1
|
Prakash J, Fay K, Gujrathi R, Rosner B, Nour N, Khurana B. Antepartum Intimate Partner Violence: Development of a Risk Prediction Model. J Womens Health (Larchmt) 2024. [PMID: 38770781 DOI: 10.1089/jwh.2024.0038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/22/2024] Open
Abstract
Objectives: To explore socio-behavioral, clinical, and imaging findings associated with antepartum intimate partner violence (IPV) and aid in risk stratification of at-risk individuals. Methods: We analyzed electronic medical records during indexed pregnancies for 108 pregnant patients who self-reported antepartum IPV (cases) and 106 age-matched pregnant patients who did not self-report antepartum IPV (controls). Sociodemographic, clinical, and radiology data were analyzed via chi-squared and Fisher's exact tests with p < 0.05 as the threshold for significance. Stepwise logistic regression was applied to derive a risk prediction model. Results: The proportion of cases reporting emotional IPV (76% vs. 52%) and/or physical IPV (45% vs. 31%) during pregnancy significantly increased from prior to pregnancy. Cases were significantly more likely to report prepregnancy substance use (odds ratio [OR] = 2.60; 95% confidence interval [CI]: 1.13-5.98), sexually transmitted infections (OR = 3.48; 95%CI: 1.64-7.37), abortion (OR = 3.17; 95%CI: 1.79, 5.59), and preterm birth (OR = 5.97; 95%CI: 1.69-21.15). During pregnancy, cases were more likely to report unstable housing (OR = 5.26; 95%CI: 2.67-10.36), multigravidity (OR = 2.83; 95%CI: 1.44-5.58), multiparity (OR = 3.75; 95%CI: 1.72-8.20), anxiety (OR = 3.35; 95%CI: 1.85-6.08), depression (OR = 5.58; 95%CI: 3.07-10.16), substance use (OR = 2.92; 95%CI: 1.28-6.65), urinary tract infection (UTI) (OR = 3.26; 95%CI: 1.14-9.32), intrauterine growth restriction (OR = 10.71; 95%CI: 1.35-85.25), and cesarean delivery (OR = 2.25; 95%CI: 1.26-4.02). Cases had significantly more OBGYN abnormalities on imaging and canceled more radiological studies (OR = 5.31). Logistic regression found housing status, sexually transmitted infection history, preterm delivery history, abortion history, depression, and antepartum UTI predictive of antepartum IPV. The risk prediction model achieved good calibration with an area under the curve of 0.79. Conclusions: This study identifies significant disparities among patients experiencing antepartum IPV, and our proposed risk prediction model can inform risk assessment in this setting.
Collapse
Affiliation(s)
- Jaya Prakash
- Trauma Imaging Research and Innovation Center, Department of Obstetrics and Gynecology, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Kathryn Fay
- Department of Obstetrics and Gynecology, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Rahul Gujrathi
- Trauma Imaging Research and Innovation Center, Department of Radiology, Boston Medical Center, Boston, Massachusetts, USA
| | | | - Nawal Nour
- Department of Obstetrics and Gynecology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Bharti Khurana
- Trauma Imaging Research and Innovation Center, Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| |
Collapse
|
2
|
DeMaria AL, Meier S, King H, Sidorowicz H, Seigfried-Spellar KC, Schwab-Reese LM. The role of community healthcare professionals in discussing sexual assault experiences during obstetrics and gynecological healthcare appointments. BMC Womens Health 2023; 23:263. [PMID: 37189119 PMCID: PMC10184971 DOI: 10.1186/s12905-023-02401-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Accepted: 04/28/2023] [Indexed: 05/17/2023] Open
Abstract
BACKGROUND Nearly half of adult women in the US report experiencing sexual assault, with almost one-fifth reporting rape. For many sexual assault survivors, healthcare professionals are the first point of contact and disclosure. This study aimed to understand how healthcare professionals working in community settings perceived their role in discussing sexual violence experiences with women during obstetrical and gynecological healthcare appointments. The secondary purpose was to compare healthcare professionals' perspectives with the patients' to determine how sexual violence conversations should occur in these environments. METHODS Data were collected in two phases. Phase 1 consisted of 6 focus groups (Sept-Dec, 2019) with women aged 18-45 (n = 22) living in Indiana who sought community-based or private healthcare for women's reproductive healthcare needs. Phase 2 included 20 key-informant interviews with non-physician healthcare professionals (i.e., NP, RN, CNM, doula, pharmacist, chiropractor) living in Indiana (September 2019-May 2020) who provided community-based women's reproductive healthcare. Focus groups and interviews were audio-recorded, transcribed, and analyzed using thematic analyses. HyperRESEARCH assisted in data management and organization. RESULTS There were three resulting themes: (1) healthcare professionals' approaches to screening for a history of sexual violence varied depending on how they ask, what setting they work in, and type of professional asking; (2) healthcare experiences can compound traumatic experiences and create distrust with survivors; and (3) sexual violence impacts patient healthcare experiences through what services they seek, how professionals may interact with them, and what professionals they are willing to utilize. CONCLUSIONS Findings offered insight into actionable and practical strategies for enhancing sexual violence screening and discussions in community-based women's reproductive health settings. The findings offer strategies to address barriers and facilitators among community healthcare professionals and the people they serve. Incorporating healthcare professional and patient experiences and preferences for violence-related discussions during obstetrical and gynecological healthcare appointments can assist in violence prevention efforts, improve patient-professional rapport, and yield better health outcomes.
Collapse
Affiliation(s)
- Andrea L DeMaria
- Department of Public Health, College of Health and Human Sciences, Purdue University, 812 West State Street, 47907, West Lafayette, IN, USA.
- Division of Consumer Science, College of Health and Human Sciences, Purdue University, West Lafayette, IN, USA.
| | - Stephanie Meier
- Division of Consumer Science, College of Health and Human Sciences, Purdue University, West Lafayette, IN, USA
| | - Hannah King
- Department of Public Health, College of Health and Human Sciences, Purdue University, 812 West State Street, 47907, West Lafayette, IN, USA
| | - Haley Sidorowicz
- Department of Biological Sciences, College of Science, Purdue University, West Lafayette, IN, USA
| | - Kathryn C Seigfried-Spellar
- Department of Computer and Information Technology, Polytechnic Institute, Purdue University, West Lafayette, IN, USA
| | - Laura M Schwab-Reese
- Department of Public Health, College of Health and Human Sciences, Purdue University, 812 West State Street, 47907, West Lafayette, IN, USA
| |
Collapse
|
3
|
Muñoz-Sellés E, Pujolar-Díaz G, Fuster-Casanovas A, Miró Catalina Q. Detection of gender-based violence in primary care in Central Catalonia: a descriptive cross-sectional study. BMC Health Serv Res 2023; 23:110. [PMID: 36732794 PMCID: PMC9893199 DOI: 10.1186/s12913-023-09091-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Accepted: 01/23/2023] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Violence against women is a serious public health problem. Primary care could be one of the ideal places for the detection of gender-based violence (GBV), since women come into contact with PC at some point in their lives to look after their sexual and reproductive health. The increase in initiatives promoted by the health authorities regarding GBV offers the possibility of observing its evolution over the last few years. METHODS A descriptive cross-sectional study of reported cases of GBV in the region of Central Catalonia, during the period from 2017 to 2021, was carried out. All women of legal age, belonging to the specified health region and suffering episodes of GBV, were included. The variables analysed were age, area of residence, health diagnoses related to GBV, whether or not they were pregnant at the time of the attack, and mental health history. RESULTS Of the total number of women studied, 1,467 presented some type of diagnosis of GBV, with a total of 3,452 episodes reported. We found an increase in the detection of cases, although it must be noted that there is an underreporting of cases in PC. The prevalence according to the total number of women assigned per year over the period studied was 0.42% in 2017 and 0.48% in 2021. It has also been observed that the average number of episodes per woman increased from 1.03 in 2017 to 1.15 in 2021. During the 5 years analysed, the minimum number of episodes per woman was 1 and the maximum was 10. In reference to the duration of the episodes, the minimum was 1 day, and the maximum was 32 years. The mean age of the women was 42.10 years, the most frequent nationality was Spanish (46.60%), and 54.15% of them lived in rural areas. CONCLUSIONS Despite the established protocols and procedures, it seems that primary health care is not the most frequent place for its detection. It is necessary to continue working to raise awareness and train professionals, and to ensure coordination among all the parties involved in accompanying women in these processes. TRIAL REGISTRATION CEIm: 21/278-P.
Collapse
Affiliation(s)
- Ester Muñoz-Sellés
- grid.22061.370000 0000 9127 6969Midwife ASSIR Osona. Institut Català de la Salut, Manlleu, Spain
| | - Georgina Pujolar-Díaz
- Research Support Unit of Central Catalonia, University Institute for Primary Health Care Research Foundation Jordi Gol i Gurina, Sant Fruitós de Bages, Spain
| | - Aïna Fuster-Casanovas
- Research Support Unit of Central Catalonia, University Institute for Primary Health Care Research Foundation Jordi Gol i Gurina, Sant Fruitós de Bages, Spain ,grid.22061.370000 0000 9127 6969Health Promotion in Rural Areas Research Group, Gerencia Territorial de la Catalunya Central, Institut Català de la Salut, Sant Fruitós de Bages, Spain
| | - Queralt Miró Catalina
- grid.22061.370000 0000 9127 6969Health Promotion in Rural Areas Research Group, Gerencia Territorial de la Catalunya Central, Institut Català de la Salut, Sant Fruitós de Bages, Spain
| |
Collapse
|
4
|
Whiting JB, Davies BN, Eisert BC, Witting AB, Anderson SR. Online Conversations About Abuse: Responses to IPV Survivors from Support Communities. JOURNAL OF FAMILY VIOLENCE 2022; 38:1-11. [PMID: 35891985 PMCID: PMC9304543 DOI: 10.1007/s10896-022-00414-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/15/2022] [Indexed: 05/21/2023]
Abstract
Purpose Intimate partner violence (IPV) impacts the lives of millions, damaging survivors and families. Many survivors are unsure how to get help, and have limited access to resources. In recent years, those affected by IPV have turned online for answers, support, and to share their experiences. This study examined the online dialogue between survivors of violence and those who respond to their posts. Method Data consisted of 451 responses to IPV survivors on the website Reddit in a domestic violence subgroup. Responses were analyzed using a combination of grounded theory coding techniques with content analysis tools to generate categories and subcategories. Results Three main categories emerged from the data, including support, sharing experiences, and sharing information. The subcategories included specific types of help, advice, understanding, and were overwhelmingly positive in their tone and content. Conclusions Findings suggest that online forums may help bridge the gap between survivors and resources. Professionals who work with IPV or create policies can use these findings to understand how to help survivors find support. This may include encouraging survivors to connect with informal supports such as family and friends, or access formal support such as hotlines, therapy, or legal counsel. The findings also suggest that more research is needed to understand what types of questions survivors of violence have, and what outcomes result from online support.
Collapse
Affiliation(s)
- Jason B. Whiting
- School of Family Life, Brigham Young University, 234, TLRB, Provo, UT 84602 USA
| | - Bria Nicole Davies
- School of Family Life, Brigham Young University, 234, TLRB, Provo, UT 84602 USA
| | - Brady C. Eisert
- School of Family Life, Brigham Young University, 234, TLRB, Provo, UT 84602 USA
| | | | - Shayne R. Anderson
- School of Family Life, Brigham Young University, 234, TLRB, Provo, UT 84602 USA
| |
Collapse
|
5
|
Bernard NK, Bogat GA, Kashy DA, Lonstein JS, Levendosky AA. Prenatal and postnatal intimate partner violence, depression, and infant-mother touch. Infant Behav Dev 2022; 67:101703. [DOI: 10.1016/j.infbeh.2022.101703] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 01/10/2022] [Accepted: 02/09/2022] [Indexed: 11/17/2022]
|
6
|
Intimate Partner Violence and Pregnancy Termination among Tajikistan Women: Evidence from Nationally Representative Data. WOMEN 2022. [DOI: 10.3390/women2020012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Intimate partner violence is the most common kind of violence and a significant public health issue. The relationship between intimate partner violence and pregnancy termination among Tajikistan women was investigated in this study. The data for this research was collected from the Tajikistan Demographic and Health Survey 2017. This research has used the data of married women aged between 15 to 49 years. The findings from the study indicate that around 23.2% of married women in Tajikistan have experienced physical violence. The respondent’s age, region, and employment status was significantly associated with pregnancy termination (p < 0.05). Similarly, women who can refuse sex with their partner and ask their partner to use a condom are more likely to terminate pregnancy (p < 0.05). The characteristics of the husband or partner that had a significant positive association with pregnancy termination of married women in Tajikistan are age, educational level, and alcohol drinking status of their husbands (p < 0.05). This study also establishes the significant relationship between pregnancy termination and physical or emotional violence experienced by women (p < 0.05). The dynamics of domestic abuse need to be understood by healthcare providers to aid women in making decisions on whether or not to terminate their pregnancy.
