± 9 versus 28.2 ± 7.2; p < .001) and father's physical aggression against mother (N = 28, 15%) compared to nonexposed one (24.9 ± 7.7 versus 28.4 ± 8.7; p: .04). Mothers' PSS score was significantly correlated with mothers' satisfaction from both fathers' emotional (r: -0.30, p: .001) and financial support (r: -0.34, p < .001) during pregnancy. Moreover, the mother's satisfaction from father's concomitance in prenatal care (PNC) visits was significantly correlated with the mother's perceived stress (r: 0.24, p: .001).Conclusion: Male partner's role during pregnancy directly affects the pregnant woman's perceived stress.