Collapse
|
7
|
Propensity score analysis of psychological intimate partner violence and preterm birth. Sci Rep 2022; 12:2942. [PMID: 35190645 PMCID: PMC8861009 DOI: 10.1038/s41598-022-06990-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Accepted: 01/27/2022] [Indexed: 11/08/2022] Open
Abstract
Psychological intimate partner violence (IPV), a global public health problem, affects mothers during pregnancy. We evaluated its relationship with preterm birth. We established a cohort of 779 consecutive mothers receiving antenatal care and giving birth in 15 public hospitals in Spain. Trained midwives collected IPV data using the Index of Spouse Abuse validated in the Spanish language. Preterm was defined as birth before 37 completed weeks of gestation. Gestational age was estimated by early ultrasound. With multivariate logistic regression we estimated the relative association of IPV with preterm birth as adjusted odds ratios (AOR), with 95% confidence intervals (CI). In propensity score analysis, using weighting by inverse probability of exposure to IPV, the whole sample was used for estimating the absolute difference in probability of preterm amongst offspring born to mothers with and without IPV. Socio-demographic and other pregnancy characteristics served as covariates in both analyses. Preterm occurred in 57 (7.3%) pregnancies. Psychological IPV, experienced by 151 (21%) mothers, was associated with preterm birth (11.9% vs 6.5%; AOR = 2.4; 95% CI = 1.1–5.0; p = 0.01). The absolute preterm difference in psychological IPV compared to normal was 0.08 (95% CI = 0.01–0.16; p = 0.04). The probability of preterm birth was 8% higher on average in women with psychological IPV during pregnancy. As our analysis controlled for selection bias, our findings give credence to a causal inference. Screening and management for psychological IPV during pregnancy is an important step in antenatal care to prevent preterm birth.
Collapse
|
8
|
Zapata-Calvente AL, Megías JL, Velasco C, Caño A, Khan KS, Rubio L, Martín-de-Las-Heras S. Screening for intimate partner violence during pregnancy: a test accuracy study. Eur J Public Health 2022; 32:429-435. [PMID: 35134894 PMCID: PMC9159325 DOI: 10.1093/eurpub/ckac009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Background Intimate partner violence (IPV) against women is a serious health problem that affects pregnancy more frequently than other obstetric complications usually evaluated in antenatal visits. We aimed to estimate the accuracy of the Women Abuse Screening Tool-Short (WAST-Short) and the Abuse Assessment Screen (AAS) for the detection of IPV during and before pregnancy. Methods Consecutive eligible mothers in 21 public primary health antenatal care centres in Andalusia (Spain) who received antenatal care and gave birth during January 2017–March 2019, had IPV data gathered by trained midwives in the first and third pregnancy trimesters. The index tests were WAST-Short (score range 0–2; cut-off 2) and AAS (score range 0–1; cut-off 1). The reference standard was World Health Organization (WHO) IPV questionnaire. Area under receiver operating characteristics curve (AUC), sensitivity and specificity with 95% confidence intervals (CI) were estimated for test performance to capture IPV during and before pregnancy, and compared using paired samples analysis. Results According to the reference standard, 9.5% (47/495) and 19.4% (111/571) women suffered IPV during and before pregnancy, respectively. For capturing IPV during pregnancy in the third trimester, the WAST-Short (AUC 0.73, 95% CI 0.63, 0.81), performed better than AAS (AUC 0.57, 95% CI 0.47, 0.66, P = 0.0001). For capturing IPV before pregnancy in the first trimester, there was no significant difference between the WAST-Short (AUC 0.69, 95% CI 0.62, 0.74) and the AAS (AUC 0.69, 95% CI 0.62, 0.74, P = 0.99). Conclusions The WAST-Short could be useful to screen IPV during pregnancy in antenatal visits.
Collapse
Affiliation(s)
| | - Jesús L Megías
- Department of Experimental Psychology, University of Granada, Granada, Spain
| | - Casilda Velasco
- Department of Nursing and Midwifery, University of Jaen, Jaen, Spain
| | - Africa Caño
- Department of Obstetrics and Gynecology, University Hospital, Granada, Spain
| | - Khalid S Khan
- Department of Preventive Medicine and Public Health, University of Granada, Granada, Spain.,CIBER of Epidemiology and Public Health (CIBERESP), Granada, Spain
| | - Leticia Rubio
- Department of Forensic Medicine, University of Malaga, Malaga, Spain
| | | |
Collapse
|
9
|
Comacchio C, Antolini G, Ruggeri M, Colizzi M. Gender-Oriented Mental Health Prevention: A Reappraisal. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:1493. [PMID: 35162515 PMCID: PMC8835536 DOI: 10.3390/ijerph19031493] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/19/2021] [Revised: 01/20/2022] [Accepted: 01/24/2022] [Indexed: 11/28/2022]
Abstract
Many studies have investigated the impact of gender on mental health, but only a few have addressed gender differences in mental health risk and prevention. We conducted a narrative review to assess the current state of knowledge on gender-specific mental health preventive interventions, along with an analysis of gender-based risk factors and available screening strategies. Out of 1598 articles screened using a comprehensive electronic search of the PubMed, Web-of-Science, Scopus, and Cochrane databases, 53 were included for review. Among risk factors for mental health problems, there are individual, familiar, social, and healthcare factors. Individual factors include childhood adversities, which show gender differences in distribution rates. However, current childhood abuse prevention programs are not gender-specific. Familiar factors for mental health problems include maternity issues and intimate partner violence, and for both, some gender-specific preventive interventions are available. Social risk factors for mental health problems are related to education, employment, discrimination, and relationships. They all display gender differences, but these differences are rarely taken into account in mental health prevention programs. Lastly, despite gender differences in mental health service use being widely known, mental health services appear to be slow in developing strategies that guarantee equal access to care for all individuals.
Collapse
Affiliation(s)
| | - Giulia Antolini
- Child and Adolescent Neuropsychiatry Unit, Maternal-Child Integrated Care Department, Integrated University Hospital of Verona, 37126 Verona, Italy;
| | - Mirella Ruggeri
- Section of Psychiatry, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, 37134 Verona, Italy;
| | - Marco Colizzi
- Section of Psychiatry, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, 37134 Verona, Italy;
- Unit of Psychiatry, Department of Medicine (DAME), University of Udine, 33100 Udine, Italy
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London SE5 8AF, UK
| |
Collapse
|
10
|
Giacci E, Straits KJ, Gelman A, Miller-Walfish S, Iwuanyanwu R, Miller E. Intimate Partner and Sexual Violence, Reproductive Coercion, and Reproductive Health Among American Indian and Alaska Native Women: A Narrative Interview Study. J Womens Health (Larchmt) 2022; 31:13-22. [PMID: 34747659 PMCID: PMC8785763 DOI: 10.1089/jwh.2021.0056] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
Background: The disproportionately high prevalence of poor reproductive and sexual health outcomes among American Indian and Alaska Native (AI/AN) women is related to histories of colonization, oppression, and structural racism. Intimate partner violence (IPV) and sexual violence (SV) contribute to these health outcomes. Materials and Methods: Narrative interviews were conducted with AI/AN women from four tribal reservation communities. Interviews explored connections among sexual and reproductive health, IPV, SV, reproductive coercion (RC), and pregnancy experiences as well as women's experiences of healing and recovery. Results: Among the 56 women interviewed (aged 17-55 years, 77% were aged 40 years and younger), all described multiple exposures to violence and highlighted lack of disclosure related to sexuality, childhood abuse, SV, and historical trauma. Access to confidential reproductive health services and contraceptive education was limited. Almost half (45%) reported experiencing RC in their lifetime. Use of substances occurred in both the context of SV and for surviving after exposure to violence. Women underscored the extent to which IPV, SV, and RC are embedded in histories of colonization, racism, and ongoing oppression. Interventions that incorporate AI/AN traditions, access to culturally responsive reproductive health and advocacy services, organizations, and services that have AI/AN personnel supporting survivors, public discussion about racism, abuse, sexuality, and more accountable community responses to violence (including law enforcement) are promising pathways to healing and recovery. Conclusions: Findings may advance understanding of AI/AN women's reproductive health in the context of historical trauma and oppression. Intervention strategies that enhance resiliency of AI/AN women may promote reproductive health.
Collapse
Affiliation(s)
- Elena Giacci
- Advocate and Training Specialist (Dine), Albuquerque, New Mexico, USA
| | - Kee J.E. Straits
- Tinkuy Life Community Transformations, LLC, Albuquerque, New Mexico, USA
| | - Amanda Gelman
- Chinle Comprehensive Health Care Facility, Chinle, Arizona, USA
| | - Summer Miller-Walfish
- Division of Adolescent and Young Adult Medicine, Department of Pediatrics, University of Pittsburgh School of Medicine, UPMC Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Rosemary Iwuanyanwu
- Division of Adolescent and Young Adult Medicine, Department of Pediatrics, University of Pittsburgh School of Medicine, UPMC Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Elizabeth Miller
- Division of Adolescent and Young Adult Medicine, Department of Pediatrics, University of Pittsburgh School of Medicine, UPMC Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania, USA
| |
Collapse
|
11
|
Meier S, Brig K, Delay C, Sundstrom B, Schwab-Reese L, DeMaria AL. "I'm More Open to Talking About It": Women's Experiences With Sexual Abuse and Reproductive Health. JOURNAL OF INTERPERSONAL VIOLENCE 2021; 36:NP13136-NP13161. [PMID: 32052686 DOI: 10.1177/0886260520905077] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Approximately one in three women experience sexual abuse, which can result in negative reproductive health consequences. A history of sexual abuse may negatively impact health care seeking and experience. The purposes of this article were to understand how women perceived their sexual abuse experiences and how these experiences integrated into their overall reproductive health, reproductive planning, and health care access. As part of a larger study about women's reproductive health, researchers analyzed 16 in-depth interviews with women aged 18 years and older (range = 18-78) living in South Carolina (May-November 2016). A constant comparative method of data analysis was completed to explore women's sexual abuse experiences as they related to reproductive health and health care experiences. HyperRESEARCH 3.7.3 assisted in data organization and management. Limited bodily agency impacted women's ability to engage in family planning, particularly when partners utilized sexual coercion to maintain desired relationships and attain desired family size, regardless of women's preferences. In addition, limited sexual violence and abuse discussion in health care contexts impacted women's autonomy in reproductive health decision-making despite participants' desire to engage in these discussions with providers. Participants expressed a desire for communication about their sexual abuse experiences; however, results indicated women had to navigate stigma within families and communities, which deterred disclosure and open discussion. Negative health outcomes and desire to discuss these experiences within the health care context highlighted a need for patient-provider communication about sexual abuse history as one aspect of gynecologic care. Findings from this study offer practical recommendations to guide communication about sexual abuse within reproductive health care experiences to empower women in their reproductive health choices. As these experiences may impact overall health and reproductive choices, provider-initiated conversations with adolescents and women may improve care and assist in prevention efforts, including the prevention of negative health outcomes.
Collapse
|
12
|
Chepuka L, Kwanjo-Banda C, Kafulafula U, Sefasi A, Chorwe-Sungani G. Prevalence and associated factors of intimate partner violence amongst women attending prevention of mother to child transmission services in Blantyre, Malawi. S Afr Fam Pract (2004) 2021; 63:e1-e7. [PMID: 34636592 PMCID: PMC8603061 DOI: 10.4102/safp.v63i1.5271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 03/09/2021] [Accepted: 03/12/2021] [Indexed: 12/02/2022] Open
Abstract
Background Intimate partner violence (IPV) during the perinatal period and when one is HIV-positive is a great concern because of the physical and mental impacts it has on health and on adherence to prevention of mother to child transmission (PMTCT) services. However, factors associated with IPV amongst perinatal women on PMTCT services are not adequately explored in Malawi. The aim of this study was to estimate the various types of IPV and the associated factors amongst HIV-positive pregnant and postnatal women in selected health centres in Blantyre district. Methods In this cross-sectional study, we recruited 200 HIV-positive women from antenatal, postnatal and antiretroviral therapy (ART) clinics from four selected primary care facilities of Blantyre district. Data were collected between March and May 2018. Results A total of 50% of the participants reported to have experienced either physical, psychological or sexual violence from their partner in the last 12 months. The multivariate logistic regression model showed that feelings about safety of the relationship and depression were the only factors that were consistently associated with IPV in the last 12 months (p = 0.001, Pseudo R2 = 0.20). Conclusion The presence of depression and safety concerns amongst our study participants calls for serious prioritisation of psychological interventions and risk assessment in the management of HIV-positive perinatal mothers who report IPV cases.
Collapse
Affiliation(s)
- Lignet Chepuka
- Department of Adult Health, Faculty of Nursing Health Studies, Kamuzu College of Nursing, University of Malawi, Blantyre.
| | | | | | | | | |
Collapse
|
13
|
Park S, Greene MC, Melby MK, Fujiwara T, Surkan PJ. Postpartum Depressive Symptoms as a Mediator Between Intimate Partner Violence During Pregnancy and Maternal-Infant Bonding in Japan. JOURNAL OF INTERPERSONAL VIOLENCE 2021; 36:NP10545-NP10571. [PMID: 31530064 PMCID: PMC7194138 DOI: 10.1177/0886260519875561] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/09/2023]
Abstract
Studies show that experiencing intimate partner violence (IPV) during pregnancy is related to poor maternal-infant bonding. However, the mechanisms underlying this relationship are unclear. This article aims to examine whether maternal postpartum depressive (PPD) symptoms mediate the association between pregnancy IPV and maternal-infant bonding, and whether the relationship differs by maternal-infant bonding subscales-lack of affection, anger/rejection. A survey was conducted among women who participated in a postpartum health check-up program in Aichi prefecture, Japan (N = 6,590) in 2012. We examined whether experiences of emotional and physical IPV were related to maternal-infant bonding and whether PPD symptoms mediated this relationship. Path analysis showed that emotional and physical IPV were associated with PPD symptoms, and PPD symptoms predicted poor bonding. The total effect of emotional IPV on poor bonding was significant, showing a marginally significant direct effect and statistically significant indirect effect. The total effect of physical IPV on poor bonding was not statistically significant. Emotional IPV was significantly associated with both lack of affection and anger/rejection bonding subscales, which were similarly mediated by PPD symptoms. Findings revealed a modest indirect association between IPV, emotional IPV in particular, and poor maternal-infant bonding, which was mediated by PPD symptoms. While prevention of IPV is the ultimate goal, the treatment of PPD symptoms among women who experience IPV during pregnancy may improve maternal-infant bonding and mitigate cross-generational effects of IPV. Identifying opportunities for detection of IPV and PPD symptoms, as well as prevention and early intervention, may improve maternal-infant bonding.
Collapse
Affiliation(s)
- Soim Park
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - M. Claire Greene
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Columbia University, New York, NY, USA
- New York State Psychiatric Institute, New York City, USA
| | - Melissa K. Melby
- University of Delaware, Newark, USA
- The Canadian Institute for Advanced Research, Toronto, Ontario, Canada
| | | | - Pamela J. Surkan
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| |
Collapse
|
14
|
Navarrete L, Nieto L, Lara MA. Intimate partner violence and perinatal depression and anxiety: Social support as moderator among Mexican women. SEXUAL & REPRODUCTIVE HEALTHCARE 2020; 27:100569. [PMID: 33157402 DOI: 10.1016/j.srhc.2020.100569] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Revised: 09/23/2020] [Accepted: 10/10/2020] [Indexed: 11/26/2022]
Abstract
AIMS To assess the frequency of perinatal Intimate Partner Violence (IPV), the association between IPV and depressive and anxiety symptoms, and the role of social support (SS) in the relation between IPV and depressive and anxiety symptoms, controlling for sociodemographic factors. METHOD Women were assessed during pregnancy and at six months postpartum (n = 210). The instruments used were: Stressful Life Events Scale; the Patient Health Questionnaire-9; the Anxiety Subscale of the Symptom Checklist-90 and the Social Support Subscale of the Postpartum Depression Predictors Inventory-Revised. RESULTS The prevalence of IPV was 10.7% in pregnancy and 11% during postpartum. IPV increases the risk of suffering depression in pregnancy (OR = 3.5) and at six months postpartum (OR = 18.3), as well as anxiety (OR = 5.9 and OR = 6.2, respectively). Women with lower educational attainment (OR = 3.8) and income (OR = 3.0) had a higher risk of being victims of IPV during pregnancy. Likewise, lack of SS has a great impact on IPV both during pregnancy (OR = 14.12) and the postpartum period (OR = 5.49). This association decreases the impact and significance of the relationship between perinatal depression and anxiety and IPV. CONCLUSIONS High levels of SS may partially offset the effect of IPV on postpartum depressive s and perinatal anxiety symptoms. it is necessary for IPV victims to have multiple protective factors. Lack of access to education, poverty and women's submissive role in relation to men lead to greater vulnerability, constituting a distinct social disadvantage for women.
Collapse
Affiliation(s)
- Laura Navarrete
- Ramón de la Fuente Muñiz National Institute of Psychiatry, Calzada México-Xochimilco 101, San Lorenzo Huipulco, Tlalpan, México, D.F. 14370, Mexico
| | - Lourdes Nieto
- Ramón de la Fuente Muñiz National Institute of Psychiatry, Calzada México-Xochimilco 101, San Lorenzo Huipulco, Tlalpan, México, D.F. 14370, Mexico
| | - Ma Asunción Lara
- Ramón de la Fuente Muñiz National Institute of Psychiatry, Calzada México-Xochimilco 101, San Lorenzo Huipulco, Tlalpan, México, D.F. 14370, Mexico.
| |
Collapse
|
15
|
Katz CC, Courtney ME, Sapiro B. Emancipated Foster Youth and Intimate Partner Violence: An Exploration of Risk and Protective Factors. JOURNAL OF INTERPERSONAL VIOLENCE 2020; 35:5469-5499. [PMID: 29294849 DOI: 10.1177/0886260517720735] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Due to their high rates of parental maltreatment and violence exposure, youth in the foster care system are considered particularly vulnerable to experiencing intimate partner violence (IPV) in adolescence and young adulthood. Those who have emancipated from foster care may be at a heightened risk, as they are significantly more likely to struggle in a variety of critical domains (i.e., mental health, substance use, and delinquency). This longitudinal study is the first to explore the impact of demographic, individual, family, and foster care system factors on IPV involvement for foster care alumni at age 23/24. Analyses were conducted on three waves of quantitative data from the Midwest Evaluation of the Adult Functioning of Former Foster Youth (the Midwest Study). We find that approximately 21% of the young adults in our sample were involved in some type of IPV at age 23/24, with bidirectional violence the most commonly reported form. Males were more likely than females to report IPV victimization, whereas females were more likely than males to report IPV perpetration and bidirectional violence. Young adults who reported parental IPV prior to foster care entry were more likely to be involved in bidirectionally violent partnerships than nonviolent partnerships in young adulthood, as were young adults who reported neglect by a foster caregiver and those who reported greater placement instability while in the foster care system. Anxiety at baseline increased the odds of IPV perpetration at age 23/24, and posttraumatic stress disorder (PTSD) at baseline decreased the odds of IPV perpetration at age 23/24. Understanding the characteristics and experiences that place these young adults at risk for IPV will allow for more effective and targeted prevention efforts.
Collapse
Affiliation(s)
- Colleen C Katz
- Hunter College, City University of New York, New York City, USA
| | | | - Beth Sapiro
- Rutgers University, The State University of New Jersey, New Brunswick, USA
| |
Collapse
|
16
|
Bo M, Canavese A, Magnano L, Rondana A, Castagna P, Gino S. Violence against pregnant women in the experience of the rape centre of Turin: Clinical and forensic evaluation. J Forensic Leg Med 2020; 76:102071. [PMID: 33075742 DOI: 10.1016/j.jflm.2020.102071] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 10/06/2020] [Accepted: 10/10/2020] [Indexed: 01/28/2023]
Abstract
Pregnant women can be victims of violence: as a matter of fact, far from being a protective factor, pregnancy can trigger or worsen episodes of abuse. Studies conducted by the WHO highlight that its incidence fluctuates between 1% and 28%. Therefore violence during pregnancy is endemic all over the world and involves all social strata. We analysed 113 medical records concerning pregnant women (average age 27.9 ± 6.0 years, 80 foreigners), who turned to the Centro Soccorso Violenza Sessuale, one of the two Italian Rape Centre, in Turin between January 1st, 2005 and December 31st, 2017. Fifty-three women were visited in the first trimester, 41 in the second, and 16 in the third, while 3 during the puerperium. The current partner was accused to be the abuser by the 84.4% of the Italian women and by the 69.2% of the foreigners. Sixty-eight women suffered multiple forms of violence, while 98 suffered only physical violence, and 3 reported only sexual abuse. According to 20 women, violent episodes increased during pregnancy. The clinical history of these women was characterized by some recurrent physical symptoms, such as pelvic pain, abdominal pain, facial pain and headache and 54 women presented injuries (abrasions and ecchymosis). Our results confirm that violence in pregnancy is a social and public health problem. Therefore it is important that the health personnel should be prepared not only to care for women seeking help, but above all its better preparation could also identify victims of violence, which do not report abuse.
Collapse
Affiliation(s)
- Marco Bo
- Legal Medicine Unit, Local Health Trust TO5, Piazza Silvio Pellio 1, 10023, Chieri, (TO), Italy
| | - Antonella Canavese
- Department of Surgical Sciences, University of Turin, corso Dogliotti 14, 10126, Turin, Italy; Città della Salute e della Scienza, Presidio Ospedaliero Sant'Anna, Centro Soccorso Violenza Sessuale, corso Spezia, 60, 10126, Turin, Italy
| | - Laura Magnano
- Corso di Laurea Magistrale in Medicina e Chirurgia, University of Turin, v. Verdi 8, 10124, Turin, Italy
| | - Alice Rondana
- Corso di Laurea Triennale in Ostetricia, University of Turin, v. Verdi 8, 10124, Turin, Italy
| | - Paola Castagna
- Città della Salute e della Scienza, Presidio Ospedaliero Sant'Anna, Centro Soccorso Violenza Sessuale, corso Spezia, 60, 10126, Turin, Italy
| | - Sarah Gino
- Department of Health Sciences, University of Piemonte Orientale, Via Solaroli 17, 28100, Novara, Italy.
| |
Collapse
|
17
|
Joppa MC. Dating Violence in Adolescence: Implications for Girls' Sexual Health. J Pediatr Adolesc Gynecol 2020; 33:332-338. [PMID: 32087402 DOI: 10.1016/j.jpag.2020.02.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2019] [Revised: 02/10/2020] [Accepted: 02/13/2020] [Indexed: 12/28/2022]
Abstract
Adolescents in the United States are too often involved in relationships characterized by coercion and violence. An emerging body of research suggests that dating violence is linked with other health risks in adolescent relationships, particularly sexual risk behavior. The confluence of risks conferred by dating violence and sexual risk behavior are particularly acute for adolescent girls. Adolescent gynecology providers need to understand the nature of dating violence in adolescence and the ways in which dating violence and sexual risk behavior are mutually influential. This article reviews the literature on the links between dating violence and sexual risk in adolescent girls' relationships. The prevalence, risk factors, and consequences of dating violence in adolescence are discussed, followed by a review of the research linking dating violence and sexual risk, with a focus on common mechanisms underlying these relationship risk behaviors. The review concludes with implications for screening, prevention, intervention, and future directions for research.
Collapse
|
18
|
The impact of intimate partner violence on the trajectory of perinatal depression: a cohort study in a Chinese sample. Epidemiol Psychiatr Sci 2020; 29:e133. [PMID: 32482189 PMCID: PMC7303793 DOI: 10.1017/s2045796020000463] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
UNLABELLED Abstract. AIMS Intimate partner violence (IPV) is an important risk factor for perinatal depression (PND). But IPV's impact on the natural prognosis of PND symptoms is not well understood. We tested two hypotheses: (1) pregnant women with IPV experiences will exhibit more severe PND symptoms than women without IPV experience; (2) IPV experience will impede the recovery prognosis of PND. We also explored the contribution of IPV to PND comparing with other risk factors. METHOD The sample is comprised of 813 pregnant women followed through perinatal period in Hunan, China. We assessed IPV experience using items from the Short Form of the Revised Conflict Tactics Scale (CTS2S), and PND symptoms via the Edinburgh Postnatal Depression Scale (EPSD). We conducted Linear Mixed-effects Model to compare the trajectories of PND symptoms between victims and non-victims and a multistage Generalised Estimating Equations Model to explore salient factors on the trajectory of PND symptoms. RESULTS There were 90 participants (11.07%) who reported IPV experience in the past 12 months. With respect to physical, psychological and sexual violence, the prevalence was 4.55% (37/813), 9.23% (75/813) and 2.34% (19/813). Victims reported more severe PND symptoms (t = 5.30, p < 0.01) and slower decreasing slope of trajectories (t = 28.89, p < 0.01). The PND trajectory was associated with IPV experience (OR = 3.78; 95% CI 1.39-10.26), social support (OR = 0.93; 95% CI 0.88-0.97), positive coping strategies (OR = 0.85; 95% CI 0.80-0.91), negative coping strategies (OR = 1.25; 95% CI 1.14-1.37) and monthly income of $0.15-$298.36 (compared to no income, OR = 0.0075; 95% CI 0.00052-0.11). CONCLUSIONS The findings suggest the reported prevalence of IPV is lower in Hunan than most of the previous studies during perinatal period in other provinces of China, and IPV victimisation is associated with increased severity and slowed prognosis of PND symptoms. Future studies that screen for victimisation and establish its explicit mechanism to the poorer prognosis of PND symptoms would benefit the prevention and treatment of PND.
Collapse
|
19
|
Greco PS, Day LJ, Pearlman MD. Guidance for Evaluation and Management of Blunt Abdominal Trauma in Pregnancy. Obstet Gynecol 2019; 134:1343-1357. [PMID: 31764749 DOI: 10.1097/aog.0000000000003585] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Blunt abdominal trauma is the leading type of traumatic injury in pregnancy, with motor vehicle crashes, falls, and assault being the most common etiologies. Several adverse outcomes can occur in pregnancy, including placental abruption, preterm labor and preterm delivery, uterine rupture, and pelvic fracture. Understanding and integration of key anatomic and physiologic changes in pregnancy are key when evaluating a pregnant trauma patient. Pregnant women should be managed in a medical center with the ability to provide adequate care to both trauma patients-the pregnant woman and fetus. Multiple clinical providers are usually involved in the care of pregnant trauma patients, but obstetric providers should play a central role in the evaluation and management of a pregnant trauma patient given their unique training, knowledge, and clinical skills. An algorithm for management of trauma in pregnancy should be used at all sites caring for pregnant women. An alignment of policies within each system optimizes appropriate triage, integration of care, management, and monitoring of pregnant trauma patients and their fetuses. Ensuring effective protocols for prehospital and hospital treatment, as well as thorough training of involved health care providers, is essential in ensuring that optimal care is provided.
Collapse
Affiliation(s)
- Patricia S Greco
- University of Michigan Department of Obstetrics and Gynecology, Ann Arbor, Michigan
| | | | | |
Collapse
|
20
|
McCauley HL, Campbell R, Buchanan NT, Moylan CA. Advancing Theory, Methods, and Dissemination in Sexual Violence Research to Build a More Equitable Future: An Intersectional, Community-Engaged Approach. Violence Against Women 2019; 25:1906-1931. [PMID: 31530103 DOI: 10.1177/1077801219875823] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Sexual violence is a devastating trauma with long-lasting effects on survivors' health and well-being. Despite the substantial impacts of the last 25 years of research, the prevalence of sexual violence has remained stable. It will be necessary to reconceptualize our work, challenging our theories, methods, and strategies for dissemination and implementation moving forward. We outline an intersectional, community-engaged approach for sexual violence research to center the stories of survivors who face systemic oppression and inequity. Finally, we suggest applications of this approach for justice, healing, and prevention to inform our collective work to end sexual violence.
Collapse
|
21
|
Arora S, Deosthali PB, Rege S. Effectiveness of a counselling intervention implemented in antenatal setting for pregnant women facing domestic violence: a pre-experimental study. BJOG 2019; 126 Suppl 4:50-57. [PMID: 31257691 DOI: 10.1111/1471-0528.15846] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/17/2019] [Indexed: 01/07/2023]
Abstract
OBJECTIVE To assess the effectiveness of a counselling intervention in antenatal care settings for pregnant women who report domestic violence. DESIGN Pre-experimental study with pretest-posttest design. SETTINGS Two public hospitals in Mumbai, India. SAMPLE In all, 2778 pregnant women accessing antenatal care (ANC) in the hospitals from February to November 2016 were approached for study participation; 2515 women consented. These women were screened by trained counsellors for domestic violence during pregnancy (domestic violence during pregnancy). Domestic violence during pregnancy was reported by 16.2% (408) of women. Of these, 155 women sought counselling services. Post-intervention analyses were carried out with 142 women at 6 weeks post-delivery; 13 women were not contactable. METHODS The 442 women who reported domestic violence during pregnancy were provided a minimum of two counselling sessions by trained counsellors during their ANC visits. A counselling intake form was used to collect pre- and post-intervention data. MAIN OUTCOME MEASURES Prevalence of domestic violence during pregnancy, change in women's ability to cope, safety, and health. RESULTS Prevalence of domestic violence during pregnancy (16.1%) was comparable to those of common obstetric complications routinely screened for during ANC. In all, 60-65% women reported cognitive changes such as recognising impact of violence and need to speak out against it. In all, 50.7% women took action at the individual level to address domestic violence during pregnancy. This change was not statistically significant (P-value 0.193). Of the women studied, 35.9% adopted at least one safety measure, and 84% of the women reported better health status post-intervention. CONCLUSIONS Routine enquiry and counselling for domestic violence during pregnancy are effective in improving women's ability to cope, safety, and health. FUNDING This study was funded by The John D. and Catherine T. MacArthur Foundation. TWEETABLE ABSTRACT Improving coping strategies, safety and health of pregnant women who reported domestic violence by providing counselling in antenatal care setting.
Collapse
Affiliation(s)
- S Arora
- Centre for Enquiry into Health and Allied Themes, Mumbai, India
| | - P B Deosthali
- Centre for Enquiry into Health and Allied Themes, Mumbai, India
| | - S Rege
- Centre for Enquiry into Health and Allied Themes, Mumbai, India
| |
Collapse
|
22
|
Sheeba B, Nath A, Metgud CS, Krishna M, Venkatesh S, Vindhya J, Murthy GVS. Prenatal Depression and Its Associated Risk Factors Among Pregnant Women in Bangalore: A Hospital Based Prevalence Study. Front Public Health 2019; 7:108. [PMID: 31131270 PMCID: PMC6509237 DOI: 10.3389/fpubh.2019.00108] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2018] [Accepted: 04/11/2019] [Indexed: 01/17/2023] Open
Abstract
Background: Depression is the commonest psychological problem that affects a woman during her perinatal period worldwide. The risk of prenatal depression increases as the pregnancy progresses and clinically significant depressive symptoms are common in the mid and late trimester. There is a paucity of research on depression during the prenatal period in India. Given this background, the present study aimed to assess the prevalence of prenatal depression and its associated risk factors among pregnant women in Bangalore, Southern India. Methods: The study was nested within an on-going cohort study. The study participants included 280 pregnant women who were attending the antenatal clinic at Jaya Nagar General Hospital (Sanjay Gandhi Hospital) in Bangalore. The data was collected by using a structured questionnaire which included. Edinburgh Postnatal Depression Scale (EPDS) to screen for prenatal depression. Results: The proportion of respondents who screened positive for prenatal depression was 35.7%. Presence of domestic violence was found to impose a five times higher and highly significant risk of developing prenatal depression among the respondents. Pregnancy related anxiety and a recent history of catastrophic events were also found to be a positive predictors of prenatal depression. Conclusion: The high prevalence of prenatal depression in the present study is suggestive of its significance as a public health problem. Health care plans therefore can include screening and diagnosis of prenatal depression in the antenatal care along with other health care facilities provided.
Collapse
Affiliation(s)
- B. Sheeba
- Research Assistant, Indian Institute of Public Health Hyderabad, Public Health of Foundation of India, Bangalore, India
| | - Anita Nath
- Wellcome Trust DBT India Alliance, Intermediate Fellow in Clinical and Public Health, Indian Institute of Public Health Hyderabad, Public Health Foundation of India, Hyderabad, India
| | - Chandra S. Metgud
- Professor, Department of Community Medicine, Pt. Jawahar Lal Nehru Memorial Medical College, Belgavi, India
| | | | - Shubhashree Venkatesh
- Research Assistant, Indian Institute of Public Health Hyderabad, Public Health of Foundation of India, Bangalore, India
| | - J. Vindhya
- Research Assistant, Indian Institute of Public Health Hyderabad, Public Health of Foundation of India, Bangalore, India
| | | |
Collapse
|
23
|
Abstract
Although trauma in pregnancy is rare, it is one of the most common causes of morbidity and mortality to pregnant women and fetus. Pathophysiology of trauma is generally time sensitive, and this is still true in pregnant patients, with the additional challenge of rare presentation and balancing the management of two patients concurrently. Successful resuscitation requires understanding the physiologic changes to the woman throughout the course of pregnancy. Ultimately, trauma management is best approached by prioritizing maternal resuscitation.
Collapse
Affiliation(s)
- Jeffrey Sakamoto
- Department of Emergency Medicine, Stanford University, 900 Welch Road, Suite 350, Palo Alto, CA 94304, USA
| | - Collin Michels
- Department of Emergency Medicine, Stanford University, 900 Welch Road, Suite 350, Palo Alto, CA 94304, USA
| | - Bryn Eisfelder
- Department of Emergency Medicine, Stanford University, 900 Welch Road, Suite 350, Palo Alto, CA 94304, USA
| | - Nikita Joshi
- Alameda Health Systems, 490 Grand Avenue, Oakland, CA 94610, USA.
| |
Collapse
|
24
|
Prenatal war exposure and schizophrenia in adulthood: evidence from the Sino-Japanese War of 1937-1945. Soc Psychiatry Psychiatr Epidemiol 2019; 54:313-320. [PMID: 30269260 DOI: 10.1007/s00127-018-1584-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2018] [Accepted: 08/20/2018] [Indexed: 01/27/2023]
Abstract
PURPOSE This study aimed to examine the long-term effect of prenatal exposure to the Sino-Japanese War during 1937-1945 on risk of schizophrenia in adulthood among Chinese wartime survivors. METHODS We obtained data from the Second National Sample Survey on Disability conducted in 31 provinces in 2006. We restricted our analysis to 369,469 adults born between 1931 and 1950. Schizophrenia was ascertained by psychiatrists based on the International Statistical Classification of Diseases 10th Revision. War intensity was assessed by the ratio of war-caused civilian casualties to the pre-war population. The effect of prenatal exposure to war on schizophrenia was estimated by difference-in-difference models, established by examining the variation of war across birth cohorts. RESULTS In the male population, war cohorts of 1937-1946 had no significant higher odds of schizophrenia compared with the pre-war cohorts of 1931-1936. In the female population, war cohorts were 1.16 (95% CI 1.01, 1.33) times more likely than pre-war cohorts to have schizophrenia. Sensitive analyses show that our estimates of war effect on schizophrenia were robust and valid. CONCLUSIONS Prenatal exposure to the Sino-Japanese War of 1937-1945 had long-run detrimental effect on risk of schizophrenia in the female adults. Further investigations are warranted to extend the enduring wartime impact on other health outcomes in China.
Collapse
|
25
|
Zelazny SM, Chang JC, Burke JG, Hawk M, Miller E. Adolescent and young adult women's recommendations for establishing comfort with family planning providers' communication about and assessment for intimate partner violence. JOURNAL OF COMMUNICATION IN HEALTHCARE 2019; 12:32-43. [PMID: 31983925 PMCID: PMC6980289 DOI: 10.1080/17538068.2018.1560073] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
BACKGROUND Intimate partner violence (IPV) is a serious public health problem that disproportionately affects adolescent women seeking family planning services. Current clinical guidelines recommend routine IPV assessment yet provide limited guidance on how to establish patient comfort in addressing this sensitive issue. Few studies exist describing the perspectives of adolescent female patients who have experienced IPV and their suggestions on how providers should communicate about IPV. METHODS This study is a subset of a larger IPV intervention trial in family planning clinics. For this study, we chose a qualitative approach using individual interviews to explore patient perspectives in an open, in-depth manner without limiting potential responses with predetermined answers or investigator-imposed assumptions. We audio recorded clinic encounters for participating providers and patients and interviewed patient participants, asking them to listen to and reflect on how their provider talked about IPV in their audiorecorded clinic encounters. RESULTS The mean age for the 44 participants was 22.8 years old. Participants named 'comfort' as a main component for discussing and disclosing IPV in the clinical setting. The sub-themes associated with how to create patient comfort include: Build the patient-provider relationship, Provider should communicate like a friend/be on the patient's level, Patient needs to feel cared for by provider, and Appropriate timing and space. CONCLUSION Methods for establishing patient comfort via communication should be incorporated into and examined within sensitive healthcare areas such as IPV and can be extended to HIV, palliative, and oncological care to improve patient health outcomes.
Collapse
Affiliation(s)
- Sarah My Zelazny
- University of Pittsburgh, Department of Pediatrics, 3414 Fifth Avenue, Pittsburgh, PA 15213
| | - Judy C Chang
- Magee Women's Hospital of UPMC, University of Pittsburgh, School of Medicine, 3380 Boulevard of the Allies, Suite 309, Pittsburgh, PA 15213
| | - Jessica G Burke
- University of Pittsburgh Graduate School of Public Health, 6132 Parran Hall, 130 De Soto Street, Pittsburgh, PA 15261
| | - Mary Hawk
- University of Pittsburgh Graduate School of Public Health, 207E Parran Hall, 130 De Soto Street, Pittsburgh, PA 15261
| | - Elizabeth Miller
- University of Pittsburgh, Department of Pediatrics, 3414 Fifth Avenue, Pittsburgh, PA 15213
| |
Collapse
|
26
|
Dasgupta A, Davis A, Gilbert L, Goddard-Eckrich D, El-Bassel N. Reproductive Health Concerns among Substance-Using Women in Community Corrections in New York City: Understanding the Role of Environmental Influences. J Urban Health 2018; 95:594-606. [PMID: 28741282 PMCID: PMC6095756 DOI: 10.1007/s11524-017-0184-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Women living in urban settings who are engaged in the criminal justice system are disproportionately affected by HIV and also contend with poor sexual and reproductive health (SRH). While studies have examined environmental influences of HIV, few have examined how these influences relate to poor SRH among this population. We used baseline data from an HIV-risk reduction study among substance-using women with a pregnancy history in community corrections in New York City (N = 299). We examined risk environment factors typically associated with HIV, and SRH outcomes of abortion, and miscarriage. We used logistic regression models to examine associations between risk environment factors with SRH outcomes. Most women identified as black and ranged in age from 18 to 62. Approximately half had miscarriages and/or abortions in their lifetime. Few women used birth control despite not wanting children in the future. While most women faced high rates of environmental influences of HIV risk, only intimate partner violence (IPV) was associated with SRH outcomes. Women experiencing IPV were significantly more likely to report both miscarriage and abortion. Community corrections present a unique opportunity for intervention around HIV risk reduction and SRH outcomes, given that effective programming for each often requires multiple and formal contacts with health providers.
Collapse
Affiliation(s)
- Anindita Dasgupta
- Social Intervention Group, School of Social Work, Columbia University, 1255 Amsterdam Avenue, New York, NY, 10027, USA.
| | - Alissa Davis
- HIV Center, Division of Gender, Sexuality, and Health, New York State Psychiatric Institute and Columbia University Medical Center, New York, NY, USA
| | - Louisa Gilbert
- Social Intervention Group, School of Social Work, Columbia University, 1255 Amsterdam Avenue, New York, NY, 10027, USA
| | - Dawn Goddard-Eckrich
- Social Intervention Group, School of Social Work, Columbia University, 1255 Amsterdam Avenue, New York, NY, 10027, USA
| | - Nabila El-Bassel
- Social Intervention Group, School of Social Work, Columbia University, 1255 Amsterdam Avenue, New York, NY, 10027, USA
| |
Collapse
|
27
|
O'Reilly R, Peters K. Opportunistic domestic violence screening for pregnant and post-partum women by community based health care providers. BMC WOMENS HEALTH 2018; 18:128. [PMID: 30041637 PMCID: PMC6056948 DOI: 10.1186/s12905-018-0620-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/01/2017] [Accepted: 07/12/2018] [Indexed: 11/19/2022]
Abstract
Background Domestic violence against women is a global endemic that can commence or escalate during pregnancy and continue postpartum. Pregnant and postpartum women generally access health care providers more at this time than at any other time in their lives. Despite this, little is known about primary health care providers’ screening practices for domestic violence. The purpose of this paper is to present survey findings that identified domestic violence screening practices of community based health care providers in pregnant and postpartum women. Methods This paper reports on the survey results of a larger sequential mixed methods study that involved a survey and semi-structured interviews, and used a pragmatic approach to the data collection and analysis. The survey sought information via both fixed choice and open responses. Quantitative data from the surveys were entered into the Statistical Package for Social Science (SPSS™ Version 22) and analysed using descriptive statistics. Open responses were collated and then integrated and presented with the quantitative data. Results Results revealed that some health care providers did not screen for domestic violence. Factors contributing to this lack of screening included: a lack of recognition that this was part of their role; and a lack of domestic violence screening policies and/or reminder systems. Further barriers to domestic violence screening were identified as a lack of time, resources and confidence in undertaking the screening and referral of women when domestic violence was detected. Conclusions The findings reported in this paper confirm that further insights into the domestic violence screening practices of community based health care providers is required. Findings also have the potential to inform interventions that can be implemented to increase domestic violence screening and promote appropriate referral practices. Electronic supplementary material The online version of this article (10.1186/s12905-018-0620-2) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Rebecca O'Reilly
- School of Nursing and Midwifery, Western Sydney University, Locked Bag 1797, Penrith, NSW, 2751, Australia.
| | - Kath Peters
- School of Nursing and Midwifery, Western Sydney University, Locked Bag 1797, Penrith, NSW, 2751, Australia
| |
Collapse
|
28
|
Weathering the storm; a review of pre-pregnancy stress and risk of spontaneous abortion. Psychoneuroendocrinology 2018; 92:142-154. [PMID: 29628283 DOI: 10.1016/j.psyneuen.2018.03.001] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2017] [Revised: 02/01/2018] [Accepted: 03/01/2018] [Indexed: 01/01/2023]
Abstract
The Weathering Effect is a theory that links stress exposure, over the life-course, with racial disparities in reproductive outcomes, through the effects of social adversity on a woman's body. The concept of maternal "weathering" captures cumulative somatic and psychological adversities that can exacerbate the effects of aging. Much of the evidence for weathering comes from observational studies linking self-report measures with reproductive outcomes. The purpose of this review is to explore biological mechanisms that underlie these observations. We focus on spontaneous abortion because this event is understudied despite evidence of racial disparities in this outcome. Spontaneous abortion is the most common pregnancy failure, and it happens early in pregnancy. Early pregnancy is a time most susceptible to the harmful effects of immune dysregulation that may, in part, result from adversities experienced before pregnancy begins. In exploring these mechanisms, we draw on well-defined signaling processes observed in the stressor-depression relationship. Pro-inflammatory dysregulation, for example, has particular relevance to immunological control occurring early in pregnancy. Early pregnancy immunologic changes affect the trajectories of pregnancy via control of trophoblastic invasion. Within the first few weeks of pregnancy, uterine derived cytokines operate within cytokine networks and play a critical role in this invasion. Programming for pro-inflammatory dysregulation can occur before conception. This dysregulation, brought into early pregnancy, has implications for viability and success of the index pregnancy. These patterns suggest early pregnancy health is susceptible to stress processing pathways that influence this immunologic control in the first six to eight weeks of pregnancy. In this review, we discuss the known mediating role of immune factors in the stressor-depression relationship. We also discuss how adversity experienced before the index pregnancy, or "pre-pregnancy" may influence these pathways, and subsequently influence early pregnancy health. There is a need to understand adversity, experienced before pregnancy, and mechanisms driving the effects of these experiences on pregnancy outcomes. This approach is a useful entry point for understanding racial inequities in pregnancy health through an understanding of differences in exposures to adversity. We hypothesize that spontaneous abortion involves cyclical changes within a woman's reproductive tract in response to stressors that are established well before a woman enters into pregnancy. Furthermore, we propose mechanisms that potentially drive weathering processes relevant to reproductive disparities. We also examine what is known about pre-pregnancy stress exposures associated with race, inequity, and adversity, and their potential impact on neuroendocrine and immune changes affecting early pregnancy risk.
Collapse
|
29
|
Abstract
Trauma is the leading non-obstetric cause of death during pregnancy and approximately 6-8% of all pregnancies are complicated by injury, both accidental and intentional. The initial evaluation and management of the injured pregnant patient often requires a multidisciplinary, collaborative team to provide the optimal outcome for both mother and fetus. It is important to recognize that even minor mechanisms of injury may result in poor outcomes for both fetus and mother. Injured pregnant patients meeting admission criteria experience a progressive increase in the number of complications as well as the number of patients that require delivery. There exists opportunity to identify patients who require admission and provide supportive measures that may reduce the complications of prematurity. Patients that are admitted may benefit from a multidisciplinary approach including on-going care from obstetricians or maternal-fetal medicine physicians. Placental abruption is the most common pregnancy complication, and may occur with even minor mechanisms of injury. Increasing severity of trauma increases the frequency of abruption, admission, delivery, and fetal demise.
Collapse
Affiliation(s)
- Christopher Kevin Huls
- Department of Obstetrics and Gynecology, University of Arizona College of Medicine, Banner University Medical Center, Phoenix, AZ.
| | - Corey Detlefs
- Department of Surgery, University of Arizona College of Medicine, Banner University Medical Center, Phoenix, AZ
| |
Collapse
|
30
|
Owaka IO, Nyanchoka MK, Atieli HE. Intimate partner violence in pregnancy among antenatal attendees at health facilities in West Pokot county, Kenya. Pan Afr Med J 2017; 28:229. [PMID: 29629015 PMCID: PMC5882208 DOI: 10.11604/pamj.2017.28.229.8840] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2016] [Accepted: 11/01/2017] [Indexed: 11/11/2022] Open
Abstract
Introduction The objective of this study was to investigate factors contributing to intimate partner violence in pregnancy among antenatal attendees at the health facilities in West Pokot Sub-County. The study was done in West Pokot Sub-County. Methods Using cross sectional study design, a total of 238 antenatal attendees were systematically sampled for the study. Four focused group discussions and 20 key informant interviews were conducted for qualitative data collection. Qualitative data was consolidated into various themes while bivariate and logistic regression analysis was done to determine factors associated with experience of IPV in the index of pregnancy with P ≤ 0.05 being considered significant. Results The study found prevalence of overall, physical, psychological and sexual IPV in pregnancy to be 66.9%, 29.9%, 55.8% and 39.2% respectively. After adjusting for confounders, Overall IPV in pregnancy was significantly associated with Alcohol intake by partner (OR 2.116, 95% CI 1.950-2.260, P 0.000) and partner's level of education (OR 1.265, 95% CI 1.079-1.487, P 0.031), while psychological and sexual IPV was significantly associated with age of partner (OR 2.292, 95% CI 2.123-2.722, P 0.007) and age of pregnant women (OR 1.174, 95% CI 1.001-1.397 P 0.049) respectively. The care offered to antenatal attendees experiencing IPV was not in line with WHO guidelines and standard on handling gender based violence cases. Conclusion The study finding indicates that IPV in pregnancy among antenatal attendees in West Pokot is very high. This unearths the gaps on gender based violence interventions in the maternal and child health programs.
Collapse
Affiliation(s)
- Isaac Ogweno Owaka
- Masters of Public Health (Reproductive Health Program), Kenyatta University, Nairobi, Kenya
| | - Margaret Keraka Nyanchoka
- Chairperson Department of Environmental and Population Health, School of Public Health, Kenyatta University, and Nairobi, Kenya
| | | |
Collapse
|
31
|
Peasant C, Sullivan TP, Ritchwood TD, Parra GR, Weiss NH, Meyer JP, Murphy JG. Words can hurt: The effects of physical and psychological partner violence on condom negotiation and condom use among young women. Women Health 2017; 58:483-497. [PMID: 28402194 DOI: 10.1080/03630242.2017.1316345] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Physical and psychological intimate partner violence (IPV) are prevalent on college campuses and may affect young women's condom use behavior. This study explored condom negotiation as a mediator of the relation of physical and psychological IPV to condom use among college women. A total of 235 heterosexual college women were recruited during September 2012-May 2013. Participants completed online questionnaires assessing lifetime history of IPV, frequency of condom negotiation, and use of condoms during the last 30 days. Specific forms of psychological IPV were related to less condom use. This association was mediated by condom negotiation, such that those who had experienced psychological IPV were less likely to negotiate condom use, and as a result, less likely to report using condoms in the past 30 days. Campus-based sexual health efforts should consider the relation of psychological IPV to condom negotiation and condom use and offer skills to promote condom negotiation among college women to increase condom use and reduce their risk of sexually transmitted infections.
Collapse
Affiliation(s)
- Courtney Peasant
- a Center for Interdisciplinary Research on AIDS, Yale School of Public Health , Yale University , New Haven , Connecticut , USA.,b Department of Psychology , The University of Memphis , Memphis , Tennessee , USA
| | - Tami P Sullivan
- c Division of Prevention and Community Research, Department of Psychiatry , Yale University School of Medicine , New Haven , Connecticut , USA
| | - Tiarney D Ritchwood
- a Center for Interdisciplinary Research on AIDS, Yale School of Public Health , Yale University , New Haven , Connecticut , USA.,d Department of Public Health Sciences , Medical University of South Carolina , Charleston , South Carolina , USA
| | - Gilbert R Parra
- e Department of Child, Youth, and Family Studies , University of Nebraska Lincoln , Lincoln , Nebraska , USA
| | - Nicole H Weiss
- c Division of Prevention and Community Research, Department of Psychiatry , Yale University School of Medicine , New Haven , Connecticut , USA
| | - Jaimie P Meyer
- f Yale AIDS Program , Yale University School of Medicine , New Haven , Connecticut , USA
| | - James G Murphy
- b Department of Psychology , The University of Memphis , Memphis , Tennessee , USA
| |
Collapse
|
32
|
Madhani FI, Karmaliani R, Patel C, Bann CM, McClure EM, Pasha O, Goldenberg RL. Women's Perceptions and Experiences of Domestic Violence: An Observational Study From Hyderabad, Pakistan. JOURNAL OF INTERPERSONAL VIOLENCE 2017; 32:76-100. [PMID: 25979535 PMCID: PMC4781660 DOI: 10.1177/0886260515585533] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/18/2023]
Abstract
This community-based observational study of 1,325 women seen for antenatal care examined how women in Pakistan define violence against women (VAW), with an emphasis on domestic violence, what an acceptable response to violence is, reasons for remaining silent, and whether participants are willing to disclose incidents of domestic violence to others. Nearly half of the study participants believed that physical violence was VAW. Verbal abuse, controlling behavior by the husband, conflict with in-laws, overburdening domestic work, and threatening to leave or remarry were also considered VAW. However, only five respondents (0.4%) considered sexual abuse to be VAW. Most women who screened positive for domestic violence responded by remaining silent or verbal fighting back. None sought professional help. Women who decided to remain silent feared that the abuse would escalate or that responding would not help them. Women cited social stigma and concerns about the impact of the violence on children as reasons for not disclosing violent incidents to others or seeking professional help. Women's lack of autonomy further reduced their ability to take steps against violence. Although societal norms, particularly patriarchal beliefs and women's subordination to men, likely explain women's tolerance of abuse, their recognition of physical abuse as violence indicates that they do not necessarily believe it is always justified. Educational interventions to drive changes in the social norms around gender violence along with effective and enforceable legal measures are likely required to ensure women's safety.
Collapse
Affiliation(s)
| | | | | | - Carla M Bann
- RTI International, Research Triangle Park, NC, USA
| | | | | | | |
Collapse
|
33
|
Hunter T, Botfield JR, Estoesta J, Markham P, Robertson S, McGeechan K. Experience of domestic violence routine screening in Family Planning NSW clinics. Sex Health 2016; 14:155-163. [PMID: 27817793 DOI: 10.1071/sh16143] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2016] [Accepted: 09/25/2016] [Indexed: 11/23/2022]
Abstract
BACKGROUND This study reviewed implementation of the Domestic Violence Routine Screening (DVRS) program at Family Planning NSW and outcomes of screening to determine the feasibility of routine screening in a family planning setting and the suitability of this program in the context of women's reproductive and sexual health. METHODS A retrospective review of medical records was undertaken of eligible women attending Family Planning NSW clinics between 1 January and 31 December 2015. Modified Poisson regression was used to estimate prevalence ratios and assess association between binary outcomes and client characteristics. RESULTS Of 13440 eligible women, 5491 were screened (41%). Number of visits, clinic attended, age, employment status and disability were associated with completion of screening. In all, 220 women (4.0%) disclosed domestic violence. Factors associated with disclosure were clinic attended, age group, region of birth, employment status, education and disability. Women who disclosed domestic violence were more likely to have discussed issues related to sexually transmissible infections in their consultation. All women who disclosed were assessed for any safety concerns and offered a range of suitable referral options. CONCLUSION Although routine screening may not be appropriate in all health settings, given associations between domestic violence and sexual and reproductive health, a DVRS program is considered appropriate in sexual and reproductive health clinics and appears to be feasible in a service such as Family Planning NSW. Consistent implementation of the program should continue at Family Planning NSW and be expanded to other family planning services in Australia to support identification and early intervention for women affected by domestic violence.
Collapse
Affiliation(s)
- Tara Hunter
- Family Planning NSW, 328-336 Liverpool Road, Ashfield, NSW 2131, Australia
| | - Jessica R Botfield
- Family Planning NSW, 328-336 Liverpool Road, Ashfield, NSW 2131, Australia
| | - Jane Estoesta
- Family Planning NSW, 328-336 Liverpool Road, Ashfield, NSW 2131, Australia
| | - Pippa Markham
- Family Planning NSW, 328-336 Liverpool Road, Ashfield, NSW 2131, Australia
| | - Sarah Robertson
- Family Planning NSW, 328-336 Liverpool Road, Ashfield, NSW 2131, Australia
| | - Kevin McGeechan
- Family Planning NSW, 328-336 Liverpool Road, Ashfield, NSW 2131, Australia
| |
Collapse
|
34
|
Bronson J, Reviere R. Pregnancy-Associated Deaths in Virginia Due to Homicides, Suicides, and Accidental Overdoses Compared With Natural Causes. Violence Against Women 2016; 23:1620-1637. [DOI: 10.1177/1077801216663658] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This research is a case study of 309 pregnancy-associated deaths that occurred in Virginia from 1999-2005. Pregnancy-associated deaths due to homicide, suicide, or accidental overdose were compared with natural deaths. Violent deaths accounted for almost 30% of the cases. Homicides accounted for 13% of all the deaths in the sample, larger than any single natural cause of death. Homicide was the leading manner of death for Black women and was 4.5 times the rate of White decedents. Recommendations include expanding maternal death surveillance, committing to ending violence against women, and promoting universal screenings for domestic or interpersonal violence.
Collapse
Affiliation(s)
- Jennifer Bronson
- Bureau of Justice Statistics, U.S. Department of Justice, Washington, DC, USA
| | | |
Collapse
|
35
|
Everett BG, McCabe KF, Hughes TL. Unintended Pregnancy, Depression, and Hazardous Drinking in a Community-Based Sample of Sexual Minority Women. J Womens Health (Larchmt) 2016; 25:904-11. [PMID: 26977978 PMCID: PMC5311462 DOI: 10.1089/jwh.2015.5290] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
CONTEXT Unintended pregnancy is a stressful life event with important implications for women's health. Little research has examined sexual minority women's (SMW; lesbian, bisexual, mostly heterosexual) experiences of unintended pregnancy, and no studies have examined the relationship between unintended pregnancy, mental health, and negative coping behaviors in this population. METHODS We used the Chicago Health and Life Experiences of Women (CHLEW) Study (n = 454), a diverse sample of SMW, to examine the relationship between self-reported unintended pregnancy, depressive symptoms, and hazardous drinking. We used generalized linear model-building techniques and adjusted for key sociodemographic controls, as well as unintended pregnancy risk factors, including childhood physical and sexual abuse and age of sexual debut. RESULTS Twenty-four percent of the sample reported an unintended pregnancy. SMW who reported unintended pregnancies also reported significantly more depressive symptoms and greater risk of hazardous drinking. Adjusting for childhood abuse explained the relationship between unintended pregnancy and depressive symptoms, but not the relationship between unintended pregnancy and hazardous drinking. CONCLUSIONS Unintended pregnancy among SMW is an understudied topic. Our results suggest that unintended pregnancy is not uncommon among SMW and highlight the need for more research to investigate the mechanisms that link unintended pregnancy to depression and to hazardous drinking within this population.
Collapse
Affiliation(s)
| | - Katharine F. McCabe
- Department of Sociology, University of Illinois at Chicago, Chicago, Illinois
| | - Tonda L. Hughes
- Department of Health Systems Science, University of Illinois at Chicago, Chicago, Illinois
| |
Collapse
|
36
|
Campbell J, García-Moreno C, Sharps P. Abuse During Pregnancy in Industrialized and Developing Countries. Violence Against Women 2016. [DOI: 10.1177/1077801204265551] [Citation(s) in RCA: 150] [Impact Index Per Article: 18.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Abuse during pregnancy has increasingly been identified as an important problem with significant consequences for maternal and infant health, particularly in North America. The authors review available evidence of the prevalence and consequences of abuse during pregnancy, including maternal mortality, outside of North America. The range of prevalence found in developing countries is much wider (3.8% to 31.7%) than that of industrialized countries (3.4% to 11%), which is much closer to findings from North America. There is a need for more studies using consistent definitions and methodologies to examine the patterns and forms of abuse related to pregnancy worldwide.
Collapse
|
37
|
Zvara BJ, Meltzer-Brody S, Mills-Koonce WR, Cox M. Maternal Childhood Sexual Trauma and Early Parenting: Prenatal and Postnatal Associations. INFANT AND CHILD DEVELOPMENT 2016; 26. [PMID: 33776590 DOI: 10.1002/icd.1991] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Existing research suggests that approximately 19% of females experience childhood sexual trauma (CST). Little is known, however, about the parenting behaviour of mothers who have experienced CST. Using propensity-matched controls, the present study examines prenatal psychosocial distress, postnatal depressive symptomatology, and caregiving behaviours of women reporting CST at or before the age of 14. Data for these analyses were obtained from mother reports and from observational protocols from a longitudinal study of low-income, rural families. Propensity score methodology was used to create a contrast group matched on family of origin variables in an effort to isolate and examine the long-term associations of CST beyond the effects of other childhood adversities such as poverty. Study findings provide evidence that women with CST histories report greater prenatal psychosocial distress compared to women without trauma histories. Findings further provide evidence for a spillover process from prenatal distress to the broader caregiving system including less sensitive parenting through postnatal depressive symptoms for women with CST histories. These results highlight the importance of screening for CST and psychosocial distress and depression prenatally. Interventions for women with CST histories and directions for future study are proposed.
Collapse
Affiliation(s)
- B J Zvara
- The University of North Carolina at Chapel Hill, Chapel Hill, NC USA
| | - S Meltzer-Brody
- The University of North Carolina at Chapel Hill, Chapel Hill, NC USA
| | - W R Mills-Koonce
- The University of North Carolina at Greensboro, Greensboro, NC USA
| | - M Cox
- The University of North Carolina at Chapel Hill, Chapel Hill, NC USA
| | | |
Collapse
|
38
|
Jones KA, Cornelius MD, Silverman JG, Tancredi DJ, Decker MR, Haggerty CL, De Genna NM, Miller E. Abusive Experiences and Young Women's Sexual Health Outcomes: Is Condom Negotiation Self-Efficacy a Mediator? PERSPECTIVES ON SEXUAL AND REPRODUCTIVE HEALTH 2016; 48:57-64. [PMID: 27077497 PMCID: PMC4909564 DOI: 10.1363/48e8616] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/18/2015] [Revised: 11/19/2015] [Accepted: 11/20/2015] [Indexed: 05/12/2023]
Abstract
CONTEXT Intimate partner violence and reproductive coercion are associated with unintended pregnancies and STDs. Greater condom negotiation self-efficacy among young women may mediate these associations. METHODS A sample of 841 female adolescents (aged 16-19) and 1,387 young adult women (aged 20-24) recruited from 24 family planning clinics in western Pennsylvania in 2011-2012 reported on intimate partner violence, reproductive coercion, condom negotiation self-efficacy and sexual health outcomes at baseline and four- and 12-month follow-ups. Mixed models were used to test associations of intimate partner violence and reproductive coercion with unintended pregnancy and STD diagnosis. The Sobel test of mediation was used to measure indirect effects of condom negotiation self-efficacy. RESULTS At baseline, 15% of adolescents and 11% of young adults reported recent intimate partner violence victimization; 7% and 6%, respectively, reported recent reproductive coercion. For both age-groups, intimate partner violence and reproductive coercion were associated with a reduced level of condom negotiation self-efficacy (coefficients, -0.27 to -0.13) and increased odds of STD diagnosis (odds ratios, 1.03-1.1). However, only reproductive coercion was associated with unintended pregnancy (odds ratios, 1.1 for each group). The only association that condom negotiation self-efficacy mediated was between reproductive coercion and unintended pregnancy among young adults (17% of total effect). CONCLUSIONS Targeting condom negotiation self-efficacy alone in abusive relationships would likely not translate into improved sexual health outcomes in this population. Other strategies are needed to prevent unintended pregnancy and STDs.
Collapse
Affiliation(s)
- Kelley A Jones
- Division of Adolescent and Young Adult Medicine, School of Medicine, University of Pittsburgh.
| | - Marie D Cornelius
- Department of Psychiatry, School of Medicine, University of Pittsburgh
| | - Jay G Silverman
- Division of Global Public Health, School of Medicine, University of California, San Diego, La Jolla, CA
| | - Daniel J Tancredi
- Department of Pediatrics, School of Medicine, University of California, Davis, Sacramento, CA
| | - Michele R Decker
- Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore
| | - Catherine L Haggerty
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh
| | | | - Elizabeth Miller
- Department of Pediatrics, School of Medicine, University of Pittsburgh
| |
Collapse
|
39
|
Stephenson R, Jadhav A, Winter A, Hindin M. Domestic Violence and Abortion Among Rural Women in Four Indian States. Violence Against Women 2016; 22:1642-1658. [PMID: 26902676 DOI: 10.1177/1077801216630148] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
The prevalence of domestic violence and abortion in India is high, yet little is known about the relationship between these experiences. Data from two linked data sets, India's 1998-1999 National Family Health Survey (NFHS-2) and a follow-up survey in 2002-2003, were analyzed. The analysis examines how the experience of physical violence affects the subsequent uptake of abortion, and how the experience of abortion affects subsequent experience of physical, sexual, and verbal violence. Women who experienced physical violence have significantly higher odds of reporting a subsequent induced abortion, whereas women who had an induced abortion have significantly higher odds of reporting subsequent sexual and verbal violence. There was no significant relationship between domestic violence and spontaneous abortion.
Collapse
Affiliation(s)
| | | | | | - Michelle Hindin
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| |
Collapse
|
40
|
Miller E, Tancredi DJ, Decker MR, McCauley HL, Jones KA, Anderson H, James L, Silverman JG. A family planning clinic-based intervention to address reproductive coercion: a cluster randomized controlled trial. Contraception 2016; 94:58-67. [PMID: 26892333 DOI: 10.1016/j.contraception.2016.02.009] [Citation(s) in RCA: 77] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2015] [Revised: 02/01/2016] [Accepted: 02/07/2016] [Indexed: 11/19/2022]
Abstract
OBJECTIVE We assessed the effectiveness of a provider-delivered intervention targeting reproductive coercion, an important factor in unintended pregnancy. STUDY DESIGN We randomized 25 family planning clinics (17 clusters) to deliver an education/counseling intervention or usual care. Reproductive coercion and partner violence victimization at 1 year follow-up were primary outcomes. Unintended pregnancy, recognition of sexual and reproductive coercion, self-efficacy to use and use of harm reduction behaviors to reduce victimization and contraception nonuse, and knowledge and use of partner violence resources were secondary outcomes. Analyses included all available data using an intention-to-treat approach. RESULTS Among 4009 females ages 16 to 29 years seeking care, 3687 completed a baseline survey prior to clinic visit from October 2011 to November 2012; 3017 provided data at 12-20weeks post-baseline (T2) and 2926 at 12months post-baseline (T3) (79% retention). Intervention effects were not significant for reproductive coercion [adjusted risk ratio (ARR) 1.50 (95% confidence interval 0.95-2.35)] or partner violence [ARR 1.07 (0.84-1.38)]. Intervention participants reported improved knowledge of partner violence resources [ARR 4.25 (3.29-5.50)] and self-efficacy to enact harm reduction behaviors [adjusted mean difference 0.06 (0.02-0.10)]. In time point-specific models which included moderating effects of exposure to reproductive coercion at baseline, a higher reproductive coercion score at baseline was associated with a decrease in reproductive coercion 1 year later (T3). Use and sharing of the domestic violence hotline number also increased. CONCLUSION This brief clinic intervention did not reduce partner violence victimization. The intervention enhanced two outcomes that may increase safety for women, specifically awareness of partner violence resources and self-efficacy to enact harm reduction behaviors. It also appeared to reduce reproductive coercion among women experiencing multiple forms of such abuse.
Collapse
Affiliation(s)
- Elizabeth Miller
- Division of Adolescent and Young Adult Medicine, Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
| | - Daniel J Tancredi
- Department of Pediatrics and Center for Healthcare Policy and Research, University of California, Davis, Sacramento, CA, USA
| | - Michele R Decker
- Department of Population, Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | - Heather L McCauley
- Division of Adolescent and Young Adult Medicine, Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Kelley A Jones
- Division of Adolescent and Young Adult Medicine, Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Heather Anderson
- Division of Adolescent and Young Adult Medicine, Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Lisa James
- Futures Without Violence, San Francisco, CA, USA
| | - Jay G Silverman
- Division of Global Public Health in the Department of Medicine & Center on Gender Equity and Health, University of California, San Diego, La Jolla, CA, USA
| |
Collapse
|
41
|
Rivas C, Ramsay J, Sadowski L, Davidson LL, Dunne D, Eldridge S, Hegarty K, Taft A, Feder G. Advocacy interventions to reduce or eliminate violence and promote the physical and psychosocial well-being of women who experience intimate partner abuse. Cochrane Database Syst Rev 2015; 2015:CD005043. [PMID: 26632986 PMCID: PMC9392211 DOI: 10.1002/14651858.cd005043.pub3] [Citation(s) in RCA: 95] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND Intimate partner abuse is common worldwide, damaging the short- and long-term physical, mental, and emotional health of survivors and children. Advocacy may contribute to reducing abuse, empowering women to improve their situation by providing informal counselling and support for safety planning and increasing access to different services. Advocacy may be a stand-alone service, accepting referrals from healthcare providers, or part of a multi-component (and possibly multi-agency) intervention provided by service staff or others. OBJECTIVES To assess the effects of advocacy interventions within or outside healthcare settings in women who have experienced intimate partner abuse. SEARCH METHODS In April 2015, we searched CENTRAL, Ovid MEDLINE, EMBASE, and 10 other databases. We also searched WHO ICTRP, mRCT, and UK Clinical Research Network (UKCRN), and examined relevant websites and reference lists with forward citation tracking of included studies. For the original review we handsearched six key journals. We also contacted first authors of eligible papers and experts in the field. SELECTION CRITERIA Randomised or quasi-randomised controlled trials comparing advocacy interventions for women with experience of intimate partner abuse versus no intervention or usual care (if advocacy was minimal and fewer than 20% of women received it). DATA COLLECTION AND ANALYSIS Two review authors independently assessed risk of bias and undertook data extraction. We contacted authors for missing information needed to calculate statistics for the review and looked for adverse events. MAIN RESULTS We included 13 trials involving 2141 participants aged 15 to 65 years, frequently having low socioeconomic status.The studies were quite heterogeneous in terms of methodology, study processes and design, including with regard to the duration of follow-up (postintervention to three years), although this was not associated with differences in effect. The studies also had considerable clinical heterogeneity in relation to staff delivering advocacy; setting (community, shelter, antenatal, healthcare); advocacy intensity (from 30 minutes to 80 hours); and abuse severity. Three trials evaluated advocacy within multi-component interventions. Eleven measured some form of abuse (eight scales), six assessed quality of life (three scales), and six measured depression (three scales). Countries and ethnic groups varied (one or more minority ethnic groups in the USA or UK, and local populations in Hong Kong and Peru). Setting was associated with intensity and duration of advocacy.Risk of bias was high in five studies, moderate in five, and low in three. The quality of evidence (considering multiple factors such as risk of bias, study size, missing data) was moderate to low for brief advocacy and very low for intensive advocacy. Incidence of abuse Physical abuseModerate quality pooled data from two healthcare studies (moderate risk of bias) and one community study (low risk of bias), all with 12-month follow-up data, showed no effect on physical abuse for brief (< 12 hours) advocacy interventions (standardised mean difference (SMD) 0.00, 95% confidence interval (CI) - 0.17 to 0.16; n = 558). One antenatal study (low risk of bias) showed an association between brief advocacy and reduced minor physical abuse at one year (mean difference (MD) change - 1.00, 95% CI - 1.82 to - 0.18; n = 110). An antenatal, multi-component study showed a greater likelihood of physical abuse ending (odds ratio (OR) 0.42, 95% CI 0.23 to 0.75) immediately after advocacy (number needed to treat (NNT) = 8); we cannot exclude impact from other components.Low to very low quality evidence from two intensive advocacy trials (12 hours plus duration) showed reduced severe physical abuse in women leaving a shelter at 24 months (OR 0.39, 95% CI 0.20 to 0.77; NNT = 8), but not at 12 or 36 months. Sexual abuseMeta-analysis of two studies (n = 239) showed no effect of advocacy on sexual abuse (SMD - 0.12, 95% CI - 0.37 to 0.14), agreeing with the change score (MD - 0.07, 95% CI - 0.30 to 0.16) from a third study and the OR (0.96, 95% CI 0.44 to 2.12) from a fourth antenatal, multi-component study. Emotional abuseOne study in antenatal care, rated at low risk of bias, showed reduced emotional abuse at ≤ 12-month follow-up (MD (change score) - 4.24, 95% CI - 6.42 to - 2.06; n = 110). Psychosocial health Quality of lifeMeta-analysis of two studies (high risk of bias) showed intensive advocacy slightly improved overall quality of life of women recruited from shelters (MD 0.23, 95% CI 0.00 to 0.46; n = 343) at 12-month follow-up, with greater improvement in perceived physical quality of life from a primary care study (high risk of bias; MD 4.90, 95% CI 0.98 to 8.82) immediately postintervention. Depression Meta-analysis of two studies in healthcare settings, one at high risk of bias and one at moderate risk, showed that fewer women developed depression (OR 0.31, 95% CI 0.15 to 0.65; n = 149; NNT = 4) with brief advocacy. One study at high risk of bias reported a slight reduction in depression in pregnant women immediately after the intervention (OR 0.51, 95% CI 0.20 to 1.29; n = 103; NNT = 8).There was no evidence that intensive advocacy reduced depression at ≤ 12-month follow-up (MD - 0.14, 95% CI - 0.33 to 0.05; 3 studies; n = 446) or at two years (SMD - 0.12, 95% CI - 0.36 to 0.12; 1 study; n = 265). Adverse effectsTwo women died, one who was murdered by her partner and one who committed suicide. No evidence links either death to study participation. AUTHORS' CONCLUSIONS Results suggest some benefits from advocacy. However, most studies were underpowered. Clinical and methodological heterogeneity largely precluded pooling of trials. Therefore, there is uncertainty about the magnitude of benefit, the impact of abuse severity, and the setting.Based on the evidence reviewed, intensive advocacy may improve short-term quality of life and reduce physical abuse one to two years after the intervention for women recruited from domestic violence shelters or refuges. Brief advocacy may provide small short-term mental health benefits and reduce abuse, particularly in pregnant women and for less severe abuse.
Collapse
Affiliation(s)
- Carol Rivas
- University of SouthamptonFaculty of Health SciencesRoom 67/20209Highfield CampusSouthamptonUKS017 1BJ
| | - Jean Ramsay
- Queen Mary University of LondonCentre for Primary Care and Public Health, Barts and The London School of Medicine and Dentistry58 Turner StreetWhitechapelLondonUKE1 2AB
| | - Laura Sadowski
- Stroger Hospital of Cook CountyDepartment of Medicine1900 W. Polk Street, 16th floorChicagoMIUSA60612
| | - Leslie L Davidson
- Columbia UniversityDepartment of Epidemiology, Mailman School of Public HealthRoom 1613, 722 W 168 StNew YorkNYUSA10032
| | - Danielle Dunne
- Department for International DevelopmentEvaluation Department22 WhitehallLondonUKSW1A 2EG
| | - Sandra Eldridge
- Queen Mary University of LondonCentre for Primary Care and Public Health, Barts and The London School of Medicine and Dentistry58 Turner StreetWhitechapelLondonUKE1 2AB
| | - Kelsey Hegarty
- The University of MelbourneDepartment of General Practice200 Berkeley StreetParkvilleMelbourneVictoriaAustralia3010
| | - Angela Taft
- La Trobe UniversityThe Judith Lumley Centre215 Franklin StreetMelbourneVictoriaAustralia3000
| | - Gene Feder
- University of BristolCentre for Academic Primary Care, School of Social and Community MedicineCanynge Hall39 Whatley RoadBristolUKBS8 2PS
| | | |
Collapse
|
42
|
Van Parys AS, Deschepper E, Michielsen K, Galle A, Roelens K, Temmerman M, Verstraelen H. Intimate partner violence and psychosocial health, a cross-sectional study in a pregnant population. BMC Pregnancy Childbirth 2015; 15:278. [PMID: 26554901 PMCID: PMC4641387 DOI: 10.1186/s12884-015-0710-1] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2015] [Accepted: 10/19/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The objective of this paper is to explore whether IPV 12 months before and/or during pregnancy is associated with poor psychosocial health. METHODS From June 2010 to October 2012, a cross-sectional study was conducted in 11 antenatal care clinics in Belgium. Consenting pregnant women were asked to complete a questionnaire on socio-demographics, psychosocial health and violence in a separate room. Overall, 2586 women were invited to participate and we were able to use data from 1894 women (73.2%) for analysis. Ethical clearance was obtained in all participating hospitals. RESULTS We found a significant correlation between IPV and poor psychosocial health: within the group of women who reported IPV, 53.2% (n = 118) had poor psychosocial health, as compared to 21% (n = 286) in the group of women who did not report IPV (P < 0.001). Lower psychosocial health scores were associated with increased odds of reporting IPV (aOR 1.55; 95% CI 1.39-1.72), with adjustments made for the language in which the questionnaire was filled out, civil/marital status, education and age. In other words, a decrease of 10 points on the psychosocial health scale (total of 140) increased the odds of reporting IPV by 55 %. When accounting for the 6 psychosocial health subscales, the analysis revealed that all subscales (depression, anxiety, self-esteem, mastery, worry and stress) are strongly correlated to reporting IPV. However, when accounting for all subscales simultaneously in a logistic regression model, only depression (aOR 0.87; 95 % CI 0.84-0.91) and stress (aOR 0.85; 95 % CI 0.77-095) remained significantly associated with IPV. The association between overall psychosocial health and IPV remained significant after adjusting for socio-demographic status. CONCLUSION Our research corroborated that IPV and psychosocial health are strongly associated. Due to the limitations of our study design, we believe that future research is needed to deepen understanding of the multitude of factors involved in the complex interactions between IPV and psychosocial health.
Collapse
Affiliation(s)
- An-Sofie Van Parys
- Department of Obstetrics and Gynaecology, Faculty of Medicine and Health Sciences, International Centre for Reproductive Health, Ghent University, De Pintelaan 185, UZP 114, 9000, Ghent, Belgium.
| | - Ellen Deschepper
- Department of Public Health, Biostatistics Unit, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.
| | - Kristien Michielsen
- Department of Obstetrics and Gynaecology, Faculty of Medicine and Health Sciences, International Centre for Reproductive Health, Ghent University, De Pintelaan 185, UZP 114, 9000, Ghent, Belgium.
| | - Anna Galle
- Department of Obstetrics and Gynaecology, Faculty of Medicine and Health Sciences, International Centre for Reproductive Health, Ghent University, De Pintelaan 185, UZP 114, 9000, Ghent, Belgium.
| | - Kristien Roelens
- Department of Obstetrics and Gynaecology, Faculty of Medicine and Health Sciences, International Centre for Reproductive Health, Ghent University, De Pintelaan 185, UZP 114, 9000, Ghent, Belgium.
| | - Marleen Temmerman
- Department of Obstetrics and Gynaecology, Faculty of Medicine and Health Sciences, International Centre for Reproductive Health, Ghent University, De Pintelaan 185, UZP 114, 9000, Ghent, Belgium.
| | - Hans Verstraelen
- Department of Obstetrics and Gynaecology, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.
| |
Collapse
|
43
|
Tancredi DJ, Silverman JG, Decker MR, McCauley HL, Anderson HA, Jones KA, Ciaravino S, Hicks A, Raible C, Zelazny S, James L, Miller E. Cluster randomized controlled trial protocol: addressing reproductive coercion in health settings (ARCHES). BMC WOMENS HEALTH 2015; 15:57. [PMID: 26245752 PMCID: PMC4527212 DOI: 10.1186/s12905-015-0216-z] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/10/2014] [Accepted: 07/30/2015] [Indexed: 11/15/2022]
Abstract
Background Women ages 16–29 utilizing family planning clinics for medical services experience higher rates of intimate partner violence (IPV) and reproductive coercion (RC) than their same-age peers, increasing risk for unintended pregnancy and related poor reproductive health outcomes. Brief interventions integrated into routine family planning care have shown promise in reducing risk for RC, but longer-term intervention effects on partner violence victimization, RC, and unintended pregnancy have not been examined. Methods/Design The ‘Addressing Reproductive Coercion in Health Settings (ARCHES)’ Intervention Study is a cluster randomized controlled trial evaluating the effectiveness of a brief, clinician-delivered universal education and counseling intervention to reduce IPV, RC and unintended pregnancy compared to standard-of-care in family planning clinic settings. The ARCHES intervention was refined based on formative research. Twenty five family planning clinics were randomized (in 17 clusters) to either a three hour training for all family planning clinic staff on how to deliver the ARCHES intervention or to a standard-of-care control condition. All women ages 16–29 seeking care in these family planning clinics were eligible to participate. Consenting clients use laptop computers to answer survey questions immediately prior to their clinic visit, a brief exit survey immediately after the clinic visit, a first follow up survey 12–20 weeks after the baseline visit (T2), and a final survey 12 months after the baseline (T3). Medical record chart review provides additional data about IPV and RC assessment and disclosure, sexual and reproductive health diagnoses, and health care utilization. Of 4009 women approached and determined to be eligible based on age (16–29 years old), 3687 (92 % participation) completed the baseline survey and were included in the sample. Discussion The ARCHES Intervention Study is a community-partnered study designed to provide arigorous assessment of the short (3-4 months) and long-term (12 months) effects of a brief, clinician-delivered universal education and counseling intervention to reduce IPC, RC and unintended pregnancy in family planning clinic settings. The trial features a cluster randomized controlled trial design, a comprehensive data collection schedule and a large sample size with excellent retention. Trial Registration ClinicialTrials.gov NCT01459458. Registered 10 October 2011.
Collapse
Affiliation(s)
- Daniel J Tancredi
- UC Davis Department of Pediatrics and Center for Healthcare Policy and Research, 2103 Stockton Blvd Suite 2224, Sacramento, CA, 95817, USA.
| | - Jay G Silverman
- Division of Global Public Health in the Department of Medicine & Center on Gender Equity and Health, University of California, San Diego, 9500 Gilman Drive #0507, La Jolla, CA, 92093-0507, USA.
| | - Michele R Decker
- Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, E4142, Baltimore, MD, 21205, USA.
| | - Heather L McCauley
- Department of Pediatrics, Division of Adolescent Medicine, University of Pittsburgh School of Medicine, Children's Hospital of Pittsburgh of UPMC, 3420 Fifth Ave, Pittsburgh, PA, 15213, USA.
| | - Heather A Anderson
- Department of Pediatrics, Division of Adolescent Medicine, University of Pittsburgh School of Medicine, Children's Hospital of Pittsburgh of UPMC, 3420 Fifth Ave, Pittsburgh, PA, 15213, USA.
| | - Kelley A Jones
- Department of Pediatrics, Division of Adolescent Medicine, University of Pittsburgh School of Medicine, Children's Hospital of Pittsburgh of UPMC, 3420 Fifth Ave, Pittsburgh, PA, 15213, USA.
| | - Samantha Ciaravino
- Department of Pediatrics, Division of Adolescent Medicine, University of Pittsburgh School of Medicine, Children's Hospital of Pittsburgh of UPMC, 3420 Fifth Ave, Pittsburgh, PA, 15213, USA
| | - Angela Hicks
- Department of Pediatrics, Division of Adolescent Medicine, University of Pittsburgh School of Medicine, Children's Hospital of Pittsburgh of UPMC, 3420 Fifth Ave, Pittsburgh, PA, 15213, USA
| | - Claire Raible
- Department of Pediatrics, Division of Adolescent Medicine, University of Pittsburgh School of Medicine, Children's Hospital of Pittsburgh of UPMC, 3420 Fifth Ave, Pittsburgh, PA, 15213, USA
| | - Sarah Zelazny
- Department of Pediatrics, Division of Adolescent Medicine, University of Pittsburgh School of Medicine, Children's Hospital of Pittsburgh of UPMC, 3420 Fifth Ave, Pittsburgh, PA, 15213, USA
| | - Lisa James
- Futures Without Violence, 100 Montgomery Street, The Presidio, San Francisco, CA, 94129, USA.
| | - Elizabeth Miller
- Department of Pediatrics, Division of Adolescent Medicine, University of Pittsburgh School of Medicine, Children's Hospital of Pittsburgh of UPMC, 3420 Fifth Ave, Pittsburgh, PA, 15213, USA.
| |
Collapse
|
44
|
Michopoulos V, Rothbaum AO, Corwin E, Bradley B, Ressler KJ, Jovanovic T. Psychophysiology and posttraumatic stress disorder symptom profile in pregnant African-American women with trauma exposure. Arch Womens Ment Health 2015; 18:639-48. [PMID: 25278341 PMCID: PMC4609532 DOI: 10.1007/s00737-014-0467-y] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2014] [Accepted: 09/12/2014] [Indexed: 01/23/2023]
Abstract
While female sex is a robust risk factor for posttraumatic stress disorder (PTSD), pregnant women are an understudied population in regards to PTSD symptom expression profiles. Because circulating hormones during pregnancy affect emotionality, we assessed whether pregnant women would have increased expression of the intermediate phenotypes of hyperarousal and fear-potentiated startle (FPS) compared to non-pregnant women. We examined PTSD symptom profiles in pregnant (n = 207) and non-pregnant women (n = 370). In a second study, FPS responses were assessed in 15 pregnant and 24 non-pregnant women. All participants were recruited from the obstetrics and gynecology clinic at a public hospital serving a primarily African-American, low socioeconomic status, inner-city population. Our results indicate that overall PTSD symptoms were not different between the groups of women. However, pregnant women reported being more hypervigilant (p = 0.036) than non-pregnant women. In addition, pregnant women showed increased FPS to a safety signal compared to non-pregnant women (p = 0.024). FPS to a safety signal in pregnant women was significantly correlated with PTSD hyperarousal symptoms (r = 0.731, p < 0.001). Furthermore, discrimination between danger and safety signals was present in non-pregnant women (p = 0.008), but not in pregnant women (p = 0.895). Together, these data suggest that pregnant women show clinical and psychophysiological hyperarousal compared to non-pregnant women, and support screening for PTSD and assessment of PTSD risk in pregnant women.
Collapse
Affiliation(s)
- Vasiliki Michopoulos
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, 49 Jesse Hill Jr. NE, Atlanta, GA, 30303, USA,
| | | | | | | | | | | |
Collapse
|
45
|
Martin-de-las-Heras S, Velasco C, Luna JDD, Martin A. Unintended pregnancy and intimate partner violence around pregnancy in a population-based study. Women Birth 2015; 28:101-5. [DOI: 10.1016/j.wombi.2015.01.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2014] [Revised: 01/09/2015] [Accepted: 01/10/2015] [Indexed: 11/25/2022]
|
46
|
McCauley HL, Silverman JG, Decker MR, Agénor M, Borrero S, Tancredi DJ, Zelazny S, Miller E. Sexual and Reproductive Health Indicators and Intimate Partner Violence Victimization Among Female Family Planning Clinic Patients Who Have Sex with Women and Men. J Womens Health (Larchmt) 2015; 24:621-8. [PMID: 25961855 DOI: 10.1089/jwh.2014.5032] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Sexual minority women are more likely than heterosexual women to have ever experienced intimate partner violence (IPV). Although IPV is associated with sexual risk and poor reproductive health outcomes among US women overall, little is known about whether IPV is related to sexual and reproductive health indicators among sexual minority women in particular. METHODS Baseline data from a prospective intervention trial were collected from women ages 16-29 years at 24 family planning clinics in western PA (n=3,455). Multivariable logistic regression for clustered survey data was used to compare women who have sex with men only (WSM) and women who have sex with women and men (WSWM) on (1) IPV prevalence and (2) sexual and reproductive health behaviors, outcomes, and services use, controlling for IPV. Finally, we tested the interaction of sexual minority status and IPV. RESULTS WSWM were significantly more likely than WSM to report a lifetime history of IPV (adjusted odds ratio (AOR): 3.00; 95% confidence interval (CI): 2.30, 3.09). Controlling for IPV, WSWM reported higher levels of sexual risk behaviors (e.g., unprotected vaginal and anal sex), male-perpetrated reproductive coercion, unwanted pregnancy, and sexually transmitted infection (STI) and pregnancy testing but less contraceptive care seeking. The association between IPV and lifetime STI diagnosis was greater among WSWM than among WSM. CONCLUSIONS IPV was pervasive and associated with sexual risk and reproductive health indicators among WSWM in this clinic-based setting. Healthcare providers' sexual risk assessment and provision of sexual and reproductive health services should be informed by an understanding of women's sexual histories, including sex of sexual partners and IPV history, in order to help ensure that all women receive the clinical care they need.
Collapse
Affiliation(s)
- Heather L McCauley
- 1 Department of Pediatrics, Division of Adolescent and Young Adult Medicine, University of Pittsburgh School of Medicine, Children's Hospital of Pittsburgh of UPMC , Pittsburgh, Pennsylvania
| | - Jay G Silverman
- 2 Division of Global Public Health, University of California San Diego School of Medicine , La Jolla, California
| | - Michele R Decker
- 3 Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health , Baltimore, Maryland
| | - Madina Agénor
- 4 Department of Social and Behavioral Sciences, Harvard School of Public Health , Boston, Massachusetts.,5 Center for Community-Based Research, Dana-Farber Cancer Institute , Boston, Massachusetts
| | - Sonya Borrero
- 6 Department of Medicine, University of Pittsburgh School of Medicine , Pittsburgh, Pennsylvania.,7 VA Center for Health Equity Research and Promotion , Pittsburgh, Pennsylvania
| | - Daniel J Tancredi
- 8 Department of Pediatrics, University of California Davis School of Medicine , Sacramento, California
| | - Sarah Zelazny
- 1 Department of Pediatrics, Division of Adolescent and Young Adult Medicine, University of Pittsburgh School of Medicine, Children's Hospital of Pittsburgh of UPMC , Pittsburgh, Pennsylvania
| | - Elizabeth Miller
- 1 Department of Pediatrics, Division of Adolescent and Young Adult Medicine, University of Pittsburgh School of Medicine, Children's Hospital of Pittsburgh of UPMC , Pittsburgh, Pennsylvania
| |
Collapse
|
47
|
Lanier P, Jonson-Reid M. Comparing primiparous and multiparous mothers in a nurse home visiting prevention program. Birth 2014; 41:344-52. [PMID: 24931744 DOI: 10.1111/birt.12120] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/16/2014] [Indexed: 11/26/2022]
Abstract
BACKGROUND An important yet overlooked feature of prominent prevention programs serving expectant mothers is the exclusion of women with children. This study examines mothers (n = 3,260) participating in a program without parity exclusion criteria, and compares demographic characteristics, risk status, service use, and child maltreatment outcomes. METHODS A longitudinal, prospective study comparing primiparous (n = 1,890) and multiparous (n = 1,370) mothers participating in a nurse home visiting program. Patient groups are compared using bivariate and multivariate methods. RESULTS Comparison by parity shows multiparous mothers had higher cumulative risk scores and individual risk factors related to maternal and child health, behavioral health, and violence exposure. Multiparous mothers were more likely to seek out services themselves and to initiate services later in the postnatal period. A significant trend exists among more children and greater caregiver stress, maternal depression, and child maltreatment. Multivariate models indicate infants of multiparous mothers have a higher risk (hazard ratio = 1.49) for later reports of child maltreatment. CONCLUSIONS As compared with primiparous mothers, multiparous mothers were at higher risk but had similar levels of service use. Programs limited to primiparous mothers are missing a critical opportunity for prevention. Programs serving multiparous mothers should incorporate strategies to directly address caregiver stress and postpartum depression.
Collapse
|
48
|
‘Every bone of my body:’ Domestic violence and the diagnostic body. Soc Sci Med 2014; 122:44-52. [DOI: 10.1016/j.socscimed.2014.10.014] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2014] [Revised: 10/03/2014] [Accepted: 10/06/2014] [Indexed: 11/20/2022]
|
49
|
Jahanfar S, Howard LM, Medley N. Interventions for preventing or reducing domestic violence against pregnant women. Cochrane Database Syst Rev 2014; 2014:CD009414. [PMID: 25390767 PMCID: PMC7104547 DOI: 10.1002/14651858.cd009414.pub3] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Domestic violence during pregnancy is a major public health concern. This preventable risk factor threatens both the mother and baby. Routine perinatal care visits offer opportunities for healthcare professionals to screen and refer abused women for effective interventions. It is, however, not clear which interventions best serve mothers during pregnancy and postpartum to ensure their safety. OBJECTIVES To examine the effectiveness and safety of interventions in preventing or reducing domestic violence against pregnant women. SEARCH METHODS We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (31 July 2014), scanned bibliographies of published studies and corresponded with investigators. SELECTION CRITERIA We included randomised controlled trials (RCTs) including cluster-randomised trials, and quasi-randomised controlled trials (e.g. where there was alternate allocation) investigating the effect of interventions in preventing or reducing domestic violence during pregnancy. DATA COLLECTION AND ANALYSIS Two review authors independently assessed trials for inclusion and risk of bias, extracted data and checked them for accuracy. MAIN RESULTS We included 10 trials with a total of 3417 women randomised. Seven of these trials, recruiting 2629 women, contributed data to the review. However, results for all outcomes were based on single studies. There was limited evidence for the primary outcomes of reduction of episodes of violence (physical, sexual, and/or psychological) and prevention of violence during and up to one year after pregnancy (as defined by the authors of trials). In one study, women who received the intervention reported fewer episodes of partner violence during pregnancy and in the postpartum period (risk ratio (RR) 0.62, 95% confidence interval (CI) 0.43 to 0.88, 306 women, moderate quality). Groups did not differ for Conflict Tactics Score - the mean partner abuse scores in the first three months postpartum (mean difference (MD) 4.20 higher, 95% CI -10.74 to 19.14, one study, 46 women, very low quality). The Current Abuse Score for partner abuse in the first three months was also similar between groups (MD -0.12 lower, 95% CI -0.31 lower to 0.07 higher, one study, 191 women, very low quality). Evidence for the outcomes episodes of partner abuse during pregnancy or episodes during the first three months postpartum was not significant (respectively, RR 0.50, 95% CI 0.25 to 1.02, one study with 220 women, very low quality; and RR 0.60, 95% CI 0.35 to 1.04, one study, 271 women, very low quality). Finally, the risk for low birthweight (< 2500 g) did not differ between groups (RR 0.74, 95 % CI 0.41 to 1.32, 306 infants, low quality).There were few statistically significant differences between intervention and control groups for depression during pregnancy and the postnatal period. Only one study reported findings for neonatal outcomes such as preterm delivery and birthweight, and there were no clinically significant differences between groups. None of the studies reported results for other secondary outcomes: Apgar score less than seven at one minute and five minutes, stillbirth, neonatal death, miscarriage, maternal mortality, antepartum haemorrhage, and placental abruption. AUTHORS' CONCLUSIONS There is insufficient evidence to assess the effectiveness of interventions for domestic violence on pregnancy outcomes. There is a need for high-quality, RCTs with adequate statistical power to determine whether intervention programs prevent or reduce domestic violence episodes during pregnancy, or have any effect on maternal and neonatal mortality and morbidity outcomes.
Collapse
Affiliation(s)
- Shayesteh Jahanfar
- University of British ColumbiaDepartment of Public Health, School of Population and Public Health2206 East MallVancouverBritish ColombiaCanadaVT6 1Z3
| | - Louise M Howard
- The Institute of Psychiatry, Psychology & Neuroscience, King's College LondonHealth Service and Population Research DepartmentBox PO 31, De Crespigny ParkDenmark HillLondonUKSE5 8AF
| | - Nancy Medley
- The University of LiverpoolCochrane Pregnancy and Childbirth Group, Department of Women's and Children's HealthFirst Floor, Liverpool Women's NHS Foundation TrustCrown StreetLiverpoolUKL8 7SS
| | | |
Collapse
|
50
|
Koci AF, McFarlane J, Cesario S, Symes L, Bianchi A, Nava A, Gilroy H, Liu F, Paulson R, Montalvo-Liendo N, Zahed H. Women's functioning following an intervention for partner violence: new knowledge for clinical practice from a 7-year study. Issues Ment Health Nurs 2014; 35:745-55. [PMID: 25259637 DOI: 10.3109/01612840.2014.901450] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Intimate partner violence affects one in three women worldwide, with women who experience violence almost twice as likely to experience poor mental health, especially depression, compared with women who are not abused. To learn the impact of interventions of safe shelter and justice services on improved mental health and behavior functioning, 300 abused women are interviewed every 4 months in a 7-year prospective study. For this paper, abuse, mental health and resiliency status of these women, 1 year after accessing services for the first time, are reported. Measures of mental health (depression, anxiety, post-traumatic stress disorder (PTSD), somatization), and adult behavioral functioning are reported. At 4 months following a shelter stay or justice services, a large effect size was measured for improvement in all mental health measures; however, improvement was the lowest for PTSD. All mental health measures plateaued at 4 months with minimum further improvement at 12 months. Both internal behavioral dysfunctions (withdrawal and somatic complaints) were worse with increased depressive symptoms, as were external behavioral dysfunctions (aggressive and rule-breaking behaviors). A concerning 39.2% of the women had clinical PTSD scores at 12 months following receipt of safe shelter or justice services, compared with a much lower percentage of women with clinical depression (14.2%), clinical somatization (9.4%), and clinical anxiety (13.5%). Depression was a significant positive predictor of internal and external behavioral dysfunctions, indicating that women who had higher levels of depression tended to report more internal dysfunctions (withdrawal, anxiety, somatization) and more external behaviors (aggression and rule-breaking).
Collapse
|